There is an obvious primary care health care shortage looming in this country. By 2025 it is estimated that the US will be short nearly 52,000 primary care physicians.1 With such a shortfall looming, everyone involved in the health care system, including medical schools, are trying to innovate change to fix it.
One of the newest medical schools in the country, Quinnipiac University’s Frank H. Netter MD School of Medicine, is one of those medical schools trying to innovate change. They are actively seeking students who are interested in primary care, and are pushing a primary care track onto their students. Their goal is to have 50% of the graduating class match into primary care. The current national average is 33%.
While many students applying to medical school have an idea of what specialties they are interested in pursuing after medical school, the fact is, the majority will likely change their mind during medical school.2 Quinnipiac, according to an NPR article, has the right idea, picking applicants from the beginning that are statistically more likely to go into primary care.
I question whether or not this sort of selection process will hinder both the experience at medical school, and the career happiness after medical school of Quinnipiac’s students. Every student, at every medical school, should be given the opportunity to do what they are passionate about. Passion is an integral part of medical education, and in life.
Applicants to medical school are no doubt passionate. But what are they passionate about? They are certainly passionate about become physicians, but the specific type of physician they want to become is a passion that is cultivated during the 4 years of their medical education. Trial and error, through every rotation, and every bodily fluid builds a students passion for what they want to do with the rest of their life.
I think Quinnipiac, and other schools that have a primary focus of training, are at risk of restricting the process of finding and developing a passion for a specific specialty. If that passion is not developed for primary care, or if the student feels pressure to choose primary care over something they are more passionate about, it’s not a simple fix. It is not easy to go back and complete a different residency, once you have chosen a specialty.
While the short term goal of increasing primary care physicians may seem to be achieved with these initiatives, the long term consequences may only hinder the progress of primary care, and more importantly patient care. I understand that the primary care shortage is of the utmost importance for our healthcare system, however, this may not be the best way.
Physicians who are not passionate will not be lifelong learners. Why stay up to date on the newest medications, newest disease management strategies and newest research if you are not passionate about what you are doing?
Physicians who lack passion about what they are doing do not have careers – they have jobs. They might as well be flipping burgers at the local golden arched restaurant for a paycheck. We are already in a current state of extreme physician dissatisfaction, with almost half of physicians stating they WOULD NOT choose medicine again as a career.3
As you, the applicant, are choosing what school you want to attend, it is very important to think about these things. Don’t just look at the MCAT score and GPA. Don’t look at the “best of” lists.
If you are truly passionate about primary care, whether it is pediatrics, family practice or internal medicine, a school like Quinnipiac might be perfect for you. But, if you just know you want to be a physician, and aren’t 100% sure about the type of physician you want to be, then you need to do your research.
Researching the schools you want to apply to is something that you should be doing anyway. Location, climate and curriculum are all important to know. Your chance at doing a sub-specialty away rotation is importation as well.
At a school like Quinnipiac, you have to be honest with them, and yourself during the interview process. You need to disclose that, while you may be interested in primary care right now, you would like to explore some of the more than 2 dozen other specialties.
Schools with a primary care objective may be the solution to the current and future health care crisis, but as a student applying, make sure you know what questions to ask of the school, and of yourself to ensure that you will be the best physician for your patients, and the most passionate person you can be.
Dr. Ryan Gray is currently a practicing physician in the United States Air Force. Ryan graduated from the University of Florida (GO GATORS!) with a B.S. in Exercise and Sports Sciences, and received his M.D. from New York Medical College. After graduating medical school Ryan completed his internship through a Tufts Medical Center transitional medicine program at Lemuel Shattuck Hospital. He is the founder of Medical School HQ where he blogs regularly.
1. Primary Care Access Report – http://www.sanders.senate.gov/imo/media/doc/PrimaryCareAccessReport.pdf; Retrieved 6 Apr 2013
2. Kazerooni, EA; Blane, CE; Schlesinger, AE; Vydarney, KH. Medical students’ attitudes toward radiology; comparison of matriculating and graduating student. Academic Radiology. 8/1/1997. 4(8). 601–607.
3. Medscape Physician Compensation Report: 2012 Results – http://www.medscape.com/features/slideshow/compensation/2012/public; Retrieved 4 Apr 2013