Difficult work and lower pay in primary care are scaring US medical students away from what used to be the hub of the United States' medical system, a study has found (JAMA 2008;300:1154-64).
The survey of almost 1200 students in their final year found that only 2% planned to work in primary care internal medicine, down from 9% in a similar survey in 1990.
The lead author, Karen Hauer, of the University of California in San Francisco, noted that the primary care doctor's job of caring for chronically ill and elderly patients was hard work, with time pressures and limited resources.
The results of another survey published in JAMA show another reason why training programmes in primary care internal medicine lack US applicants (2008;300:1131-2). Family doctors had the lowest average salary last year, at $186,000 (£108,000; €140,000) compared with $436 000 for orthopaedic surgery.
Medical students in Australia have praised