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How Do We Get More People to Become Primary Care Physicians?

We need more primary care physicians.

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Answer by Jae Won Joh, M.D.:

A few thoughts:

Don’t require an undergraduate degree before medical school. We’re currently asking people to go into a relatively lower-paying field after accumulating a minimum of eight years of educational debt and three years of rapidly growing interest during residency training for family medicine, internal medicine, or pediatrics—why?

Virtually no other country in the world outside of the U.S. requires an undergraduate degree to enter medical school, yet they are still quite capable of producing excellent physicians. Multiple U.S. institutions have already proven that lacking an undergraduate degree in science means nothing when it comes to the success of M.D./D.O. candidates passing their licensing exams, meaning you can start from scratch and still become a very passable physician. It’s simple: Cutting initial debt burden in half would greatly reduce the mental/financial barrier to choosing primary care, since physician reimbursement is highly unlikely to improve in the foreseeable future.

Cut the fat out of the curriculum to shorten medical school. When, exactly, does any primary care physician actually have to care about the Krebs cycle? The answer is never. Yet every medical school spends months of time teaching molecular-level interactions that have little to no meaningful day-to-day clinical applications for the overwhelming majority of their graduates. Again, why?

This is an ancient holdover from the days when medicine was so primitive that fields such as biochemistry were simply one of the few courses that had any substantial material to supplement a medical curriculum alongside physiology, anatomy, and pharmacology. Frankly, in the modern era we would be better served substituting more coursework in medical ethics, finance, or politics.

Focus on apprenticeship. Pair students with clinicians who have proven track records in mentorship from the get-go, seeding a deep relationship that nurtures the passion for primary care. Medical students regularly cite positive interactions as the reason for choosing a specialty.

While these suggestions are a significant deviation from the current norm in U.S. medical education, I firmly believe that the system as-is has become outdated and desperately needs a modern 21st-century update.

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