Balance becomes key to specialty pick

Family practice and general surgery are taking the biggest hit, but fewer students are choosing medicine overall.

By Myrle Croasdale, AMNews staff. Sept. 22/29, 2003.

U.S. medical students want careers that give them more control over their personal lives, according to a study in the Sept. 3 Journal of the American Medical Association.

That's good news for specialties considered to favor controllable lifestyles, such as anesthesiology, dermatology, emergency medicine, neurology, ophthalmology, otolaryngology, pathology, psychiatry and radiology.

"Not to cast aspersions on primary care, but to look at the numbers from our study, what is happening is that the best and brightest are applying in increasing numbers to controllable-lifestyle specialties," said Greg Rutecki, MD, lead author of the study. "Consequentially, the students applying to primary care are not in as high a standing in their class."

Fields with demanding schedules, such as family medicine and general surgery, are also drawing fewer doctors. U.S. medical school seniors filled 73% of family practice resident positions in 1996 but only 47% in 2002. In general surgery, U.S. seniors made up 89% of residency slots in 1996, compared with 75% in 2002.

The overall fill rate for general surgery was more than 90% in 2002 when international medical graduates and U.S. doctors who weren't fresh out of medical school were included. Family practice programs filled only 80% of their slots.