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Mark H. Ebell, MD
University of Michigan Medical Center Chelsea

JAMA. 1989;262(12):1630.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

To the Editor.—

Recent results from the National Residency Match Program again indicate a relatively poor performance for the primary care fields. Programs in internal medicine and family practice have seen their initial match rates drop significantly in the past 3 years.¹ Discussions with fourth-year medical students about their choice of specialty reveal discouragement with primary care specialties and a trend toward subspecialization. The usual reasons include academic interest, desire for mastery of a subject, or desire for a better life-style with a shorter workweek.²

While not mentioned often as a primary motivator for choosing a particular specialty, it seems odd that monetary gain is not a consideration. I examined the competitiveness of the most common specialties and how it correlated with future earning power. Competitiveness for a given specialty was defined as the total number of residency positions filled by graduates of US medical schools on September . . . [Full Text PDF of this Article]

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