Medical school attitude: If you're ‘too dumb,’ then primary care is for you


Cultural and structural problems that have existed for decades discourage medical students from becoming primary care doctors, according to a new study.

That disparaging attitude--that students are “too smart” to choose primary care--which exists during training, has contributed to the country’s shortage of primary care doctors, according to the study published in the Annals of Family Medicine.

The study’s author, Joanna Veazey Brooks, Ph.D., from the University of Kansas School of Medicine, reviewed 52 oral histories from primary care doctors from the National Library of Medicine, seeking a better understanding of attitudes about primary care medicine. Her study found 63.5 percent of the histories indicated the physicians experienced discouragement or disparagement of primary care at some point during their medical training--a hostility that persisted over five decades.

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That hostility towards primary care is embedded in both cultural and structural aspects of medical training and needs to be addressed, the study said.

Take the comments from a physician who studied internal medicine at the University of Minnesota Medical School in 1971. “When I first started as a generalist that was not the thing to do . . .  the attitude was that if you were in general medicine, then you were too dumb to get a fellowship,” the doctor said, recalling the reaction of a former professor to his news that he had gone into general medicine. “You would have thought I said I’d been in jail for two years. The look on his face told me that [I] somehow failed,” he said.

The attitude that primary care isn’t appealing or important needs to be changed, as researchers project a shortage of 33,000 primary care physicians by 2035, the study said. The need for more primary care doctors is being driven by a growing and aging population and by increasing numbers of patients with insurance as a result of the Affordable Care Act.

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