Yet another study has reported increasing difficulty in recruiting medical students to careers in general internal medicine. This study from the United States showed that although 24% of 1177 students who graduated in 2007 planned careers in internal medicine, they perceived this specialty to be associated with a higher workload and more stress than other specialties and were less interested in a career in general internal medicine than students in a similar study in 1990.1 The trends in these data are not dissimilar to those reported in relation to general practice and family medicine in Australia,2 New Zealand and Canada,3 and the United Kingdom.4

Recruitment to general practice has improved a little in Australia in recent years since the creation of rural clinical schools that provide undergraduates with at least half of their clinical training in rural environments. But the fact remains that around the world primary medical care is not a favoured career choice for specialty training and practice.

Medical students make their career choices for a variety of reasons, including other people’s perceptions of …