primary care is an unattractive field

The practice of medicine has changed dramatically and the doctors of today hardly resemble the doctors of yesterday. Medical students are choosing their fields for the wrong reasons: lifestyle, liability, and leisure (earning potential). "Lifestyle" fields are some of the most competitive residencies to get into. Unfortunately this means that our most apt medical students are going into fields that allows them to work 9-5 with weekends off and lots of money. It's unfortunate that some medical students work hard to be at the top of their class and then become dermatologists (which Jerry Seinfeld so poignantly referred to as "pimple popper MD"). 

Primary care is no easy field. Primary care doctors work grueling hours, do not get paid well, and are subject to liability if they miss anything. There is a severe shortage of primary care doctors in the U.S. and unfortunately part of this shortage comes from the fact that this field is not very well respected.  The US is in desperate need of more primary care doctors and thus we are forced to accept foreign medical graduates and less than stellar domestic grads into primary care residencies. This means that US medical students often feel that going into primary care is akin to accepting defeat.  This also means that the students going into primary care are often not ideal, either because they are from a foreign country and may have language and cultural shortcomings when treating American patients, or because they haven't done very well in medical school. 

The US needs more medical schools overall and more schools with a primary care emphasis. This already exists to a limited extend in D.O. programs, but these programs involve a different outlook on medicine that is not for all. Additionally D.O. programs are not yet very well established or respected. We need to de-stigmatize D.O. programs as well as start more M.D. programs with a greater emphasis on primary care. Medical school also needs to be subsidized by the government (the way it is in many foreign countries). This will allow medical students to choose a field without worrying about the 200K+ debt they have amassed in the process of becoming a doctor.