The nation's medical schools continue to attract record numbers of applicants while administrators wrestle with ways to interest students in primary-care careers.
"The larger interest in medical careers will allow the schools more chances at being selective," said David Altman, director of the office of generalist physician programs and associate vice president for educational policy at the Association of American Medical Colleges.
Some 45,100 people had applied for medical school admission as of June 15, compared with 42,808 the previous year, researchers at the American Medical Association reported. Of the applicants entering the 1993 class, 17,362, or 40.6%, were accepted. Acceptance figures for 1994 weren't available.
But the boom in applicants also gives medical schools more flexibility in training. If they want more primary-care students, they can admit more.
Medical schools also will be able to become more attractive when affiliating with hospitals and other healthcare providers to establish student training programs.
"You're going to see a lot of consolidation and realignment among medical schools," Mr. Altman said. "Medical schools are going to look for new venues of training students."
Various governmental advisory organizations and the Clinton administration have urged that there be a 50-50 split in the number of specialists and generalists. Currently, about 20% to 25% of medical students choose careers in primary care.
An AMA study of the deans of the nation's 125 accredited medical schools showed a lack of guidance for students who might be interested in primary care. The research cited a dearth of mentor programs or other practical experience that could lead students to choose generalist training and careers.
"The findings suggest that no single variable under the control of the medical school can substantially alter the proportion of graduates who will become generalists," according to the study, which was published in the Sept. 7 issue of the Journal of the American Medical Association.
"Medical schools clearly have to do things to enhance students' interest," Mr. Altman said.