Choice of Specialty: It's Money That Matters in the USA

Abstract

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.1Discussions 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 desirefor 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

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