Primary Care Is Starving While Training Hospitals Feast - Scorecard - MDSpire

Primary Care Is Starving While Training Hospitals Feast

Internal medicine residents are choosing primary care at the lowest rates in a decade — and the system is built to make sure they do.

  • By

  • Kerri Miller

  • May 11, 2026

  • 2 min

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Clinical Scorecard: Primary Care Is Starving While Training Hospitals Feast

At a Glance

CategoryDetail
ConditionDecline in primary care specialty choice among medical residents
Key MechanismsStructural factors in medical education and funding favoring hospital-based care over outpatient training
Target PopulationInternal medicine residents and medical students
Care SettingGraduate medical education and residency training programs

Key Highlights

  • Fewer than 9% of internal medicine residents chose primary care in 2024–2025.
  • Average medical student graduates with over $200,000 in debt.
  • Primary care provides 35% of ambulatory services but receives under 5% of total health care spending.
  • Residents spend over 70% of training on inpatient services due to funding structures.
  • The 'hidden curriculum' influences specialty choice and values in training.

Guideline-Based Recommendations

Diagnosis

  • Identify structural barriers to primary care training.

Management

  • Reform graduate medical education funding to prioritize outpatient training.

Monitoring & Follow-up

  • Evaluate the impact of training changes on primary care workforce supply.

Risks

  • Resistance from subspecialists benefiting from current funding structures.

Patient & Prescribing Data

Medical students and internal medicine residents

Increased emphasis on primary care training can improve workforce supply.

Clinical Best Practices

  • Require more substantive primary care training in residency programs.
  • Fund longitudinal outpatient experiences for residents.
  • Hold medical schools accountable for workforce outcomes.

Related Resources & Content

Original Source(s)

Primary Care Is Starving While Training Hospitals Feast

  • by Kerri Miller

  • May 11, 2026

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