A common assertion is that excessive school debt factors in a medical student’s choice of specialty.

It’s something that I still believe, but Colin Son points to some studies showing debt load to be an insignificant point for medical students when it comes to choosing primary care or not.

I concede that the point is controversial, as you can find students on both sides of the fence.

What’s less disputable is the lack of any happy primary care role models, which may be a more important factor. As Colin observes, “in my experience, I met only one happy primary care physician.” Internist Matthew Mintz agrees, noting that when medical students “are exposed to primary care, they see unhappy physicians,” and that, “the larger salaries of the specialist and students’ looming debt is only the icing on the cake in their decision not to choose primary care.”

So, does money matter? I continue to believe that the answer is yes, but only as part of a larger construct of reasons that dissuades many American medical students away from generalist practice.