Loan forgiveness programs such as through the National Health Service Corp (http://nhsc.hrsa.gov/) have been an important means of urging primary care providers to work in underserved regions of the country. This can include rural areas as well as medically underserved areas (MUAs) that can exist anywhere but often are found in low income urban areas. Some countries have a medical education system that is tuition-free but requires medical school graduates, upon graduation, to give a year of service to their country in a medically underserved region. With the shortages of primary care providers that we have currently, and which is projected to become worse as the ACA is fully enacted, should US medical schools consider this option in medical education? What would be the pros and cons for this system in the US?
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The option of tuition free medical school with a one year service require is a viable option that may attract more students considering careers in medicine, to careers in primary care. Some of the reasons for the impending shortage are the medical care requirements of the aging population, increase in care needed under ACA, when more patients will have health care benefits, and the low numbers of medical residents planning on going into primary care or internal medicine. Many opt for specialty services, which can be more lucrative and in some cases, believed to be more mentally challenging or financially lucrative (Mann, 2012). In addition, many older primary care physicians will be retiring.
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