Patterns of graduating medical student career selections from 1993 to 1998 and their effect on surgery as a career choice.

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Abstract
THE 1996 REPORT of the Council on Graduate Medical Education identified an oversupply of physicians in the United States.1 Specialists, both surgical and medical, were said to make up the overwhelming majority of the reported excess. Recent legislative and marketplace changes have sought to address this issue. Responding to these forces, the public universities of California, unique in their predominately managed care contract base, have altered the training of their physicians, favoring a shift toward education in primary care. This study addresses the efficacy of the legislative, institutional, and market pressures in increasing the numbers of graduating medical students in California who pursue primary care residencies and the effect, if any, on general surgery as a career choice.