The crisis in primary care and the role of medical schools. Defining the issues

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Abstract
THE HEALTH care theme of the mid-1960s was insufficient physician supply, and the need to increase medical school enrollment was endorsed by many. Both federal and state legislators provided considerable financial incentives to schools to increase their enrollments and to prospective medical students to defray the costs of their medical education through low-interest loans. As a result, new first-year enrollments at US medical schools rose from 8483 in 1961 to 16103 in 1986 and have been maintained essentially at this level, with only a slight decrease in 1990 to 15998.1 In 1980, the publication of the Summary Report of the Graduate Medical Education National Advisory Committee raised for the first time the question of whether, with the exception of primary care physicians, we were training far more physicians than were needed.2 A future "physician glut" became commonly assumed. Over the last several years, the accuracy of this prediction

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