Trends in Medical Education and Health Services

The selection of careers from among available specialties partly depends on an assessment of trends in medicine. More obviously than other specialties those providing primary care (e.g., family practice) are "system-defined" — i.e., they are shaped and made real by the needs of the present system of care. Students now selecting careers in family medicine are acting on current assumptions about the medical-care system of the future, although opinion in academic medicine and among medical practitioners remains divided about these issues. This analysis of factors acting to shape the system of medical care indicates a slow, ponderous and steady movement toward emphasis on primary care, family medicine and family practice. That movement may be expected to accelerate during the next two or three years — a time that will be critical in determining whether the function of primary care and family medicine will be fully professionalized and built into the evolving American medical system.