Influencing intention for a family medicine career may need a whole-curriculum approach

[Extract:] In this edition of Medical Education, Phillips and her colleagues qualitatively explored the importance of income in shaping second-year medical students’ preferences for their choice of specialty training pathway postgraduation. They mention that many countries are struggling to produce sufficient numbers of doctors taking up primary care and certain other specialties, with detrimental consequences for patient care and their health systems. Phillips et al. found income to be of varied importance to medical students, with specialty prestige also a significant factor underlying preference for postgraduate specialty training. Through this work, they suggest how medical educators could frame conversations in ways that might boost student attitudes to specialties currently experiencing shortages. Although behaviourists would attest to the difficulties in changing people’s attitudes and intentions, helping students to reflect on and understand their values is likely to be a valid strategy given that the curriculum and clinical experiences embedded in many medical schools rarely emphasise the importance of primary care and generalist doctors to health systems, let alone promote more altruistic values such as community service