Income ratio and medical student specialty choice: the primary importance of the ratio of mean primary care physician income to mean consulting specialist income.

United States medical student choice of careers in the primary care disciplines has waned significantly over the past 15 years. A complex array of factors influence this decline, which has had an adverse effect on the quality and cost of medical care in the United States. Recent data suggest that the ratio of primary care physician income to specialty physician income (the income ratio) may be the most important factor in specialty career choice.