Despite a record number of new doctors, primary care providers remain difficult to find
Fact checked by Catherine Gianaro
U.S. medical school enrollment hit an all-time high in 2025, topping 100,000 students for the first time, according to the Association of American Medical Colleges. Yet difficulty securing appointments with primary care providers persists.
The percentage of American adults without a usual source of care has increased in recent years, from 23.6% in 2010 to 29.7% in 2022, according to the Milbank Memorial Fund. The proportion of physicians practicing primary care stands at 24.4%, far below the recommended 50%.
Chicago medical school officials, researchers, and survey participants cite several factors that deter physicians from primary care, including:
- Work-life balance challenges
- Burnout
- Pay
- Desire to pursue competitive specialties
- An aging population
“We have an aging population, we have a relatively growing population, and yet the number of primary care providers isn’t growing that much,” says Jay Behel, PhD, associate dean of medical student affairs and professor of psychiatry and behavioral sciences at Rush University Medical Center. “We haven’t incentivized people to pursue primary care, and I think that’s sort of really at the core of things.”
Burnout, work-life balance challenges
Tyler Lockman, assistant director for career advising and medical school communications at the University of Chicago’s Pritzker School of Medicine, says the known potential for burnout can deter students from considering primary care.
“Burnout has been increasingly a hot topic in medicine, particularly as the focus on mental health has been growing for physicians,” Lockman says.
Fear of burnout and difficulty maintaining a healthy work-life balance contribute to hesitancy among prospective physicians to enter primary care.
A National Institute of Health study surveying primary care residents found significant concern about burnout in primary care. Survey participants also described feeling ill equipped for addressing patients’ social service needs. Respondents cited frustration with a lack of administrative support, particularly in delivering those services.
Pay
Primary care providers earn, on average, less than physicians in most other specialties — another disincentive for graduates.
American Medical Association data show that between 2024 and 2025, family medicine physicians earned an average of $275,000, while physicians in specialties such as general surgery, anesthesiology, and cardiology earned more than $400,000 annually.
Medical school graduates often enter the workforce with hundreds of thousands of dollars in debt, making compensation a key consideration.
Competition for residency program spots also influences specialty choice.
Traditionally, specialties that feed into primary care, such as pediatrics and family medicine, are less competitive, according to medical school officials.
Behel says many students feel pressure early in medical school to build resumes that align with competitive specialties, keeping those options open and ultimately steering them away from primary care.
Some of the most competitive fields include surgical specialties such as neurosurgery or orthopedic surgery, Behel says.
“It’s sort of this premature closure toward a specialty that, if they didn’t have the pressure driving them forward, a subset of those students would have probably remained open to doing something different,” he says.
At the end of medical school, students enter the Match process, which determines where they complete residency training. Students rank specialties and locations and are matched with a program, leading to certification in a given specialty.
The National Residency Match Program reported a 4.2% increase in total residency program placements in Illinois in 2025 from 2024.
Most residency spots are filled. However, programs that typically produce primary care physicians saw some positions go unfilled in 2025. Nationally, family medicine residency programs filled only 85% of available spots.
Among internal medicine residents, most go on to subspecialize. Data shows only 9.4% of internal medicine residents entered primary care between 2019 and 2021.
Nancy Parlapiano, executive director of graduate medical education at Northwestern University’s McGaw Medical Center, calls the shift toward more competitive specializations an ongoing trend.
“We’re just getting to the point where the lines are really meeting, and we need more in primary care,” Parlapiano says. “The question is: How do you make primary care more attractive to trainees?”
Demographic shifts
Physicians are only part of the equation. Patient demand also drives the shortage.
Lockman says one overlooked factor is the growing number of Americans age 65 and older, which increases demand for care.
“There comes a point where the supply of doctors is not meeting the increasing demand,” Lockman says.
Across all specialties, the U.S. faces a shortage of physicians. Researchers predict a shortage of up to 86,000 physicians by 2036. For patients, that means longer waits — and a growing challenge in finding care.
