General Medical Sciences, currently funds 40 programs involving 45 degreegranting institutions. 2 Approximately 75 US allopathic medical schools offer MD/PhD degree programs not supported by MSTP grants. 2 Historically, the primary intent of these joint MD/ PhD degree programs, regardless of their funding mechanisms, has been to produce highly trained physicianscientists who will engage in biomedical science research careers.The medical education environment in which MD/PhD programs are offered has changed markedly in the past 15 years. The demographic characteristics of medical school graduates have changed; most notably, the proportions of women among matriculating medical student populations have steadily increased and are now approaching parity. 3 Specialty choice preferences for graduate medical education (GME) among recent US allopathic medical graduates have shifted away from the generalist specialties of family medicine, internal medicine, and pediatrics as greater proportions of gradu-ates have chosen to pursue GME in "controllable lifestyle" specialties. 4,5 In addition, professional setting options for physicians have expanded well beyond the dichotomy of academic medicine or private clinical practice. 6 Moreover, US allopathic medical graduates are faced with steadily increasing debt loads. 7 The extent to which the characteristics and professional plans of recent US allopathic medical graduates may differ between MD/PhD program gradu-ates and other MD program graduates has not been investigated. Therefore, we sought to identify factors associated For editorial comment see p 1208.

Generalist-primary care specialty choices declined since 1997, whereas primary care subspecialty and no-board-certification specialty choices increased. Associations between primary care specialty choices and demographic, attitudinal, and career intention variables can inform the design of interventions to address expected primary care workforce shortages.