Med School’s Prescription for Family Doctors : Health Care: Southern Illinois University says it ‘weeds out the barracudas’ with interviews, and tries to recruit those who think ‘$100,000 a year is real money.’

Dr. Richard Moy relies on a refreshingly simple strategy to find medical students who will become primary care doctors: Screen out the barracudas.

It seems to work.

Moy is dean and provost of Southern Illinois University in Springfield, Ill., which is tied with East Carolina University as the national leader in turning out general doctors.

According to a ranking by the Assn. of American Medical Colleges, both schools send 54% of their students into primary care training programs.

The association releases its list of the Top 40 in this accomplishment, but won’t say where the nation’s other 86 medical schools come in. The unidentified school in last place puts 9% of its students into primary care.

From the start, Southern Illinois was intended to be a school that would turn out family doctors. Before it opened in 1973, Moy recruited the chairman of family practice as his first department head.

In their junior years, students work off-campus with successful family practitioners for six weeks.

The school accepts only Illinois students, and it looks for young people who share the school’s goals. The interview is key.

“We try to keep from getting the barracudas who go into medicine for the money,” Moy said. “We spend a lot of time. There are a bunch of really delightful young men and women who want to go into medicine and take care of sick people. For them, $100,000 a year is real money.”

The medical college association agrees with the strategy of seeking out applicants who will go into primary care. It lists this among the ideas in a policy statement released last fall.

Among its other recommendations to medical schools:

* Set up loan and scholarship programs for students interested in primary care.

* Make sure family doctors and other generalists on the faculty have the same chance for promotions and tenure that specialists do.

* Promote research by generalists in such areas as medical decision-making and cost-effectiveness.

* Require that all students learn about primary care medicine.

* Put family doctors on the admissions committee.

* Get community-based primary care doctors to help with teaching.

Just how effectively medical schools can steer students into primary care is in doubt, however. Schools cannot change the bigger paychecks, better hours and more interesting work that specialists often enjoy.

“Medical education can’t do it alone,” said Dr. Jordan Cohen, dean of the State University of New York medical school at Stony Brook. “Simply beating on medical schools won’t be a sufficient answer, I fear, because of these powerful incentives that are driving the situation in another direction.”