I think that what makes a lot of med students frown on being a PCP (from an income perspective, at least) is the fact that there are so-called "mid-level" practitioners out there who earn 2.5-year master's degrees who make that much or close to it. For example, I know for a fact that new CRNA/AA graduates in my area start out at $135k with 6-8 weeks of PTO, and that's for a 40-hour workweek. Taking call pays more. I have been told that surgical PAs also start out at $120k-$130k. So when you compare what a CRNA/AA working 40 hours/week for $135k makes per hour to a PCP who works 60+ hours/week (including call), the CRNA/AA/PA actually earns a higher hourly wage in a lot of scenarios, aside from the fact that most PCP docs don't start at 6 weeks of PTO/year. I know 2 medical students who are gunning for orthopedic surgery and radiology, and when I asked them if they'd consider primary care as a back-up residency choice, they actually said, "if you're going to do a field that pays what they make, you might as well do nursing and then CRNA school." So apparently the mentality is pretty common. I think this is also what is driving a lot of the top pre-med students to apply to dental schools these days (e.g., higher median/average income than PCP docs for only a 40 hour workweek).