I am a resident member of one of the budget committees and I saw a document with the salaries of various staff members a few weeks ago. The FP faculty earn on average half what general surg and ortho earn and about 60% of what medicine specialists earn. So, for an extra 2 years of residency the 20 years earnings difference between surg and FP was $3 million. For cardiology it was $2 million for an extra 3 years of residency. I know it's not all about the money, but when the differential is so huge - enough to pay off all those loans, kids through college, and a comfortable retirement - then it makes FP even more unattractive. When your speciality is making 20 - 25% more than the CRNA's then that tells you all you need to know. And if you think that FP is some sort of general physician then think again. To make a decent income you'll have to see pt's every 15 mins. You become a triage/Rx doctor - you can address their HTN and HLD, but then refer to ortho for the carpel tunnel because you don't have time to do the steroid injection yourself, and refer to GI for the chronic diarrhea because you just don't have time to work it up. Being an FP is simply not interesting. The ob training in most programs is so inadequate to be of any practical use. In fact most programs are very close to IM programs in their true practice - so go into IM and at least give yourself more options later down the line. Then there's the applicant pool. Why would you want to be part of a "speciality" which never fills, is full of IMG's, and has zero competition for places - certainly for US grads who pass step 1 the first time. Why go through med school and post grad training just to be part of the underclass of medicine?