The federal government plays a role in setting the incentives for medical schools and state programs. A major incentive is research dollars. If the federal government continues to increase National Institutes of Health at a higher and higher rate then medical schools will:
· Continue their pattern of embracing research efforts at the expense of education and service.
· Continue to choose students who are more likely to be good researchers rather than those who are more likely to become doctors who will choose careers of service and teaching
· Continue to choose more and more students from out of state, the ones least likely to go to rural areas.
The federal government can either increase the incentives for service and teaching, or it can develop policies that make in difficult for medical schools to forget about the needs of the nation for doctors that will choose underserved areas.
National Health Service Corps could be a vehicle to choose the right students for medical school, but currently it suffers by having to accept the students that medical schools choose.
NHSC has spent years learning how to select the right students, but it has no ability to do so. They discovered this the hard way as some of the candidates were ill suited to NHSC and service and sacrifice and adaptation. NHSC is doing much better in this, but it could choose far better than most admissions committees.
The current policies are expensive and do not make sense.