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Lawmakers are considering several incentive programs aimed at attracting medical students to the lower-paying specialties of family medicine, internal medicine and pediatrics, the Minneapolis Star Tribune reports. According to estimates provided by the Council on Graduate Medical Education, general physicians constitute up to 35 percent of the current physician workforce. However, just 20 percent of medical school graduates now choose to enter the field. Should this disparity in supply and demand continue, the nation could face a shortage of as many as 44,000 general physicians by 2025, a rate that could increase exponentially if health care reform extends health insurance to a greater portion of the population. According to experts, students most frequently forgo careers in lower-paying fields because of mounting loan debt. Although some states currently offer loan forgiveness programs to entice medical students to pursue such careers, experts argue that the programs are too restrictive and the awards are too small to attract the necessary number of physicians. Currently, lawmakers are considering more comprehensive loan repayment programs. However, the Council on Graduate Medical Education wrote in a letter to Congress that such programs would be more effective if they were combined with a reduction in income disparities between various subspecialties and primary care, a factor that they say is a far more potent driver of student career choice. Beyond loan forgiveness, other tools proposed to offset the primary care shortage include educating more nurse practitioners. For example, lawmakers are considering legislation that seeks to increase the ranks of nursing faculty and offer loan repayment and scholarship programs. Still, others contend that wholesale changes in how care is provided and physicians are reimbursed will be necessary to elicit change (Ross, Minneapolis Star Tribune, 10/27/09).