Two percent of medical students in a survey said they planned to go into general internal medicine, according to a study published Wednesday, September 10, 2008, in the Journal of the American Medical Association (JAMA).

According to the study, general internists provide a large portion of care for older patients and people with chronic illnesses, but the number of students becoming general internists is declining as the number of older U.S. residents is expected to nearly double between 2005 and 2030. The survey notes that according to one estimate, there will be a shortage of 200,000 doctors in the U.S. by 2020.

JAMA also ranks internal medicine as one of the lowest paying medical specialties. In 2007, family medicine had the lowest average salary of $186,000, with 42 percent of residency spots filled by U.S. students. Meanwhile, orthopedic surgery had an average salary of $436,000, with 94 percent of residency spots filled by U.S. students.

Richard Deichmann, associate medical director of primary care at the Ochsner Medical Center, said that about 1 percent to 2 percent of doctors who finish internal residency programs go on to practice general internal medicine, while about half become hospitalists and the other half become sub-specialists.

A separate study in JAMA found that, while from 2002 to 2007 there were 2,600 fewer U.S. doctors training in primary care specialties, the number of foreign graduates pursuing those careers rose by 3,300.