This report examines the decline in the number of medical students choosing generalist or primary care specialties, along with the efficacy of strategies designed to encourage students to choose generalist and primary care training. Based on surveys of college and medical school students, residents, and medical schools, the study focused on: (1) the characteristics associated with students who are more likely to choose generalist or primary care specialties in medical school; (2) curriculum requirements that expose medical students and residents to primary care training; and (3) the role federal financing plays in setting the focus of medical education. Although the strongest predictor of whether students would choose primary care careers was their stated preference for primary care before they entered medical school, the study found that some features of medical schools, such as the existence of a family practice department, were associated with an increased likelihood that students would go into primary care. Four appendixes provide information on personal and institutional characteristics associated with choice of primary care residency program, public health service funding of medical education, survey methodology for medical school and residency surveys, and General Accounting Office contacts and staff acknowledgements. (Contains 45 references.) (MDM)