The average college graduate owes about $24,000 in student loans, but a medical school graduate owes up to twelve times as much — about $280,000. With that much debt, many young doctors are choosing to enter more lucrative specialties like dermatology or cardiology over primary care.

Why? The numbers add up better. While the average salary in the United States for a primary care physician is $180,000, it is about $310,000 for a dermatologist and nearly $400,000 for a cardiologist. If you had $280,000 in student loans to pay back, making the decision to specialize would be a no-brainer, wouldn’t it?

Unfortunately, this means there is a shortage in primary care physicians. As of July 2011, the U.S. Department of Health and Human Services reported about 6,400 primary care shortage areas nationwide. Over the past decade, the number of American medical-school graduates pursuing family medicine has dropped by 52 percent, and primary care physicians make up only 30 percent of physicians in the United States, while subspecialists account for the other 70 percent.

“For a long time, there were questions about the viability of careers in primary care because of the way it’s reimbursed at lower levels than for other specialties,” said Atul Grover, chief advocacy officer of the Association of American Medical Colleges.

But this could change. Healthcare reform may increase reimbursement payments for primary care physicians. Discussions about health-care legislation, Grover said, “have highlighted primary care’s role and given students more of a sense that they will have a good career in primary care,” particularly if their reimbursement levels are raised, as expected, under the proposed legislation.

Universities are actively recruiting young doctors to rural primary care, especially, through residency programs. Research shows that physicians tend to stay within 100 miles of where they did their residency training, so those who need to hire primary care physicians are wise to be proactive.

Lori J. Heim, president of the American Academy of Family Physicians, said that 2010’s “Match Day” results saw a rise in students seeking residencies in family medicine. She also attributed the increase to the recognition in health-legislation talks of the need to reimburse primary-care doctors more and to provide more forgiveness of student loans and debts.

“When I talk to students,” she said, “they’re very excited about the fact that primary care is being recognized and valued.”

She said students may also have been encouraged by the recent push toward a “medical home” model, in which patient care is coordinated by a primary care physician.

“Students [are beginning] to realize,” she said, “that family physicians will be able to practice the kind of medicine they envisioned when they decided to become doctors.”