In recent years, interest in generalist care among the national medical school graduate population has dwindled from near 50 percent to somewhere around 25 percent. Allen says that Binghamton campus graduates have mirrored the numbers at the main campus, and have been consistent with national averages. In 1989 and 1990, however, Binghamton had more graduates entering primary care fields.

Perhaps most reassuring is the fact the SUNY Syracuse medical students have a healthy interest in learning more about primary care. The Binghamton campus assignment was formerly made by random selection. But since it became a voluntary choice, Allen says, students make it often.

Moreover, the statistics alone may be deceiving. After all, some may ask, if Binghamton's figures approximate falling national averages, why brother with the special clinical program at all? Quite simply, because whatever number of primary care physicians Binghamton produces is more than would have been produced without the campus. And the country needs absolute numbers of such practitioners to serve its public, not percentages.

The other difference is that those Binghamton graduates who do end up in specialty practice have been exposed to the basic importance of primary care. As Allen points out, 85 percent of all physicians practice in a community, rather than an academic setting, which means that the training Binghamton campus graduates receive in their last two years of medical school makes them more prepared for real-life practice.

When medical schools give more attention and exposure to primary care, it fosters a healthy interest and generates more primary care physicians. Research-based institutions like Harvard Medical School would do well to take a close look at the SUNY program.

A suburban satellite campus in this area might accomplish the same goals. Many of the raw materials for such a campus, modeled on the SUNY program, are already in place. For example, many area physicians already hold faculty appointments at the Medical School. Harvard Community Health Plan, an extensive health care network in the region, is already a training site for third and fourth-year medical students.

When Harvard Medical School introduces innovations, other institutions take heed. If Harvard takes up the SUNY model, what started in Binghamton could blossom into a successful new design for medical education in the United States--and solve the primary crisis.