The "Doctor with a Capital D" episode of the Not Otherwise Specified podcast explores the joys and challenges of general primary care and ways to foster medical student interest in the field.[1][3] The discussion touches on the historical development of medical education, including the Flexner reform of the early 20th century, which replaced community practitioners with research-oriented academics.[1] The article cites a seminal 1961 study published in the New England Journal of Medicine called "Ecology of Medical Care," which found that only one in a thousand people from the community ended up in a tertiary care facility.[1] There are now medical schools that offer specialized programs in family medicine with the option of graduating in three years with a greater emphasis on clinical practice rather than research.[1] The episode highlights the need to reconcile two approaches to medical education—research-oriented institutions and programs focused on the practical training of physicians for communities and rural areas.[1]