Trish Valusek will add a new title to her name Friday afternoon. At her graduation ceremony, the University Medical School student will be called “doctor” for the first time.

The ceremony marks the end of formal education and the beginning of experiential learning for Valusek and her 201 fellow University graduates who will go on to residencies throughout the country.

“It all went by so fast,” Valusek said of her four years in medical school. “But at the same time, it feels like my first day of anatomy class was yesterday.”

Valusek will spend the next six years in a residency program at the Hennepin County Medical Center, where she will practice general surgery with other doctors and receive approximately $10 per hour. She then will be fully certified to practice surgery.

While choosing a residential specialty can be difficult for some students, Valusek said she knew early on she wanted to be a surgeon.

“I like that you’re able to diagnose a problem, sometimes cure it and follow it through all the way,” she said. “It’s not just a chronic temporizing of the problem.”

She is among a growing number of graduates who choose to forgo primary care – family practice, internal medicine and pediatrics – to specialize in other fields.

Interest in primary care by University graduates dipped 11 percent from last year, tracing a nationwide trend.

The number of graduates specializing in primary care fluctuates yearly, said Dr. Helene Horwitz, Medical School associate dean of administration. In the past, she said, more graduates went into primary care than specialized fields.

“A couple of years ago, people were saying that students shouldn’t go into anesthesiology because it was a dead field – anesthesiologists were working as taxi drivers,” she said. “Now anesthesiology is one of the hottest fields.”

Growing student debt could be one reason for the decreased interest in primary care, Horwitz said.

“Students are graduating with huge debts,” Horwitz said. “They’re bringing more debts into medical school from their undergraduate studies, too.”

The average debt for a graduating medical student is $100,000, Horwitz said.

At around $100,000, salaries in primary care are historically lower than in other fields. An anesthesiologist’s salary, for example, can reach $400,000.

“It’s on the lower end of the spectrum,” said Dr. Julie Hauer, the University’s pediatrics residency program director, a position that rotates among five hospitals in the Twin Cities.

A lower salary didn’t dissuade University student Matt Schultz from specializing in family practice. With plans to practice in rural Minnesota, Schultz said he will take his wife and son with him for his residency in Nebraska.

“Money isn’t everything,” he said. “You couldn’t pay me enough to be a specialist and treat only one kind of problem day in and day out.”

Valusek said she also didn’t consider financial issues while deciding to become a surgeon.

“I wanted to do something that I knew would make me happy every day,” she said. “Besides, my family would help me if I ever couldn’t make rent sometime.”

Her family’s support kept Valusek in Minnesota during school, she said.

“My dad was in the Air Force, so we moved around a lot,” she said. “Now I’d like to stay here for a while.”

More than half of University graduates will stay in Minnesota for their residencies, a trend Horwitz partially credits to their families.

“Many of our students have families here and support structures that keep them here,” Horwitz said.

For others, choosing a specialty is an inherent decision, Hauer said.

“A lot of the time, students have some of the personality traits people in the field have,” she said. “They just feel like they fit into the specialty.”

University medical student Ryan Bortolon said he chose to specialize in anesthesiology because he fit in with other anesthesiologists.

“They were all just like me,” he said. “In general, they were outgoing and laid-back.”

There are plenty of factors graduates consider when choosing specialties and the locations where they will conduct their residencies, Horwitz said.

“There are a lot of lifestyle issues to think about,” Horwitz said. “Students these days want to have more balanced lives.”

For Valusek, the balanced lives of the surgery department’s faculty drew her to HCMC – 100 percent of the faculty members are married and have children.

“The faculty are aware of the fact that people want to have families,” she said. “There are many female surgeon role models out there that have shown it can be done.”

For now, Valusek said, she will adjust to the transition between medical student and medical doctor, although it sometimes seems daunting.

“I’ll be cosigning a student’s order when I’ll be waiting for someone to cosign mine,” she said. “It will be weird to have someone call me ‘doctor.'”