Biomedical dominance and the underrepresentation of primary care: An analyses of self-claimed research priorities of German medical schools.

Background: Primary care providers deliver the majority of medical care serving as essential first points of contact and care coordinators. Despite the significant challenges they face, primary care research seems to lag behind and stay low-funded. Since the mid-1990s, academic reforms have emphasised metrics like third-party funding and high-impact publications. Medical schools were encouraged to develop distinct research profiles and to compete both internally and externally, leading to shifts in how research areas were prioritised, potentially disadvantaging primary care research.

Objectives: To investigate the thematic priorities in German medical schools' research, assess the diversification of these priorities, and examine the role of primary care research.

Methods: We conducted an analysis of the research priorities of all 39 German medical schools associated with the German Association of Medical Faculties. Data was extracted from medical school websites in October 2023. Research priorities were categorised and analysed using descriptive statistics and relationship mapping.

Results: Research profile topics per medical school ranged from 1 to 7 (mean 3.51, SD 1.41). The most common research priorities were 'Neuroscience & Neurology' (69.2%), 'Immunology/Infectiology/Immunotherapy' (59.0%), and 'Oncology' (51.3%). Only a few institutions, primarily those in rural areas or recently established medical schools, prioritised adjacent primary care research fields such as health services research or community medicine.

Conclusion: Our analysis reveals a significant concentration of research priorities in a few biomedical fields across German medical schools, with an underrepresentation of primary care research. This suggests a potential misalignment between academic focus and societal healthcare needs.