Philadelphia ? Reflecting an epidemic of disillusionment among American doctors, medical school applications are declining, and graduates are increasingly choosing specialties that will give them reasonable control of their hours, incomes and lifestyles.

Such fields as dermatology, radiology, anesthesiology, genetics and emergency medicine are hot — while becoming a primary care doctor is not, newly published surveys show.

“Young people today read the newspaper,” said Richard Pascucci, senior associate dean of clinical education at Philadelphia College of Osteopathic Medicine. “They see physicians’ earnings are down, physicians get sued. I’d say, in some humble ways, they’re smarter than my generation. They don’t want to work as long or as hard.”

Echoed Gail Morrison, vice dean for education at University of Pennsylvania School of Medicine, “They’re trying to have a life as well as be a doctor.”

These trends and the implications are examined in today’s Journal of the American Medical Assn., a theme issue on medical education.

Medical school applicants have been steadily declining for 10 years, hitting 33,625 this academic year, researchers report in the journal. Although the academic quality of admitted students has been stable since 1997, the applicant pool keeps shrinking, with slightly fewer than two applicants for every opening.

When the ratio drops that low, “everybody starts worrying,” Morrison said, “because not everybody who applies to medical school should be a doctor.”

Another national trend: the steady increase in the percentage of women aspiring to be doctors. Women now account for 49 percent of all applicants to U.S. medical schools, and 45 percent of med school graduates.

Unlike women doctors of earlier generations, today’s do not feel they have to prove their professional dedication by postponing marriage or childbearing, or both, physicians agree.