Postgraduate Medical Education

Because of the shortage of physicians in rural and inner city areas, it was decided in the late 1960s to increase the number of practicing physicians. It was assumed that this would bring about a surplus of urban physicians and induce a better geographical distribution of health professionals. This has not come about and the underserved areas have had only modest improvement in spite of a higher ratio of specialists to generalists of 70:30. Projections of a surplus of over 100,000 specialists and a shortage of 30,000 generalists by the year 2000 have been reported.

In partial response to this situation, the number of allotted residency slots have diminished from 135% to 100%. Medical schools are beginning to focus on training primary care physicians by giving students an opportunity to complete ambulatory clerkships. Nevertheless, greater emphasis on the changing health care scene has to be brought to the attention of prospective physicians so that they can find their appropriate place in the professional world.