Putting together the pieces of the physician supply puzzle
CMAJ 2000;162:314
I am astounded that no one seems able to agree on the cause of the physician supply problem, let alone the solution [full article].1 A sudden increase in medical school enrolment will not solve the problem immediately. As Greg Stoddart and Morris Barer pointed out, it takes 6 to 7 years to train a physician, so we either have to live with our physician shortage or find alternatives.
One unfortunate development is the recent requirement for medical students to choose their specialty while they are undergraduates. This means they are streamlined into a surgical or medical specialty or family medicine instead of experiencing the year of general internship that prepared physicians to understand and commence general practice. With the current practice of selecting a specialty during the clinical years at medical school, my prediction is that the shortages and imbalances within specialties will become even more severe. How is a medical student supposed to select a lifelong specialty with minimal experience?
The supply of physicians is not unlike the supply of hogs. When the price goes up farmers raise more hogs, creating a surplus; when the price drops they get out of hogs, creating a shortage. Given our background and training, one would expect that we might have done better.
William W. Arkinstall
Respirologist
Kelowna, BC
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Reference
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Stoddart GL, Barer ML. Will increasing medical school enrolment solve Canada's physician supply problems? [editorial]. CMAJ 1999;161(8):983-4.
© 2000 Canadian Medical Association or its licensors
