[Need for effective collaboration between medical education and the health services].

The article reviews the health manpower training problems involved in the commitment of all countries to extend the coverage of their health services to the entire population by the year 2000. The author points out that the number of physicians in Latin America will double in seven or eight years, and doubts that they can all be absorbed by the labor market unless they are given a well-defined part to play in primary health care, which is the key to that goal. Necessary changes in medical practice--among them regionalization of the services--should, he feels, be accompanied by appropriate changes in the medical education process. Since the physician practicing at the primary care level stands at the point of entry to the regionalized health system, his training should be slanted toward dealing with the prevalent pathology, and particularly toward the care of the groups at highest risk: mothers and children. In addition, he will have to be ready to take the lead on a team consisting of the auxiliary staff and the members of the community itself. He admits that the breadth of the range of subjects studied in medical training today may have to be traded off for more intensive concentration on the basic fields of internal medicine, general surgery, obstetrics and pediatrics. Other essential changes include closer coordination between the medical school and the health services not only in the framing of policies and programs, but also in routine work; the provision of incentives to improve the geographic distribution of health personnel, and determining the contribution required of each discipline at the different training levels and in operating the services.