Future Training in Medicine and Medical Specialties

New medical knowledge has accumulated at a tremendously rapid rate, especially during the past decade. Simultaneously, there has been an increasing demand for improvement in the quality and quantity of medical education, research, and patient care. Financial support for teaching and research has been expanding considerably. Moreover, the financial, social, and general educational status of the public has developed sufficiently to demand marked improvement in medical care. The extent to which physicians are facing the problems is variable, as shown in figure 1, but most of us have been insufficiently progressive in our planning. Large investments are being made in new medical school and hospital buildings, as well as in large staffs; but without adequate study of long-range developments, optimal success will be handicapped. The situation may be compared with the tremendous traffic jams that have developed as a result of insufficient planning in many large cities; making changes later