Medical Workforce Development: Challenges and Opportunities for the Next 25 Years

AbstractThe determinants of population health are complex and draw upon factors related to educational achievement, social infrastructure, economic development and the availability of an appropriate and accessible health service. Whilst recognizing this complexity, the provision of a well-trained and skilled medical workforce is a very important component. This paper will explore the critical factors impinging upon the development and provision and training of the next generation of medical practitioners.Fundamental to this debate is the core role of the doctor within the health care sector. Historically, professions have defined a large part of their existence as holding and maintaining a specific body of knowledge. Both because of the massive explosion in this knowledge base and also, largely as a result of the internet, of much greater public accessibility of medical information, the doctors role is changing from the holder to the interpreter of this knowledge. This will require changes in education and training of the doctor but also will result in increasing alterations in the relationship between a physician and their patient.Much of the debate around the future role of the doctor has focused on what range of tasks should be carried out by a physician and which can be devolved or delegated to other health care workers. This process is difficult and challenging, throws up debates around the values of the cognitive skills of a doctor compared to procedural skills and is often seen as fundamentally undermining the perceived value to society of the medical profession. How this issue is dealt with will either enable or inhibit significant progress.Changes in population demographics, increasing capabilities of the health care system and patient and health care worker expectations have all suggested that across the globe a significant increase in the numbers of physicians being trained will be required. Not all agree, pointing to the relatively weak link between physician numbers and broad measures population health. A robust debate of this issue will be required if pragmatic sustainable health care systems are to be maintained.These issues suggest that a well-informed and robust debate is required an appropriate model for future physician training is to be produced for the next 25 years and beyond