- © 2004 Canadian Medical Association or its licensors
I could not agree more with Dr. Ursus about the tragic situation he describes in the Feb. 3 issue of CMAJ.1 He is perfectly correct in saying that “[t]he single greatest change in the firmament of modern Canadian medicine will remain the death of the generalist.”
Of course, the reasons for this “death” are many, but, in my opinion, they rank in the following order. First, the loss of the rotating internship has unfortunately resulted in the exposure of virtually none of our graduating medical students to the joy of general practice. Second, because medical schools are now being administered and the teaching is being done by specialists and subspecialists, students get a view of the practice of medicine that is totally different from that of the generalist. Third, general practitioners have disappeared from major teaching hospitals, so there are no role models in this area, an aspect of training that I think is extremely important for the typical medical student in 2004.
Dr. Ursus suggests that physicians were better served by the rotating internship, and I can only commiserate with him on this point. Family doctors indeed are a dying breed, and I suspect that 10 to 15 years from now there will be none left.
Noel Barry Hershfield Gastroenterologist Calgary, Alta.
Reference
- 1.