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Structuring medical manpower: the Canadian response.

Our basic challenge in skilling and re-skilling health workers is to ensure that all training is relevant to our population's current and emerging health needs and consistent with technological progress. It is fundamental to success that we create re-skilling opportunities. Once is not enough in health training. Change is far too rapid and profound to allow any health worker, nurse, technician or physician to perform effectively for very long without gaining significant new skills and knowledge. As health work is restructured by effort to enhance quality and reduce cost everyone will need new skills. It is also essential in a country such as Canada with the continuing reality of open access to medical practice that matching of needs and training programmes occur. What efforts have been undertaken in Canada? Two recent and significant policy developments surrounding physician resource policies in Canada will be considered. The first policy is the work on physician supply management which emanated from the Barer-Stoddart Report. The second, which underscores another aspect of the changing relationship between physicians and society, was the strengthening of legislation regulating the profession in the matter of sexual abuse of patients.