Medical education is facing today one of the strangest combinations of paradoxes imaginable. In the first place, medical schools and voluntary hospitals in the United States have been confronted with the gravest of financial crises in a decade of unprecedented prosperity. In the second place, there is the paradox of rising per diem hospital costs with fewer and fewer patients who cannot meet them. A third and related paradox is that, although as a result of both shorter stay and more beds there is a vast increase in numbers of patients hospitalized each year, there has been a steady decline in patients available for postgraduate teaching. A further complication is the marked increase in the numbers of those seeking postgraduate education.
In order that we may not starve in the midst of this plenty, in order that we may fulfill our obligation to those who will follow us by providing
Hamilton TS. PROBLEMS IN SPECIALTY TRAINING CREATED BY THE CHANGING STATUS OF PATIENTS. JAMA. 1958;167(2):187–192. doi:10.1001/jama.1958.02990190041009