Who pays for MD training?

The Annals, Royal College of Physicians and Surgeons of Canada, 2001;34(3), has reached a new editorial low in its article “A Point of View/Laser Eye Surgery” by Gordon H. Guyatt, professor of clinical epidemiology and biostatics, McMaster University. It is obvious he belongs to the University milieu and knows little about private practice when he makes a statement, correctly, that medicine and medicare impose a stronger obligation for public service than any other profession. However, he continues with a commandment directly from the Holy Grail saying the public pays most of the cost of a doctor’s medical training which should strengthen that duty. He carries this absurdity further by suggesting physicians who leave the system for money making private activities might be subjected to: 1. Exclusion from public reimbursement. 2. A demand to repay the money the public has spent on their medical education. 3. A surtax on profits for delivery of private medical care.

Welcome to the new millennium. Let us start with a few observations.

Was it the doctors and ophthalmologists who decided years ago to restrict the number in training? Small wonder the system should now be strained.

How much money has the public lost in training physicians of any sort? I have 35 years of income tax receipts which indicate doctors are a great public investment. There are how many doctors in Canada? 57,000 perhaps? This capsizes any statement about the public paying the cost of training and the absurdity which followed.

It is true doctors escape some taxation by incorporation, but keep in mind, while physicians may have actively sought this taxation wrinkle, without fee adjustment, it was the politicians who authorized it.

When I consider physicians who are obligated by law to medicare, and receive no praise but only further procrastinations about their performance and obligations, it is time to ask what about the dentists and lawyers, and to acknowledge physician persecution is now over. My suggestion is to re-invent the wheel. Any physician completing 30 years of private practice should receive recognition. While Governor General accolades, by way of Order of Canada, are not feasible, some thought should be directed toward federal government recognition with a Good Citizen Award which would also include limited disability insurance. It would be well earned to say the least.

—G.F. Roseborough, MD 

G.F. Roseborough, MD. Who pays for MD training?. BCMJ, Vol. 43, No. 6, July, August, 2001, Page(s) 318 - Letters.

Above is the information needed to cite this article in your paper or presentation. The International Committee of Medical Journal Editors (ICMJE) recommends the following citation style, which is the now nearly universally accepted citation style for scientific papers:
Halpern SD, Ubel PA, Caplan AL, Marion DW, Palmer AM, Schiding JK, et al. Solid-organ transplantation in HIV-infected patients. N Engl J Med. 2002;347:284-7.

About the ICMJE and citation styles

The ICMJE is small group of editors of general medical journals who first met informally in Vancouver, British Columbia, in 1978 to establish guidelines for the format of manuscripts submitted to their journals. The group became known as the Vancouver Group. Its requirements for manuscripts, including formats for bibliographic references developed by the U.S. National Library of Medicine (NLM), were first published in 1979. The Vancouver Group expanded and evolved into the International Committee of Medical Journal Editors (ICMJE), which meets annually. The ICMJE created the Recommendations for the Conduct, Reporting, Editing, and Publication of Scholarly Work in Medical Journals to help authors and editors create and distribute accurate, clear, easily accessible reports of biomedical studies.

An alternate version of ICMJE style is to additionally list the month an issue number, but since most journals use continuous pagination, the shorter form provides sufficient information to locate the reference. The NLM now lists all authors.

BCMJ standard citation style is a slight modification of the ICMJE/NLM style, as follows:

  • Only the first three authors are listed, followed by "et al."
  • There is no period after the journal name.
  • Page numbers are not abbreviated.

For more information on the ICMJE Recommendations for the Conduct, Reporting, Editing, and Publication of Scholarly Work in Medical Journals, visit www.icmje.org

BCMJ Guidelines for Authors

Leave a Reply