BOOKS OF RtfiDIfGS - PAHO/WHO

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1. A change in the immigration policy for foreign medical
graduates has led to the reduction of the number of foreign
medical graduates available to enter this specialty. In 1972 for
example, 58% of anesthesiologists in formal training programs were
graduates of foreign medical schools [6].
2. The percentage of U. S. medical school graduates entering
anesthesia is decreasing.
3. The anesthesiologists who entered the specialty during
the immediate post-World War II period - a time of the highest
recruitment into the specialty - are now approaching retirement.
Much has been said about physician maldistribution.
Anesthesiologists reflect the same maldistribution. The pronounced
migration out of the snow belt into the southern and western
coastal areas and into the sun belt of the population in general
is reflected also in the movement of anesthesiologists. This
outer-migration further reinforces the problem of anesthesia
coverage in small peripheral hospitals of the North. The small and
peripheral community hospitals have historically experienced the
most difficulty in acquiring anesthesiologists. Of the 7000
hospitals in the U.S., one half have 100 or fewer beds. Of this
latter 3500 hospitals, only 9% have anesthesiologist (MD) coverage
[7]. There is a maldistribution of coverage for obstetrical needs
as opposed to surgical needs [8,9]. Lastly, in situations where
anesthesiologists work alone and without support personnel, it is
fair to assume that they cannot spend the time outside the