[The supply of physicians in Mexico: excess and shortage]. / La oferta de médicos en México: exceso y escasez.

The purpose of this paper is to find out whether a decrease in the number of medical undergraduates doing their social service has any influence on the quantity of medical services provided by health care institutions in Mexico. Spearman's Rank Test was used to correlate the number of medical undergraduates and the number of services. Data for analysis were taken from the statistical information bulletins of the Ministry of Health for the decade of the 1980's. The analysis found that there is a significant correlation between the number of medical undergraduate and the number of primary health care services provided, and that this correlation disappears in the cases of secondary and tertiary health care services. The results underscore the importance of reconsidering the adequate number of physicians required to satisfy the health care needs of the Mexican population.

Patterns of medical employment: a survey of imbalances in urban Mexico.

This article quantifies the magnitude and correlates of the major imbalances affecting the employment of physicians in the urban areas of Mexico. Since the early 1970s the country has experienced a rapid increase in the supply of doctors, which its health system was unable to absorb fully. In 1986, we conducted a survey in the 16 most important cities based on a probability sample of households where someone with an MD degree lived. A total of 604 physicians were interviewed for a response rate of 97 percent. The unemployment rate was 7 percent of potentially active physicians; 11 percent held a nonmedical job, and another 11 percent exhibited low productivity and/or income. All in all, we project that 23,500 physicians in these cities were either unemployed or underemployed. This medical employment pattern was analyzed against five independent variables: generation (i.e. the year in which the physician started medical school), gender, social origin, medical school quality, and specialty. Apart from generation, type of specialty exhibited the strongest correlation with the employment situation of a physician. The results suggest that higher education and health care in Mexico may be producing rather than correcting social inequalities. Policy alternatives are discussed to restore a balance between the training of physicians, their gainful employment, and the health needs of the population.

[Policies for training and employment of physicians in Mexico 1917-1988]. / Políticas de formación y empleo de médicos en México 1917-1988.

In this article we analyze education and employment policies for medical doctors in Mexico, which have led to a situation characterized by unemployment, under-employment and multiple-employment in urban areas, as well as lack of services in several rural zones. The analysis is divided into four defined periods according to the modes of State participation in health care: 1917-1958 (creation and slow growth of health care institutions); 1959-1967 (growth of scientific medicine); 1968-1979 (crisis period); and 1980-1988 (reform). In each one of these periods the evolution of medical manpower is analysed through the actions of three main actors: the State, the universities and the medical profession. The general conclusion of this historical analysis is that the present imbalance in the medical labor market has derived from a lack of joint planning of supply and demand, where by the educational and health care institutions, could decide together the crucial aspects of the quantity and quality of doctors that the population requires.