residents an opportunity to undertake a research project and write a PhD thesis as part of their residency training.
The Dutch Ministry of Health funded several scenario studies over the past ten years that provide interesting visions on possible future developments, ranging from the use of home-care technology to the future treatment of coronary artery disease. Unfortunately, no attempts have so far been made to link these studies with health manpower training. The studies do not provide a straightforward answer to the question of how the physician of the twenty-first century must work, but at least they show that the health sector is well aware of the changes in technology, delivery systems, and requirements of an aging population. Two contrary trends are visible already: the need for both the high-tech, cure-oriented specialized physician, on the one hand, and for the generalist, care-oriented physician on the other.
The European dimension will increasingly become important. Each year over two hundred Dutch physicians move permanently to another EEC country and about one hundred physicians from other EEC countries move to the Netherlands. The EEC has a generous student exchange scheme, called the ERASMUS program, which allows students to do parts of their training in another EEC- country. An increased mobility within Europe will at some point activate discussion of a European training standard for physicians. Strong national traditions must change in view of the development of a European policy in this area.
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