MEDICAL HUMAN-RESOURCES IN MEXICO, 1970-1 990

A study was carried out in 1970 on the distribution of medical personn el in Mexico. At that time an unequal distribution of physicians was d etected, but not emphasized given the general shortage of physicians i n the country. At the present time, the situation has changed. In this article the analysis of the 1990 census data using traditional indica tors of availability of physicians in the country, as well as indirect criteria of physician requirements is presented. In the year of refer ence there were 157 407 physicians in the country, with a national ave rage of 673 persons per physician. The distribution of physicians by s tate showed a great deal of variation in the number of persons per phy sician. For example, the state of Chiapas has 1 642 inhabitants per ph ysician, whereas the Federal District has 292. The relation between tr ained and employed physicians shows another important phenomenon: ther e is a high percentage of physicians that do not practice clinical med icine (19.4%). Nevertheless the number of physicians almost tripled th e growth experienced by the general population, and important differen ces among and within states do persist. Furthermore, a new paradoxical effect has emerged, the presence of underemployment and unemployment of physicians, even in communities with greater needs for medical care . This indicates that the strategy of training more physicians has not solved the problems of accessibility and coverage, but in fact has fo stered new problems and perhaps greater inequalities.