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.