The modern emphasis on evidence-based medicine has come about for good reasons but the decreased use of old-fashioned clinical assessment of the individual patient interferes with the doctor’s capacity to administer “whole” patient care. Furthermore, health research has become increasingly sophisticated and specialized, leaving little or no room for the amateur, no matter how gifted. In the background of all these trends, there is the welcome increase in prevalence of women in medicine and the need to continue to address issues associated with this demographic shift. In one way or another, all of the above trends have generated some dissatisfaction and anxiety among medical practitioners but, in almost every instance, their benefits have greatly exceeded their negative effects.
So, is it a more difficult working world for the Canadian medical specialist than it used to be? On balance, I don’t think so, but there are potential pitfalls out there and it is advisable to anticipate and prepare for them. Here I am projecting beyond specialty exams and selection of a career niche, both of which are important mileposts in any career. I do not wish to minimize their importance, but there is excessive focus on the specialty exam now as the consummation rather than the beginning of a career.