There is no doubt that we need to alter the distribution of physicians. We appear to have an abundance of specialists and a scarcity of generalists. We are disappointed, however, that the College has chosen to support government regulation to institute a 50/50 ratio of generalists to specialists. This position is both untimely and counterproductive.

First, the 50/50 ratio is completely arbitrary and lacks any hard scientific supporting data. Even one of the strongest supporters of this ratio, the Council on Graduate Medical Education admits that "experimental data does not exist to define the proportion of generalists and specialists needed to provide optimal access to primary care services" [2]. How can one advocate such a radical redistribution on the basis of data that do not exist?

Second, we agree that planning should be done. It should be based, however, on physician-to-population ratios, regional variations, sex-based differences, and use of certain practice models. In addition, we should be using positive incentives such as loan forgiveness, role models, and financial remuneration to encourage medical students and young physicians to enter primary care.

Finally, the government intervention that the College advocates is unprecedented. As residents beginning our medical careers, we take offense at this interference. Should the government redistribute law students, making sure that enough go into criminal law, so that we have enough competent attorneys to serve as public defenders? We cannot force people who may lack the appropriate skills or interest to enter a particular practice field.

We suggest that the private sector be given more time to correct the maldistribution. Already, last year's residency match has shown an increase in the number of graduating medical students entering primary care.

"Freedom of choice" is the phrase patients use to ensure their ability to choose their physician. Let's give that same freedom to physicians and medical students.