As someone who has trained for over a decade in medicine, as well as represented junior doctors at a national level for the AMA, I agree with Melissa Sweet that the balance of power within medicine — and health for that matter– is tilted  towards big city specialists, particularly those who stick things in or pull things out.

However, the burden of health care will increasingly be shouldered by up and coming doctors, especially those who are now medical students. By 2012, there will be almost a trebling of the number of medical students in the country as medical schools pop up all over the country. The reasoning is clear — to put a downward pressure on wages and put a stop to the huge numbers of overseas-trained doctors that currently prop up the system in needy areas.

The result will be a large influx of training doctors swirling within the public hospital system attempting to become specialists, but unable to do so because of a combination of the learned college structure, crucial for doctors to retain control of their profession, as well as governments incapable of supplying appropriate training positions.

I am training to be a psychiatrist, a specialty that has the lowest pass-rate for its final exams — around 40% — for any medical college in the Western world. This is plainly ridiculous. Being a psychiatrist is not such an extraordinary task. The result is a great number of perfectly competent doctors who are stuck, trapped in the public sector but effectively managing the most difficult patients.

It is already happening in the UK, where only last month the biggest protests in a decade took place among junior doctors. Why? Because there were no jobs for even the very brightest among them due to a combination of oversupply and NHS bureaucracy.

There is every chance the same will occur here. Future doctors can look forward to being the next version of teachers, as they are trapped for lengthy periods in the public sector with a low ceiling on their wages and limited international mobility. I advise young bright things to choose any career in medicine with great caution.