[Demography and medicine in Switzerland: medical manpower and project "DEMOMED"]

The situation as regards medical manpower in Switzerland in 1975 is characterized by high enrollment in the medical schools and a doubling time for the number of physicians in practice of approximately twenty years. A federal commission concerned with problems related to medical studies (CEPREM) conducted a study aiming at defining an optimum figure for intake of students into the medical schools. A survey of the international literature and a statistical study of availability of physician services region by region in Switzerland were conducted. The results show that it is impossible to define with precision an optimum "medical density" for Switzerland. The system of health and the functions of its various professions are not defined, and powers of decision in this field are not uniformly attributed. In the national survey, the most striking feature was disparity between various regions as regards access to medical or paramedical services. This disparity is parallel to state of economical development, and unlikely to be corrected even by an excess of overall medical manpower. Four hypotheses are presented on the consequences of increase, decrease, or stable enrolment in the medical schools. We conclude that there is no technical basis for defining an optimal medical density, but that it would be reasonable to decrease the number of second-year students by a factor of the order of 25% on the basis of a political decision.