Dr. Roy is the Interim Director of Programs Branch, Medical Research Council of Canada, and Professor Emeritus, Department of Pediatrics, Universit de Montr al, Gastroenterology Nutrition Service, H pital Ste-Justine, Montreal, Que. These words are not from Yogi Berra, the celebrated contemporary sage, but from the 19th century romantic poet who enlightened the tumultuous adolescent years of my generation.
Society is in a state of change that some claim is as dramatic as the Industrial Revolution.
In the twilight of this century, our cherished health care system has undergone profound changes, dictated by fiscal pressures to downsize and by patients' demands for access to new technologies. Academic medicine, the cornerstone of the health care system, is particularly threatened by these changes. The decline in federal transfer payments, large decreases in provincial budgets for universities and their teaching hospitals and a substantial reduction in the core budget of the MRC are imperilling the scientific performance of Canada, jeopardizing the future of an emerging generation of talented investigators and driving away from a research career as clinician investigators young physicians needed for the changing of the guard. A chorus of alarm has been raised in the US about the depleted ranks of physicians in academic medicine and their diminishing role in biomedical and health sciences research. Difficult times for biomedical and health sciences research Federal and provincial governments have recently moved directly and strongly to control the growth of health care expenditures.