June is graduation month and approximately 700,000 young doctors throughout the world will receive diplomas. These medical degrees may be quite variable. In some countries non-traditional practitioners, local medical specialists and dentists are counted as doctors, whereas in others, physicians must undergo six years of rigorous medical education before they get medical doctorates. Nonetheless, they will all join the pool of doctors in the world and will become serious players in the medical field within ten years.
Most of these doctors will greet the turn of the next century. In 2100 life expectancy is expected to be much longer than it is today. Continuing population growth will add further stress to the healthcare system, though eventually continued population growth will not be sustainable.
The number of old people, many of whom will have chronic illnesses, will grow exponentially and the burden to society will be tremendous. Most countries will be unable to support all the retirees, so the retirement age will increase faster than the lifespan. Doctors who graduate this year will probably have to work until they are 80 to 85 years old. Just a century ago, no one thought that
it would be normal to be working at age 70, as is common today.
During these years, medicine will change so dramatically that much of what graduating students have learned in medical school will be obsolete. The rate of change is increasing, and there are projections that in the 21st century the philosophy of medicine will change completely every 20 years. In the beginning of the 20th century a sick patient was committed to bed rest and fed a calorie-diet rich. In the beginning of the 21st century, the same sick patient is mobilized and the calories may be restricted.
If aging genes or cancer-predisposing genes are discovered in the next 20 years, medicine will go in a completely new direction. The most important questions in medical ethics will be related to business issues – expensive medications, gene therapy and cell transplantation will not be accessible to everyone. While it might be possible to extend life indefinitely, this will no be available to everyone.
Welcome, young doctors, to the medical profession. Welcome to the World Medical Association.
Editor in Chief, WMJ
Dr. Pēteris Apinis