Bias in awarding research grants.

in this report, showed a desire for an increase in consultant physicians by about 126 (12%) over the next two years. This is considerably more than the figure quoted by the DHSS in its guidelines of August 1984, in which a net increase of27 posts a year was predicted for the next four years. The numbers of other supporting staff-hospital practitioners, associate specialists, and clinical assistants-were not inconsiderable, amounting to 557 sessions a week, the equivalent of 50 whole time physicians. One should question whether 4-7% of the total workforce (and this is probably an underestimate) should be so constituted while consultant expansion is constrained. Further information on the role of these grades, particularly in technique oriented specialties such as endoscopy is required. What is the future for general medicine? Whatever the trends towards increasing specialisation the need to care for acute medical admissions, which account for an overwhelming proportion of the inpatient workload, will continue. Even if specialty transfer becomes more common in teaching hospitals logistics will make it impossible in all but the largest district hospital. The development of special interests is likely to continue at all grades, and to cover the wide range of different interests in the smaller hospital doctors may need to develop more than one interest. Other alternatives include cross district contracts and the development of a special interest by geriatrician colleagues. What is clear from this survey is that the general physician remains an essential component ofhospital staffin the United Kingdom, and future training programmes must be structured with this in mind.