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Johnson The problems can also be traced back to medical schools, where there is scant science behind deciding how many positions to allot to each field, said Dr. John Haggie, president of the Canadian Medical Association. We dont know as a nation or a province or a jurisdiction what kind of physician population we actually need going forward, he said. As a result, people often take a fairly opportunistic, almost random career path, and end up with skills that are fairly focused and difficult to accommodate where they want to be. Successfully predicting needs is not necessarily easy, given the five-year lag before a medical-school graduate finishes specialty training. Ms. Frechette said the Royal College is hoping to gather data that will contribute to better planning in future and avoid knee-jerk decisions on training doctors. In the meantime, some worry about a medical exodus like that seen in the 1990s. Even Dr. Loewen, who wants nothing more than to work in Canada, said he may have to consider relocating to the U.S. soon. If recent graduates take more than a year or two to find a position in Canada, they may go to the States. If they do go to the States, history tells us that they are not likely to come back, said Dr.
As sexual beings, potentially all of us are sexual medicine patients, whether we are sexually active or not. The problems we physicians see are quite varied. Some of them are sexual dysfunctions, which include erection problems (getting or maintaining), orgasms (too quick, not quick enough or not satisfying), desire (too much, too little or for the “wrong” thing) or pain with sex. Sometimes the patient’s concern is not a lack of functioning, but how to enhance functioning. Physicians who specialize in sexual medicine help people improve their body image, broaden their sexual interests and feel more comfortable with their sexuality. We treat sexually transmitted infections and other diseases that affect sexual functioning. We review the effects that medications can have on sexual functioning and whether other medications can enhance it. We provide primary care for sexual- and gender-minority patients, as well as individuals living alternative sexual lifestyles. We manage the hormonal treatment of transsexuals, hormone replacement therapy and contraceptives. Physical vs. psychological When I started in this field, sexual medicine physicians and sex therapists believed that 90 percent of sexual concerns had a psychological cause and that only 10 percent were physiologically based. Then we decided it was the exact opposite.