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By Alejandro Portes

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Sample text

T h e objective difficulty is subjectively perceived: In T a b l e 2 . 2 , 8 4 % of nonemigrant doctors believed it would be difficult for them to reach their career aspirations. Argentina has evolved into the paradoxical situation o f having both a severe deficit and an oversupply o f physicians. An urgent demand for medical attention in the interior goes hand in hand with emigration abroad of physicians from the capital. Scarce resources are spent in training students whose alienation increases in proportion with their professional expertise.

Research, the use of modern and costly techniques, and familiarity with the scientific literature are emphasized over the mere everyday practice of the profession. T h e cognitive dichotomy that evolves among those so trained is between "good" medicine—with access to laboratories and modern logistical support—and "empirical" medicine—the more traditional practice based on observation and clini49 cal interviews. Career orientations are tailored accordingly. T h e point is illustrated by career preferences of a small sample of Argentine physicians interviewed in Buenos Aires in 1 9 7 3 .

T h e counterperspective on migration was popularized by Gunnar Myrdal 17 under the label cumulative causation. "Backwash effects" by which surplus is drained from underdeveloped areas are not self-regulating but cumulative, leading to an ever-greater impoverishment and depopulation of these regions. In a manner similar to Mill, Myrdal portrayed population and capital resources as flowing in the same direction and from identical sources. In mid-twentieth century, however, these flows did not originate in the core, but in the periphery and did not function to develop peripheral areas, but to deepen their underdevelopment.

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