Are medical errors responsible for as many deaths as believed; how easy is it to predict the future of healthcare; and why are so few doctors embracing scientific research? This month's column examines these issues

An editorial in the US journal Science (293: 573) bewails the shrinking number of American doctors choosing a career embracing science as well as medicine.

'The revolution in molecular biology, ' they write , 'portends a new era in the treatment and prevention of human diseases.' Translating discoveries into treatments requires properly trained clinical investigators, 'yet in the United States their ranks are shrinking'. And quite dramatically - from more than 23,000 in 1984 to fewer than 15,000 in 1999.

The reasons, say the authors, include the high cost of medical education. The average debt of newlyqualified American doctors has apparently reached $95,000 - and many are keener to devote their time to 'billable services' than acquiring the extra training to follow a less profitable research career.

Things are not entirely rosy here either.

Medical academics in Britain have been saying for years that having two employers - the universities and the NHS - leads to an excessive workload. As demands from the health service increase, the less time and energy they have for the teaching and research half of their job. According to the Council of Heads of Medical Schools, more than 70 chairs are vacant, half of them unfilled for more than six months.

The budget of the US National Institutes of Health has risen by almost half since 1998. Growth in Britain has been less spectacular. But it would be wasteful indeed for either country to find itself having more ideas worth testing than there were medically qualified researchers to do so.