There is a widespread conviction among health policy experts that a severe imbalance exists in the ratio of primary care to specialist physicians. There are too many specialists, including radiologists, and several health manpower planning commissions have recommended steps to change the "imbalance". The federal government, because of its position in residency funding, proposes to play a major role in the implementation of the changes in the number of medical specialists. In contrast to the discord surrounding other aspects of medical reform, the major agencies have considerable accord on the need for reducing the supply of specialists and are close on the method for doing so. This article reviews the current situation, outlines the proposals for action, and speculates on likely scenarios for their implementation.