In the mid-1970s the Permanent Working Group (PWG) of European Hospital Doctors was formed when it became apparent that junior doctors in different European countries shared many common problems and experiences. The PWG now represents 17 national organisations of junior hospital doctors and is recognised by European institutions such as the European Commission; British doctors are represented by the British Medical Association. The PWG organised a conference in Maastricht in the Netherlands in 1982 bringing together politicians, planners and the medical profession to try to plan the future supply of doctors to match the anticipated demands for services at a time when large-scale unemployment was beginning to appear in a number of western European countries. From this developed a major study of medical manpower in western European countries which formed the core of a conference on ‘Medical Manpower in Europe: from surplus to deficit?’ on 31 October 1991, hosted by the PWG in Florence. Europe in this context was defined as the member states of the EEC and EFTA.