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A system of training for general practice
Book reviews
127
and the Inquisition, the account of this particular heresy trial and the pluralistic response of Rome to Placied Tempels was a revelation. The J a m a a represented a singularly difficult problem to the Church and it is not at all clear what a fully adequate response might have b e e n . But I think that no one who had not had considerable experience with the Vatican would have credited it with the ambiguous and non-authoritarian response it ultimately made. To the outsider it is fascinating, and saddening, to see how this ambiguity in Rome permitted the sanctions against Tempels from within his own order. Simply as a case history of a critical event within a very successful and tittle-known bureaucracy, this chapter is a valuable contribution to our understanding of social organization. A paper by Dr, DeCraemer on "A Sociologist's Encounter with the Jamaa" (Journal of Religion in Africa 8, 153, 1977) usefully complements the book in its description of the psychology of the participant observer in the encounter-group atmosphere of the Jamaa. It took me
back 30 years to psychoanalytic training in the old Washington-Baltimore Institute, when remarkably similar processes of self-discovery were preoccupying a quite different group of y o u n g men. The description had the ring of authenticity and brought home to me still more of the meaning of this strange experience in a foreign culture. The Jamaa and the Church is a powerful book, a work of literature as well as of scholarship. It is superbly crafted, from the exquisite style of its E n g l i s h - - u n u s u a l in someone who learned it so late in life--to the carefully calculated sequence of events that would do credit to Alfred Hitchcock. The book was able to draw me into this utterly alien world and make it seem fully credible and, after a time, familiar, and always enthralling. It should appeal to any n u m b e r of others.
A System of Training for General Practice by D. J. PEREIRA GRAY. Occasional Paper 4. The Journal of the Royal College of General Practitioners, London, 1977. 129 pp. £2.75
The same general difficulty exists with respect to the Exeter Department of General Practice objectives, which although predicated by the requirement that the student demonstrate his/her ability to put them into practice, do not specify how, nor with what degree of competence. Nevertheless, that objectives and aims find a place in the paper is a positive indication of the educational sophistication of the R.C.G.P. The educational strategies are considered lucidly and critically. The appropriateness of hospital training, training courses and group work for general practice training is discussed. A review of the educational strategies currently in use is supported with copious anecdotal evidence of implementation w h i c h makes interesting reading. The section on assessment of trainee educational progress is not as sophisticated as the section on educational methods, nor indeed perhaps can it be with the present state of the art of behavioural assessment. But it does take into account considerable contemporary thought on assessment in a way which should be exemplary for other planners of postgraduate programmes. The report is brightly and crisply written. It makes pleasant reading and is full of interest. It would serve as a useful resource document for enlightened planners of any postgraduate course and for those people actively involved in training for general or family practice in other English speaking countries, as well as Great Britain.
As the author points out early in his treatise, in 1950 general practice had no College, no university department anywhere in the British Isles, no postgraduate training programmes, no academic journal and no corporate plan for progresS. Today, there are active programmes of training and research within general practice, stimulated recently by the National Health Service (Vocational Training) Act which calls for a compulsory period of vocational training prior to full-time general practice. . The paper looks first at the historical and political b a c k ground of vocational training in general practice and then examines the educational model on which training promoted by the Royal College of General Practitioners is based. The educational model is a familiar one to medical educators, with its emphasis on declared a i m s and objectives for learning, the experimental use of different forms of educational intervention, followed by assessment measuring student behaviour. In the fourth section of the book, aims and objectives for the training p r o g r a m m e s are examined in greater detail. The educational aims which emerged from the Leeuwenhorst working paper in 1974 are re-stated, aims which are difficult to interpret because they call for no clearly identifiable behaviour on which the success of student learning can be assessed. They speak instead of knowledge, general skills and understanding, and the development of attitudes.
Dept. of Psychiatry University of Pennsylvania Philadelphia, U.S.A.
School of Medicine. Uni~'ersity of Newcastle, New South Wales, Australia
ALBERT J. STUNKARD
STEPHEN R. LEEDER
127
and the Inquisition, the account of this particular heresy trial and the pluralistic response of Rome to Placied Tempels was a revelation. The J a m a a represented a singularly difficult problem to the Church and it is not at all clear what a fully adequate response might have b e e n . But I think that no one who had not had considerable experience with the Vatican would have credited it with the ambiguous and non-authoritarian response it ultimately made. To the outsider it is fascinating, and saddening, to see how this ambiguity in Rome permitted the sanctions against Tempels from within his own order. Simply as a case history of a critical event within a very successful and tittle-known bureaucracy, this chapter is a valuable contribution to our understanding of social organization. A paper by Dr, DeCraemer on "A Sociologist's Encounter with the Jamaa" (Journal of Religion in Africa 8, 153, 1977) usefully complements the book in its description of the psychology of the participant observer in the encounter-group atmosphere of the Jamaa. It took me
back 30 years to psychoanalytic training in the old Washington-Baltimore Institute, when remarkably similar processes of self-discovery were preoccupying a quite different group of y o u n g men. The description had the ring of authenticity and brought home to me still more of the meaning of this strange experience in a foreign culture. The Jamaa and the Church is a powerful book, a work of literature as well as of scholarship. It is superbly crafted, from the exquisite style of its E n g l i s h - - u n u s u a l in someone who learned it so late in life--to the carefully calculated sequence of events that would do credit to Alfred Hitchcock. The book was able to draw me into this utterly alien world and make it seem fully credible and, after a time, familiar, and always enthralling. It should appeal to any n u m b e r of others.
A System of Training for General Practice by D. J. PEREIRA GRAY. Occasional Paper 4. The Journal of the Royal College of General Practitioners, London, 1977. 129 pp. £2.75
The same general difficulty exists with respect to the Exeter Department of General Practice objectives, which although predicated by the requirement that the student demonstrate his/her ability to put them into practice, do not specify how, nor with what degree of competence. Nevertheless, that objectives and aims find a place in the paper is a positive indication of the educational sophistication of the R.C.G.P. The educational strategies are considered lucidly and critically. The appropriateness of hospital training, training courses and group work for general practice training is discussed. A review of the educational strategies currently in use is supported with copious anecdotal evidence of implementation w h i c h makes interesting reading. The section on assessment of trainee educational progress is not as sophisticated as the section on educational methods, nor indeed perhaps can it be with the present state of the art of behavioural assessment. But it does take into account considerable contemporary thought on assessment in a way which should be exemplary for other planners of postgraduate programmes. The report is brightly and crisply written. It makes pleasant reading and is full of interest. It would serve as a useful resource document for enlightened planners of any postgraduate course and for those people actively involved in training for general or family practice in other English speaking countries, as well as Great Britain.
As the author points out early in his treatise, in 1950 general practice had no College, no university department anywhere in the British Isles, no postgraduate training programmes, no academic journal and no corporate plan for progresS. Today, there are active programmes of training and research within general practice, stimulated recently by the National Health Service (Vocational Training) Act which calls for a compulsory period of vocational training prior to full-time general practice. . The paper looks first at the historical and political b a c k ground of vocational training in general practice and then examines the educational model on which training promoted by the Royal College of General Practitioners is based. The educational model is a familiar one to medical educators, with its emphasis on declared a i m s and objectives for learning, the experimental use of different forms of educational intervention, followed by assessment measuring student behaviour. In the fourth section of the book, aims and objectives for the training p r o g r a m m e s are examined in greater detail. The educational aims which emerged from the Leeuwenhorst working paper in 1974 are re-stated, aims which are difficult to interpret because they call for no clearly identifiable behaviour on which the success of student learning can be assessed. They speak instead of knowledge, general skills and understanding, and the development of attitudes.
Dept. of Psychiatry University of Pennsylvania Philadelphia, U.S.A.
School of Medicine. Uni~'ersity of Newcastle, New South Wales, Australia
ALBERT J. STUNKARD
STEPHEN R. LEEDER