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ANESTHETIC FILMS
979 Part 1 should include a stiffly marked paper and " viva" by a pathologist. Certain textbooks might be recommended. Part I.-This should cover those general principles of physiology, pathology, bacteriology, surgery, and therapeutics which the general surgeon (perhaps with some truth) accuses the modern specialist of forgetting. It should include the general pathology of such ubiquitous diseases as tuberculosis, syphilis, and neoplastic disease. the principles of chemotherapy and antibacterial agents, and of the healing of wounds. Part 2 should cover the detailed anatomy and physiology of the special region, experimental laboratory work of practical value, and embryology and comparative anatomy-thus corresponding roughly with part I of the examination for some special diplomas. Part 3 should cover the pathology and surgery of the special areas concerned, and more general knowledge of certain systemic diseases-for example, cardiorenal disease for the ophthalmologist and central nervous for the otologist. This approximates to examination for some special diplomas.
’
system disease part 2 of the
General surgeons would have a similar examination ; but special regions and branches, including orthopaedics, would be excluded. Part 1 should not be taken till about a year after qualifying, and admission to part 3 should not be permitted unless the candidate has to his credit 1-3 years of postgraduate work in a special department. This examination would make it possible to reduce the considerable time wasted by,medical students in cramming detailed anatomy, while the prospective specialist would not spend time on useless facts and theories : his teachers would know how to help him, and where his real interests lay. SPECIALIST-SURGEON. London.
ANESTHETIC FILMS SIR,-Films for medical instruction have been and are being made at a much smaller cost than the expensive ones discussed by Mr. Rogerson in his letter of June 8. For example, groups of short silent films are needed to be used as animated illustrations to lectures. This is indicated by the replies given to our questionnaire by the deans of medical schools and the tenor of the papers and discussion at the meeting held at the Royal Society of Medicine in February (Lancet, March 16, 1946, p. 383). Films of this type can be made for .8100 or less, an expenditure well within the range of a medical school. The field to be covered is so large that there is scope for sponsorship by individuals, medical schools, philanthropic trusts, industry, and Government departments. London, W.1
RONALD MACKEITH Chairman, Medical Committee, Scientific Film Association
EX-SERVICE DOCTORS to be demobilised, we are much concerned at the fate of those who have preceded us, and are grateful for the public exposure of their difficulties recently made in your columns. From personal experience, we already know that the picture you draw of prospects for the demobilised doctor is far from exaggerated, and not only in our own interests hope that positive action will speedily be taken to improve the situation. Whilst agreeing that the solutions you propose-a Government subsidy to existing hospitals and overworked general practitioners for extra staff and assistants would go some way to solving the problem, especially if these subsidies were made in the most needy areas, we feel that administrative difficulties might in some cases obstruct such a plan, which does nothing to provide for new development areas, nor for those already backward in their medical services before the war. It seems to us, therefore, that what is needed is a beginning, now, on the provision of new. hospitals. For this purpose we believe existing accommodation, such as disused Service establishments with their equipment, could in many cases be found. Such a project should be financed, staffed, and run by the Government as an interim device to bridge the gap until the regional boards take over the hospitals. In the same way, local
Sm,-As Service specialists shortly
in the worst-served districts should be to provide, by adaptation or new building, health-centres in which intending general practitioners released from the Services could work, within the National Health Insurance framework. Government subsidies should be available for such doctors where necessary. We, believe that only by such direct Government action can the present plight of many doctors, and those who need their services, be remedied. and that not only ex-Service medical officers would welcome such a transitional phase before the introduction of the new service. JOHN B. ATKINS. H. L. M. ROUALLE. P. F. FLETCHER. R.A.F. Hospital, Ely.
authorities
empowered
SiB,—Your leading article, " Interim " (June 8), was welcome and well timed. One class, to which I happen to belong, has, however, been overlooked. The registrartype appointments, originally designed for those who " wish to be specialists," all pass to those who have been specialists in the Forces or have already obtained higher degrees. I myself have always sought to specialise in paediatrics. I qualified in 1939, and a year later joined the R.A.F., in which I served for nearly six years ; during this time, detached as I was from opportunities for clinical work in hospitals, it was impracticable to work for higher qualifications. Now, after demobilisation, the only type of appointment open to me is a junior post at j6350 a year for six months. At the end of that time I intend to take the D.c.H.; and the next problem will be to work for the M.R.C.P. while still meeting family commitments. If I am forced to go into practice to obtain a home and a living, I feel that I shall once again have fallen out of the running. In view of the pressing need for specialists in the National Health Service, it seems that the criteria for the encouragement of specialisation are too narrow. CLASS I. _
INACTIVE HORMONE PREPARATIONS Sm,—It is to be regretted that, at the Medical Exhibition in Glasgow, inactive hormone preparations for oral administration are still advertised. The knowledge of endocrine medicine among the majority of the profession has, in the past, largely been influenced by advertisements and circulars from the’ manufacturing firms, and much of the disrepute into which this branch of medicine has fallen has been due to failures in therapy through the misapplication of useless and expensive remedies, purporting to cure anything from impotence to prostatic
hypertrophy.
The correct application of genuine active and standardised hormones in adequate doses for suitable conditions will effect results of great value, and the advances in endocrine biochemistry, in which this country holds a prominent position warrant a greater interest and recognition of endocrine medicine. Clinical material is abundant in any big hospital in medical, surgical, and gynaecological departments, and if only this material were coordinated on a sound basis, backed by adequate laboratory facilities, advances in knowledge would be bound to follow. Such developments, without adequate experience and coordination, will be slow. The recent formation of the endocrine section of the -Royal Society of Medicine and the Society for Endocrinology is a sign that at last those interested in the subject are determined to seek progress, and the profession has shown signs of recognition by the appointment of an endocrinologist to the teaching staff of a London hospital. Let us clear the decks for action. It behoves all reputable manufacturers to scrap their useless preparations now ; by so doing they will play their part in casting aside finally the mantle of quackery and suspicion which has so long enshrouded this important branch of medicine. GEORGE L. FOSS. Bristol. A GENERAL meeting of the Medical Society for the Study of Venereal Diseases will be held at 11, Chandos Street, London, W.I, on Saturday, June 29, at 2.30 P.M. A discussion will be held on Treatment of the Infected Female with Penicillin.
’
system disease part 2 of the
General surgeons would have a similar examination ; but special regions and branches, including orthopaedics, would be excluded. Part 1 should not be taken till about a year after qualifying, and admission to part 3 should not be permitted unless the candidate has to his credit 1-3 years of postgraduate work in a special department. This examination would make it possible to reduce the considerable time wasted by,medical students in cramming detailed anatomy, while the prospective specialist would not spend time on useless facts and theories : his teachers would know how to help him, and where his real interests lay. SPECIALIST-SURGEON. London.
ANESTHETIC FILMS SIR,-Films for medical instruction have been and are being made at a much smaller cost than the expensive ones discussed by Mr. Rogerson in his letter of June 8. For example, groups of short silent films are needed to be used as animated illustrations to lectures. This is indicated by the replies given to our questionnaire by the deans of medical schools and the tenor of the papers and discussion at the meeting held at the Royal Society of Medicine in February (Lancet, March 16, 1946, p. 383). Films of this type can be made for .8100 or less, an expenditure well within the range of a medical school. The field to be covered is so large that there is scope for sponsorship by individuals, medical schools, philanthropic trusts, industry, and Government departments. London, W.1
RONALD MACKEITH Chairman, Medical Committee, Scientific Film Association
EX-SERVICE DOCTORS to be demobilised, we are much concerned at the fate of those who have preceded us, and are grateful for the public exposure of their difficulties recently made in your columns. From personal experience, we already know that the picture you draw of prospects for the demobilised doctor is far from exaggerated, and not only in our own interests hope that positive action will speedily be taken to improve the situation. Whilst agreeing that the solutions you propose-a Government subsidy to existing hospitals and overworked general practitioners for extra staff and assistants would go some way to solving the problem, especially if these subsidies were made in the most needy areas, we feel that administrative difficulties might in some cases obstruct such a plan, which does nothing to provide for new development areas, nor for those already backward in their medical services before the war. It seems to us, therefore, that what is needed is a beginning, now, on the provision of new. hospitals. For this purpose we believe existing accommodation, such as disused Service establishments with their equipment, could in many cases be found. Such a project should be financed, staffed, and run by the Government as an interim device to bridge the gap until the regional boards take over the hospitals. In the same way, local
Sm,-As Service specialists shortly
in the worst-served districts should be to provide, by adaptation or new building, health-centres in which intending general practitioners released from the Services could work, within the National Health Insurance framework. Government subsidies should be available for such doctors where necessary. We, believe that only by such direct Government action can the present plight of many doctors, and those who need their services, be remedied. and that not only ex-Service medical officers would welcome such a transitional phase before the introduction of the new service. JOHN B. ATKINS. H. L. M. ROUALLE. P. F. FLETCHER. R.A.F. Hospital, Ely.
authorities
empowered
SiB,—Your leading article, " Interim " (June 8), was welcome and well timed. One class, to which I happen to belong, has, however, been overlooked. The registrartype appointments, originally designed for those who " wish to be specialists," all pass to those who have been specialists in the Forces or have already obtained higher degrees. I myself have always sought to specialise in paediatrics. I qualified in 1939, and a year later joined the R.A.F., in which I served for nearly six years ; during this time, detached as I was from opportunities for clinical work in hospitals, it was impracticable to work for higher qualifications. Now, after demobilisation, the only type of appointment open to me is a junior post at j6350 a year for six months. At the end of that time I intend to take the D.c.H.; and the next problem will be to work for the M.R.C.P. while still meeting family commitments. If I am forced to go into practice to obtain a home and a living, I feel that I shall once again have fallen out of the running. In view of the pressing need for specialists in the National Health Service, it seems that the criteria for the encouragement of specialisation are too narrow. CLASS I. _
INACTIVE HORMONE PREPARATIONS Sm,—It is to be regretted that, at the Medical Exhibition in Glasgow, inactive hormone preparations for oral administration are still advertised. The knowledge of endocrine medicine among the majority of the profession has, in the past, largely been influenced by advertisements and circulars from the’ manufacturing firms, and much of the disrepute into which this branch of medicine has fallen has been due to failures in therapy through the misapplication of useless and expensive remedies, purporting to cure anything from impotence to prostatic
hypertrophy.
The correct application of genuine active and standardised hormones in adequate doses for suitable conditions will effect results of great value, and the advances in endocrine biochemistry, in which this country holds a prominent position warrant a greater interest and recognition of endocrine medicine. Clinical material is abundant in any big hospital in medical, surgical, and gynaecological departments, and if only this material were coordinated on a sound basis, backed by adequate laboratory facilities, advances in knowledge would be bound to follow. Such developments, without adequate experience and coordination, will be slow. The recent formation of the endocrine section of the -Royal Society of Medicine and the Society for Endocrinology is a sign that at last those interested in the subject are determined to seek progress, and the profession has shown signs of recognition by the appointment of an endocrinologist to the teaching staff of a London hospital. Let us clear the decks for action. It behoves all reputable manufacturers to scrap their useless preparations now ; by so doing they will play their part in casting aside finally the mantle of quackery and suspicion which has so long enshrouded this important branch of medicine. GEORGE L. FOSS. Bristol. A GENERAL meeting of the Medical Society for the Study of Venereal Diseases will be held at 11, Chandos Street, London, W.I, on Saturday, June 29, at 2.30 P.M. A discussion will be held on Treatment of the Infected Female with Penicillin.