The Enrolment of the Medical Profession.

737 has been deemed impossible, and other difficulties have never been made light of by any who understand the real situation of affairs, but the work of the Central Medical War Committee has not been rendered easier by masses of criticism, some of which may have been perfectly legitimate, but some of which has been ill-inspired, and some has had a suspect origin. The following train of thought is, for example, rather tortuous :-(1) The Army Medical Staff declares that a large number of officers are required in the Royal Army Medical Corps to meet growing armies and to make good depletions; (2) but the Army Medical Staff cannot know what is required because it has never consulted its Advisory Board; (3) therefore, when the Central Medical War Committee states that more medical men are and will be wanted for commissions in the Royal Army Medical Corps the Committee is misleading the medical profession. Yet that is a fair summary of the kind of way in which the work of the Committee and the behaviour of the Army Medical Staff have been criticised in letters to lay journals and in questions addressed in the House of Commons to the Under Secretary of State for War. There have been variants in the pattern of the argument, according as to whether the critic has been chiefly concerned in acclaiming the immorality of neglecting the Advisory Board, or in finding fault with the constitution of the Central Medical War Committee, or in criticising the way in which the officers of the Royal Army Medical Corps are employed when they have been recruited; but the assumption that there has been a great deal of mismanagement by everybody has been made so persistently that those who do not know the facts may have been impressed. But lately the public has become aware of the unsubstantiality of the strictures; some of the complainants have been proved to be wrong in their facts, and others to have erred in their deductions, while a third class have come under strong suspicion of being inspired in what they have said, not so much by a desire to help in public affairs as by an itch to damage those at whose hands they believe themselves to have suffered material damage or personal slight. Categorical stories of lamentable breakdowns have been shown to be incorrect. Clear reasons for much of the plan adopted in the organisation of the Royal Army Medical Corps have been given. A story of an extraordinarily fine bill of health in an army of unprecedented numbers makes an absolute reply to those who consider that in the absence of an Advisory Board the authorities of the Army Medical Staff did nothing, or did only, that which The medical profession has already was wrong. made great sacrifices with splendid results. Its members are being asked to meet a further demand on their services which many of them can ill meet. This is fully recognised. But if all show readiness to bear the burden, the weight should fall on the shoulders fittest to carry it. And it has now been definitely stated that unless a large proportion of the remaining available medical men under 45 enrol, the scheme of the Central Medical War Committee will not be proceeded with. That Committee is now reinforced by the formation of an Advisory Committee of the Royal College of Physicians of London and the Royal College of Surgeons of England, who will assist in the task of selecting the officers for the Royal Army Medical

profession

THE LANCET. LONDON: SATURDAY, APRIL 1, 1916.

The Enrolment of the Medical Profession. THE conferences of representatives of the Local Medical War Committees which were arranged by the Central Medical War Committee to take place last week should, we think, have a distinctly valuable outcome, and the medical profession owes a debt of gratitude to the British Medical Association for having arranged (and paid for) a very practical method of dissipating some of the doubts and relieving some of the difficulties attendant upon the enrolling of the medical profession for military service. We published brief notes last week on the proceedings of the conferences at Leeds and London. This week we publish notes on those at Birmingham and Bristol, and the same general lesson may be drawn from the proceedings at all four gatherings-confidence in the policy and actions of the Central Medical War Committee has been promoted by a discussion of vexed questions. The widespread anxiety lest the Central Committee should override the judgment of Local Committees in the selection of names has also been allayed. It has in this way become obvious to audiences, who are themselves representative of these Local Committees, and therefore of the greater number of medical men concerned, that no alternative presents itself to voluntary enrolment save compulsion, in the event of the military authorities demanding further recruits from the medical profession. A stratum of the profession has now been reached, as Dr. ALFRED Cox reminded the representatives of the Local Medical War Committees at the conference in Leeds, where great hardship may be experienced by the interchange of civil for military work, and the chances that those hardships, being intelligently recognised, will be removed as far as possible are greater, we think, under a system of voluntary enrolment than under one of compulsion, assuming that enrolment is effected by the bulk of those concerned. The Central Medical War Committee has never concealed either from itself or from the constituency that the work of enrolment undertaken by the Committee is delicate in the extreme; the members of the Committee, or the majority of them, quite probably share the opinion which was expressed in this journal as soon as the overwhelmingly serious nature of the war was recognised, that a conscription of the medical profession would have given a fairer result. But the time has gone by when conscription can possess the virtues that it would have possessed originally, and although many members of the medical profession at the different conferences, notably at the gather-

ings

in Birmingham and London, expressed a preference even at this date for compulsory enrolment, we think that the voluntary enrolment

scheme is preferable if the difficulties in carrying it through are met fairly and squarely. A com’pulsory scheme applicable only to the medical

Corps.