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There will be no competitive examination on entry ; ’’,candidates must be under 28 years of age, be British ’,subjects, the sons of British subjects, and of pure ’,European descent, be nominated by the dean of arecognised medical school or teaching hospital, andwill be interviewed personally by the Director of

’’

Medical Services, Royal Air Force, before acceptance. ’,Each candidate must produce :- ’

1. Birth certificate. 2. Medical registration certificate.3. A declaration containing the following information:(a) Age and place of birth. (b) That he is a British subject,the son of British subjects, and of pure European descent.(c) That he is ready to engage for general service at home orabroad as required. (d) The qualifications he is possessedof, and what medical or other appointments he has held(if any). (e) That he is willing to fly as a passenger whenevercalled upon to do so.

Each candidate will be required, before acceptance,to pass a medical examination to ensure that helabours under no constitutional or mental disease ordiseases or weakness, nor any imperfection or disabilitywhich may interfere with the efficient discharge ofthe duties of a medical officer in any climate, inpeace or war.On appointment entrants will undergo an initial

course of eight weeks, during which they will be giveninstruction in the special medical aspects of aviation,the organisation and administration of the Royal AirForce, and the general and special duties to beperformed by officers in the Medical Branch.

In order to avoid the necessity for further examina-tions the position of entrants in order of seniorityin the Air Force List will be determined at the endof the initial course by a system of marking andreports on the actual work done during theirinstruction.

Uniform and Equi_pment.Medical officers are required to provide themselves

with the uniform, service dress, and mess dress of theirrank and with the distinguishing badges of the RoyalAir Force Medical Branch. The provision of full dressis entirely optional at present. An allowance of £50towards the cost of uniform is made on joining tocandidates who have not had previous commissionedservice in H.M. Forces.

Emoluments.

The emoluments of medical officers of the Royal AirForce are given in outline above. The standard ratesof pay and retired pay were drawn up on the basis of the high cost of living in 1919, and 20 per cent. ofeach of the standard rates is detachable and subject ’,to alteration either upwards or downwards as thecost of living rises or falls. Under this provisionthe current rates now in force represent a reductionof approximately 6 per cent. on the standard rates.The next revision will take effect from July 1st, 1930,and subsequent revisions will be made at intervalsof three years.

RETIRED PAY.

The minimum period of service qualifying forretirement on retired payis 20 years. Standard ratesof retired pay are as follows :-

Air Officers.Air Vice-Marshal .. .. £790 to £1010 per annum.Air Commodore .. .. £650 " £950 ,, ..

The maximum standard rates of retired pay andthe compulsory retiring ages for the several ranksare

* Limited to five years.

Gratuities.—A permanent officer allowed to retire-before having qualified for retired pay may be granteda gratuity provided he has not less than ten years’commissioned service, namely :-£1500 if he has 10 but less than 15 years’ commissioned service.£2500 " 15 or more than 15 11 " "

Short-service officers will be eligible on passing tothe Reserve for gratuities on the following scale : -.£100 for each of the first two complete years of service,£150 for each of the third and fourth complete years,and £200 for the. fifth complete year ; that is :- -

For three years’ service on the active list ...6350For five 11 " " " .. £700

These gratuities will not be payable to officers grantedpermanent commissions, but their service on a short-service commission will count towards retired pay.

COLONIAL MEDICAL SERVICE.

IN the self-governing dominions, Canada, Australia,New Zealand, the Union of South Africa, and New-foundland, and territories under their control, such asPapua and the Cook Islands and in the self-governingcolony of Southern Rhodesia, medical appointmentsare made concerning which information can be obtainedfrom the High Commissioners or Agents-General inLondon ; appointments in Egypt and the Soudan areregulated from the Foreign Office ; in North Borneoapplication should be made to the British NorthBorneo Company, 37, Threadneedle-street, E.C., for

appointments ; and those in Sarawak are in the handsof H.H. the Rajah. Much valuable information willbe found in the " Professional Handbook," Part II.,issued by the Oversea Settlement Office, 3 and 4,Clement’s Inn, Strand, London, W.C. 2. price 9d.As a general rule, each Colony or Protectorate has.

its own public service distinct from that of everyother; and it is usually only the higher officers whoare transferred by the Secretary of State from oneColony to another. There are three exceptions tothis rule : (a) The West African Medical Staff, whichserves Nigeria, the Gold Coast, Sierra Leone, and theGambia, is one service. (b) The East African MedicalService, which serves Kenya, Uganda., Zanzibar,Nyasaland, Somaliland, and the Tanganyika Terri-tory is one service. (c) In practice the medical ser-vices of the Straits Settlements and the Malay Statesmay be regarded as one, as the officers may be andfrequently are transferred from the Colony to theStates or vice versa.

’, The Colonies, Protectorates, and Mandated Terri-tories to which medical officers are appointed by theSecretary of State for the Colonies are (a) the WestAfrican—viz., Nigeria, the Gold Coast, Sierra Leone,and the Gambia; (b) the East African-viz., theKenya Colony and Protectorate, the Uganda, Nyasa-

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land, Somaliland, and Zanzibar Protectorates, the ]

Tanganyika Territory, and Northern Rhodesia ; (c) :the Eastern-viz., Ceylon, the Straits Settlementsand Malay States, Hong-Kong, Mauritius, andSeychelles; (d) the West Indian-viz., BritishGuiana, Jamaica, Trinidad, the Windward Islands,the Leeward Islands, Barbados, British Honduras,and the Bahamas ; (e) Fiji and the Western Pacific,Cyprus, Gibraltar, St. Helena, Bermuda, and theFalkland Islands ; and (f) Palestine.

In Ceylon, Mauritius, Jamaica, Barbados, theBahamas, and Bermuda vacancies are practicallyalways filled locally by the appointment of qualifiednative candidates, or-in the case of some of thehigher posts-bv transfer from other Colonies.In the Bechuanaland Protectorate, Basutoland, andSwaziland appointments are usually filled locally.Appointments in Malta are all filled locally. Vacanciesoccur most regularly and frequently in the WestAfrican Medical Staff, the East African MedicalService, and the Straits Settlements and MalayStates.

All applicants for medical appointments in the giftof the Secretary of State for the Colonies should bebetween the ages of 23 and 35,1 and must be doublyqualified ; preference will be given to those who haveheld hospital appointments as house physicians andhouse surgeons ; testimonials to character and pro-fessional competence will be required, and everyofficer before being definitely appointed will bemedically examined by one of the consultingphysicians of the Colonial Office : Sir William Prout,C.M.G., O.B.E., and Dr. A. E. Horn, C.M.G., 79,Harley-street, London, W. 1 ; Major-General J. J.Gerrard, C.B., C.M.G., the Royal Hospital, Kilmain-ham, Dublin ; Dr. Foster Coates, 9, Shaftesbury-square, Belfast; and Lieut.-Colonel Glen Liston,C.LE., I.M.S., 33, Comely Bank, Edinburgh ;Applications for such appointments must be addressedto the Private Secretary (Appointments), ColonialOffice, 38, Old Queen-street, S.W. 1.

EAST AFRICAN MEDICAL SERVICE.

The Medical staffs of the Kenya Colony andProtectorate, the Uganda, Nyasaland, Somaliland,and Zanzibar Protectorates, and the TanganyikaTerritory form one service, the members of whichare liable to be posted to any of the Dependenciesas the exigencies of the service may require. Thepreferences of individual officers are, however, takeninto consideration as far as possible.

Selected candidates are appointed as medicalofficers on probation in the first instance for twoyears, at the end of which period their appoint-ments are made permanent if their service hasbeen satisfactory. Unless the Secretary of Statedirects to the contrary, they are required toattend a course of instruction at the e Londonor Liverpool School of Tropical Medicine or theUniversity of Edinburgh before taking up theirappointments. If such a course is not takenbefore proceeding to East Africa, they are requiredto take it during their first leave of absence.Medical officers (but not sanitation officers) are

permitted to take private practice at some stationson the understanding that they give precedence totheir official duties. It must be understood thatadditions to their income from this source are notlikely to be substantial, and that the privilege isliable to withdrawal at any time.

Officers are provided with quarters free of rent orthe Government may provide temporary accommoda-tion, or an allowance in lieu of quarters calculated at15 per cent. of the initial salary of an officer’s appoint-ment may be paid. The salary of a medical orsanitation officer is £600 per annum. rising byannual increments of £30 to £840, and thence byincrements of £40 to £920, subject to an efficiency

1 In the case of East Africa, preference will be given to candi-dates who are over 25 years of age. In the case of Fiji and theWestern Pacific, preference will be given to candidates who are under 30.

bar at 840. Senior medical officers and seniorsanitation officers are paid on the scale £1000 byannual increments of £50 to £1100. Officers whopossess the Diploma in Public Health on entering, orwho acquire it while in the Service, receive two specialincrements in the scale.

Officers of the East African Medical Service are

permitted to retire with gratuity, if they wish, insteadof waiting to retire on pension as follows : (a) Afternine years’ service, of which at least six must havebeen spent in East Africa, £1000 ; (b) after 12 years’service, of which at least eight must have been spentin East Africa, .81250. If an officer elects to retirewith gratuity he thereby forgoes all claim to

pension.The grades and salaries (apart from ordinary

medical and sanitation officers) in the medical depart-ments are as follows :-

Kenya.—Director of Medical and Sanitary Services,£1500 ; Deputy Director of Medical Service, 1200 : DeputyDirector of Sanitary Service, £1200 ; Deputy Director ofLaboratory Service, £1200.

Uganda.—As Kenya.Tanganyika Territory.-As Kenya.Nyasaland.-Director of Medical and Sanitary Services,

£1300.Zanzibar.—Director of Medical and Sanitary Services,

.B1400 ; Deputy Director of Sanitary Service, £1200.Somaliland.—Principal Medical Officer, £1000- £50- £1100.

Sanitation officers are selected from the ranks ofmedical officers as occasion arises.

ASIA.

Straits Settlements and Federated Malay States.-European medical officers are appointed on thefollowing scale of salaries:$500 per mensem, rising to$550 per mensem during three years’ probation;then, if they are placed on the pensionable establish-ment, rising to$575 per mensem, and thence byannual increments of$25 per mensem to$800 permensem, with a strict efficiency bar at$600 permensem. This scale of salaries has been fixed on thesupposition that medical officers join the service atabout the age of 27. Officers possessing the D.P.H.receive an additional allowance of$100 per mensem.Above the concluding figure of$800 per mensem

there are certain higher appointments, as follows:Principal Civil Medical Officer, Straits Settlements, andPrincipal Medical Officer, Federated Malay States,$1200 per mensem ; Director, Institute for MedicalResearch, Federated Malay States, Chief HealthOfficer, Federated Malay States, and PrincipalMedical College, Straits Settlements,$1100 permensem ; 12 posts at$1050 per mensem ; and 24

posts at$850 per mensem, rising annually by$30 to$1000 per mensem.The following temporary allowances are at present

paid to all officers recruited from Europe in theGovernment Services of the Straits Settlements andFederated Malay States : unmarried officers, 10 percent. of salary; married officers, 20 per cent. ofsalary. ’Private practice by Government medicalofficers is not allowed. They may, however, do, andreceive fees for, consultative work, if approved by theGovernment. Information about general conditionsin Malaya is obtainable from the Malay StatesInformation Agency, 88, Cannon-street, E.C. 4.

Seychelles.-The chief medical officer receivesRs. 7000 and fees. There are four assistant Govern-ment medical officers, two receiving Rs. 6500, theothers Rs. 3000. The Resident Surgeon at the newhospital at Victoria is provided with free quarters inthe hospital.Hong-Kong.-The present establishment of the

medical department is : principal civil medicalofficer, £1000- £50- £1200 ; five medical officers, £600-£25- £1000 ; three medical officers of health andthree port health officers, £600- £25- £1000 ; bacterio-logist, £700- £25- £1000 ; two health officers, .8600.£25- £1000, are also attached to the SanitaryDepartment. A temporary allowance on a scalevarying with the sterling exchange value of the dollar

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is at present payable. Salaries are converted locallyat the rate of 2s. =$1. Free quarters are not provided,but in certain instances a rent allowance is paid bythe Government.

AMERICA.

British Guiana.—There are the following posts inthe medical service of the Colony: one surgeon-general, £1000- £1200 per annum, with consultingpractice ; one medical officer of health, £900 ; one

bacteriologist, £450-£700 (increment £25), with £50allowance in lieu of fees; 34 medical officers at£500- £25- £700. Some of the senior posts also carryduty allowances (varying from £50 to £300 per annum) and quarters. All the junior appointments in which Iprivate practice is not allowed carry duty allowances.Private practice is allowed in certain cases.

Trinidad and Tobago.-In Trinidad and Tobagothere are over 40 appointments. On appointmentGovernment medical officers, who are provided withfree unfurnished quarters, receive salary at the rateof £400 per annum with annual increments of £25accruing from the date of first appointment as super-numerary medical officers, until reaching the maximumof £600. An officer appointed to a district receives,in addition to his salary, a travelling allowancevarying from £100 per annum in a normal district to£150 per annum, and is allowed private practice,the value of which is estimated at from £50 to £800per annum. Officers employed in institution workreceive allowances in lieu of private practice varyingfrom £50 (and furnished quarters) to £300. Medicalofficers having completed 10 years’ resident service arepensionable at the age of 55.Windward Islands (Grenada, St. Lucia, St. Vincent).

There are over 25 appointments. The chiefmedical and health officer, Grenada, receives £600-700. The chief medical officer, St. Lucia, receives600-700 plus forage and subsistence allowances;the post is pensionable, but private practice is notallowed except as a consultant. Most of the remain-ing appointments are district appointments withthe right to private practice attached ; the salariespaid by Government vary from £400- £500, and withallowances in certain cases. The Governor hasthe power to transfer a medical officer from oneisland to another. Appointments are pensionable.

Leeward Islands (Antigua, St. Christopher andNevis, Dominica, Montserrat, Virgin Islands).-Thereare 20 appointments with salaries varying from£375 to £400 of the same nature as in the WindwardIslands and pensionable. An* officer when firstsent out is not appointed to a particular islandbut to the service of the Leeward Islands, with asalary varying from £312 to £400, according to station,and the Governor decides as to the district which is tobe allotted to him. He is liable to be transferred atthe Governor’s discretion to any medical district inthe Leeward Islands, and in certain districts may berequired to perform magisterial duties. The medicalofficers receive fees for successful vaccinations, post-mortem examinations, evidence at courts of justice,certificates of lunacy, and, in the larger islands, forburial certificates. They are also, as a rule, allowedprivate practice. The chief medical officer, St. Kitts,receives £700- £25- £750 without private practice.

Antigua. - Medical Superintendent, HolburtonHospital, and Chief Medical Officer is in receipt ofa salary of £600, plus £50 as Chief Medical Officer andtravelling allowance of £25. Fees average £100.

British Honduras.-There are seven medical appoint-ments (besides the post of principal medical officer)at a salary of $2430 per annum with incrementsof$120 to$3150. Unless they already possessa diploma of public health, medical officers are

liable to be required, before they join the colony,to undergo a course of instruction at a laboratory ofpublic health or analogous institution. The salaryof the Principal Medical Officer is$4008, with oneincrement of$120 to$4128. The value of the dollaris approximately the same as that of the United States.

OTHER OVERSEAS APPOINTMENTS.

Fiji.-The Chief Medical Officer receives £1000- £50-£1100 ; the Medical Superintendent, Colonial WarMemorial Hospital, £800- £25- £1000 ; the MedicalSuperintendent, Makogai Leper Asylum, £2700-£50-£950 ; the Medical Officer of Health, Suva, £750- £25-£900. There are 12 District Medical Officers whoreceive £500- £25- £725. All the above, except theMedical Officer of Health, are entitled to free partlyfurnished quarters or an allowance in lieu thereof.District Medical Officers are allowed private practiceon the understanding that their official duties are notneglected. The Chief Medical Officer, the MedicalSuperintendent, Colonial War Memorial Hospital,and the Medical Officer of Health are allowed con-sulting practice only. In five districts the MedicalOfficer is also District Commissioner and receives anadditional allowance of from £175 where there issome private practice to £275 where there is none.In the other districts the value of private practice isestimated at from £200 to 8600 a year.

Western Pacific High Commission.-The staff in theBritish Solomon Islands Protectorate consists of aSenior Medical Officer (£650- £750), one DistrictMedical Officer (£550-£650), and one Travelling MedicalOfficer (£550-£650). Partly-furnished quarters are

provided and a local allowance of £50 per annum ispaid in respect of resident service in the Protectorate.

In the Gilbert and Ellice Islands Colony there is aSenior Medical Officer (£650- £750) and one MedicalOfficer (£500-£25-£600). Partly furnished quartersare provided. There is hardly any private practicein the British Solomon Islands Protectorate or theGilbert and Ellice Islands Colony.

Cyprus.-There is a chief medical officer paid at therate of £750, rising by annual increments of £25 to

£900, and three district medical officers paid at therate of £500 a year, rising by annual increments of £20to £600 a year, all enjoying private practice (exceptthe chief medical officer, who is allowed consultingpractice only) and receiving 2s. per diem forageallowance. There is also a medical officer of healthon £600, rising by £20 increments to £720 withoutprivate practice; these are the only medical appoint-ments open to English candidates.

Gibraltar.-There is a surgeon of the ColonialHospital receiving £750, and private practice. Thereare also two assistant surgeons with a salary of £720per annum, who are allowed private consultingpractice only. Free quarters, unfurnished, are

provided for all three officers.St. Helena.-The colonial surgeon at present

receives £550 per annum, fees estimated at about £27a year, and £30 horse allowance. The assistant colonialsurgeon at present receives £500 a year and £30 horseallowance. Private practice is allowed, and suchpractice, together with the duties of non-Governmentappointments, is divided between the colonial surgeonand the assistant colonial surgeon in a proportionapproved by the Governor. The value of privatepractice and appointments is estimated at about£536 a year.

Falkland Islands.-There are two appointments.The colonial surgeon is paid at the rate of £600 perannum, with free furnished quarters. The assistantcolonial surgeon is paid at the rate of £500 per annum,with an allowance of 850 per annum in lieu of quarters.Private practice is shared between the colonial surgeonand the assistant colonial surgeon. The office ofcolonial surgeon is pensionable.

Palestine.2—The grades and salaries of superiorappointments in the Department of Health are :

Director, 8E.1200, plus 8E.200 expatriation allowance.Deputy Director, £E.900-50-1100, plus £E.150expatriation allowance. Assistant Director (Labora-tories), Specialist Surgeon,3 and five Senior Medical

2 £1 Egyptian (of 100 piastres) is equivalent to £1 0s. 6d.sterling, but a new currency is being introduced.

3 A certain amount of private practice is allowed.

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’Officers, £E.750-25-950, plus £E.100 expatriationallowance. One Assistant Senior Medical Officer andGovernment Analyst £E.550-25-750, plus £E.100expatriation allowance. The remainder of the staffis recruited locally.

LEAVE AND PENSIONS.

Leave and Passages.-Leave of absence in EastAfrica on full salary is granted in the normal caseafter a tour of residential service (of not less than20 and not usually more than 30 months) to an amountof six days for each completed month of residence(or three days when for any reason the officer isnot returning to East Africa) exclusive of the periodsof the voyages to and fro, for which full pay is alsogiven. Officers serving in certain stations in Kenya-and Nyasaland are allowed five (or two and a half)- days’ leave and in Northern Rhodesia four (or two)- days’ leave in respect of each month of serviceinstead of six (or three) days’ leave respectively. InSomaliland special leave regulations exist whichprovide for an officer taking leave after a shortertour of service than in other parts of East Africa.Free first-class passages are provided for the officeron first appointment and on leave, and in certaincases assistance towards family passages is given.

In the Malay Peninsula two months’ leave of absencewith full salary may be granted in respect of eachyear’s service, and this leave may be accumulated upto a maximum of eight months. Additional leave onhalf-pay may be granted on special grounds. Up tothe end of 1928 free passages are granted on firstappointment and on leave, and free passages on firstappointment or transfer are granted permanently forofficers with salary under £800.

In other Colonies outside Tropical Africa, subjectto the necessities of the service, leave of absence onhalf salary may be granted after a period of threeyears’ resident service without any special grounds.It may be given before the expiration of that period incase of serious indisposition, or of urgent privateaffairs. In the absence of special grounds, the leavemust not exceed one-sixth of the officer’s residentservice ; on special grounds it may exceed that periodby six months. In addition to the above, vacationleave on full pay may be granted, if no inconvenienceor expense is caused thereby, not exceeding threemonths4 in any two years. In British Guiana assistedpassages are granted to officers proceeding on leave.British Guiana, Jamaica, and Trinidad officers are.allowed to accumulate full-pay leave at the rate ofsix weeks for each year’s service up to six months,exclusive of the period of the voyages to and fro,and no leave of absence may (except in veryspecial circumstances) exceed six months in allunless the officer has served for five years or morewithout leave, in which case two months on half-paymay be taken in addition to six months’ full-payleave.On first appointment an officer will, except in

the case of a few Colonies possessing RepresentativeAssemblies, be provided by the Crown Agents for the.Colonies with free passages to the Colony for himselfand his wife and children, if any, not exceeding fourpersons besides himself. The officer so appointedwill be required to execute an agreement binding him10 repay the cost of the passage or passages so obtainedin the event of his leaving the Government servicewithin three years. An officer taking leave out ofthe Colony has in most cases to provide his ownpassages.

Pensions.-East Africa.-Officers on the pension-able establishment retire on attaining the age of50 years ; but they may be retained in the service,with their own consent, for such further period as theGovernment may recommend. Earlier retirement inthe event of ill-health is also provided for. Pensionis computed at one-four hundred and eightieth ofpensionable emoluments-i.e., salary and value of free

4 Or, in the case of Fiji and the Western Pacific and theFalkland Islands 4 1/2 months in any three years.

quarters 5 in respect of each month’s pensionableservice-at the time of retirement, subject to anaverage of emoluments for the last three years beforeretirement instead of the actual emoluments at thetime of retirement being taken as the basis forcalculation in certain circumstances.

Other Colonies.-In most of the other Colonies anofficer holding a pensionable appointment may beallowed in the case of ill-health to retire on a pensionafter ten full years’ resident service ; otherwise hemust have attained the age of 55. For ten full years’resident service fifteen-sixtieths of the average annualsalary of the retiring officer’s fixed appointments forthree years prior to retirement may be awarded, towhich one-sixtieth may be added for each additionalyear’s service ; but no addition will be made in respectof any service beyond 35 years. For pension purposesabsence on vacation leave counts as full service, andleave on half-pay as half service. In a few cases theretiring age is 60 and the pension after ten years’service is ten-sixtieths instead of fifteen. In theStraits Settlements and Malay States, an officer may,with the consent of Government, retire at age 50.Pensions are calculated on a basis of length of servicein months instead of years.

WEST AFRICAN MEDICAL STAFF.Applicants for appointment as medical officers

or medical officers of health in the West AfricanMedical Staff (the higher grades will usually befilled by promotion from the lower) must beBritish subjects of European parentage and between23 and 35 years of age ; preference is given to candi-dates who are over 25 years of age. Applicants mustpossess a complete double qualification, and must beon the Medical Register. Passages for wives andchildren are not provided by the Government, andhouses for the wives of junior medical officers arerarely available. Officers are not usually allowed totake their wives and young children out with themuntil they have acquired experience of the localconditions and have obtained the sanction of theGovernor. When an officer has obtained permissionto be accompanied by his wife a grant of one-half thecost of his wife’s passage to and from West Africa ismade subject to certain conditions.

Candidates whom it is proposed to select forappointment will have to be medically examined byone of the medical advisers of the Colonial Office (or,in the case of those residing in a Colony, by a medicalofficer appointed by the Colonial Government), andno appointment will be made unless the candidate is

declared to be physically fit for service in West Africa.Candidates are allowed to express a preference forany particular Colony or Protectorate, and theirwishes in this respect will be borne in mind and metas far as possible, but they are liable to be posted inthe first instance, or transferred afterwards if necessaryto any other West African Colony or Protectorate atthe discretion of the Secretary of State. Candidates

, who wish to be posted to Nigeria will probably find ituseful to be able to ride. Transfers from one

Colony or Protectorate to another will be made as.

seldom as possible. Candidates should on no accountapply for, or accept, a West African appointmentin the expectation of ultimately being transferred.Those transferred to pensionable Crown appoint-

ments elsewhere than in West Africa do not forfeit, their claim to pension in respect of their West African

service on final retirement, provided that they havebeen members of the staff for at least 12 months.

- Every officer selected for appointment is required toE have himself revaccinated before proceeding to West, Africa, unless one of the medical advisers of the Colonial Office certifies that this is unnecessary.

Instruction in Tropical Medicine.-Every candidateselected for appointment will. unless the Secretary of

5 The value of free quarters for pension purposes is taken as15 per cent. of the minimum salary of the grade in which anofficer is serving at the time of retirement, subject to a

maximum of £150.

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State decides otherwise, be required to undergo a course of instruction either at the London School ofHygiene and Tropical Medicine, Endsleigh-gardens,N.W. 1, or at the Liverpool School of TropicalMedicine, University, Liverpool, or at EdinburghUniversity. The cost of tuition will be borneby the Government, but candidates must make theirown arrangements for board and lodging ; an

allowance of £25 a month will be paid to themmonthly in arrear while they are under instruction,and may be continued up to the date of embarkation.Each candidate is required to sign an agreementunder which he is bound to refund all sums issued asallowances and the cost of tuition (1) if he declines toaccept an appointment in any of the Colonies or Protec-torates for which he may be selected ; (2) if he fails toobtain a certificate in regard to progress and efficiency;or (3) if he relinquishes the Service for any otherreason than mental or physical infirmity, or is removedfor misconduct, within three years of his arrival inWest Africa.

If at the end of the session there exists no vacancy in the Staff to which a candidate can be appointed, Ihe will be placed in a Reserve and granted an allow- Iance at the rate of £200 a year until the occurrence of.a vacancy.

Leave of Absence.-European officers in WestAfrica may be granted vacation leave on full salarynot exceeding in all one week’s leave in the UnitedKingdom for every completed calendar month oftotal residential service in West Africa, plus the timenecessarily taken on the journey to the UnitedKmgdom, and, if the officer is returning to WestAfrica for further service, the time necessarily takenon the journey from the United Kingdom to theColony. Vacation leave may be granted without anyspecial grounds after 18 consecutive calendar months ofresidential service in West Africa. An officer willnot be required to serve a tour of more than 24consecutive calendar months’ residential serviceexcept in special circumstances ; and the Governormay grant vacation leave to any officer at any timeafter he .has completed 12 consecutive calendarmonths’ residential service. Vacation leave on fullsalary may also be granted to an officer if he is invalidedfrom West Africa after less than 12 consecutivecalendar months’ residential service, and sick leaveon full salary may be granted for any period notexceeding six calendar months.

Appointments and Salaries.-Medical officers forthe West African Colonies and Protectorates-namely, the Gambia, Sierra Leone, the Gold Coast(including Ashanti and the Northern Territories), andNigeria (Southern and Northern Provinces)-areselected by the Secretary of State for the Colonies,and are on one list for employment and promotion.The grades and emoluments of the Staff are at presentas follows :—

The Director of the Medical and Sanitary Service, Nigeria,receives a salary of £1800 a year, with a duty allowance atthe rate of £360 a year. The Director of Medical andSanitary Service in the Gold Coast receives a salary of£1600 a year, with a duty allowance at the rate of £320 ayear. The Director of Medical and Sanitary Service inSierra Leone receives a salary of £1400 a year, with a dutyallowance at the rate of £280 a year. The DeputyDirector of Medical and Sanitary Service, Nigeria, and theDeputy Director of Sanitary Service, Nigeria, receive salariesof £1500 a year, with duty allowances at the rate of £300 ayear. The Deputy Director of Medical and Sanitary Service,Gold Coast, and the Assistant Director of Medical andSanitary Services, Nigeria, receive salaries of £1400 a year,with duty allowances at the rate of £280 a year. AssistantDirectors Medical Service : There are seven appointmentson this grade, five in Nigeria, two in the Gold Coast. Thesalary is at the rate of £1300 a year, with duty allowance atthe rate of £260 a year. The Assistant Director of SanitaryService, Nigeria, the Deputy Director of Sanitary Service inthe Gold Coast and the Deputy Director of Sanitary Servicein Sierra Leone receive salary at the rate of £1300 a year,with duty allowance at the rate of £260 a year. Specialists :The number of these appointments is not fixed, officers ofoutstanding professional merit being eligible for appointment.

The salary is at the rate of £1300 a year, with dutyallowance at the rate of £260 a year. After fiveyears’ approved service as such, the specialist officeris eligible to receive a salary at the rate of £1400 a year,with duty allowance at the rate of £28) a year. Thereare at present five officers appointed specialists in Nigeria,three in the Gold Coast, and one in Sierra Leone. SeniorMedical Officer : There are twenty appointments of thisgrade, with salary at the rate of £1000 a year, rising byannual increments of £50 to £1150 a year, and seniorityallowance at the rate of £100 a year. The Senior MedicalOfficer, Gambia, is allowed " staff pay " of £150 a year, inaddition to duty allowance, but he is debarred from privatepractice. Senior Sanitary Officer : There are nine appoint-ments of this grade, with salary at the rate of £1050 a year,rising by annual increments of £50 to £1200 a year, and aduty allowance at the rate of £210 a year. Possession of theDiploma in Public Health is usually required for appoint-ment to this grade. Special facilities are granted to study forthe diploma during leave. Medical Officers of Health :There are at present 21 appointments of this grade. Thesalary scale is the same as that of Medical Officers, exceptthat Medical Officers of Health are granted an initialsalary at the rate of 2800 a year, together with seniorityallowance at the rate of £72 a year and staff pay at therate of £150 a year, half of which is payable during leave.After three years’ service on the maximum of the scale,viz., £960 a year, and on undergoing an approved course ofstudy, Medical Officers of Health are eligible, if unpromoted,subject to the recommendation of the Governor, to be placedon the scale £1000 a year rising by annual increments of£50 to £1150 a year, together with seniority allowance atthe rate of £100 a year and staff pay a,s before. The holdersof these appointments are not allowed private practice.Candidates selected for service as Medical Officers of Healthmust obtain the Diploma in Tropical Medicine and Hygieneof Cambridge, London, or Liverpool as a condition of

appointment, and are appointed subject to the condition that,if after a period of service in West Africa they are consideredunsuitable to serve in that capacity, they may be called uponto transfer to the medical side. In such cases the officersare given the rate of salary which they would have reachedif they had been appointed to be Medical Officers instead ofMedical Officers of Health in the first instance. MedicalOfficer : The salary attached to this grade is at the rate of ;{;660a year, rising by annual increments of £30 to £720 a year.Then, if confirmed in the appointment, 9720 a year, rising byannual increments of £40 to £960, with seniority allowance atthe rate of 272 a year. Before.passing £800, medical officersare required to take a special course of study for three months.If they obtain satisfactory certificates at the end of thecourse they draw their further increments up to £960 a year.

A medical officer who has served for three years onthe maximum salary of this scale (£960) withoutobtaining promotion is eligible, if recommended bythe Governor, to be placed on the scale £1000- £50-£1150, with £100 seniority allowance (as for SeniorMedical Officers).

Special Appointments.-The Director of the MedicalResearch Institute, Lagos, and the Director ofResearch, Accra, receive a salary of £1300 a year, witha duty allowance of £260 a year, rising after five years’approved service to a salary at the rate of £1400a year and duty allowance at the rate of £280 a year.There are a number of appointments for pathologistsand bacteriologists in Nigeria and the Gold Coast.The salary and other conditions attached to these postsare similar to those of Medical Officers of Health. Dutyallowances, seniority allowance, and staff pay are notpensionable emoluments.

Increments.—Increments to salaries are payableonly when the service of an officer during the periodof employment qualifying for increment is approved.

Payment of Salaries.-Information as to the pay-ment of officers’ salaries or of monthly remittances topersons in England may be obtained from the CrownAgents for the Colonies, 4. Millbank, S.W. 1. Allallowances are paid locally.

All officers of the staff, except directors, deputydirectors, assistant directors, senior sanitary officers,and a few other officers holding special appointments,are at present allowed to take private practice,provided that it does not interfere with the faithfuland efficient performance of their official duties, butit is within the power of the Governor to withdraw

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or suspend the privilege in such places and forsuch periods as he may consider desirable. Privatepractice does not exist at the majority of stations,and no guarantee can be given that an officer will beposted to a station in which he will be able to practiseprivately. As a general rule, and subject to theexigencies of the service, stations where there is privatepractice are allocated to senior members of the Staff.

Pensions and Gratuities.—Pensions and gratuities onretirement are granted in accordance with the law andregulations of each individual Colony.

Fuller information can be obtained from the PrivateSecretary, Colonial Office, 38, Old Queen-street,London, S.W.l.

SUDAN MEDICAL SERVICE.

This service is responsible for carrying out civilmedical and public health duties in the Sudan. Thestaff consists of :-(a) A Director-pay 1500-1800.(b) A Senior Physician and a Senior Surgeon tothe Khartoum and Omdurman Civil Hospitals-pay £1200- £1750. (c) An Assistant Director andMedical Officer of Health, Khartoum Province-pay £1200. (This post is temporary and the termsand duties are subject to alteration.) (d) Twenty-eight " Senior Medical Inspectors " and " MedicalInspectors " who are all British. The pay of theInspectors commences at £720, and rises, subjectto the recommendation of the Director, by fivebiennial increases to £1080, and thence, after 13years’ service, to £1200. The Senior Medical Inspectorsare eligible by selection to the four senior posts. AllMedical Inspectors are appointed on probation for twoyears. If at the expiration of this time they are takenon the permanent service of the Government, theincrease of pay is subject to passing such examinationin Arabic as may be required by the regulations. (e)A number of medical officers trained at one of theSyrian medical schools. (f) A number of assistantmedical officers, natives of the Sudan, who havebeen given a purely clinical training in one of thelarger Sudan hospitals.Among the attractions of the service are : Annua1

leave of 90 days for every year’s service, whichin ordinary circumstances is granted each year,study-leave for some definite purpose, and two yearsgranted towards pension to those who have obtainedspecial qualifications and experience. The pensionfor a medical inspector retiring after 20 years’ serviceis, as a rule, not less than £500 a year. Privatepractice is limited to a few of the larger towns, butmay be carried on so long as it does not in any wayinterfere with official duties. These duties includeacting as consultant to the principal hospitals, andsupervising smaller hospitals or dispensaries; initiatingand supervising the medical and sanitary work of aprovince; the medical supervision of schools; theexamination of candidates for Government serviceand pension; and the training of assistant medicalofficers and native sanitary overseers. In theKhartoum medical school there are opportunities forteaching ; the Registrar receives £250 a year, andthe other teachers receive remuneration in addition ’’

to their pay. The country is developing rapidlyand the Medical Department is being enlarged tomeet the increased requirements of the service.Four additional medical inspectors have recently

been appointed, bringing the total number up to28, and there will be further vacancies next year,

. which will be advertised in THE LANCET as theyarise. Candidates must be single, under 30 yearsof age, and they must have held a resident post,preferably house surgeon, in a large general hospital.They may be required to take out a course of TropicalMedicine in this country before leaving ; the fees,in addition to an allowance of £4 15s. per week duringthis period, will be paid by the Sudan Government.

Applications for further information should be madeto Dr. T. Dyke Acland, 19, Bryanston-square, W.,or to the Deans of the principal medical schools.

WOMEN’S MEDICAL SERVICE FOR INDIA.

AMONG careers open to medical women abroad theWomen’s Medical Service for India deserves honour-able mention. This service is open to fullyqualified medical women of British or Indiannationality, and with the present amount of Govern-ment subsidy the number of medical officers islimited to 44. Medical women proceeding to Indiato join the Women’s Medical Service receive a

sufficient sum for a first-class passage to India. Onlanding they are posted to one of the larger women’shospitals to gain Indian experience and to learn thelanguage. During this period (from six months to twoyears) private practice is not allowed. For a furtherperiod they are appointed to act temporarily for

medical women on furlough, during which timeprivate practice is allowed. They are then definitelyappointed to the charge of hospitals. Private prac-tice is always allowed after the first two years, pro-vided it does not interfere with official duties. Theonly exception is in administrative or educationalposts, when an allowance in lieu of practice is given.The amount obtained from practice varies accordingto the station, but in most cases it forms a fair additionto the salary, varying from £150 to £1000 a year.

Excellent opportunities for surgery-especiallygynaecological-are found in the Women’s MedicalService. To those who are not keen surgeons oppor-tunities are likely to open in the future in connexionwith maternity and child welfare ; medical womenwith administrative ability are also needed for theinspection of women’s hospitals and other medicalinstitutions.

Rates of pay are as follows :—

Years Overseas Salary Englishallowance per equivalent*of service.

per mensem. mensem. per annum.1 to 3 .... Rs.100 .... Rs.450 .... £4404 to 6 ........ Rs.500 .... 4807 to 9 ........ Rs.550 .... P52010 to 12 ........ Rs.600 .... £56013 to 15 .... Rs.150 .... Rs.650 .... £60016 to 18 ........ Rs.700 .... £64019 to 21 ........ Rs.750 .... £68022 to 24 ........ Rs.800 .... £720over 24 ........ Rs.850 .... 760

* At rupee value Is. 4d.

Furnished quarters are provided, representing anadditional Rs.150 per mensem.The cost of living in India is much higher than

formerly, but it should be possible for a medicalwoman (with house provided) to meet actual householdexpenses for about Rs.200 per mensem, leaving theremainder of her salary for dress and personal expenses.To this must be added the necessary saving to meetadditional expense for furlough and leave spent inthe hills.One month’s privilege leave on full pay is granted

each year. Furlough-on half-pay at the rate of twomonths for every year of service is granted after everythree years. Study-leave on two-thirds pay is grantedto the extent of 12 months in the total service. Thereis a provident fund to which members of the servicecontribute 10 per cent. of their pay. The servicecontributes another 10 per cent., which accumulates atinterest and is repaid on retirement.

Admission to the service is made by selection. Can-didates in the United Kingdom should apply to theHon. Secretary, United Kingdom Branch of theCountess of Dufferin’s Fund, care of Major-GeneralJ. B. Smith, India Office, Whitehall, London.

DONATIONS AND BEQUESTS.-The late Mr/F. Lloyd,of London and Sittingbourne, left, among other bequests,21000 each to the Croydon General Hospital, the CroydonSocial Service League (upon trust to provide holidays for,or otherwise for the benefit of, crippled children of Croydon),Lord Mayor Treloar’s Cripples’ Hospital and College, Alton,and Mrs. J. A. Spender, of Chantrey-place, Marden, Kent (forsuch public or charitable purposes as she, in her absoluteand uncontrolled discretion, may think fit).