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serious accidents and were killed. Inquiry into whether theythought it right that they should continue to drive often tappedthis reservoir of bitterness in intelligent patients. Clearly mostfelt that this restriction was too unfair to be tolerated, and thatthey were justified in going on driving, risk or no risk. Time andagain a man would ask, resentfully, what he could do if hestopped driving: he would lose his job, and his family wouldsuffer. He was not prepared to stop unless an attack when hewas actually driving showed that the danger was real. Againand again the point was made that it was unfair to expect a manto ruin his life because he might have an attack when driving.

Discussion

Though small, this sample is probably fairly representa-tive of the well-controlled and moderately controlled

epileptic population. The striking thing is that nearly halfdrove or had valid licences. If some approximate adjust-ment is made for the inadequate, the unemployable, andthe younger patients still being looked after at home verymuch as children, probably two-thirds of the men capableof driving did so. If they are to be believed, none of themhad had any important accident when driving: this wouldbe a remarkable enough finding in any comparable groupof " normal " drivers.

The point of practical importance is that these men donot intend to stop driving. Because it is important thatthey should, ought steps be taken to see that they do ? Itseems only common sense that a man liable to episodes ofaltered consciousness should be forbidden to drive, yet wemust bear in mind that such a prohibition may fall unfairlyon the epileptic because of the very notoriety of hiscomplaint. The man whose coronary circulation is pre-carious must be at least as dangerous a driver, but he is asyet under no obligation to give up his licence even after afrank infarction.

There is no reliable information to guide us on theincidence of epileptic attacks as a cause of traffic accidents,and this is unlikely to be forthcoming. While the healthydriver is only too ready to attribute his failure to a momen-tary

" blackout ", the epileptic driver on the contrary willkeep quiet about a lapse of consciousness which mightbring to notice his illegally obtained licence, with all theconsequent difficulties about insurance.

At present all the doctor can do is to advise his patientto give up driving, and perhaps try to influence the decisionthrough other members of the family. He can do no more.The patient holds his licence perfectly legally until thetime comes for its renewal, when he must declare hisdisability. With the new three-year licences, this may befor quite a long time. The local authority has power torevoke a driving licence when satisfied that by reason ofdisease or physical disability the holder is a danger asa driver, but in practice there would have to be anaccident demonstrating the disability before this couldhappen.The position seems to be that a high proportion of

epileptics will continue to drive, and they will do sodespite advice to the contrary from their doctors. The

only practicable way of stopping them would be theabhorrent one of requiring notification of epilepsy to thelicencing authority, as in some areas in the United States.On the other hand, as far as this small study goes, there isno indication that these patients are any more liable toaccidents than other people. The observations give nogreat cause for worry.

I am grateful to the medical committee of the Maida Vale Hospitalfor Nervous Diseases for permission to publish these findings.

GENERAL MEDICAL COUNCILSESSION MAY 30 AND 31

Sir DAVID CAMPBELL’S presidential address to theCouncil was summarised in last week’s issue (p. 1222).REGISTRATION OF POSTGRADUATE QUALIFICATIONSThe Council accepted a report by a special committee

which expressed the hope that Parliament would agree tocorrect the anomaly by which persons obtaining certainpostgraduate qualifications in the British Isles occupy aninferior position, so far as the registration of such qualifi-cations is concerned, to persons who have obtained analo-gous diplomas in Commonwealth and foreign countries.

In its report the special committee remarked that part IIIof the Medical Act of 1956 empowered the Council to registerat its discretion higher or additional qualifications granted inCommonwealth or foreign countries with which reciprocityexists. By contrast the Council is not empowered by part IIof the Act to register any higher or additional qualificationgranted in England, Wales, Scotland, or Ireland unless it is

directly specified in the third schedule to the Act. Thisschedule reproduces with relatively minor amendmentsschedule A to the Medical Act of 1858. Thus, while the RoyalCollege of Obstetricians and Gynxcologists is entitled to

choose a member of the Council, the Council is not empoweredto register any of the college’s qualifications, because the thirdschedule mentions neither the college nor its qualifications.

PHARMACOPOEIA COMMITTEE

Lord COHEN OF BIRKENHEAD said that the British

Pharmacopaeia Commission had discussed the adoption ofan abbreviation of " microgramme ". Sometimes -.g.and y was used, but neither was suitable. There was a

danger in typography " and certainly in doctors’ writing "of confusion with other abbreviations. The Commissionrecommended the adoption of

"

mcg. " because this was

less likely to be mistaken for other abbreviations; it wasalready used in some countries and had been adopted bythe United States Pharmacopczia. It was proposed to use"

mcg." in the next edition of the British Pharmacopaia,and the Commission stated in its report that it wouldwelcome the general adoption of this abbreviation inmedicine and pharmacy.

MEDICAL CURRICULUM

The PRESIDENT submitted the report of the specialcommittee on the medical curriculum, appointed to

consider reports received from licensing bodies andmedical schools.The Council’s 1957 Recommendations as to the Medical

Curriculum were devised with the main aim of reducing thecongestion in the curriculum. Much of the detail which hadhitherto appeared in the Recommendations was removed, andlicensing bodies and medical schools were recommended toexperiment freely with different courses and examinations andwith various methods of teaching.The committee says that statements on policy by licensing

bodies and medical schools " bear witness to a wide variety ofexperiments already in progress or in contemplation ". Thecommittee was glad to note in particular the finding of theUniversity of London that " the degree of flexibility in medicaleducation encouraged by the new Recommendations is a

particularly welcome feature in this federal University as itoffers the opportunity to include in Degree Regulations a

number of new provisions that will enable Medical Schools toexercise certain options with their teaching arrangements ".Many schools have welcomed the new latitude with regard tothe arrangement of courses and are planning integration ofcourses and teaching, although some regret has been expressedthat it has not been found possible to proceed more rapidlywith the development of " internal

" examinations.

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Basic SciencesThere is concern at the lack of adequate training in certain

aspects of the basic sciences of some students who enter thepreclinical course direct from school. Various plans suggestedor adopted to remedy this deficiency include: (1) a voluntarycourse in medical physics, with emphasis on radiation, specialoptics, electronics, and other matters of special interest inmedicine; (2) a special course in organic chemistry in thepreclinical period, in order to bridge the gap between chemistryat G.C.E. advanced level and biochemistry; and (3) instructionin biology, to continue throughout the clinical course (examplesof subjects to be taught in the clinical period are humangenetics, immunology, and radiobiology).Anatomy, Physiology, Biochemistry, and Related SubjectsOne university has decided to include the whole of the

course in anatomy in the first preclinical year, during whichhistology, human biology, and organic chemistry will also bestudied. The examination in these subjects will be held at theend of the first year. Physiology and biochemistry will betaken in the next year, together with psychology, pharmaco-logy, and elementary pathology.A suggestion has been made that the written and practical

portions of the second M.B. examination should be abolishedand replaced by a faculty assessment of the candidate’s recordof class work, supplemented by an oral examination.

It is evident that there is a welcome increase in the inter-

change of teachers in the clinical and preclinical subjects, andin the institution of combined lectures and demonstrations.

Clinical StudiesResident clerkships.-Many schools wish to increase the

period spent in residence in hospital in the various clinical

departments. For example, one university intends to arrangefor its students to spend at least two months as whole-timeclerks in clinical pathology; and three schools propose tointroduce a period of (say) one month to be spent in residencein a mental hospital or as a whole-time appointment in thestudy of psychiatry.

Free time.-With the reorganisation undertaken under therevised Recommendations, it has been found possible to allowstudents in the clinical period to have some free time beforethe final examination.

Elective courses, appointments, or periods of study.-A numberof universities and schools have decided to give to each student,at some stage in the clinical period, an opportunity to pursueintensively one or more special subjects, either by supervisedresearch, by attending special lectures, by holding an appoint-ment, or by other methods of study.Tutorial SystemSome universities and medical schools have introduced a

system by which students are attached to members of the staffacting as tutors to advise on academic and personal problems.New Curriculum Suggested by One UniversityThe committee finds of some interest a proposed new

curriculum based on the 1957 Recommendations, though,says the committee, the number of examinations may militateagainst the integration of studies. In this curriculum it is

proposed that the preclinical period proper shall be reducedto three terms. There will follow a year in hospital withsystematic and clinical medicine and surgery, pathology, andbacteriology, and then a year of " integrated studies ". Duringthis year the various systems of the body will be studied inturn. The outline of the proposed curriculum is as follows:

First year, " premedical ".-In the first two terms physics,chemistry, and biology, with an examination in physics and biologyin March; in the third term chemistry and anatomy, with anexamination in chemistry in June.

Second year, " preclinical ".-Anatomy, physiology, and bio-

chemistry, with an examination in these subjects in June.Third year,

" paraclinical and clinical ".-Physiology, pathology,bacteriology, systematic medicine and surgery, clinics, with anexamination in June in pathology and bacteriology with physiology.

Fourth Year, " integrated studies " (preclinical, paraclinical, andclinical).-These studies, undertaken partly in the preclinicaldepartments and partly in hospitals, will include applied anatomy

and physiology and clinical biochemistry, together with materiamedica. There will be an examination in June in all these subjects.

In the fifth year " specialty classes " will be held during the firsttwo terms in public health, medical jurisprudence, psychologicalmedicine, and the special clinical subjects. There will be an examina-tion in March in public health and medical jurisprudence." Intensive studies ", including periods of residence in medicine,surgery, and obstetrics, will commence in the third term.

In the sixth year " intensive studies " will continue during thefirst two terms, but the third term will be left for revision before thefinal examination in June.

Medical Disciplinary CommitteeThe committee met on May 31 and June 1, under the

chairmanship of the President.CASES CLOSED

The committee determined that the Registrar should not bedirected to erase the names of Gerald Francis Adye-Curran,M.c., L.R.C.P.I. (1934), registered as of 4, Park Place, Liverpool,Norman Thomas Brown, M.B. St. And. (1923), registered as of331, Bowes Road, New Southgate, London, N.11, and GeorgeHorace Tancred Williams, M.R.C.S. (1938), registered as ofS.S. City of Birmingham, c/o Mail Office, Ellerman Lines Ltd.,18-20, Camomile Street, London, E.C.3. Judgment in thesethree cases had previously been postponed.

CASES POSTPONED

The committee was still not satisfied that the evidence sofar received would warrant it in discharging at the presenttime the case of Richard Maurice Dooley, M.B. Dubl. (1945),registered as of 74, Eglinton Road, Donnybrook, Dublin.Judgment had been postponed for one year in November, 1959,following convictions involving drink, and in November, 1960,judgment was further postponed for six months.

Florence Berchmans Lawlor, M.B. N.U.I. (1936), registered asof 35, Belsize Park Gardens, London, N.W.3, had had judgmentpostponed for one year, until November, 1960, following con-victions of being in charge of a motor-car when under theinfluence of drink and of unlawfully obtaining drugs by falsepretences, and last November judgment was further postponed.Judgment was postponed for a year, until May, 1962.

In the case of Michael Ambrose Owen, M.B. Wales (1951),registered as of 49, Bro-Deg, Cwmbach, Aberdare, Glam., dueto appear for postponed judgment, the committee postponedjudgment for a further period of a year.John Anthony Perpoli, M.C., L.R.C.P.E. (1939), registered as of

11, Bank Street, Hillhead, Glasgow, W.2, due to appear forpostponed judgment following convictions in 1939, 1958, and1959 involving drink, was not present. The committee post-poned judgment until its November session.

INTERIM APPEARANCES

Peter Louis Milbourne Hartley, M.R.C.S. (1941), M.B. Camb.(1946), registered as of 408, Wimbledon Park Road, London,S.W.19, had had judgment postponed for two years, with arequirement for an interim appearance at this session. Thecommittee confirmed its decision to postpone judgment untilMay, 1962.

Gerard Joseph McCann, L.R.C.P.E. (1949), registered as ofLaurel Bank, Woolton Road, Liverpool, 16, made an interimappearance. Judgment had been postponed for two yearsfollowing drink convictions. The committee continued con-sideration until May, 1962.The committee noted the evidence as to the conduct of

Robert Walter Simmons, M.B. N.U.I. (1942), registered as ofHertford County Hospital, Hertford, Herts, against whomjudgment had been postponed for two years, subject to aninterim appearance.

ERASURES

Alan Robert Ellerker, L.M.S.S.A. (1947), registered as of5, Idmiston Road, West Norwood, London, S.E.27, was

charged with having been convicted on Aug. 23, 1949, at theBirmingham City Magistrates’ Court of being in charge of amotor-car when under the influence of drink; of being con-victed at Melbourn (Cambridgeshire) Magistrates’ Court on

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Nov. 30, 1959, of driving a motor-car when under the influenceof drink; and of being convicted on Dec. 20, 1960, at theLeyland Hundred Magistrates’ Court of driving a motor-carwhilst disqualified and of driving when under the influence ofdrink.Mr. G. J. K. Widgery, solicitor to the Council, said that Dr.

Ellerker had been conditionally discharged at Boston Magis-trates’ Court on May 16, 1952, for obtaining E2 by false pre-tences. He had also been conditionally discharged for otheroffences in the same year. His name was erased under Sec-tion 14 of the Medical Act, 1858 (now Section 41 of the MedicalAct, 1956) because he did not answer letters from the Registrar.In October, 1956, whilst his name was off the Register, he wasconvicted at Darlington Magistrates’ Court of obtaining creditby paying a hotel bill with a worthless cheque and obtainingmoney by fraud by worthless cheques; further similar offenceswere taken into consideration and he was sentenced to twelvemonths’ imprisonment. As he was not on the Register he wasnot charged with these convictions. In 1957 he was put on

probation at Newmarket Magistrates’ Court when he pleadedguilty to stealing S3 from a till in a garage, further offences ofobtaining credit being taken into consideration. On Nov. 23,1959, he appeared before the executive committee of theCouncil and appealed for his name to be restored. He had madethree previous applications, but on this occasion he knew of theMelbourn case but did not inform the executive committee.His name was restored on Nov. 23, 1959, but since then therehad been these further convictions.By reason of the convictions proved against Dr. Ellerker, the

Registrar was directed to erase his name from the Register.Dr. Ellerker has twenty-eight days in which to appeal.

Alfred Francon Williams, M.B. Edin. (1940), registered as of18, Crabtree Lane, Sheffield, 5, was charged that on Jan. 12,1961, at the City of Sheffield Magistrates’ Court he was foundguilty of being found drunk in a public place, and that at thesame court on March 13 he was found guilty of being drunkand disorderly in a public place and of causing wilful damage toproperty.Mr. Widgery said that Dr. Williams last appeared at the

November session, because of two convictions for drunkennessin July and September, 1960. He was before the committee inNovember, 1959, in respect of two earlier convictions: the casewas concluded and his name was not erased. Within the pasttwo weeks there had been a further conviction for driving amotor-car while under the influence of drink, when he wassentenced to four months’ imprisorment, but that convictionwas under appeal.Announcing that the committee had directed the Registrar to

erase the name of Alfred Francon Williams, by reason of theconvictions, the President said: " The committee wish me tosay that if you come before them again cured of your addictionto drink, an application for the restoration of your name will besympathetically considered." Dr. Williams has twenty-eightdays in which to appeal.David Howard Hiley, registered as of 13, Warham Road,

South Croydon, Surrey, M.R.C.S. (1942), was charged that heformed an improper association with a married woman, as aresult of which she left her husband, that from March 7, 1960,he had lived with her and frequently committed adultery withher, that he stood in professional relationship with the womanat the material times, and that in relation to the facts alleged hehad been guilty of infamous conduct in a professional respect.Mr. Widgery said the case was unique in that the first informationabout the charge came to the notice of the Council in a letterwritten by the practitioner in which he confessed to adulterywith a woman patient. The committee found the facts provedand that Dr. Hiley had been guilty of infamous conduct in aprofessional respect. After deliberation in camera the Registrarwas directed to erase the name of David Howard Hiley. He hastwenty-eight days in which to appeal.

CASES DISMISSED

When yohn Edwin Harpham Griffiths, M.R.C.S. (1942), regis-tered as of 10, The Esplanade, Douglas, Isle of Man, was

charged with having behaved improperly to and committedadultery with a woman patient, Mr. Widgery said he could notproceed with the case because the witnesses had declined tocome and give evidence. They were resident in the Isle of Man,and the powers of the committee to issue subprenas could notbe exercised because the Judicature Act did not extend to theIsle of Man. The complaint was brought by the husband of thewoman. Mr. Widgery said he had in mind requesting anadjournment of the inquiry to the Isle of Man as there wasprovision for holding inquiries elsewhere than in the Council’shouse, but even then they could not insist on the witnessesattending. In the absence of any evidence to support theallegation the committee found that Dr. Griffiths was not

guilty of infamous conduct in a professional respect in relationto the facts alleged against him in the charge.Loh Mung Sun, L.R.C.P.E. (1917), registered as c/o The

Chartered Bank, Raffles Place, Singapore, 1, was charged withinfamous conduct in a professional respect as a result of aconviction in the High Court of Sarawak, North Borneo, andBrunei at Sandakan, for an unnatural offence against a malepatient, for which he was sentenced to twenty-two months’imprisonment and ordered to pay the costs of the prosecutionwith an alternative of a further three months’ imprisonment.Dr. Sun was not present and was not represented.Mr. Widgery explained that as this was a conviction outside

the British Isles he had to proceed with it as a case of infamousconduct and prove the facts alleged in the conviction. This hewould do by reference to the transcript of the trial (from copiesof which, handed to the members of the committee, partswhich would have been inadmissable in a United Kingdomcourt were excluded).The Legal Assessor said it was laid down in the Spackman

case that, where there was a finding of a court of competentjurisdiction on a question of fact, that finding itself might beregarded by the committee, and indeed must be regarded, assome evidence of the fact found, although it was not, as waspointed out in the Spackman case, conclusive evidence. In onerespect the committee was in a better position than the trialjudge, because some of the evidence in this case was highlytechnical. A very disquieting feature of this case which emergedfrom the judgment of the court of appeal was that at some stagethe trial judge had a document which was prejudicial to Dr.Sun. In Borneo, apparently, they did not try cases of this sortwith a jury. If the case had been tried in England the convic-tion would have been quashed. The court of appeal, upholdingthe conviction and sentence, said the trial judge studiouslyignored the document. It was a very difficult thing to put outof one’s mind once it had entered. The Legal Assessor dealtat length with the need for corroboration and examined theevidence in this respect. He said the only evidence which mightbe corroborative was the medical and technical evidence.

The committee determined that the facts alleged against Dr.Sun in the charge had not been proved to its satisfaction, andit accordingly found that he was not guilty of infamous conductin a professional respect.

CONSIDERATION ADJOURNED

Roy Wilfrid Downie, M.B. Edin. (1950), registered as of

88, Comley Bank Avenue, Edinburgh 4, was charged withhaving been convicted on June 30, 1960, at the WolverhamptonBorough Magistrates’ Court on six charges of unlawfully pro-curing dangerous drugs; and on Dec. 20, 1960, at the RochdaleBorough Magistrates’ Court, of nine charges of unlawfullyprocuring dangerous drugs and two charges of failing to makeentries in his dangerous drugs register.

Dr. Downie was not present. The Chairman announced thatthe committee thought it better that it should adjourn considera-tion of the case until November. It should be impressed on Mr.Downie that he should be present on that occasion.

APPLICATIONS FOR RESTORATION

The committee rejected applications for restoration fromLouis Aimée Newton and Liam O’Shea.