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or unfurnished, fuel and light. Permanent medicalappointments are in all cases established posts withinthe meaning of the Asylums Officers’ SuperannuationAct, 1909.Posts at these hospitals offer medical officers scope

for initiative and promotion. Very few new appoint-ments have been made during the war, and medicalstaffs have been much curtailed. There should be goodopenings in these immediate post-war years.The mental health services of the LCC are responsible

for a large medical service, vacancies in which arenQrmally advertised at short intervals. No new per-manent appointments are being made at present ;indeed the staffs of the various hospitals have beenreduced as a war measure. An applicant enters theservice as assistant medical officer at a salary of £470 ayear, rising by annual increments of j625 to fit570.Salaries are graded through the various ranks to fi1450paid to superintendents of large hospitals ; a super-intendent is also provided with an unfurnished house onthe hospital premises. Assistant medical officers may berequired to live in the institution which they are servingand to pay fixed rates for board, lodging, and washing.Officers contribute to a superannuation fund. They arerequired to take a diploma in psychological medicinewithin three years of entering the service and the diplomacarries with it a payment, in addition to salary, of 250a year. Promotion is reasonably rapid for men. Themental health services are actively concerned in theEMS. Three hospitals are used entirely as emergencyhospitals and at three others there is an emergencyhospital section. Treatment is provided for all types ofacute, medical, and surgical cases, and the hospitals arestaffed and equipped to give specialised treatment. Themedical staff for these hospitals is drawn mainly fromthe emergency medical service. -

MINES MEDICAL SERVICE, THE Mines Medical Service now consists of eightregional mines medical officers, with a chief minesmedical officer and a deputy at headquarters.The white-paper on coal proposed the establishment

of this service " with a view particularly to checkingwastage of labour." Thus much of the work of themedical staff is concerned with applications -for releasefrpm the industry on medical grounds. Before themedical service was founded all such applicants weresent by the Ministry of Labour for independent medicalexamination. The functions of the service have beentwofold: to relieve the workman of such examination,if the medical evidence put forward by him was suffici-ently conclusive ; and in doubtful cases where inde-pendent medical examination is necessary, to secure ahigh standard of examination. These services havebeen of value both to the workmen individually and inhelping to check unwarranted wastage of labour. Butit has always been realised that these activities, essentialas they are at present, are not constructive, except inthat they lead to better medical or surgical treatmentof the patients concerned. From the start the medicalofficers have been enjoined to devote all the timepossible to professional activities at the mines and inconnexion with the hospitals, rehabilitation centres, andother institutions to which the miners go for treatment.Professional work at the mines themselves is increasingin volume. Medical officers have charge of the first-aidand ambulance arrangements both below and aboveground ; they study the working conditions in relationto the miners’ health, and are getting a wide first-handexperience of the coal-mining community at work.Special attention is being given, and will be givenincreasingly, to a practical study of the causes of theso-called industrial diseases, and to measures for pre-venting or alleviating them. The field to be covered iswide, and previous work and experience have alreadyshown that there are no easy roads to speedy improve-ment ; but it is hoped to improve conditions graduallyby concentrating on particular difficulties and problems.Several studies of this kind are already in hand. Theuse of morphine for the first-aid treatment of cases ofpainful injury underground has proved beneficial. Alarge number of cases have been treated with goodresults, the drug easing the patient and lessening the shock.The conditions governing the use of the drug at mines

are strictly enforced. Various industrial hazards, suchas dermatitis, epidermophytosis, Weil’s disease, andoccupational diseases such as the " beats " and pneumo-coniosis, are continuously studied. The medical serviceis looking forward to the time when the whole of itsenergies can be concentrated on constructive work of thiskind, and in the meantime will devote to it all the timethat can be spared from dealing with the temporaryproblems and difficulties arising out of the war.

PRISONSAT the larger prisons whole-time officers are appointed,

sometimes with deputy medical officers to assist them.Unfurnished quarters are provided or an allowance madein aid of rent. Posts are pensionable and promotionsare made as vacancies occur. Candidates with a

diploma in psychological medicine receive £50 perannum more on appointment than candidates withoutthis qualification, and are given preference providedthey also have good all-round general experience. Atthe smaller prisons no whole-time officers are employed ;local practitioners are usually appointed as part-timeofficers. Further particulars can be obtained from thePrison Commissioners, Kensington Mansions, TrebovirRoad, London, SW5.

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Services Abroad

INDIAN MEDICAL SERVICERECRUITMENT to the Indian Medical Service, which is

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designed primarily to meet the needs of the Indian Army,was modified by the war, and officers have been appointedto emergency commissions in the military branch for theduration of the war, in the East. The method of recruit-ment of men medical officers, other than those of Indianor Dominions origin, has been altered and those wishingto be appointed are required to join the Royal ArmyMedical Corps first. After a course of instruction theycan apply to be posted to the Indian establishment, andare then given an opportunity to transfer to the IndianMedical Service. Officers selected for transfer will begiven preference when applying for permanent commis-sions in the Indian Medical Service, if these are grantedagain now the war is over. The upper age-limit forEuropean emergency commissioned officers on appoint-ment is at present 45.

Officers on appointment to the IMS are eligible for thegrant of antedates, which are reckoned in assessingservice for seniority and promotion, in respect of speci-fied higher medical qualifications (six months or a year)or approved whole-time hospital appointments (maxi-mum a year). The antedating in these cases is limitedto a total period of 1 t years. Antedating equivalent tohalf the period spent in practice, less the period grantedin respect of hospital appointments, is also allowed up toa maximum of 5 years. All previous full-pay commis-sioned service with the Armed Forces as a medical officeralso counts towards rank and seniority on transfer.

Qualified officers selected for specialist posts are

granted appropriate temporary rank with the pay andallowances of the appointment. Passages to India arenot granted to wives and families ; but if, at the end of ,his service, an emergency commissioned officer elects toreside in India, he can be allowed the cost of transport ofhimself and his family to the place where he wishes to live.The pay of a European lieutenant in India is £585

yearly, and of a captain on promotion £750; on hisrelease an emergency commissioned officer receives aminimum gratuity of Rs. 2000 if his date of registrationas a doctor was before Jan. 1, 1940, or Rs. 1000 ifregistered on or after that date, provided he completes ayear of service ; he gets an addition of a month’s pay foreach further year of Army service. If invalided out fora disability due to service he receives disability retired-pay appropriate to his rank and degree of disablement,which for Europeans is as for officers of the RAMC. Ifhe dies as a result of military service during the war,provision is made for his widow and children.Women medical officers are appointed direct for service

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with the Indian Medical Service by the Secretary ofState for India under conditions similar to the above,and a number have already been appointed from theUnited Kingdom. Full information regarding theseappointments and those available for Indian medical

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officers, for whom the age-limit is 40, may be obtainedfrom the secretary, Military Department, India Office,4, Central Buildings, Matthew Parker Street, London,SWl.The Indian Army Medical Corps is organised on

similar lines to the RAMC, and has received by transferthe whole existing personnel of the Indian MedicalDepartment and the Indian Hospital Corps. All regularcommissioned officers of the Indian Medical Service inmilitary employ as well as emergency commissionedofficers of that Service are seconded to the IAMC butretain their IMS privileges.

WOMEN’S MEDICAL SERVICE FOR INDIAAdmission to the service is by selection in India and

England. Appointment is open to English and Indianqualified women. Vacancies are few-usually only 3 or 4in each year-and there is little recruitment from England.There is also a training reserve of qualified womenrecruited from Indian universities. Since the outbreakof war no members of the training reserve have been sentto England for postgraduate study, and leave out of Indiahas also been restricted. Vacancies in the service arebeing filled by doctors in India as need arises butapplications from Europeans holding higher medicalqualifications will be welcomed. The post of medicaladviser in the United Kingdom is now held by Dr.Charlotte Houlton, CBE, SPG House, 15 Tufton Street,London, SW1.Women medical officers are still being appointed

direct to emergency commissions in the Indian MedicalService by the Secretary of State for India, under con-ditions similar to those for men, as noted above.

COLONIAL MEDICAL SERVICEVacancies in the Colonial Medical Service occur most

often. in the larger medical departments in tropicalAfrica. Specialist appointments are usually reservedfor officers holding higher qualifications who haveshown outstanding merit in a particular branch ofmedical practice. Opportunities to gain these quali-fications will be made available whenever possible.Vacancies already exist, and will occur in greater numbersin future, for women with experience in maternity andchild welfare work. Selected candidates are generallyrequired to attend a course in tropical medicine andhygiene, before going overseas or during their first leaveperiod. The various government medical departmentsemploy about 700 European medical officers, includingsome 30 women, and about 1200 locally appointedmedical officers. Medical experience may include-among other diseases associated with the tropics-malaria, yaws, leprosy, sleeping sickness, plague, yellowfever, and cholera, as well as the diseases of commonmedical practice. An officer in the Colonial MedicalService has special opportunities for the practice of hisprofession in preventive medicine as well as in otherbranches ; there are also opportunities for teaching andresearch. The medical and -health services will have tobe considerably expanded in order to fulfil the schemesfor post-war development already planned. Full par-ticulars of the terms and conditions of service may beobtained from the Director of Recruitment (ColonialService), Colonial Office, 2, Park Street, London, Wl.

SOUTHERN RHODESIAN MEDICAL SERVICEThe Government of Southern Rhodesia maintains a

medical and public health service with an establishmentof 16 whole-time administrative, specialist, or publichealth officers and 40 Government medical officers.

Whole-time officers are classified as follows :Annual salary

Medical Director ..... £1500—£50—£1750Assistant Health Officers (2 posts) School Medical Officer (male) Field OfficerRadiologists (2 posts) Directors of Laboratories (2 posts) £1000—£50—£1250Government PathologistGovernment Psychiatrist Medical Superintendent, Mental HospitalMedical Superintendent, Leprosy Hospital School Medical Officer (female) 2 posts £600—£25—£900Medical Officer, Leprosy Hospital J Government Medical Officers are graded as follows :

Senior Government Medical Officers (2) £1000—£50—£1250Government Medical Officers (38) £600—£25—£900

Whole-time medical officers and the two seniorGovernment medical officers are not permitted privatepractice, but are allowed consultant practice. Govern-ment medical officers, except those stationed at Salisburyor Bulawayo, are allowed private practice which bringsin from £100 yearly upwards according to the station.Their duties include the supervision of the 18 Govern-ment hospitals and numerous native clinics, and attend-ance on police, boarders in Government schools, andprisoners. They also undertake medico-legal work andpublic health duties. Leave may be granted at the rateof one-eighth of service and may be taken in periods notexceeding 184 days at one time ; study leave may alsobe granted.

After 2 years’ service medical officers under the age of45 can be appointed to the fixed establishment andcontribute to a pensions scheme. The retiring ageis 60.On appointment, Government medical officers are

usually stationed at Salisbury or Bulawayo where theyare not permitted private practice but are paid anallowance of £130 yearly in compensation. They areusually required to do relieving duties at various out-stations until a permanent vacancy occurs.Appointments in Great Britain to -the service are made

by the High Commissioner for Southern Rhodesia,Rhodesia House, 429, Strand, London, WC2. Thoseseeking further details should write to him.

SUDAN MEDICAL SERVICE

In providing a complete health service for the Sudanesepeoples, for Sudan Government officials, and for theSudan Defence Force the Sudan medical service covers thewhole of the Anglo-Egyptian Sudan-a territory of somemillion square miles- (about the size of British India).The total population, however, is probably still less than8,000,000. In accordance with the terms of the Anglo-Egyptian Agreement of January, 1899, the country isunder the joint protection of Great Britain and Egyptand its connection with the British Government isthrough the ambassador in Cairo and the British ForeignOffice..

The country is just developing educationally, politic-ally, and economically, and the Government intend thatSudanese shall have the opportunity of filling all Govern-ment posts for which they may be fitted by personality,ability, and training. It is therefore important thatnewly appointed British officials should be sympatheticto this policy, and ready and willing to play their partin it.The British personnel of the service consists at present

of 44 doctors, 32 nurses, and some public health in-spectors and laboratory and X-ray technicians. Thereare also more than 70 Sudanese doctors trained at theKitchener School of Medicine in Khartoum-some ofwhom have had postgraduate experience in London-public health officers and overseers, medical assistantsin charge of dispensaries, and a large number of hospitalorderlies, nurses, and midwives. The headquarters arein Khartoum, and here and in the adjacent town ofOmdurman are the central hospitals and specialistservices, the Kitchener Medical School, the StackLaboratories, and Midwifery and Nursing TrainingSchools. An entirely new hospital of 400 beds had beenapproved for Khartoum in 1939 and this will be builtas soon as circumstances permit. Outside Khartoumthe country is divided into seven main provinces and inthe principal town of each there is a large and well-equipped hospital. In the smaller towns there are otherhospitals, each in charge of a Sudanese doctor, and thereare some 300 dispensaries serving the still smaller townsand rural areas. British medical inspectors are attachedto the main hospitals and supervise the areas they serve.

Since private practitioners-- are few, all medical,surgical, and gynaecological work as well as public healthand preventive work is undertaken by members of theservice. There is a varying amount of administrativework. Although it may be possible in the outstationsto arrange that a man who is keener on medicine or onsurgery is able to concentrate on the work he prefers, alljunior members of the service should be competent toundertake whatever comes their way. At present mostspecialist appointments are filled by selection from thesenior medical inspectors ; such promotion is unlikely