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SCOTLANDAberdeenApart from postgraduate training of registrars in all

departments, refresher courses for general practitionersare held. These are either fortnightly courses, or extendedcourses consisting of eight or ten weekly afternoonmeetings. Certain graduates are, from time to time,attached to the different departments for special post-graduate research and study.

EdinburghThe Edinburgh Post-Graduate Board for Medicine,

representing the university and the Royal Colleges ofPhysicians and Surgeons of Edinburgh, arranges pro-grammes of graduate studies. The board offers courses ininternal medicine, general surgery, and medical sciences,and refresher courses for general practitioners.Two courses in internal medicine, lasting twelve weeks,

are held, starting in April and October of each year. Thesecourses comprise lectures, lecture-demonstrations, clinicalteaching, and clinical pathological demonstrations ; theyare suitable for graduates wishing to specialise in medicineor who require a refresher course in the current outlookon internal medicine.Two courses in general surgery are held each .year,

starting in March and October. These courses are oftwelve weeks’ duration ; they include lectures on surgicalpathology and selected surgical subjects, as well as clinicaldemonstrations. Clinical instruction is obtained by theattachment of graduates for periods of six weeks to ageneral surgical charge, and to a special unit. In additionto the Edinburgh Royal Infirmary, other general andspecial hospitals in the city cooperate in the provisionof clinical teaching facilities.A comprehensive course in the medical sciences of

anatomy, physiology,’ pathology, bacteriology, and bio-chemistry is held in the summer; two hundred and eightyhours of instruction are given in this course, a hundredof which are devoted to practical work ; and in con-nection with it a series of twelve open lectures are givenby leading authorities in their various specialties. Thiscourse is suitable for those requiring a final preparationin these subjects. It is desirable that those taking thiscourse should already have considerable basic knowledge.

General-practitioner courses have been completelyreorganised, with the teaching either at the bedside orby means of lecture-demonstrations. Emphasis is laid onrecent advances in treatment, and free discussion, aswell as constructive criticism by members of the course,is encouraged.Open postgraduate lectures of wide interest are

organised in conjunction with. the courses in surgeryand medicine. Courses are often booked up severalmonths in advance, so those intending to apply shoulddo so at an early date. Applicants should write, givingparticulars of their medical qualifications and post-graduate experience, to Sir Alexander Biggam, F.R.C.P.,the Director of Postgraduate Studies, Surgeons’ Hall,Edinburgh, 8.

GlasgowGlasgow University Postgraduate Medical Education

Committee, representing the University and the RoyalFaculty of Physicians and Surgeons of Glasgow, proposeto offer the following courses during the ensuing session.An eight-week part-time course of instruction inanatomy, physiology, biochemistry, pathology, andbacteriology will be held from October to December.,The course is suitable for candidates preparing for theprimary examinations of the surgical fellowships, and willprovide a total of approximately one hundred and sixtyhours of instruction. The course is organised primarily forthe junior staff of hospitals in the Western Region, but itis also open to other applicants. Where possible, anhonorary part-time clinical attachment will be arrangedfor members of the course who have no hospital appoint-ment. The medical school provides annually a coursefor the diploma in public health and there are signs ofa revival of interest in this qualification. A shortfull-time course in child health and a three-week full-time course in mental deficiency will be held in theautumn. Courses in industrial health and other

specialties will be arranged if the demand arises, and

will be advertised in the medical journals. Trainingin radiodiagnosis and radiotherapy, recognised for theD.M.R.(D.) and D.M.R.(T.), is available. Refresher coursesfor general practitioners are held from time to time;these consist largely of clinical demonstrations butinclude also a few lectures on modern methods of therapy.All inquiries should be addressed to Prof. G. M. Wishart,F.R.F.P.S., the Director of Postgraduate Medical Education,The University, Glasgow, W.2.

St. AndrewsThe type of education and training which is offered in

the university and its associated hospitals differs some-what from that in other parts of the country. The largenumber of those in training in the university laboratoriesand attending postgraduate lectures are registrars andsenior registrars within the hospital service of the region.There are, however, a certain number of vacancies alwaysreserved for overseas students. The university has madeavailable to first-year registrars laboratory training inanatomy and physiology with particular emphasis inone or the other, depending on whether the registrar hassurgical or medical leanings. In the second-year registrarposts, university laboratories of pathology, biochemistry,bacteriology, and pharmacology are open to the registrarsand they may elect to study two of these subjects duringany academic year. By arrangement with the regionalhospital board, the registrars are free from hospitalresponsibilities during several afternoons a week to enablethem to undertake further education. In addition to this,registrars of all grades attend weekly open postgraduatelectures and there are weekly colloquia and clinical patho-logical conferences. The number of registrars attendingany university department at one time is not more thansix and this allows of personal tuition by the professorand his staff. The director of postgraduate education isProf. R. B. Hunter, F.R.C.P.E., Medical School, Universityof St. Andrews, Small’s Wynd, Dundee.

NORTHERN IRELANDBelfast

Refresher courses are held for general practitioners,and in 1950 the course took place during the first fort-night in September. A monthly refresher course indiseases of children was given at the Royal BelfastHospital for Sick Children for eight months. The directorof postgraduate education in Northern Ireland is Prof.J. H. Biggart, M.D., the Queen’s University, Belfast.

The Defence Services

Royal Naval Medical ServiceMedical officers are admitted to the Royal Navy on

a short-service engagement of 4 years. Opportunityis given for transfer to the permanent list during thisperiod. Officers who leave the service on completion oftheir engagement receive a gratuity. Additional seniorityup to a limit of 2 years is granted for house-appoint-ments and equivalent professional experience gained priorto entry. Opportunities for specialisation are given toofficers on the permanent list. Dental officers are admittedunder similar conditions. Copies of regulations and formsof application may be had from the Medical Departmentof the Navy, Admiralty, Queen Anne’s Mansions, St.James’s Park, London, S.W.I.

Royal Army Medical CorpsThe Royal Army Medical Corps offers to well-qualified

medical men’ a satisfactory career, with good oppor-tunities for the practice of their profession and forspecialisation in many subjects, reasonable pay, goodprospects of promotion to higher rank, and, for thosegranted a regular commission, an adequate pension onretirement. Entry is, in the first instance, by means of a.short-service commission, and subsequently by selectionto a regular commission on completion of 6 months’combined national service and short service.

Appointment to a Short-service CommissionAppointment will be in the rank of lieutenant with

promotion to captain on completion of 1 year’s serviceas a medical officer. All previous full-pay service as amedical officer -counts for promotion. At the time of

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application candidates ’must be registered under theMedical Acts in force in Great Britain and NorthernIreland; be British subjects or citizens of the IrishRepublic ; and should normally be under the age of 45years. Short-service commissions are for a period of8 years from the date of appointment, of which anyperiod from 2 to 8 years may be spent on the active list,and the balance on the Regular Army Reserve of Officers.Civilians liable for service under the National ServiceActs will not be accepted for less than 4 years on theactive list. Extensions of 1 or more years may be

granted during the active-list period of the short-servicecommission, providing that the period on the active listdoes not exceed 8 years. Short-service commissionofficers R.A.M.C. are eligible for an ante-date up to amaximum period of 2 years for civil experience in thehospital field. Such ante-date will not count as servicefor promotion to captain, but will, on such promotion,count for increments of pay in that rank and forpromotion to major. Short-service commission officersappointed for 4 or more years’ service on the active listwill, after completion of 6 months’ service, if suitable, anddesirous, be given consideration for specialist trainingin anaesthetics, army health, dermatology, medicine,obstetrics, ophthalmology, otology, pathology, psychiatry,radiology, or surgery. On completion of the active-list period of their short-service commission, those notselected for, or not desirous of, a regular commissionwill be eligible for a gratuity of oB240 for 2 years’ service,B450 for 3 years’ service, plus B150 per year for each year’scompleted service over 3 years. Applicants appointedto short-service commissions within 12 months of leavingsuperannuable employment as medical practitioners onthe staff of an employing authority under the HealthService may, at their own option, continue to pay con-tributions during the active-list period of their short-service commissions and thus preserve their super-annuation position under the National Health Service.Appointment to a Regular Commission

Short-service officers on completion of 6 months’ totalservice as a medical officer may apply for appointmentto a regular commission. Those who are granted regularcommissions will reckon the active-list period of theirshort-service commission and other service towardsultimate retired pay or service gratuity on the regularofficer’s scale but they are not entitled to any short-service gratuity. All regular officers between the 4thand 10th year of service are given a 5-month courseof postgraduate study at the Royal Army MedicalCollege, London, and in London hospitals. This isfollowed by a year’s course of study in a special subjectselected by himself, provided he has .shown specialaptitude in his postgraduate course or during his previousservice. During the course of all this study the officerremains on full pay-the fees for the course being paidby the State. Promotion to major is on completion of8 years’ total commissioned service as a medical officer,but promotion to the higher ranks is by selection and isdependent on vacancies. All previous full-pay serviceas a medical officer counts for promotion. A regularofficer is permitted to resign or retire voluntarily at anytime with the approval of the Army Council. His retire-ment is compulsory at ages varying from 53 to 60years of age according to the rank he holds at the timeof retirement. Very few need retire before reaching theage of 57. The rates of retired pay payable to medicalofficers holding regular commissions vary from oB500 ifretiring as a major to oB1200 a year if retiring as a major-general. In addition, a terminal grant of oB1000 will beawarded on completion of 20 years’ reckonable service.The grant of retired pay to regular officers retired other-wise than as invalids is normally conditional on com-pletion of 20 years’ service. For invalided officerscompletion of 10 years’ service is necessary. Gratuitiesat the following rates are payable to regular officers who,on retirement, have completed insufficient service toqualify for the grant of retired pay : on completion of 10years’ service JBIOOO ; for each complete year of service.in excess of 10 years a further JS150 ; maximum totalgratuity 22350. Pensions may be granted to the widows,and compassionate allowances to the children, of officersdying either on the active or retired’list. A gratuitymay also be granted in addition to pension to the widow

of an officer who was killed in action or died of woundsreceived in action. In certain circumstances pensionsare payable to dependent parents, brothers, or sisters of anofficer who leaves neither widow nor child and whosedeath is directly attributable to service. Vacancies areavailable and further details may be obtained from theUnder-Secretary of State, the War Office (A.M.D. 1),London, S.W.I. A personal interview with a repre-sentative of the Director-General, Army Medical Services,is readily available at Lansdowne House (room 130),Berkeley Square, London, W.1 (Telephone Grosvenor8040, ext. 548).Appointment to a National Service CommissionOn the nomination of the Central Medical War Com-

mittee doctors are appointed to national service com-missions in the R.A.M.C. in the rank of lieutenant.During their period of national service they can applyfor a short-service commission and can be subsequentlyconsidered for a regular commission.

PROFESSIONAL TRAINING OF ARMY MEDICAL OFFICERS

All medical officers commissioned into the R.A.M.C.receive postgraduate professional training at the RoyalArmy Medical College, London. The college has a directorof studies and a tutorial staff for the teaching of Armyhealth, military surgery, tropical medicine, psychiatry,radiology, dermatology, venereology, and entomology.The Queen Alexandra Military Hospital, Millbank, alsoprovides clinical instruction, tutorials, and demon-

strations. At the College newly commissioned lieutenantson first appointment are given an introduction to theclinical problems and procedures peculiar to militaryservice in both temperate and tropical climates. Short-service officers are required to take the first part of thesenior officers’ course. Regular R.A.M.C. officers betweentheir 6th and 13th years of service pass through thesenior officers’ postgraduate course of professional studies.This course, divided into two parts, lasts approximately5 months. The first part, of 10 weeks’ duration, includesrevision in Army health military surgery, tropical medicineand entomology, pathology, and psychiatry. The secondpart, which lasts 3 months, consists of demonstrationsand tutorials in- clinical medicine and surgery, dermato-logy, and venereology. Officers who qualify at the endof this course and who are recommended by the R.A.M.College council are eligible for 12 months’ individualadvanced study for different specialties at approveduniversity medical centres.The -department of Army health at the college, in addition

to the teaching of military hygiene, provides facilities for

special study in the maintenance and enhancement of thehealth of the Army. It has laboratories for instruction inchemistry as applied to hygiene and also in biochemistry, andthere is an- instructive and well-equipped hygiene museum.Officers intending to specialise and become Army healthofficers are given the opportunity of taking the D.P.H. duringtheir specialist course, and are assisted in obtaining theirD.T.M. & H.

The department of military surgery gives instruction in theprinciples and practice of up-to-date military surgery andcovers both general and regional surgery.’ The syllabusincludes the surgery of tropical diseases and the managementof surgical conditions peculiar to service both at home andabroad.The department of tropical medicine provides instruction

and clinical demonstrations in tropical medicine, particularlythose disease processes to which Service personnel and theirfamilies are exposed in tropical areas. The R.A.M. College isrecognised for the full course of instruction for the D.T.M. & H.

The entomology department provides instruction in appliedentomology as it affects service personnel, while research isalso carried out into insecticides, insect repellants, and methodsof pest control. Insects from all commands at home andoverseas are referred to this department for identification.The department of pathology provides lectures, demon-

strations, and practical classes covering the laboratorydiagnosis and pathological aspects of general, tropical, andpreventive medicine and military surgery. Candidates for

specialisation in pathology receive 6 months’ training at thecollege in bacteriology, hoematology, chemical pathology, andmorbid anatomy ; while a further 6 months’ study in a particu-lar branch of pathology is made at a selected university medicalcentre.

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The department of psychiatry provides lectures and clinicaldemonstrations in psychiatry and psychopathology and theapplication of psychological principles to morale, discipline,personnel selection, and other purely military matters. Clinicaldemonstrations of cases and the use of modern methods ofphysical treatment and group therapy are held at -the RoyalVictoria Hospital, Netley, which is a recognised hospital forthe D.P.M. of the Royal Colleges. Demonstrations of selectiontests are given by a personnel selection officer.The college also provides courses of instruction for

nursing officers of the Queen Alexandra’s Royal ArmyNursing Corps, when emphasis is laid on the nursingproblems encountered in the service, particularly in thetropics.

ROYAL ARMY DENTAL CORPS

Civilians who are liable for service under the NationalService Act may apply for short-service commissions for notless than 4 years on the active list, followed by 4 years in theRegular Army reserve of officers, which will be granted fromthe date of joining. Civilians who are not liable for serviceunder the National Service Act may apply for short-servicecommissions for a period of 8 years from the date of appoint-ment of which any period from 2 to 8 years may be spenton the active list and any balance on the Regular Army reserveof officers. Candidates must not be over 35 years of age and

they must be British subjects whose parents are Britishsubjects ; they must also possess a degree or licence in. dentalsurgery of a British university or recognised licensing body,be registered under the Dentists Act in force in Great Britainand Northern Ireland, and undertake to remain so registeredthroughout their service. They will be eligible to be consideredfor the grant of a regular commission during the active-listperiod of their short-service commissions subject to currentrules. If they do not desire or are not selected for a permanent tcommission they will, on completion of their period of shortservice on the active list, be eligible for a gratuity of :L200after 2 years’ service, JE375 after 3 years’ service, and E125for each year’s completed service over 3 years. Officers

granted permanent regular commissions will reckon the

period of their short-service commissions towards ultimateretired pay or service gratuity applicable to regular officers.They will not be entitled to any of the gratuity mentionedabove. Civilians who are eligible to apply may obtain

application forms from the Under-Secretary of State, theWar Office (A.M.D.6), London, S.W.I.

Royal Air Force Medical BranchThe Royal Air Force offers short-service commissions

of 4 years’ active-list service, with a tax-free gratuity of£ G00, to qualified men and women practitioners. Medicalpractice in the Service brings medical officers into closecontact with flying, parachuting, the carrying of sick andwounded by air, and mountain rescue, as well as with themedical treatment of service families. Suitable malemedical officers may be selected for training in pilotingduties in order to work as flying personnel medicalofficers. There are also openings in the clinical specialties,and in the non-clinical such as aviation medicine andphysiology, hygiene, industrial medicine, and rehabilita-tion. Medical officers may serve at R.A.F. stations of alltypes including hospitals in Great Britain and a limitednumber at stations and hospitals in Germany, theMiddle East, East Africa, Rhodesia, Malaya, &c. Thenormal short-service commission is for 4 years’ regularservice and is open to candidates of British nationalitywho have not reached the age of 30 on appointment, butcandidates above this age may be considered. It maybe extended by one period in order to complete 5, 6, 7,or 8 years’ regular service. Medical officers who are servingon national service commissions may apply for short-service commissions for 3, 4, or 5 years’ regular service.Upon completion of their period of regular service, short-service commissioned officers are required to serve for aperiod of 4 years on the reserve. A tax-free gratuity atthe rate of 2150 a year for each year of satisfactory active-list service is payable on transfer to the reserve. Medicalofficers who are serving on short service, or exceptionally,on national service commissions, may be selected forpermanent commissions at any time. A permanent com-mission earns retired pay after satisfactory completion of20 years’ service. It may allow study leave on full pay,accelerated promotion for professional or scientific distinc-

tion, and offers a full career for clinical specialists. Furtherinformation may be had from the Under-Secretary ofState, Air Ministry (M.A.1), Awdry House, Kingsway,W.C.2 Telephone Temple Bar 1216, extension numbers3515 and 3513).

ROYAL Air FORCE DENTAL Branch

Short-service commissions for 4 years’ regular service areavailable in the R.A.F. Dental Branch to qualified dentalsurgeons of British nationality. At present there is no upperage-limit for appointment. Officers holding national servicecommissions are eligible for short-service commissions for3, 4, or 5 years’ regular service ; alternatively they maycontinue to serve on the active list on temporary commissionsfor 1 or 2 years. Short-service officers will be eligible to beconsidered for one extension of service to complete a total-of5, 6, 7, or 8 years’ regular service. On completion of theirregular service, short-service officers are required to serve4 years on the reserve. A gratuity at the rate of E125 a yearwill be payable on transfer to the reserve on satisfactorycompletion of the full active-list period of a short-servicecommission and any extension thereof, or i80 for each yearof service on a temporary oommission. Selections for per.manent commissions will be made at any time during theperiod of the short-service, temporary, or national servicecommission. Further particulars can be obtained on applica-tion to the Under-Secretary of State for Air (M.A.6.), AwdryHouse, Kingsway, London, W.C.2.

Health Services at Home

PUBLIC HEALTH

. THE post-war years have brought many changes in theduties of medical officers of health. The National HealthService Act in particular has profoundly affected thework of medical officers of health of counties and countyboroughs. Under part ill of the Act, these local healthauthorities, as they are now termed, provide clinic andother services for mothers and children, domiciliarymidwifery, health visiting, home nursing, immuriisationand vaccination, ambulances, care and aftercare, anddomestic help, and some have preliminary schemes forhealth centres. There has been a rapid growth of someof these services, particularly ambulances, home nursing,and domestic help. Their intrinsic importance is greatand their contribution to the hard-pressed hospitalservice no less. The responsibility for the administrationof these services falls on the M.O.H., and in most countiesand county boroughs he is also the school medical officerand is thus able to coordinate the preventive healthservices over the whole range of childhood. In environ-mental hygiene the duties of the M.O.H. remain com-paratively unchanged. These are responsibilities whichhave evolved over the last hundred years from the basicsanitary services introduced with difficulty and by slowdegrees at the instigation of the first 2.o.ii.s Originallythe M.o.H. was closely concerned with the detailedexecution of all this sanitary work, but the passage ofyears has led to the general acceptance of much thatwas originally secured only with difficulty and spasmodic-ally by his personal intervention. Health departmentsare now organised to allow the M.o.H. freedom frommuch detailed work which can be performed by trainedlay officers, or even transferred to the care of otherdepartments as in water-supply and sewage disposal.Naturally the extent of this devolution of responsibilitymust vary widely. Rural water-supplies and sanitationremain a constant concern of the M.o.H. The super-vision of housing conditions, again- mainly throughsanitary inspectors, is a health department responsibility.All this work must remain under the general control ofthe M.o.H., and he must also supervise the purity of water-supplies even though their production is not his concern.Though less concerned with detailed work he nowsupervises a far wider field than his predecessor of ahundred years ago..

Control of infectious diseases has always been one of themain concerns of the M.o.H. The old emphasis on

isolation has now been replaced by the provision ofmodern hospital treatment, but there remains theactive home follow-up. Bacteriologists have made grP,lI.J;