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and 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 the Director of Postgraduate,Studies, Surgeons’ Hall, Edinburgh, 8.

GLASGOW UNIVERSITY offers from time to time inten-sive postgraduate courses in general medicine and generalsurgery. These courses consist of clinical meetings,pathological demonstrations, and lectures. Courses inchild health, ophthalmology, and dermatology are

organised when the demand arises and are advertisedin the medical journals. A three-week course in mentaldeficiency is held in the autumn. Training in radio-diagnosis and in radiotherapy, recognised for theD.M.R.-D. and D.M.R.-T., is also available.For general practitioners refresher courses of a fort-

night’s duration are held from time to time ; they consistmainly of clinical demonstrations, but include also a fewlectures on modern therapy. All inquiries should beaddressed to the Director of Postgraduate MedicalEducation, The University, Glasgow, W.2.

NORTHERN IRELAND

The director of postgraduate education is :Belfast.-Prof. J. H. BIGGART, M.D., Queen’s University,

Belfast.

The Defence Services

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

a short-service engagement of four 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 one year is granted for house-appointmentsheld prior to entry. Opportunities for specialisation aregiven to officers on the permanent list. Dental officersare admitted under similar conditions. At presentno women medical or dental officers are employed.Copies of regulations and forms of application maybe had from the Medical Department of the Navy,Admiralty, Queen Anne’s Mansions, St. James’s Park,London, S.W.I.

Royal Army Medical CorpsDirect applications are now invited for short-service

commissions in the R.A.M.C. for a period of eight years,of which the first four years will be on the active listof the Army and the remainder on the Regular Armyreserve of officers. Appointment will be in the rank oflieutenant. Candidates must be : (1) normally not over30 years of age; (2) at the time of application, Britishsubjects or citizens of the Irish Republic and thesons of British subjects or citizens of the IrishRepublic; and (3) registered under the Medical Acts inforce in Great Britain and Northern Ireland. Suchofficers will, during their service on the active list, beconsidered for appointment to a Regular commission.If they do not desire or are not selected for a Regularcommission they will, on completion of their four years’short service on the active list, receive a gratuity of 600.Full conditions of service and forms of application canbe obtained on application in writing to the AssistantDirector-General, Army Medical Services (A.M.D.l),Lansdowne House, Berkeley Square, London, S.W.I.On the nomination of the Central Medical War Com-mittee doctors are appointed to National Servicecommissions in the rank of lieutenant. During theirperiod of service they can apply for a short-servicecommission, and they can be subsequently consideredfor a Regular commission under the conditions alreadyoutlined.

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, Millbank, London, S.W.I. The

college has a director of studies and a tutorial staff for

the teaching of Army health, military surgery, tropicalmedicine, psychiatry, radiology, dermatology, venereology,and entomology. The Queen Alexandra Military Hospi-tal, Millbank, also provides, clinical instruction, tutorials,and demonstrations.At the college newly commissioned lieutenants on first

appointment are given an introduction to the clinicalproblems and procedures peculiar to military service inboth temperate and tropical climates.

Regular R.A.M.C. officers between their eighth andtenth years of service pass through the senior officers’postgraduate course of professional studies. This course,divided into two parts, lasts approximately 5 months.The first part, of 10 weeks’ duration, includes revision inArmy health, military surgery, tropical medicine andentomology, pathology, and psychiatry. The secondpart, which lasts 3 months, consists of demonstrationsand tutorials in clinical medicine and surgery, derma-tology, and venereology. Officers who qualify at the endof this course and who are recommended by the R.A.M.College council are eligible for twelve 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 specialstudy in the maintenance and enhancement of the health ofthe Army. It has laboratories for instruction in chemistry asapplied to hygiene and also in biochemistry, and there is aninstructive and well-equipped hygiene museum. Officers

intending to specialise and become Army health officersare given the opportunity of taking the D.r.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 instructionand clinical demonstrations in tropical medicine, particularlythose disease processes to which Service personnel and theirfamilies are exposed in tropical areas. The R.A.M. Collegeis recognised for the full course of instruction for theD.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, demonstra-

tions, and practical classes covering the laboratory diagnosisand pathological aspects of general, tropical, and preventivemedicine and military surgery.

Candidates for specialisation in pathology receive 6 months’training at the college in bacteriology, hoematology, chemicalpathology, and morbid anatomy ; while a further 6 months’study in a particular branch of pathology is made at a selecteduniversity medical centre.The department of psychiatry provides lectures and clinical

demonstrations in psychiatry and psychopathology and theapplication of psychological principles to morale, discipline,personnel selection, and other purely military matters.Clinical demonstrations of cases and the use of modern methodsof physical treatment and group therapy are held at BansteadMilitary Hospital and Belmont Hospital, Sutton. Demonstra-tions of selection tests are given by a personnel selectionofficer.

The college also provides courses of instruction fornursing officers of The Queen Alexandra’s Royal ArmyNursing Service, when emphasis is laid on the nursingproblems encountered in the Service, particularly in thetropics.

ROYAL ARMY DENTAL CORPS

Direct applications for Regular commissions in the RoyalArmy Dental Corps are not being invited at present. Onthe nomination of the Ministry of Health dental surgeons areappointed to National Service commissions with the rank oflieutenant. Such officers may apply at once for Regular

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short-service commissions under existing regulations, and ifselected are eligible for appointment, at any time, to a per-manent Regular Army commission. Candidates for short-service commissions must be not over 35 years of age, andthey 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,and be registered under the Dentists Act in force in GreatBritain and Northern Ireland and undertake to remain so

registered throughout their service. If they do not desireor are not selected for a permanent commission they will,on completion of their four years’ short service on the activelist, receive a gratuity of 500. Immediately on qualificationdental surgeons wishing to enter the Royal Army DentalCorps should notify the -Secretary, Ministry of Health,Whitehall, London, S.W.I.

Royal Air Force Medical BranchShort-service commissions for four years’ active-

list service followed by four years in the reserve, areavailable in the R.A.F. Medical Branch to registeredmedical practitioners of British nationality who havenot reached the age of 32 on appointment. Selections forpermanent commissions will be made at any time duringthe short-service commission. A gratuity of ;B600 willbe payable to officers who transfer to the reserve onsatisfactory completion of four years’ service on theactive list. Further particulars can be obtained on

application to the Under-Secretary of State for Air(M.A.I.), Awdry House, Kingsway, London, W.C.2.

R.A.F. DENTAL BRANCH

Short-service commissions for a period of four years in theDental Branch of the R.A.F. are available to qualifieddental surgeons. Officers holding short-service commissionswill be eligible for selection for permanent commissions.Those not selected will receive a gratuity on completion oftheir short-service engagement. Further information may beobtained on application to the Under-Secretary of Statefor Air (M.A.6).

Health Services at Home

PUBLIC HEALTH

THE introduction of the National Health Service hasno direct effect on the duties of the medical officer ofhealth in environmental hygiene. These responsibilitieshave evolved over the last hundred years from the basicsanitary services introduced with difficulty and by slowstages at the instigation of the first M.o.H.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 with difficulty and spasmodicallyby his express personal intervention. Health depart-ments are now organised to allow the M.o.H. freedomfrom much detailed work which can be effectively per-formed by trained lay officers or even transferred tothe care of other departments, as in water-supply andsewage disposal. Naturally the extent of this devolutionof responsibility varies widely. Rural water-suppliesand sanitation remain a constant concern of the M.o.H.The supervision of housing conditions, again mainlythrough sanitary inspectors, is a health-departmentresponsibility. All this work must remain under thegeneral control of the M.O.H., and he must also supervisethe quality of water-supplies even though their productionis not his concern. Though less concerned personallywith detailed sanitary work, he now supervises a farwider field than his predecessor of a hundred years ago.

Control of infectious diseases has always been one of themain concerns of the M.o.H. The old emphasis on isola-tion has now been replaced by the provision of modernhospital treatment but there remains the active homefollow-up. Bacteriologists have made great advancesin the identification of different strains within certainof the pathogenic species, and these new techniques,applied to epidemic control, have given the M.o.H. aninstrument of precision in much of his epidemiologicalwork. The application of specific prophylactic measuresagainst various of the acute infections is now a majorfunction of health departments ; and already the control ofsuch diseases as diphtheria and enteric fever is in sight.

The National Health Service Act has profoundlyaffected the work of the M.o.H.s of counties and countyboroughs-local health authorities as they now are,

They have ceased to hold any responsibility for adminis.tration of hospitals, except that some individuals aremembers of hospital management committees. Afterthe Local Government Act of 1929 came into force,hospital administration occupied the time of theseM.o.H.s in some sense at the expense of preventivemedicine in which they have been specially trained.Nevertheless it will rest very largely with them to secureclose coördination of hospital and preventive services atthe management-committee level ; indeed their influenceat this point is crucial. No other medical men will beso well placed to survey the whole field of medicalactivity in an area. Regional hospital boards usuallyhave regular meetings of liaison committees of M.o.H.s,and rely on the M.O.H. of the local health authority todetermine the urgency of social grounds for admissionof patients to hospital, especially maternity cases andthe chronic sick. Local health authorities, under part 3of the Act, provide clinic and other services for mothersand preschool children, domiciliary midwifery, healthvisiting, home nursing, immunisation and vaccination,ambulances, care and aftercare, and domestic help ; andsome have preliminary schemes for health centres.There has been rapid growth of some of these services,particularly ambulances, home nursing, and domestichelp. Their intrinsic importance is great, and theircontribution to the hard-pressed hospital service no less.The M.o.H. is the officer on whom the administration ofthese services falls. Their complexity and the need forlocal knowledge in day-to-day administration has ledmost counties to devise schemes of divisional adminis-tration which are of particular importance to the studentbecause of their effect on the path of entry to the public-health service, especially where divisional county postsare combined with the office of M.o.H. to one or morecounty districts.The mode of entry to the service will probably not, as

in earlier years, be through the clinical side but throughassistant administrative posts concerned with control ofinfectious diseases and organisation of clinic services.Thus there will be far less likelihood of medical officerswho have taken postgraduate qualifications in publichealth devoting the rest of their professional lives toclinical work in a limited field. The very fact l thatthose who undertake clinical preventive work will alsobe engaged in curative work will bring the administrativemedical officer responsible for the organisation of clinicservices into far closer contact with his professionalcolleagues. It is probable that experienced generalpractitioners will play an increasing part in the clinicservices of local health authorities. For many yearsthere will, of course, be whole-time officers engaged inclinic work, but it does seem likely that the public-health officer of the future will be usually concerned withorganisation rather than with routine clinic duties. Thisredistribution of work coupled with the provision bylocal health authorities of health-centre buildings forgeneral practice should help to produce an ever closerassociation between M.o.H. and general practitioner-avoluntary association arising from a knowledge of thehelp each can give the other.The curriculum for the diploma in public health now

provides a first part which is suitable for men engagedin tuberculosis or venereal-diseases work ; a certificate isgiven to those who pass the examination for part 1

only. The course for part 2 provides for those whointend to take the diploma and enter the publicservice. Possession of a D.P.H. is necessary for any-one now seeking appointment as a medical officer ofhealth.

INDUSTRIAL MEDICAL SERVICES

WE said last year that the future of the industrialmedical services will depend largely on the report of thecommittee which the Prime Minister set up on June 1last year under the chairmanship of Judge Dale. Thecommittee has not yet presented its report, but weunderstand that it is expected shortly. In the meantime,an account of the existing situation might be of interestto students and newly qualified doctors.