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650 because someone thinks he looks promising, and his subsequent training and final destiny largely depend on luck. Time and chance, as the Preacher remarks, happen to all men ; but a planned society refuses to accept them blindly. The medical laboratories of this country can testify that the old fortuitous methods did not work too badly, but that is not to say they cannot be improved. The efficiency of the present technical staffs of the medical laboratories of this country is largely due to the efforts of the Pathological and Bacteriological Laboratory Assistants Association. Lately a committee of the Association of Scientific Workers has been considering the training and future status of these essential workers in the medical field. The PBLAA has applied for registration, under the name of the Institute of Medical Laboratory Technology, and is asking for statutory powers to organise and direct the training, examination and qualification of its members. It has been suggested that a commission should be set up to consider the question of training, on which all interested bodies, including the IMLT (when established), the Pathological Society, the Association of Clinical Pathologists and the ASW should all be represented. In the past the young technician has always been expected to spend a good part of his time as bottle-washer. His training has depended upon opportunity, the goodwill of the senior technician and his own capacity to take advantage of whatever chances offered. Sometimes one, sometimes another, and sometimes all three have been lacking. Any scheme for the education of technicians should ensure that entrants have the capacity and desire to learn, and that they have the opportunity to use them. Not all lads who may fancy laboratory work prove to be suited to it, and aptitude can only be determined by experiment; all entrants should serve a probationary period before undertaking the career of technician. Bottle-washing as a preliminary test of aptitude is not to be despised-the lad whose presence is signalised by the crash of shattered glass-ware is obviously better directed elsewhere-but it should not be allowed to engulf so much of the accepted student’s time that he has no opportunity to learn more skilled work. The existing state of affairs in which the most recent entrant to the laboratory may find himself stuck indefinitely on the lowest rung of the ladder must be remedied. The ASW committee has made some suggestion about the age and stageof education at which the technology probationer should be accepted but this as yet seems scarcely necessary. The school-leaving age must set the lower limit ; in all towns possessing a laboratory fitted to take probationers there will almost certainly be a technical school at which they may attend evening classes in the needful subjects. The probationary period should be limited, and at the end of it the student should have the opportunity of entering at once upon his training proper. Not all medical laboratories offer teaching facilities appropriate to such training. It can only properly be pursued in those offering considerable facilities for teaching ; these are few and attached for the most part to universities, but it may be that with increase of laboratories as a part of a national hospital service others not necessarily attached to universities " may be fitted to take on this work. The student will have to learn the basic principles of chemistry, physics and biology, to the standard acquired by medical students in, their preclinical years. Some systematic instruction is essential, but it should not become a burden; though the laboratory technician must be sufficiently acquainted with the essentials of the sciences with which he deals to be able to -understand what he really is doing, his work is primarily practical and he needs practical instruction in all the routine laboratory methods applied to general medicine. The committee feel that an appropriate course could not be taken in less than two years by a student who had passed matricu- lation, but this may be setting the academic standard too high, and might exclude practical technicians in favour of those who were merely good at their books. An examination conducted by the court of the IMLT would qualify the student to take up a junior post in a labora- tory ; 2 or 3 years of experience as a junior would entitle him to attempt to sit for his final examination as a master of his craft. The period in the training school might be too expensive for some likely candidates, but this difficulty could be overcome by a scheme of scholar- ships, bursaries or repayable grants in aid. To devise and put into effect a scheme of training for the technician is not a simple matter ; but the provision of an adequate supply of properly trained medical laboratory technicians has national importance and the efforts of the ASW committee will command the fullest sympathy of those interested in the development of the national medical service. THE SAILOR NURSE MEN who have trained for the sick-berth staff of the Royal Navy and retire after at least twenty years’ service are at a disadvantage when it comes to finding a job in civil life. Surgeon Rear-Admiral J. Falconer Hall asked on their behalf in our columns 1 that they should be given a definite status in any new nursing act which might come into force. He wrote as secretary of the Central Council of the Royal Naval Sick Berth Associations, a voluntary body formed by Naval medical officers to help these men to find work. At the beginning of their training the men are entered on probation, only after a stiff medical and educational test. During their first year they have a course of training and pass an examina- tion for the rating of sick-berth attendant; if they fail they are discharged from training. Later they take practical and written examinations for the ratings of leading sick-berth attendant and sick-berth petty officer. The rating of petty officer is equivalent to that of a sergeant in the Army and cannot usually be obtained after less than 7 years’ service. The central council considers that these qualifications in no way fall short of those required for the certificate of state registration. The men join for 12 years and may leave after serving that time, but most of them go on to complete the 22 years which qualifies them for a pension, and are then usually over 40. Nearly all of them hold the good conduct medal, which means that for 12 consecutive years they have had a " very good " report on their service certifi- cate. Their service is spent in Royal Naval hospitals at home and abroad and in ships all over the world, and they look after surgical, medical and mental cases. They get experience with nearly every type of acute case and during training are instructed in the principles and practice of general nursing, first-aid, invalid cookery, disinfection, stretcher drill, and medical accounts and store-keeping. They undertake the care of instruments and learn elementary dispensing. Some specialise as masseurs, and are registered under the Chartered Society; others become radiographic, laboratory or theatre assistants. The numbers adversely affected are not large: about 50 leading sick-berth ratings are discharged annually and of these perhaps 30 will want to continue nursing. Lacking the state qualification, however, they are debarred from all the better paid posts as male nurses in civil life, and cannot participate in the superannuation schemes of local authorities. The General Nursing Council are powerless to help them because their hands are tied by the Nurses Registration Act. State registra- tion is the only recognised qualification for nurses in Great Britain, and the only portal of entry to it is through the state examination. Men between 40 and 50, however, who have been practising as skilled nurses for many years, are not anxious to take more examinations ; 1. Lancet, Nov. 21, 1942, p. 628.
