Læknablaðið - 01.06.1972, Page 53

LÆKNABLAÐIÐ
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forward for themselves in a hospital specialty. There was an assump-
tion by the hospital specialists of a superiority which had its origin
in the traditionally antagonistic relationship between physician and
apothecary in London in the 18th and 19th centuries. Indeed 20 years
ago the standard adopted for admission to the Medical Register by
the General Medical Council, which is the registering authority in
Britain, was essentially that the man so admitted should be a safe
doctor, capable of entering general practice and sufficiently trained
for that purpose. Even then practice was ahead of this declared in-
tention and most doctors recognised that they needed more experi-
ence in hospital before the year in hospital work became compulsory
in 1954.
By 1957 the General Medical Council in its recommendations to
medical schools had clearly moved away from the concept of the
doctor who was safe for independent practice at the time of his full
registration and it relaxed the rules previously imposed on medical
schools, on the assumption that any doctor would intend to undergo
further training before becoming independently established. Four
years earlier a Committee of the British Medical Association chaired
by the present President of the General Medical Council, Lord Colen,
had produced a report, recommending a pattern of training which
would involve three years more of varied experience after passing
the qualifying examinations before a doctor entered general practice
on his own account. The B.M.A., however, did not endorse the report.
Ten years later the General Medical Council further modified its
regulations to give the schools even greater discretion about the way
in which they arranged their courses.
Despite this obvious intention of the central registering authority,
the early postgraduate training of recently qualified practitioners was
poorly organised. Even the compulsory one year after qualification
before full registration was not effectively supervised or planned by
the schools. The young graduate had to have a certificate from his
school of satisfactory performance of his duties during that year, but
few of the schools put themselves in a position of being really well
informed.
The universities approved a sufficient number of posts and then
more or less left the rest to the senior staff of the hospitals where
those posts were located. Even the posts approved included a very
odd mixture which could include for instance radiotherapy as a
medical or obstetrics as a surgical post. With few exceptions schools
did little to place their graduates in posts best suited to their needs
and the new graduate was left very much to his own devices to
aetermine where he should go. The position was not helped by the
fact that remuneration paid through the health service to doctors in
these earliest appointments was low by contemporary standards, even
if it was better than the unremunerated work which an earlier
generation had had to do. In the period after full registration it was
possible for the new graduate to apply for a variety of junior posts