Læknablaðið - 01.06.1972, Síða 60

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LÆKNABLAÐIÐ
all general practitioners and it would not of itself be sufficient. It is
difficult to tell how much this incentive has meant in promoting our
postgraduate educational schemes. It has been alleged that it is an
invasion of the doctor’s freedom since he should do postgraduate
education, but by his own choice.
In specialist medicine there is of course the knowledge that to
practice in a specialty a man must be appointed to a specialist post
in the hospital service, if he is to be credible to the general practitioner
colleagues who refer patients to him and to have a place to do his
work. Doctors are selected for such appointments on the advice of
professional Advisory Committees and all know that they would have
little chance if they have not been properly prepared. There is no
such requirement, actual or implied, in recruitment to general prac-
tice. The logic of this would suggest that there should be some such
requirement for entry into general practice, but the shortage of re-
cruits would have made it difficult to introduce this even if the
profession were ready for it. There is a financial inducement, but it
is small compared with the immediate financial advantages of earlier
entry into general practice. Some action will undoubtedly be necessary
eventually here and may well be sought by the profession.
Various specialty associations and colleges play a very important
part in British medical life, as they have done since the foundation
of the Royal College of Physicians of London over 450 years ago and
the establishment of other Royal Colleges of Surgeons and of Phy-
sicians, and now of Obstetricians and Gynaecologists, General Prac-
titioners, Pathologists and Psychiatrists. The original educational
activities of the older Royal Colleges were limited. They were rather
the assessors of standards of professional attainment and along with
the Society of Apothecaries of London they were the first to introduce
qualifying examinations. They have remained the arbiters of standards
of postgraduate training, although the universities also give higher
degrees in medicine and surgery. The plethora of higher diplomas in
Britain is commonly a source of astonishment to doctors from other
countries. They are less systematically organised than the Specialty
Boards of North America, the Registration of Specialties in Scan-
dinavia, the Netherlands, Australasia and many European countries.
Possession of a diploma is not necessarily evidence of complete train-
ing, but rather of success in a competitive examination, often only
indicating fitness for further training. The colleges may well become
certifying bodies as to the completion of training in a specialty. The
Royal College of Surgeons of London does undertake organised teach-
ing in basic sciences and the associated Faculty of Anaesthetics has
its own teaching and research department. But in the main the
teaching activities of the Royal Colleges and the Faculties and
Specialty Associations are intermittent and additional to the con-
tinuing instruction the aspirant to a specialty requires. However, the
Royal Colleges have drawn up programmes of training in the various
specialties in consultation with other specialty associations where
appropriate and have published these proposals as recommendations,