Where shall John go? Holland.

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There are several options open to doctors wanting to work in Holland for a year or two. Although many of the Dutch speak English, language remains the main bar to clinical medicine; this is less of a disadvantage in such specialties as radiology, pathology, and anaesthetics, and vacancies are fairly frequently advertised in the BM7. The main opportunities lie in academic or industrial medicine. The choice of academic centre for the doctor who has funds from England will depend on individual interests and training requirements. Most Dutch medical research is funded centrally through Government agencies, though contributions do come from industry and charitable foundations. There is strong competition for research posts (which are regarded as an important phase of medical training) and the English doctor may find it difficult to obtain support from this source, although occasional vacancies are advertised in English journals. An alternative often practised by American university staff is an exchange, either concurrently or sequen tially over two years. The former may have advantages, as houses and cars can often be exchanged as well as jobs. This sometimes leads to disappointment but the proximity of Holland to Britain allows both parties to assess the desirability of an exchange before being irrevocably committed. Research depending heavily upon doctor-patient relationships suffers from the same disadvantages as clinical medicine. An American psychologist friend of mine found the small nuances of meaning difficult to convey and was disappointed with the clinical aspect of his visit. On the other hand, it is surprising how much a little newly learned Dutch, a patient's half-forgotten English, and much goodwill can achieve in terms of a simple clinical history. Areas of incomprehension can at least be defined and resolved with the help of an interpreter, and it should not be difficult for the visitor to function effectively in this way, given that most of his colleagues (as well as the laboratory technicians) will speak very good English. Several large British and American companies have quite sizable operations in Holland, mainly in petrochemicals. Most of these companies are based in the Hague or Rotterdam in the south of the country and advertise in medical journals. Schooling and housing are usually arranged by the company and such posts may have attractions for the doctor with a young family, particularly since several of the English schools are situated in this area.