Doctors In Britain Research Articles

Erasmus Darwin: Master of Interdisciplinary Science

AbstractDr Erasmus Darwin (1731–1802) was by profession a physician, at Lichfield and later Derby, and was widely regarded as the leading doctor in Britain, author of the massive treatise Zoonomia (1794–6). His many original contributions to science cover a wide range of disciplines, including physics, chemistry, geology, meteorology, plant growth and nutrition and evolutionary biology. He was a prolific inventor, a close friend of Boulton and Watt, and a leading spirit in the ‘Lunar Society’ of Birmingham. In the 1790s he became the most famous poet of the day with his Botanic Garden, which greatly influenced Coleridge, Wordsworth and others.

Professional Self-Help in Alcoholism

The North West Doctors and Dentists Group is part of the wider British Doctors Group. In Britain Doctors' groups began when the London Group was formed in 1973. Since then new groups have been established in Birmingham, Bristol, Durham, Glasgow, Manchester, Northampton, Petersfield and Portadown.

Third World Smoking— The New Slave Trade

The epidemic of tobacco smoking is quickly spreading to developing countries with the encouragement of UK- and US-based companies. A 1983 World Health Organization (WHO) report catalogues the evidence that the smoking diseases have already arrived in the developing countries. High death rates for lung cancer are reported from India, China, Hong Kong, and Cuba, and in the Bantu of Natal. Coronary heart disease associated with cigarette smoking is a major feature in India, Pakistan, and the Philippines. Perinatal mortality rates are doubled in Bangladesh women who smoke. WHO makes a strong appeal for effective change. The question is whether governments and health ministries will face up to this challenge any more than they did to 2 earlier WHO reports on smoking. Developing countries are now urged to give high priority to smoking control activities. Although malnutrition and infectious diseases may seem to be more pressing, only action now can prevent their exacerbation by smoking-related diseases. Each country should establish a central agency with responsibility for smoking control action. Special steps should be taken to safeguard the health of children through educational programs. The sale of cigarettes to minors should be prohibited. Particular attention should be paid to traditional smoking materials as a cause of ill health, and advertising and promotion of tobacco products should be banned. Where tobacco is a commercial crop, every attempt should be made to reduce its role in the national economy and to investigate alternative use of land and labor. The UK bears considerable responsibility for the present situation. Yet, far from discouraging exports to developing countries, the reverse is true. Britain offers no overseas assistance for anti-smoking programs. Instead, it has provided funds for the development of tobacco industries. Individual doctors in Britain can provide an example by pressing for smoking control policies in all hospitals and health service premises. They can voice their concern at the activities of the tobacco companies both at home and abroad, and they can consider the propriety of holding tobacco shares either themselves or via the universities or institutions with which they are associated.

The British contribution to sponsored postgraduate training for overseas doctors.

More effective use could be made of the resources devoted to the sponsored postgraduate training of overseas doctors in Britain. There is need for careful selection and planning of training programmes. More attention should be given to providing skills in communication, management and education. Clinical training requires the better provision of posts carrying responsibility. Training of leaders in the basic medical sciences should be based to a greater extent on courses leading to M.Sc. and less upon pure research degrees (there is also a major need for a broadly based M.Sc. for non-medical science graduates who will teach the basic sciences). A major recommendation is that a centra office should be established which would plan programmes for and supervise all sponsored trainees, under contract with the sponsoring body.

Overseas doctors: coming to Britain.

Without doctors who qualified overseas the National Health Service would not have been able to grow as fast as it has done nor would it be able to do the work it does today. In 1978 there were about 66 000 doctors working in the NHS and of those about 18 000?about one-third of hospital doctors and one fifth of general practitioners?had qualified overseas.1 2 Ever since the 1950s they have been coming to Britain in large numbers, as many British doctors were emigrating and British universities could not produce medical graduates quickly enough for the rapidly expanding NHS. The relationship between the NHS and overseas doctors was tacitly assumed to be one of mutual benefit: overseas doctors did essential work and in return received a good training. No comprehensive study of overseas doctors in Britain was made, however, until 1977. The results of that study?carried out by David Smith for the Policy Studies Institute?were reported last year,2 and they will be discussed at a conference in London this week. That study, looming medical unemployment, and the worries of overseas doctors who want to remain in Britain and yet who do not have career posts have thrust overseas doctors' problems to the fore. There are two main problems, and they are quite different. Firstly, how can Britain contribute in the future to the training of overseas doctors ? Secondly, what will happen to the overseas doctors who want to stay in Britain and yet who do not have career posts ? An emotional debate on these questions is already beginning in the medical press, while the Commons Social Services Committee, the General Medical Council, and the British Medical Association are all looking at various aspects of the problem. Furthermore, the Central Manpower Committee, which has since 1972 advised the Health Departments on staffing in the hospital grades, has to take into account the impact of overseas doctors on NHS manpower planning. These three articles aim at supplying information for the debate and discussing suggested proposals for change. One thing that emerges from studying overseas doctors' problems is that they are in many ways the problems of the whole profession. As a vulnerable group, they have always experienced the worst aspects of manpower, training, and career problems. But their problems today are likely to be those of other groups?particu? larly women doctors?tomorrow.

1 - Education in Sexuality in the Medical Curriculum

Medical curricula have been deficient in the area of education in sexuality, and it is only over the last decade or so that medical schools in the UK and abroad have recognized the importance of teaching human sexual physiology and sexuality. Attention in this discussion of education in sexuality in the medical curricula is directed to the following: present status of sex education in British schools and in medical schools; a suggested component of human sexuality in the undergraduate medical curriculum (learning objectives and strategy for introducing education in sexuality in the medical curriculum); and postgraduate education in sexual matters. Secondary schools, whether comprehensive, grammar, or private, have been slow to develop cognitive learning in such topics as the place of sexual drive within and without marriage, variations in sexual orientation, and the technicalities of various contraceptives methods. They have done even less to encourage the development of positive responsible attitudes to human sexuality. Students at the time of arrival at a medical school will have many gaps in their knowledge of the commonplace in human sexuality and in reproduction. If they have positive, healthy, and responsible attitudes toward their own sexual drives and to the sexuality of others, it is only because they are among the minority whose parents have been able to transmit them to their offspring. The Royal Commission on Medical Education (Todd report 1965-1968) identified deficiencies in the sex education of Britain's doctors and recommended that medical students should learn about the reproductive organs and their physiology and should also have an awareness of the wide implications of the problems of fertility and infertility and know something about marital problems and their management. In the older and well established medical schools, the teaching of human sexuality, especially in the earlier preclinical part of the course, depends upon enthusiasts, persuasion and a desire to interest basic and clinical disciplines. The General Medical Council in Britain has recommended such developments, and these are slowly being implemented. Postgraduate education programs, and especially those for training gynecologists, now recognize the need for all gynecologists to have an awareness of and sensitivity to psychosexual problems. A basic requirement for all gynecologists is comfort in dealing with sexual concerns.

Appointment and reappointment of doctors in Canadian hospitals

The mechanisms are described by which medical staff are selected and reviewed in an average Canadian hospital. Unlike the United Kingdom, all clinical appointments have a defined term and the onus is upon the incumbent to indicate his suitability for continued appointment. Ultimate legal responsibility for the administrative and medical management of hospitals is that of a lay representative board which delegates authority to doctors nominated by their peers. Thus, the credentials committee is held responsible for the initial investigation and subsequent annual monitoring of all doctors with respect to professional and personal suitability to practise. It is suggested that, despite the differences in provision of health care in Canada, some of these concepts might be worthy of discussion in the United Kingdom. Possible guidelines on several of the issues now being debated in Britain concerning hospital doctors are already incorporated in the Canadian way of medical life. This does not mean that they necessarily provide answers, on either side of the Atlantic, but they may throw some light of experience on the form of contract and on the methods both of appointment and of monitoring the continuing suitability of individual doctors. Obviously there are major basic differences between the provision of health care in the two systems; some of these differences are inherent and inevitable, and others may offerproved alternatives for the National Health Service. For example, Canadian hospitals are run with relative autonomy by individual local boards within guidelines laid down at provincial and federal levels; few have any house staff unless specifically affiliated to a teaching hospital, and the role of the British junior doctor thus falls upon the general practitioners and specialists, who are, almost exclusively, independent contractors. In view of this lack of employment contract between doctors and hospitals, it may seem paradoxical that Canadian doctors are more explicitly regulated than their colleagues inBritain. One example relevant to this discussion is the monitoring of individual doctors. On btaining a postgraduate qualification and leaving a training grade, a hospital doctor in Britain is effectively independent of further review; but in Canada, regular review is a condition of continued practice in hospital. Moreover, since nearly all GPs in Canada work in hospitals as well as in the community, this review involves practically all doctors who havecompletedtraining Although the hospital board is responsible for the overall running of the hospital, considerable authority is delegated to the doctors (referred to as the ‘medical staff’ even if they are not employees) through the medical staff ‘bylaws’.1 This written document, agreed between the doctors and the board, defines what the board expects of the medical staff.

Recognizing India's doctors: the institutionalization of medical dependency, 1918-1939.

In 1975 the British General Medical Council ceased to recognize Indian medical degrees as sufficient qualification for practice as a doctor in Britain. For several years previously the G.M.C. had refused to grant automatic recognition to the degrees of the new Indian medical colleges, and this had soured relationships between the G.M.C. and its Indian counterpart, the Medical Council of India. In retaliation for the British move, the M.C.I. ceased to recognize British medical degrees, and higher qualifications from Britain awarded after 1976 would not be accepted from candidates for promotion in medical colleges and other public sector jobs. This controversy was not as novel as recent commentators have supposed. Indian medical degrees had been refused recognition once before—in 1930—and the issue of G.M.C. recongnition had been at the heart of a dispute between the Indian medical colleges and the British medical authorities which had raged from the end of the First World War to the eve of the Second.

The place of medicine in the American prison: ethical issues in the treatment of offenders.

In Britain doctors and others concerned with the treatment of offenders in prison may consult the Butler Report (see Focus, pp 157) and specialist journals, but these sources are concerned with the system in Britain only. In America the situation is different, both in organization and in certain attitudes. Dr Peter L Sissons has therefore provided a companion article to that of Dr Paul Bowden (page 163) describing the various medical issues in prisons. The main difference between the treatment of offenders in prisons in America and in Britain lies in the nature of the federal system which means that each state may operate a different system in a variety of prisons and prison medical services are as various. Nationally, the prison systems are 'structured to treat and cure the offender'. Therefore it follows that the prison medical officer is only one of the professionals concerned with this 'cure' of the offender. This principle also applies to any form of research: medical research in prisons is part of a programme which covers a wide field of social and judicial research. The prison medical officer (where there is one) has of course to look after sick prisoners, and the American idea of 'cure' is also expressed in the need for more corrective surgery where, for example, it is necessary to remove physical impediments to social rehabilitation. But a doctor is only found on the staff of those institutions which are large: in the smaller prisons there may be only first-aid facilities, and no specially appointed doctor in the community. Moreover medicines are often dispensed by medical auxiliaries who are sometimes prisoners themselves. Finally, in America prisoners are regularly invited to volunteer as subjects for medical and social research for which they are paid. In short, although it is hoped to 'cure' a prisoner he is a criminal first and a patient second.

Overseas-born doctor migration 1962-66.

Overseas-born doctor migration 1962-66.

Alien Doctors in Britain

Alien Doctors in Britain

Alien Doctors in Britain

Alien Doctors in Britain