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Social Medicine
There has been an increase in the number of patients referred to the Health
Visitor, and it is expected that this upward trend will continue.
The numbers that have been dealt with have not been included in the overall
volume of work done.
Education
Postgraduate Education has continued in many ways—by tape recordings, films
and discussions at our periodical luncheons, and by meetings of various medical
bodies.
Undergraduate Education—This year has seen the inauguration, and very nearly
the completion, of the "Student Scheme" by which, through the generosity of the
Sir Halley Stewart Trust, two studentships of three months were given to two final
year students from Charing Cross Hospital. As it ended very shortly after the period
covered by this report, a review of this project has been included.
It can be said that it was a complete success in giving the participants a very
wide introduction into all the facets and problems of general practice. It did not
have any effect or interruption of their final year curriculum as, within a very short
time of the completion of the Scheme, they each passed their final Conjoint Medicine
and the whole of their M.B.B.S. The success of this scheme may be attributed in
large measure to the encouragement given by a large number of general practitioners,
both urban and rural, to whom they were attached and who introduced them to all
problems concerned with general practice, academic and administrative, and to the
pattern of industrial medicine in the area. They were particularly enthralled with their
attachment to St. Christopher's Hospice for Terminal Care. Here they realised how
much could be done for the treatment of terminal pain and the ease and happiness
that could be given to dying patients in the last days of their life.
They also attended general practitioners' functions in the area and found of
great importance the contact between the general practitioner and the hospital and
were able to contrast the early presentation of disease in general practice and the
later stages of the disease seen in hospital. The difference in attitude impressed them.
The emphasis placed on the person by the general practitioner as compared with the
emphasis placed on the disease in hospital. They were interested too, in the workings
of the Emergency Bed Service and the London Ambulance Service.
An attachment to a family for the whole period had been arranged for each of
them, butjthis was not a success. The idea was that the mother should be shortly to be
confined; because of this they did not get the problems and patterns of illness in an
ordinary household.
At the conclusion they combined to write an excellent report and made several
criticisms, entirely justified, which can be rectified in any similar scheme in the future.
I think it is relevant and instructive to quote one or two passages which indicate
the value they received.
1. "Our views on general practice have been changed completely by what we have
seen. Before, we considered it to be a branch of medicine being done in a second
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