College news

Meetings of Council Professors and Lecturers for 1975/76 were elected At the Extraordinary Meeting of the Council held (see p. i 68). on gth July Sir Rodney Smith KBE, President, was The following were elected as new Members of in the Chair. the Court of Examiners: Professor N L Browse Professor Emerich Polak, of Prague, was admitted and Mr C V Mann (General Surgery) and Mr to the Honorary Fellowship of the College. V T Hammond (Otolaryngology). In addition Mr Dr Denis Dooley, Dr Frederic Kohn, Dr R G W R I, B Beare, Mr C W S F Manning, Mr J P Ollerenshaw, Mr Giles Romanes, and Mr Norman Mitchell, and Mr J N Ward-McQuaid (General Rowe were admitted to the Fellowship by election. Surgery), Mr R F Macnab Jones (Otolaryngology), Diplomas of Fellowship were granted in accord- and Mr Lorimer Fison, Mr M J Gilkes, Mr C G ance with the pass list (see p. I 69). Tulloh, and Mr J Winstanley (Ophthalmology) were Diplomates were presented in order of medical re-elected for second terms of three years. and dental schools as follows: Fellows, Fellows in The Nuffield Prize was awarded to Dr David Dental Surgery, Fellows in the Faculty of Anaes- John Gwilt. thetists, Members, Licentiates in Dental Surgery. Sir Michael Woodruff FRS FRCS then delivered Faculty of Anaesthetists an address to the new diplomates (see p. I 66). It was noted that the following had been admit- ted to the Honorary Fellowship in the Faculty: Professor Sir Geoffrey Organe Dr Vernon Hall At the Quiarterly Meeting of the Council held on Professor W D M Paton FRS I oth July Sir Rodney Smith KBE was re-elected and that Dr S C Cullen, Professor J Severinghaus, President and Mr R H Franklin CBE and Mr R S and Dr C H Boyd had been admitted to the Handley OBE were re-elected as Vice-Presidents for FFARCS by election. the ensuing year. The Faculty has followed the decision of Coun- Mr A W Badenoch FRCS and Mr A S Frere CBE cil to rescind the rule preventing Fellows in the were admitted to the Court of Patrons. Faculty from being eligible to apply for election Mr George Qvist was re-admitted as a Member to the Board until i o years after the acquisition of Council and Mr Ian Todd and Professor Geoffrey of their Fellowship. Slaney were admitted as newly elected Members of As from Ist January I976 the MCQ paper in the the Council of the College. Dr Brian Sellick, Vice- Primary FFARCS examination will be used as a Dean of the Faculty of Anaesthetists, was admitted filter for entry to the rest of the examination. to Council as an invited representative of the Faculty. Donations to the College Sir Stanley Clayton PRCOG was admitted as the During the past few weeks the following generous newly co-opted Member of Council representing donations have been received: obstetrics and gynaecology. £io OOO.OO Sir Cyril Kleinwort Charitable Dr A J Whitaker was admitted to the Fellow- Settlement (further gift) ship by election. £3300.00 Smith's Charity Estate (further gift) Professor Gordon Seward was admitted to the £2104.98 The late Mr S H Hardy (legacy) Board of Examiners in Dental Surgery. £538-44 F C Eyre Esq (7-yr covenant £50 p.a. Council noted that Professor E S R Hughes FRCS + tax-further gift) had been elected President of the Royal Austral- £150.00 C T Bowring and Co Ltd (further gift) asian College of Surgeons for the ensuing year. iI5o.oo The Royal London Mutual Insurance Mr L B Scott FRcSEd, of Liverpool, and Mr Society (further gift) R E D Williams FRCSEd, of Leeds, were elected In addition there have been a number of gifts to the Fellowship ad eundem. under £ioo which total £595.89. College news

Faculty of Surgery: Election of Dean 20th October I975, stating their date of birth in and Vice-Dean the application. At the meeting of the Board of Faculty of Dental Surgery held on i8th Mr H Hovell Victor Horsley Memorial Lecture 1975 July 1975, John The Victor Horsley Memorial Lecture for TD was rc-elected Dean of the Faculty for the I975 cnsuing year. wAill be delivered by Mr Walpolc Lewin Hon. DSC At the same meeting Professor Paul Bramley was MS FRCS in the Edward Lumley Hall of the Col- elected Vice-Dean of the Faculty for the ensuing lege under the auspices of the British Medical year. Association on Thursday iIth December at 5.30 p.m. The title of the lecture will be 'Changing attitudes to the management of severe head Court of Examiners injuries'. Notice is hereby given that the Council on 8th Jan- ulary 1976 will elect members of the Court of Exam- College Dinner iners as follows: The College Dinner on Wednesday 12th November GENERAL SURGERY Three examiners to be will be followed by a talk by Mr Alistair Cooke elected, one of the retiring examiners being KBE (Hon.). eligible for re-election. Applications for tickets for the Dinner, price Fellows of the College desirous of becoming can- £6.oo including cocktails and wines at table, should didates for the office must make application by let- rcach Mr \V F Davis at the College not later than a ter to the Secretary of the College on or before week before the date of the Dinner.

ELECTION TO THE COUNCIL, 1975 On Thursday 3rd July 1975, as a result of the LAWRIE, Reginald Seymour (Guy's Hospital, postal ballot of Fellows, Mr George Qvist was re- London) 514 elected and Professor Geoffrey Slaney and Mr Ian KIRK, Raymond Maurice (Royal Free Pelham Todd were elected as Members of the Hospital and Willesden General Hospital, Council of the College. Mr Neville Stidolpli and London) 368 Lt-Col W C Moffat acted as Scrutineers on this WOOD, Kenneth Fowler (The Leicester Royal occasion. Infirmary) 354 The result of the Poll wvas as follows: NAYLOR, Arthur (Bradford Royal Infirmary) 338 STUBBS, John (Kensington and Chelsea Elected Group of Hospitals) 334 Votes BASSETT, Harold Frank McGhie SLANEY, Geoffrey (University of (Manchester Royal Infirmary and Royal Birmingham, Queen Elizabeth Hospital, Manchester Children's Hospital) 329 Birmingham) 759 QVIST, George (Royal Free Hospital) 756 MOLONEY, George Edward (The Radcliffe TODD, Ian Pelham (St Bartholomew's and Infirmary, Oxford) 320 St Mark's Hospitals, London) 730 HORTON, Robert Elmer (United Bristol Hospitals) 312 Not elected TINCKLER, Laurence Francis (Maelor General Hospital, Wrexham) 276 KINMONTH, John Bernard (St Thomas's Hospital, London) 6I2 KESSEL, Lipmann (Royal National LLOYD-ROBERTS, George Charles (Hospital Orthopaedic Hospital) 265 for Sick Children, Great Ormond Street) 603 BRADLEY, John William Paulton WADE, James Stanley Hilary (University (Hillingdon and Harefield Hospitals) 230 Hospital of Wales, Cardiff) 54I CASSIE, Gordon Fordyce (Queen Elizabeth II BROOKS, Donal Aleredith (University Hospital, Welwyn Garden City) I70 College Hospital and Royal National In all 3071 Fellows voted and in addition I8 Orthopaedic Hospital) _j23 votes wverc found to be invalid. I 62 College nIews ADMISSION TO HONORARY FELLOWSHIP Professor Emerich Polak At the Ceremony of Presentation of Diplomates held both classical anid modcerni music to perfection. on gth July 1975 with Sir Rodney Smith, Presiclent, 'This citation would be incomplete if I did not in the Chair Professor Emerich Polak, of Prague, refer to his personal qualities of kindness, sympathy, Czechoslovakia, was admitted to the Honorary and deep understanding. I feel sure, Mr President, Fellowship. Mr Ronald Raven delivered the Cita- this congregation will applaud with enthusiasm as tion in his honiour as follows: you confer the Honorary Fellowship on this dis- tinguished man, the first Czech surgeon to receive 'Mr President, this honour, who has dedicated his life to the art 'Today, when we welcome newv diplomates, it and science of surgery.' is my privilege to introduce, Professor Emerich Polak of Charles University, Prague. This ancient univer- Tnhe President theni admitted Professor Polak to sity was founded in 1348 by the Emperor Charles the Honorary Fellowship with the words: 'Professor IV. His father was sufficiently misguided to fight Polak: From the applause you can see that it gives against the English and consequently died in the everybody here very great pleasure indeed to see Battle of Cruchy. During World War II Charles you in Liondon andl at this College for such a University was transferred temporarily to Oxford, reason, and I think it gives particular pleasure where some of Professor Polak's students continued to those of us who have had the opportunity to their education. visit Prague and to be able to speak with first- 'Professor Polak has distinguished surgical an- hand knowledge of the great regard, respect, and cestry. In this pedigree I see several well-knowrn affcction with which you are heldl in your own names in surgery, including Professor E Albert, who country by all your colleagues. For my part it introduced Lord Lister's surgical methods to the gives me personally much pleasure; and what Continent, and Professor K Maydl, who organized greater bond outside medicine could there be than a modern surgical department in Prague at the end to remember that you and I first met in the gar- of the last century. Professor Polak's teacher wvas den where Mozart stayed when he was composing Professor Rudolf Jedlicka, remembered for his work "Don Giovanni"? And so, by the authority of on the surgery of peptic ulceration and pancreatic the Council and by the powers vested in me I admit cysts, who always spoke with enthusiasm about his you to the Honorary Fellowship of this College visit to London at the beginning of this century. and congratulate you.' In 1926 the Moynihan Club visited Jedlicka's de- partment in Prague, when Dr Emerich Pol'ak wel- Professor Polak replied as follows: comed them in his first speech in English and 'Mr President, Fellows of the Royal College of assisted his professor with the surgical demonstra- Surgeons of England, ladies, and gentlemen. tions. At first I must express my best thanks to Mr 'For 40 years Professor Polak has directed an im- Raven for the nice words he spoke about me. portant surgical department in Prague, where he has On the occasion I receive this great honour from educated and trained many surgeons. They showed the College I will say some words about my im- their respect and admiration for him when they pression of English surgery. I finished my studies organized an international surgical congress in his in 1925 just after the First World War. Czech sur- honour. He has wide interests in surgery which gery was then influenced by the school of Vienna range through gastrointestinal, paediatric, and thora- and by German surgery. After the war we had some cic surgery. He has contributed much to surgical contact with French surgery and the French sur- literature, including several monographs. In 1934 geons Rene Leriche, Mallet-Guy, Fontaine, ancd he published his mponograph on blood transfusion Marion, but French surgery at the time was at the which introduced this new treatment to Czecho- same level and we could not learn much from them. slovakia. Bctween the two wars we had not much contact 'In the Hunterian tradition, Professor Polak is w\ith English surgery, though we,c knew the names interested in other sciences-in botany and ento- of prominent English surgeons. My first teacher mology. His chief interest, however, outside surgery was Rudolph Jedlicka, who was known to Sir is music, like other distinguished surgeons, for Berkeley (later Lord) Moynihan, who esteemed him he is an accomplished violinist who can render very much and in I926 sent some puplls of his College news I63 to Prague, lut we had no direct contact. In 1935 British surgeons preparedl a very fine programme I began as Chief of the Department of a big surgical for our stay of three weeks anid we were accepted department in Prague. In 1938 the Germans oc- very kindly and warmly. After London we went cupied our country and we were for about 20 to Liverpool, where we met Mr Ronald Edwards years -without contact with the rest of the scicntific and Mr John Bickford, and Miss Elizabeth Fenton world. After the Second World War the first con- showed us a lot of her work in surgery and anaes- tact came from Russia, which had made great pro- thesiology. Anaesthesiology was at that time in its gress in surgery during the war, especially in war infancy in our country. English surgery made a surgery. With the west the first contact was with big impression on us for its very serious approach, the surgeons of the United States, who sent a for its exact technique, and for the excellent or- mission with Alexander Brunschwig to Prague and gainization of British medicine. later sent us some journals and plublications so that 'Now I am standing here to receive the great- Czech surgery developed very rapidly. There was est honour of the Royal College of Surgeons of a great day in I957 when I was sent with some England. I think it is the happiest day in my surgeons to England to learn thoracic and heart surgical career and I never imagined that my surgery. We saw Sir Russell (later Lordl) Brock, name would figure in the same list as so many Sir Thomas Holmes Sellors, Sir Clement Price names of prominent surgeons from all over the Thomas, andl maniy other surgeons at work and could world and I thank you so much for this honour admire the high standards of British surgery. The anid for your friendship.' THE MERRISON REPORT Memorandum of evidence from the Royal College of Surgeons of England and the Faculty of Anaesthetists Introduction immediate contact with the patient, the College and It is not the intention of the College and Faculty to Faculty have a particular responsibility to ensure comment in detail on the Report, with whose ar- that the young doctor is trained from an early stage gumenits anci recommendations they are in general to relate the science of medicine to the clinical agreemenit. Inideed, the College and Faculty sub- situation in which he must work. It is natural there- scribe to the favourable comments of others on the fore that wve should view with particular anxiety any clarity and good sense shown by the Committee of tendency to diminish the clinical content and em- Inquiry. They particularly welcome the emphasis phasis of undergraduate medical education. It has that the Committee has placed on the need for long been urged by the Faculty of Anaesthetists, and close consultation between the General Medical this view is supported by the College, that the study Council and the Colleges and Faculties on a num- of anaesthesia in the undergraduate curriculum ber of important matters concerned with medical would make for the production of better doctors. education and standards of practice. We welcome, therefore, the suggestion that the pre- We welcome the opinion that the General Med- registration year should be extended to two years ical Council should have as its objective the en- of graduate clinical traininig, which would allow couragement of high standards rather than the for an earlier experience in a wider range of preservation of minimum standards. At a time when specialties, including anaesthesia; but we must ex- economic, social, and political pressures are increas- press our anxiety at the prospect of a shortened ingly tending to erode the quality of training and undergraduate curriculum in which the trend might practice, we regard it as essential for independent be towards further exclusion or diminution of the bodies like the GMC and the Royal Colleges and clinical and clinically-related disciplines. Many of Faculties to work for and fight to preserve excellence us fear that this process has already gone too far, in the interests of the community as a whole. and that new generations of doctors are emerging This memorandum is concerned therefore with a from our medical schools who are inadequately number of fundamental issues on which the Col- equipped in the basic skills of patient management. lege and Faculty have a particularly strongly held As surgeotns, many of whom have experience as ex- view to put forward. aminers for university final medical examinations, Undergraduate medical education Members of Council are concerned at the apparent As bodies concerned with practice at the point of failure to teach undergraduates simple practical pro- I 64 College news

cedures such as spinal puncture and aspiration of have the power to cnforce their standards by with- the chest to an adequate standard; knowledge and holding recognition under the regulations for their experience of such procedures appear progressively higher diplomas. Visitors appointed by the College to have declined among examination candidates in and Faculty to inspect general professional train- recent years. At this formative stage more rather ing posts have, over a period of very many years, than less contact with patients in the clinical context recognised that their primary obligation is to the is required to stimulate the student's interest and trainees who will be attracted into these posts in to enable him to see the relevance of what he is order to comply with the Fellowship regulations; learning in the clinical situation. The Membership they have therefore been able to insist that those examination of the College, held jointly with the trainees are given the best possible facilities and LRCP, has played an important part in emphasis- supervision. We would emphasise the importance ing the essential virtues of clinical judgment and of this role and its significance in the improvement sound practical disciplines and we see a danger not only of standards of training but of the quality of this and comparable examinations losing the of facilities provided in the hospital service. The place that they have, for British graduates at least, role of the universities and Councils for Postgrad- if entry to a Restricted Register is based on com- uate Medical Education in the development and pletion of an undergraduate course with diminished general supervision of general professional education clinical content. It is our view that no amount of is recognised, but in our view this cannot be a sub- postgraduate training can wholly make good the stitute for the influence that the Colleges and Facul- ground if omissions occur in the undergraduate ties can exercise through the weight of the authority years. they possess and the sanctions they can impose. We therefore urge The same comments apply to the training re- i) that it is fundamental to good medical educa- quired in preparation for the postgraduate diplomas tion that from an early stage the undergraduate for which the College is jointly responsible with the should be brought into contact with patients and Royal College of Physicians through the Examining given thereby the stimulus to acquire the knowledge Board in England. he will need to treat them; and 2) that it is important for the safety of the pub- Specialist registration lic that the clinical judgment and approach of all We approve the proposals for the creation of an young doctors should be tested by examination. If indicative Specialist Register and agree that it the only examination by universities is to be at the must be the Colleges and Faculties and the Joint end of an undergraduate curriculum from which Committees on Higher Specialist Training that will the clinical disciplines have been largely excluded, grant the accreditation that will be the commonest a further examination must be held during or after basis for entitlement to entry to the Register. graduate clinical training. We do not agree, as suggested in paragraph I37 It is naturally the view of the College and Faculty of the Report, that Joint Committees need estab- that the best examination for this purpose would lish a corporate identity in order to justify the be one that ensures a consistent national standard. acceptance of their accreditation procedures by the The Royal College of Surgeons has a further GMC. We have adopted the practice of specific to requiring point make in relation to undergraduate certificates of accreditation to be granted, in most education. It is a matter of serious and growing cases, by the Colleges themselves in order to ensure concern to the College and its examiners to find that they have a statutory significance. a continuing deterioration in the anatomical know- We see other potential sources of difficulty in ledge of aspiring surgeons. The College would like the relative areas of authority of the GMC and to discuss urgently with the GMC and others the the Councils for Postgraduate Medical Education dangers of the decline in the number of medically and the Colleges and Faculties respectively but be- qualified teachers of anatomy and the increasing lieve that these can be resolved by consultation. disincentives to their recruitment. The creation of a separate Register of Special- ists as defined by the Medical Directives of the General professional training EEC is, as the Report has indicated, an outstanding It has long been the view of the College and Faculty point of difficulty but we again believe that this that there is no adequate substitute for thorough problem can be resolved so long as the Colleges inspection of hospital training posts by bodies that and Faculties and the Joint Committees are recog- College news 165 nised as being the appropriate authorities to in- there should be clear safeguards to protect the dicate specialist status. bodies responsible for preserving educational stan- dards from being out-voted on matters that funda- Overseas doctors mentally affect these. Acceptance by the GMC of The College and Faculty remain convinced of the encouragement of high standards as its objective necessity of an adequate system of clinical assess- should ensure this in principle; there must be no ment to supplement the new TRAB examinations, danger of anything less being accepted in practice. and they see this as necessary to fulfilling the laud- able intention of ensuring one standard for regis- General tration of doctors practising in Britain. The role.proposed for the newly-constituted GMC seems to us appropriate and sensible. We have Constitution some misgivings however that the considerable tasks We welcome the proposal to give the Faculty of it is being asked to undertake may prove beyond Anaesthetists direct representation on the GMC, and its capacity. We would therefore emphasise how in general we recognise that the balance between important it will be to make full use of the other elected members and nominated members has been educational bodies and to avoid duplicating the carefully thought out. We believe, nevertheless, that work that they are already doing.

MEETING OF THE FIVE NORTHERN REGIONAL ASSOCIATIONS OF SURGEONS A meeting of the surgeons of the Leeds, Liverpool, were given on the following subjects: Silastic re- Newcastle, Sheffield, and Manchester regions was construction of the face by Mr W Simpson and held at the University Hospital of South Manches- Mr P Craig; Parotidectomy by Mr N Gleave; Le ter on 2nd May 1975. This meeting was also at- Fort II osteotomy for maxillary hypoplasia by Mr tended by Sir Rodney Smith, President of the Royal J Lendrum and Mr J Curphy; and Carotid endarter- College of Surgeons of England, together with I4 ectomy by Mr S S Rose and Mr D Charlesworth. members of the Council of the College. The following displays were also arranged: Opera- Videotape television operative demonstrations tive treatment of varicose veins by Mr S S Rose;

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Breast trial by Mr LJ Turner and others; Gastric l,ngland, Professor Martin Allg6wer, of Basle, plasmin by Mr L Turner, Dr L Poller, Dr S Whit- was admitted to the Honorary Fellowship of the taker, and Miss J Thompson; Collagen metabolism College. Following admission, Professor Allg6wer in scars by Mr P Craig; Surgery related to the gave a Moynihan Lecturc on General surgery and temporomandibular joint by Mr J Curphy; Treat- trauma (see p. 133). He impressed on his audience ment of rectal prolapse by Mr N F Kirkman; the fundamental requiremenit that all surgeons deal- Rtadiological display by Mr G Hartley and members inig with trauma should be widely experienced in of the X-ray Department staff; Treatment of burns general surgery. At the conclusion of the formal by Mr F Robinson; and Sterilized air, envelope proceedings a dinner was held for the members (Iressing of amputation stumps, and controlled en- of the five Northern Regional Associations of Sur- vironment by Dr Herbert Day. geons and their guests-Sir Rodney Smith PRCS, In the afternoon papers were read on the fol- Professor Martin Allgower, and the Council rep- lowing subjects: Space-occupying lesions of the kid- resentatives of the Royal College of Surgeons. ney by Mr R Barnard; Screening of the breast The photograph shows Sir Henry Osmond-Clarke for cancer by Professor R A Sellwood; Gastric (left) delivering the Citation for the presentation emptying after vagotomy by Mr D J Cowley; and of the Honorary Fellowship to Professor Allgower Haemorrhoids by Mr B Hancock. (centre). On the right of the picture are the Presi- Following the lectures, in the presence of the dent, Mr R H Franklin FRCS (obscured), and Mr Council of the Royal College of Surgeons of Robert V Cooke FRCS. CEREMONY FOR THE PRESENTATION OF DIPLOMATES At a ceremony held on gth July I975 new diplo- told that they would be Fellows of the College as mates of the College were presented to the Presi- soon as the further fee which was prescribed hadl dent. After the formal presentation the following been paid. And that was that. address was delivered by Sir Michael Woodruff After witnessing this splendid ceremony I do not FRS FRCS FRCSEd FRACS. Professor of Surgery, Uni- know which the new Fellows regard as the better versity of Edinburgh: system, but since neither they nor I have any choice in the matter I must ask them and the other new Mr President, Fellows, new diplomates, and diplomates to bear with me while I make a few guests: comments on some of the things about which I It is my first and very pleasant duty to congrat- would really prefer to hear their views. Inevitably ulate the new diplomates on their great achievement these relate to the MRCS and FRCS, but I hope in passing this milestone-leaping this hurdle might that the dental surgeons and anaesthetists among perhaps seem to them a more appropriate meta- the new diplomates will be able to extract some- phor-in their professional careers. This I do most thing which seems relevant to their particular warmly. specialty. It would be interesting, and indeed salutary, to Not so very long ago the surgical part of the hear from our new diplomates what they think of Conjoint examination for the qualification of MRCS the examination they have just passed, and of their LRCP was, I think, easier than the examination plans for the future. But fairly recent custom has set by most if not all British iiniversities for their prescribed for them the further ordeal of listening own qualifying degree in medicine. Today the to this address. Things were not ever thus. When position seems to have been completely reversed, I sat the Fellowship examination-you would I and the standard in surgery in the Conjoint examina- am sure be astonished and perhaps even feel cheated tion has advanced to the point where even Fellows if I did not use these words somewhere-having of the College have been known to fail. This seems finished all our vivas we wandered round Lincoln's to me bizarre, but I hasten to add that while the Inn Fields until late aftemoon and then retumed College may perhaps have over-reacted a little it to the College, where we were called up one by is, in my view, the universities which are mainly at one by an official whom we had never seen before fault, for they have allowed the standard in sur- and told whether we had passed or failed. Those gery to fall to a level which the College rightly who had failed slunk away as inconspicuously as finds unacceptable. possible; those who had passed went upstairs to Stories about the Fellowship cxamination, and meet their examiners, to sign the book, and to be the examiners, are legion. I sat the Primary in College news I67

4elbournc when I was an unidergradluatc. Our ex- as I, ancl probably quiite a number of your examin- aminer in aniatomy was Sir Gordon Gordon-Taylor, ers, did in the days before yesterday. who was not only a very fine anatomist but was After the Primary, what then? Again my views reputed to have spent much of his time on the may not be very popular, but I wish that the four-wveek journey by sea to Australia in mugging College would award a Licence in place of the up such esoteric subjects as the ossification of the present Membership and its Membership to those sphenoid bone. He did not ask me about this, who pass the present Fellowship examination or though at the time I knew the answer, but he something like it. The Fellowship could then be did toss one of the carpal bones to another can- awarded to those who have completed their training didate and when the latter deftly caught and named in some chosen branch of surgery. There would the bone he asked him whether it was left or right. of course be some confusion for a time, but this A friend of mine who w-as examined by Gordon- would be a small price in relation to the advan- Taylor some years later was coming to the end of tages which wrould be gained. It is ironical that his viva, which was based on a partly dissected the Royal College of Physicians, which had a cadaver, when as a final question his examiner scheme something like this, has seen fit to put the placed a pointer on the liver and said 'What's that?' clock back. The physicians have, on the other The poor canclidate, feeling that he was being hand, in my view taken a remarkable step forward asked to name some obscure tubercle, was con- in achieving a common examination in all parts strained to say, 'I am sorry, Sir, I don't know'. At of the United Kingdom. I say in my view because that moment of course the bell rang. The can- I know that not a few of my surgical colleagues dlidate walked out crestfallen, and as he reached in Edinburgh, and I suspect also in London, think the door he heard Sir Gordon say gently, 'It's the differently. Perhaps my antipodean background has liver, my boy'. However, he must have done all helped me to take a broader view. right elsewhere for he was awarded the Hallett Finally, may I make a few comments about the Prize. Another story with an anatomical flavour practice of medicine-including general practice, uised to be told by our professor, Frederic Wood anaesthesiology, surgery, and, dare I include, dental Jones, about a previous examiner in the Primary surgery-in this changing world and the responsibil- in Australia. This particular gentleman claimed to ity which rests on all who undertake to care for be able to sex a dried skull, a task which Wood patients. Jones said was impossible. To put the matter to Sir Willam Osler, whose numerous Graduation the test Wood Jones gave him two male aboriginal Addresses are full of wisdom, once described skulls, and a week or two later these were re- 'work' as the 'master word in medicine'. I would turned with a note saying that they were clearly not underestimate the importance of hard work, both female. The only basis for this erroneous diag- unpopular as it seems to be to many of our fellow- nosis, according to Wood Jones, was that one countrymen, nor of technical skill, nor of that qual- skull was labelled 'Charlotte Waters' and the other ity so essential to a good doctor, and especially 'Alice Springs'. perhaps to a good surgeon, which Osler called I hope that in recounting these stories I have aequanimitas; but for me, and I hope for you, not left you with the impression that I am one the master word in any branch of medical practice of those who disapprove of the old-style Primary is 'compassion'. This means far more than a pious examination and of the emphasis it placed on gross hope that the patient will get better; it implies anatomy. On the contrary, I am firmly convinced that the doctor has spared no effort to fit himself that in these days, when less and less knowledge for his job and will spare no effort, despite the of anatomy is asked of undergraduates in our univer- many frustrations he may encounter, to do all he sities, it is essential for those who are seeking can for his patient. But there is even more to it a career in surgery to have the incentive which than this, for the doctor's responsibility is not only an examination provides to leam anatomy to some- to his patient, however important that may be, but thing like the level required when I was a student, to many other people including, inter alia, the though of course without such frivolities as the patients of tomorrow who are going to develop ossification of the sphenoid. Personally I see no diseases for which our present methods of treat- reason wvhy those who are prepared to do the addi- ment are inadequate. tional dissection which is necessary should not be In my Moynihan Lecture this afternoon I shall allowed to take the examination as undergraduates have something to say about the inadequacy of i68 College news cuirrent methods of treating cancer, and one could makes this seem desirable; at another time thinking casily add cxamples from many of these fields to and acting as a clinician to whom the luxury of in- illustrate my conviction that we all have a re- definite procrastination is denied. Most difficult of sponsibility, whether or not we engage in research all is the problem presented by the need for clin- ourselves, to encourage and support research which ical trials of new drugs and new procedures if may lead, either now or in the distant future, to medicine is to advance at all. This is not the therapeutic advances. occasion on which to attempt a detailed analysis The clinician who engages in research encoun- of this problem; let me say only that while I ters many problems. It is difficult to find the time have no magic formula which will tell you how and energy. It is even more difficult to be con- you should act in any given circumstances, I believe stantly changing one's mental spectacles, as it were, that if your main concern is really the welfare so that at one time one is thinking as a scientist, of your fellows you are unlikely to go far wrong. accepting nothing until there is good experimental Your ordeal is ended. Thank you for enduring evidence for it and even then being prepared to it so patiently. My congratulations and best wishes modify one's hypothesis whenever new evidence to you all. ELECTION OF PROFESSORS AND LECTURERS Hunterian Professorships Arris and Gale Lectureships RICHARDS, Harold James-Tendon healing and RUSSELL, Ronald Christopher Gordon-The role return of function. of glucagon in surgical physiology. ATTENBOROUGH, Christopher George-Total WILLIAMS, Hywell Thomas-Studies on the meta- knee replacement using the stabilized gliding bolism of testosterone by hamster prostatic tissue prosthesis. and their relevance to certain aspects of the HARRISON, Max Henry Montague-Perthes' dis- pathogenesis of treatment of human prostatic ease-new perspectives of aetiopathology and cancer. treatment. COLLIN, Jack-The current state of transplanta- GREEN, Norman Alan-Cryosurgery of the prostate tion of the pancreas. gland. HUGHES, Sean Patrick Francis-The extraction FOX, Miles-Isolation and transplantation of islets by bone and the clearance by the tissues of of Langerhans with the aim of treating diabetes technetium-labelled ethane- i -hydroxy- i, I-diphos- mellitus. phonate. KATTAN, Yousif Bahjat--Intrabiliary rupture of GEORGAKAKIS, A-Experimental pancreatic islet hydatid cyst of the liver. transplantation. LEONG, Che Hung Edward-The use of the MALT, Ronald A-Molecular mechanisms of com- stomach for urinary diversion and bladder pensatory renal hypertrophy. replacement. GILMORE, Owen Jeremy Adrian-A reappraisal Erasmus Wilson Demonstratorships of the use of antiseptics in surgical practice. KEIGHLEY, Michael Robert Burch-Biliary in- ASHERSON, Geoffrey Lister. fection: a preventable cause of postoperative BROWN, I N. morbidity. BRYCESON, A D M. SAIDI, Farrokh-A new surgical approach to hy- CURRIE, Graham. datid cyst disease. LEWIS, Graham Pritchard. POSWILLO, David Ernest-A biological approach SANDERSON, A R. to surgical reconstruction of craniofacial an- omalies. Arnott Demonstratorships HENDERSON, Derek-Photocephalometric predic- DOBSON, Jessie. tion and its influence on the surgical management ADAMS, D. of symmetrical facial deformity. BARRETT, Graham Stuart. PRYS-ROBERTS, Cedric-Medical problems of LEVENE, Arnold. surgical patients; hypertension and ischaemic PIASECKI, C. heart disease. RICHES, D J. College news I69 REPORT OF THE COURT OF EXAMINERS, 22nd MAYg1975 At the recent Final Examination for the Fellow- RUSHTON, Neil (Middlesex). ship 46 candidates presented themselves for the MUNDY, Anthony Richard (St Mary's). Examination in Ophthalmology, I5 of whom ac- §WATSON, Deirdre Clare Torbitt (Guy's). quitted themselvcs satisfactorily; 46 candidates KIDSON, lain Gordon (St George's). presented themselves for the Examination in Oto- MANSEL, Robert Edward (Charing Cross). laryngology, II of whom acquitted themselves ROOKER, Guy David (Charing Cross). satisfactorily; and 375 candidates presented them- BAMRAH, Niranjan Singh (Bombay). selves for the Examination in General Surgery, 144 MUKHERJEE, Dhruba Jyoti (Calcutta). of whom acquitted themselves satisfactorily. Of the KHAN, Mohammad Zafar Ullah (Punjab successful candidates, John Lang Benyon, Michael (Pak.)). Andrew Coe, and William Ellis Morgan have not yet complied with the tMAHMOUD, Nabil Abdel Hafez (Cairo). regulations. Dereck The following are the names of the I 67 can- GIBSON, Anthony (Birmingham). didates who are therefore entitled to the Diploma NAGASAYANA RAO, Kothapalli (Andhra). of Fellow: *HANNA, Onsy Farag (Cairo.) EDALAT, Moosa Agha (Tehran). tFRASER, Ian Rae (U.C.H.). MOHAN, Surinder (Lucknow). BISHOP, Michael Charles (U.C.H.). WEEDON, Maxwell Robert (Melbourne). *COOK, John Holford (Royal Free). ABDUL HAMEED, Mohamed Saood (Ceylon). WRAGG, Peter George (U.C.H.). AL-ANI, Miqdad Abdul Jabbar (Baghdad). COOKE, John Louis (St Thomas's). *BOASE, David Louis (St Thomas's). KHAN, Sirajur Rahman (Dacca). *FISHER, ffolliott Francis (Royal Free). PINTO, Anthony Filipe Clovis (Nagpur). HOFFMAN, Martin Geoffrey (K.C.H.). DHASMANA, Janardan Prasad (Lucknow). BENKE, Graham John (St Bart's). *BALAKRISHNAN, Balasunderam (Ceylon). BODEY, William Norman (Charing Cross). D'COSTA, Elias Francis (Padua). *CHERRY, Paul Martin Hempsall (St Mary's). FALAHI, Basil Abdul Rahman (Baghdad) *§FRANK, Helena Janet (Royal Free). FANSA, Maher Rashid (Alexandria). LOVEGROVE, John Emest (St Bart's). FEHRSEN, Oloff du Plessis (Cape Town). FYFE, Ian Stuart (Liverpool). FODA, Mohamed Ragaie Mahmoud (Cairo). BERSTOCK, David Anthony (St Bart's). KAZEM, Galal el-Din Hussein (Cairo). CLIFTON, Martin Anthony (St Bart's). MASIEH-UD-DIN, Mohammed (Marathwada). GEORGE, Nicholas James Robert (K.C.H.). MONGA, Lajwant Singh (Punjab (India)). *MARKHAM, Richard Hugh Clement (St Bart's). ABULATA, Kaiss Abdel-Dayem (Cairo). SIRCAR, Samar (Calcutta). ATTAR, Nawzad Ahmad (Baghdad). BOURNE, Roger (St Mary's). COOK, Michael Anthony Thomas (Birmingham) HENRY, Michael Meldrum (Guy's). EL TAHIR, Ahmed El Tigani (Khartoum). tJOHN, Anthony Christopher (St Mary's). HILL, Ronald Ian (W. Australia). MOTSON, Roger Wingfield (Charing Cross) *HOPKISSON, Bryan (St George's). tPEARMAN, Kenneth (Royal Free). INNES, David Barclay (Otago). *SPALTON. David John (Westminster). KASSIS, Samir Naim (Alexandria). WOODHOUSE, Christopher Richard James PARULEKAR, Narendra Shrikrishna (Poona) (Guy's). *TOOR, Karamjit Singh (Punjab (India)). ALLEN, Paul Richard (K.C.H.). §AGRAWAL, Meena Ram (Bombay). THOMPSON, Peter Melville (K.C.H.). *AHMAD, Ziauddin (Punjab (Pak.)). SMITH, Roger Battersby (St George's). ARTHUR, Gordon William (Melbourne). BINTCLIFFE, Ian William Lewis (St Bart's). BONAR, Francis John (Sydney). CRAIG, David McKean (St Bart's). CHOPRA, Ramesh Kumar (Allahabad). DAVIES, David Michael (St Bart's). CHOWDHURY, Amal Kanti (Calcutta). KENNING, Brian Richard (Guy's). EL-ARABI, Yahia Eltayeb Mohd (Khartoumn). tMARTIN, Francis William (St Bart's). tGLENNIE, Henry Ronald Ross (Otago). RENNIE, John Aubery (St Bart's). tHOULIHAN, Finian Peter (Dublin). *In Ophthalmology. tIn Otolaryngology. §Woman. 170 College news

NADARAJA, Raveendra (Ceylon). BEDFORD, Alan Frederick (Westminster). SAGAR, Shanti (Osmania). BLACKFORD, Hubert Noel (St Thomas's). SOURI, Mahadev Kumar (Sri Venkateswara). BLUNT, Richard John (Birmingham). VELLAR, Dominic (Melbourne). BRAWN, WVilliam James (The London). tBALDOCK, Craig Richard (W. Australia). CABLE, Robert Loudon (Otago). CARTMILL, Ross Ashley (Queensland). CHAN, Kong Kiong (K.C.H.). CHARNOCK, Frederick Mark Luckhoff (Cape DUFFIELD, Robert George Maxwell (St Town). George's). DALE, Richard Foley (Westminster). EDWARDS, Anthony Norman (Manchester). FLEETCROFT, John Paul (Westminster). FARNDON, John Richard (Newcastle). FOGARTY, Paul Diarmuid (Sydney). FERMONT, David Calvin (Middlesex). FORSTER, Ian William (U.C.H.). FOUNTAIN, Saunders William (Glasgow). GROSSER, David Maxwell (Sydney). FOY, Patrick Michael (Leeds). GUNASEKERA, XVijith Sri Lal (Ceylon). GLASGOW, Malcolm Mervyn Stanley HARVEY, John Scott (Leeds). (Westminster). HINDMARSH, John Reed (Newcastle). GOODALL, Robert John Rhodes (Leeds). KALAPESI, Boman Keki (Bombay). HENDERSON, Hugh Peter (St Thomas's). *KHAN, Akhtar Jamal (Sind). HONEY, Richardson John D'Arcy (St KIELY, Edward Mathew (Cork). Thomas's). *§McDERMOTT, Maeve Anne (Cork). HOWCROFT, Andrew John (The London). §RAMAN, Hymavathy (Bombay). INGRAM, David Maurice (Melbourne). RAWLINS, Richard Duddingston (Middlesex). *JAY, Jeffrey Louis (Glasgow). RAY, Kali Kumar (Calcutta). LEAPER, David John (Leeds). SONGONUGA, Babatunde Owolabi Odununga LOGIE, John Robert Cunningham (Aberdeen). (Ibadan). MATHESON, Duncan Mackenzie (St Thomas's). TELANG, Ramesh Narayan (Bombay). PARSONS, Keith Francis (Liverpool). BIANCHI, Adrian (Malta). PRICE, Dilwyn Arthur (Newcastle). BORE, Peter James (Newcastle). RANGECROFT, Laurence (Newcastle). BUXTON, Richard Anthony (St George's). REECE, Victor Alan Cyril (Newcastle). DAVIES, John Stewart (St Bart's). ROBERTS, Carl (Newcastle). FORRESTER-WOOD, Christopher Patrick (St SAIKALI, Wael Alfred Michel (Cairo). Bart's). SINGH, Shiva Dayal (Kanpur). tGRIMALDI, Peter Martin Gort Beaufort (St STANIFORTH, Paul (Birmingham). Thomas's). THORNELOE, Michael Hugh (Dublin). JOSA, David Patrick (West Indies). ULLAL, Ravindranath Rao (Mysore). KOKRI, Manmohan Singh (Newcastle). VALERIO, David (Sheffield). LIPPEY, Eric Roger (Sydney). WALSH, Timothy Hays (U.C.H.). tLITCHFIELD, Hugh William Baird (Otago). DOWD, George Simon Edmund (Liverpool). MALYCHA, Peter (Adelaide). HEARN, Alan Raymond (Bristol). SCOTT, Alan Reid (Glasgow). MILEWSKI, Peter Jan (Oxford). SCOTT, Ian Hetherington Kenneth (Guy's). SWAIN, Charles (Malta). tTALBOT, James Leonard (Otago). THOMAS, David Michael (Middlesex). ATTARA, Kerim Antoine (Cairo). WHELAN, Peter (U.C.H.). BAINBRIDGE, Edward Thomas (Birmingham). WOLFE, John Henry Nicholas (St Thomas's). BAKER, Ronald (Wales). PEPPER, John Robert (Guy's).

*In Ophthalmology. tIn Otolaryngology. §Wornan. College news 171 ANNUAL MEETING OF FELLOWS AND MEMBERS Wednesday ioth December 1975 I.OO p.m. Lunch. (Tickets for coffee and lunch, 9.30 a.m.-i p.m. Symposium on TEACHING price £2.70 including VAT, may be POSTGRADUATE SURGERY obtained from the Principal 9.30 a.m. Welcome and introduction by the Administrative Assistant at the President College.) TECHNIQUES-Chairman: Mr Selwyn Taylor 2.30 p.m. ANNUAL MEETING OF FELLOWS 9.35 a.m. Audiovisual aids-Mr G J Hadfield AND MEMBERS (The final agenda 9.55 a.m. The art of lecturing-Dr R G W will be published in the Annals for Ollerenshaw November) I0.15 a.m. Clinical teaching-Mr P G Bevan 4.00 p.m. lea 10.35 a.m. Panel discussion 4.30 p.m. BRADSHAW LECTURE-Mr I 1.00 a.m. Coffee Ronald Raven-Oncology- IDEOLOGY-Chairman: Professor R B attainment and anticipation Welbourn 7.30 p.m. College Dinner, open to diplomates of I 1.30 a.m. Surgery by presentation-Mr Michael the College and their guests. (Further Hobsley details and tickets available from I1.50 a.m. The value of research-Professor Mr W F Davis at the College) I D A Johnston 12.10 p.m. Mathematics and the surgeon- All medical and denital practitioners, whether or Professor J Crank niot they are diplomates of the College, are welcome I 2.30 p.m. Panel discussion to attend the Symposium and the Bradshaw Lecture. SURGERY LECTURES, AUTUMN 1975 September Thursday 25 AMonday I5 Mr P B Clark-Carcinoma of the bladder Mr A B Birt-Arteriovenous fistulae (6 p.m.). (6 p.m.). Tulesdav i6 Friday 26 Mr J Thornton Holmes-Feeding ill patients Mr P M Perry-The surgery of the parathyroid (6 p.m.). glands (5.I5 p.m.). HUNTERIAN LECTURE Professor C G Mr N Thompson-Management of chronic Attenborough-Total knee replacement using the lymphoedema of the extremities (6.30 p.m.). stabilized gliding prosthesis (5 p.m.). Monday 29 WVednesday 1 7 Mr P R Hawley-Rectal prolapse (6 p.m.). Dr C M T Gleave-Intensive care in surgical Tuesday 30 patients (6.I5 p.m.). Mr D J Waterston-Paediatric cardiac surgery 7Thursday i8 (6 p.m.). Mr P G Bevan-Acute biliary tract infection (6 p.m.). October Friday 1g WVednesday I Professor H Ellis-Resume on malignant discase Professor I E Gillespie-Selection of surgery for (5.I5 p.m-)- peptic ulcer (6.I5 p.m.). Professor L E Hughes-The management of Thursday 2 pigmented skin lesions, benign and malignant Mr R J Earlam-Management of retrosternal (6-30 p.m.). and epigastric pain (6 p.m.). Monday 22 Friday 3 Mr A J Edwards-Mesenteric ischaemia (6 p.m.). Mr D R Sweetnam-The foot (6 p.m.). Tuesdav 23 Monday 6 Mr D Calvert-Investigation and treatment of Mr Selwyn F Taylor-Surgery of the thyroid obstructed kidney (6 p.m.). (6 p.m.). lVednesday 24 Tuesday 7 Mr NV D George-Moderni attitudes to breast Mr P M Aichroth Internial derangemenits of the cancer (6.I5 P.m.). knee (6 p.m.). I 72 College news

Wednesday 8 No further applications can be accepted for the Mr M S Owen-Smith-Gunshot wounds CLINICAL, PART of the course. ATTENDANCE (6.15 p.m.). AT THE LECTURES ONLY IS UNRESTRIC- T hursday 9 TED. Fees Lectures only: £20 or Li for a singlc CECIIJ JOLL LECTURE-Mr Selw%,yn Taylor- lecture (apart from statutory lectures). Hyperparathyroidism: retrospect and prospect Applications for Lecture tickets (whole course or (5 p-m-)- specific lectures) should be sent to Mr W Webber, Mr P S London- Management of multiple trauma Administrative Assistant, Royal College of Surgeons (6 p.m.). of England, 35/43 Lincoln's Inn Fields, London Friday io WC2A 3PN (01-405 3474, Ext. 28), accompanied by Mr J S P Wilson-The scope of surgery in the a cheque for the appropriate fee, or payment may treatment of cancer of the head and neck (6 p.m.). be made at the door.

FACULTY OF DENTAL SURGERY: FOURTH FACULTY EVENING Temporomandibular joint disorders The programme of the Fourth Faculty Evening, to 7.45 New coincepts for surgical treatment- be held at the College on Friday evening 24th Oc- Professor David Poswillo (Dental Research tober I975 under the chairmanship of Mr Paul Unit, Royal College of Surgeons) Toller, is as follows: 8.io General discussion 6.oo Diagnostic approaches-Mr Malcolm Harris 8.50 Summary and closure-Mr Paul Toller (King's College Hospital) A maximum of 130 applications can be accepted 6.25 Likely causes of observed clinical for the meeting, which is open to all dental and phenomena-Mr Peter Rothwell (Turner medical practitioners. Admission fee is £2.50, which Dental School, Manchester) includes light refreshments during the evening. 6.45 Logical conservative treatment-Mr Stephlen Applications, which should be accompanied by Gould cheques made payable to the Faculty of Dental (Eastman Dental Hospital) Surgery, will be dealt with in strict rotation and 7.10 Interval for refreshments will be accepted up to Friday i8th October pro- 7.35 Criteria for use of intra-articular vided tickets are still available. corticosteroids-Mr Paul Toller (Mount (The Fifth Faculty Evening, on 'Occlusionl', will Vernon Hospital, Northwood) be held on Friday 26th March 1976.)

COLLEGE DIARY September October Saturday 13 Monday 6 Surgery Course begins. Faculty of Anaesthetists Course begins. Tuesday i6 Final Fellowship (Otolaryngology) and DPatl First Membership, DOrth (Part I), and LDS examinations begin. (Part II) examinations begin. Wlednesday I7 Wednesday 8 Hunterian Lecture-Professor C G Attenborough Day-release course in Basic Medical Sciences -Total knee replacement using the stabilized begins. gliding prosthesis p.m.). (5 Thursday 9 Monday 22 Council Primary FFA, First LDS, and DCH examinations Quarterly (2 p.m.). begin. Cecil Joll Lecture-Mr Selwyn Taylor- Thursday 25-Friday 26 Hyperparathyroidism: retrospect and prospect Course on Recent advances in anaesthesia. (5 p.m.). .llonday 29 Saturday i I DOrth (Part II) examination begins. Surgery Course ends. College news I73 Monday '3 Tliursday 23 Basic Medical Sciences lectures and Board of Faculty of Dental Surgery (II.I5 a.m.). demonstrations begin. Final Fellowship (Ophthalmology) and DMRT Friday 24 examinations begin. Faculty of Dental Surgery Evening (6 p.m.). Anaesthetics Course ends. WVednesday I5 DA and DPH examinations begin. Board of Faculty of Anaestlhetists (3.30 p.m.). Monday 27 Basic Dental Sciences lectures anid demonstrationis T'hursday i6 begin. Arris and Gale Lecture-Mr H T Williams- First LDS examination Studies on the metabolism of testosterone by begins. hamster prostate tissue and their relevance to certain aspects of the pathogenesis and treatment WVednesday 29 of human prostatic cancer. Tudor Edwards Memorial Lecture-Dr N Primary Fellowship examination begins. Oswsvald-Pulmonary metastases (5 p.m.) (at the Royal College of Physicians).

AMonday 20 Thursday 30 Course in General Oral and Dental Surgery THOMAS VICARY COMMEMORATION. begins. Thomas Vicary Lecture-Sir Francis Avery Jones CBE-The Norwich schools of surgery (5 p.m.). WVednesday 22 Final Fellowship (General Surgery) examination Ilunterian Trustees (4.30 p.m.). begins.

Notices

'Lives of the Fellows': important notice and Lord Webb-Johnson. There are some numbers left of Volume IV of Applications for this volume should be sent to the Lives of the Fellows of the Royal College of the Library of the College. Surgeons of England, 1952-I964, and the Coun- cil of the College has agreed to sell these at £3.50 instead of £6.oo. Volume IV makes a strong ap- St. George's Hospital and SW peal to surgeons all over the world because it Metropolitan Orthopaedic contains the lives of numerous surgeons who en- Training Scheme joyed an international reputation-to mention a Teaching Calendar, Winter Term, I975 few: Ian Aird, Victor Bonney, Sir Hugh Cairns, OCTOBER Sir Hugh Devine, Sir Thomas Dunhill, Sir Thomas Fairbank, Sir Harold Gillies, Sir Gordon Gordon- Thursday 2 Taylor, Sir Geoffrey Jefferson. Sir Arthur Keith, Lecture: Mr WV Boiid-Enginceriiig techniqlucs Sir Hugh Lett, Sir Archibald Mclndoe, Philip (8-15 p.m.). Mitchiner, Sir Max Page, Sir John Parsons, Sir T7'hursday 9 Henry Souttar, Julian Taylor, Sir James Walton, Journal Club (8.15 p.m.).