915LEADING ARTICLES

Scientific Manpower—and Medicine

THE LANCETLONDON 21 OCTOBER 1961

THE Committee on Scientific Manpower,! thoughvery cautious about the basis of its estimates, givesdefinite and helpful figures, first on the future supply ofscientists and technologists, and secondly on the futuredemand for their services. The total annual output ofscientists and technologists is expected to rise fromabout 14,300 in 1959 to about 27,500 in 1970, and thetotal demand from 173,000 in 1959 to 328,500 in 1970.Those employed in industry, who constituted about 44%in 1959, may amount to about 50% by 1970, while thereis likely to be a corresponding fall in the proportion em-ployed by the Government and the public corporations.There will, however, be a falling annual rate of increasein scientific manpower employed by Government andprivate industry, whereas in the public corporationsand education the rate of increase will probably rise.A point of interest is that, whereas by 1965 scientificmanpower will roughly balance demand, there will

actually be a shortage of technologists offset by an excessof scientists. By 1970, it is thought, there will be anexcess of both scientists and technologists.The committee, over which Sir SOLLY ZUCKERMAN

presided, does not give corresponding figures for themedical profession; but it notes that in 1959 the full-time students preparing for qualifications in medicine(human and veterinary), dentistry, and agriculture wereabout 19,000 and in 1970 the estimated figure is 21,000.On the committee’s estimate there may, it seems, bea big transfer of manpower from medicine into scienceand technology; and this could seriously damage ourprofession, by depriving it of its fair share of goodminds.

Obviously it is right to try to forecast future require-ments for all sorts of manpower which need a long periodof education, and to try to fill expected deficiencies.And the need for doctors should certainly not be ignored.But it would be a mistake to suppose that doctors arerecruited wholly from the scientifically minded, or thatcompetition for the best brains lies exclusively betweenmedicine and science. Medical students compete withscience in that they need places in the scientific side ofeducation; but there are motives other than scientificinterest which lead a man to spend a lifetime in medicine,and the medical profession does not draw from exactly1. The Long-term Demand for Scientific Manpower. Advisory Council on

Scientific Policy: Committee on Scientific Manpower. Cmnd. 1490,1961. H.M. Stationery Office. Pp. 26. 1s. 9d.

the same field of interest as the scientific and tech-

nological professions. It is all too easy to say that theNational Health Service is responsible for providing theincentive-that if the pay is made adequate there will beplenty of doctors. But in point of fact the motives whichdetermine entry into medicine or any other profession arenot as clear as they may appear. Probably only aminority of the young think first about the monetaryoutlook: they may be influenced more by the mentalimage of

" the doctor ". This image can change con-siderably over the years, and there is no doubt that ithas lost status in the last half-century-partly because ofthe behaviour of a small but conspicuous minority of theprofession after the introduction of the National HealthService and partly because increase in knowledge aboutmedicine among the lay public has diminished the

feeling that doctors, individually, are men of mysteryand power. The doctor portrayed by LUKE FILDES-a noble, determined, learned, strong, resourceful, gentle,and unselfish figure-is sometimes derided by the youngtoday; but as an ideal he did attract the best, and hewould still do so if people still believed that doctors werelike that. One still meets young doctors who admit that

they went into the profession as a result of admirationof a particular doctor. In other words, although it iseasy to put the responsibility on the authorities, theraising of the status of the profession is not entirely athing for " them " to do. " They " might retort that itis within the power of every doctor who comes in contactwith laymen to influence the public in the right direction.The medical profession is to no small extent responsiblefor its own future.

1. Garrod, A. E. Inborn Errors of Metabolism. London, 1923.

The Meliturias

WHEN THOMAS WILLIS tasted the urine of a diabeticin 1666 and found it sweet he might have forestalledterminological confusion by describing the condition as" melituria ". In three hundred years the term wouldhave no doubt acquired an air of venerable quaintness:instead it has now been attached to a group of metabolicdisorders which do not include the two commonest

examples of "

honeyed " urine-diabetes mellitus andrenal glycosuria-but which do include at least one con-dition in which the urine contains sugar but does nottaste sweet and possibly another in which it smells likesyrup but contains no sugar. Biochemically the meli-turias have little in common; and in clinical practice,while they are probably all genetically determined andall have at one time or another been mistaken for dia-betes mellitus, they vary from harmless curiosities tousually fatal diseases.Among the meliturias, familial pentosuria may be

accorded first place, not because of its clinical import-ance (which is slight), but as one of the original quartetof " inborn errors of metabolism ". GARROD notedthat it tends to crop up in more than one member of a

family, that it is detectable by chemical tests at birth,and that it causes no symptoms 1; and fifty years laterthere is little we can add to his observations. Unlikethe mixed bag of five-carbon sugars which are some-