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staff should have time over and above service commitmentsto devote to education, and this should be borne in mindin the review of hospital staffing to be carried out followingthe Platt report.

c. In each of these hospitals or hospital groups a con-sultant should be nominated by the Regional Committeefor Postgraduate Education (see below), as clinical tutor,responsible for teaching arrangements and the general" care " of those under training. He should have admin-istrative support and adequate secretarial assistance.

d. The clinical tutor should also be the person respon-sible, in consultation with general practitioners in thearea, for organising opportunities for them to participatein clinical discussions and in clinicopathological confer-ences. They should, of course, have access to the libraryand to the diagnostic departments for consultation.

e. Certain physical facilities are necessary for the unit:i. Seminar room.

ii. Library (in which there should be a part-timelibrarian).

iii. Clinical tutor’s room.iv. Laboratories adjacent to the wards in which trainees

can perform tests on their patients.v. Married quarters for junior hospital staff, to allow them

to move from hospital to hospital.vi. Lunch room, as a focal point where hospital medical

staff can meet and be joined by general practitioners.The immediate objectives should be to provide nos. i, ii,and iii; the rest should follow as soon as practicable.

f. Certain criteria should be developed to create stand-ards to which all such units should aspire. These willrelate to:

i. Standard of supervision.ii. Quantity and variety of clinical material.

iii. Standard of records.iv. Postmortem service.v. X-ray and pathological services.vi. Laboratory facilities.vii. Seminars, clinicopathological conferences, &c.

Postgraduate medical education should be organised ina regional scheme, in which the units are the basic elements,but there must be an association with the regional university

a. There should be a postgraduate dean and/or direc-tor, appointed by the medical faculty of the universityconcerned, on whom the success or otherwise of thisscheme will very much depend. He should have properoffice accommodation and secretarial assistance. Such a

person or persons’ main responsibilities will be:i. The interrelationship between the region and the

university.ii. Arrangements for teaching in the region.

iii. Advising on careers.iv. Advising and placing of overseas graduates.v. The integration of general practitioners into these

postgraduate arrangements.b. There should be a strong Regional Committee for Post-

graduate Education, the convenor of which should be thepostgraduate dean, and on which will be represented: theuniversity, the regional hospital board, the Royal Colleges,and the College of General Practitioners. Its main taskswill be the coordination of services and division of res-

ponsibilities between the various authorities, includingeventually the arrangements for rotating junior staffs asnecessary in a regional training scheme. It will also beresponsible for appointing the clinical tutors at theRegional Postgraduate Training Units.

FINANCE

The financial responsibility might follow basically theresponsibilities between educational and National HealthService commitments. Thus the university should beresponsible for the appointment and payment of the deanand his secretary, and for honoraria to the clinical tutors.The regional hospital board should meet the expensesincurred in such a scheme by regional board staff.

URGENT NEED FOR FORMULATION OF

MORE DEFINITE PRINCIPLES AND POLICY

Immediate action will depend largely on local initia-tive, but there ought to be some central formulation ofprinciples and of policy for postgraduate medical educa-tion. This is a matter of urgency, and to achieve it, someofficial body should be established as soon as possible,representing the University Grants Committee (and uni-versities), the General Medical Council, the Departmentsof Health, the Royal Colleges, the Royal Corporations,and the College of General Practitioners.

Such a body should consider the desirability or

otherwise of central arrangements for supervision anddesignation of training and qualifying posts.

EpilogueThe conference was generally agreed about what needed

to be done, but it did not discuss in detail how it was tobe done. Nevertheless, it was clear that certain regional-board hospitals have already begun to develop educa-tional facilities along the lines proposed. Others are in a

position to begin once they have fully appreciated theneed. For those who have begun, for those who couldbegin, and for others who might begin, the success of theprogramme will depend greatly on the support given bythe universities and regional boards.The conference thought that detailed suggestions for

financial and other aid to the scheme were ultra vires.However, the vast amount of common ground and ofgood will for the general objectives outlined left no doubtthat a modest investment of support would yield a hand-some dividend in terms of quality of medical service athome and improved relations abroad.

SUPPORT FROM NUFFIELD TRUST

E250,OOO set aside for Postgraduate TrainingAFTER considering the report on the conference des-

cribed above, the governing trustees of the NuffieldProvincial Hospitals Trust have decided to reserve

6250,000 to finance regional and area schemes for post-graduate training in the provinces. Such projects shouldseek to apply the principle enunciated in the outline

arrangements which the conference agreed were needed,and which seemed the most practical means of improvingthe situation with regard to postgraduate training andeducation of doctors in the health services in the UnitedKingdom.The trustees are therefore looking forward to receiving

applications from interested bodies for grants over

limited periods to initiate suitable schemes. The trusteeswill be specially concerned to see that the appropriateuniversity and regional hospital authorities are both

wholeheartedly behind any approach to the Trust, andwhether there is evidence of an appreciation of the

urgency, as well as of local interest and self-help by wayof financial support.