474

Number of fully registered doctors on the Medical Register.

increasing number of Commonwealth practitioners who obtainfull registration, without (except in a minority of cases) firstapplying for provisional registration.The number obtaining provisional and full registration in 1953

was much lower than in the preceding five years. This is attributableto two things: (1) some people who would normally have registeredin 1953 took special steps to obtain registration before the end of1952 in order to avoid the preregistration year; and (2) the length-ening of the curriculum at certain Scottish universities meant thatfewer than usual qualified and became provisionally registered in1953. The striking increase in the number of newly registered doc-tors in 1952 (4493 as against 3075 in 1951) was largely due to theaddition of 1452 names to the Commonwealth List in 1952 (ascompared with 471 in 1951).

The Defence Services

Royal Naval Medical ServiceThe Medical Service of the Royal Navy affords, to medical

practitioners who are attracted by the prospect of sea serviceand work with the Royal Navy, a wide opportunity to practisetheir profession in an attractive environment. A backgroundof naval tradition naturally permeates the Royal Naval Hos-pitals and Naval Training Establishments, as well as Her

Majesty’s ships. Officers serving on the permanent list areencouraged to specialise in all branches of medicine, and theyare given full facilities to obtain higher qualifications. Coursesof postgraduate study are carried out not only in naval hos-pitals but also at civilian teaching centres. There is a wide

variety of subjects comprised in the title " naval medicine ",and it might often be claimed that certain of these subjects areunique. They include the physiology of diving, the physicalaspects of service afloat and ashore, Commando service,tropical diseases, and industrial hygiene; an important furtherspecialty is that of aviation medicine, and a small number ofNaval medical officers undergo full pilot training before under-taking duties with the Fleet Air Arm or in research establish-ments. Furthermore, a naval medical officer is no longerconcerned with the care of the sailor alone, but must alsohave up-to-date knowledge of the diseases of women andchildren so that he may attend the needs of the W.R.N.S.,members of the Q.A.R.N.N.S., NavalV.A.D.s, and the wives andchildren of Servicemen and Admiralty personnel servingabroad.The Royal Naval Medical Service offers a life career with

service on the active list up to 55 for all officers, to 57 for

surgeon captains, and to 60 years of age for surgeon rear.admirals. Provision is made in the regulations for countingprevious experience, both service and professional. Allprmou;commissioned service as a medical officer in one of the Amic:Forces is allowed to count in full, and all non-medical com.missioned service is allowed to count as half. Civilian hospinexperience, and also experience of a special nature in prm:;practice which is recognised by the Medical Director-Genet"as warranting additional seniority, may be allowed to count L;to a limit of seven years in all.The additional seniority will be reckoned as service for py.

and promotion but not for retired pay or gratuity. Leave z.granted to officers at the following scales : in the UnitsKingdom, 42 days a year; when appointed to H.M. Ship,on general service, at the rate of 3 days a month; when 0,

foreign service, 14 days local leave a year with a further 2 day;for each month abroad on return to the United Kingdom.

Entry in the first place is for a short-service commission oieither three or four years which may be extended. During thi:time application may be made for transfer to the permanent list,Medical practitioners who undertake their National Servic;in the Royal Navy are also eligible to apply to transfer to tkpermanent list. The normal career for a medical office:

provides for promotion to the full rank of surgeon lieutenamafter one year’s service, and to surgeon lieutènant-commanderafter a further seven years’ service. Surgeon lieutenant-com.manders are promoted to surgeon commander by selection atabout their 15th year of total service and surgeon commander,are promoted by selection to surgeon captain about their 2Myear of total service. Subsequent promotion to surgeon rear.admiral is by selection.

Rates of nav are as follows’ v

Additional allowances are granted to married officers according to rr,When the officer is not accommodated or messed, additional alloaapccare paid.

Medical officers are also eligible for allowances, in addition L’the basic rates of pay, on the same scale and under the sa1]1;

conditions as for other officers of equivalent rank. Th-include travelling expenses, subsistence allowance, and pl-ages for wives and families. Officers who transfer to pemaMKcommissions after a minimum of one year’s service will .:

paid a permanent commission grant of C1500 (taxable).The maximum rates of retired pay in addition to termin.

grants are payable to officers who complete certain specif,," cm

periods of service. Officers allowed to withdraw who ,t;

ineligible for retired pay will be eligible to receive gratult1’-,Further information may be obtained from the Medic.

Department, Admiralty, Queen Anne’s Mansions, St. JamesPark, London, S.W.l.

ROYAL NAVAL DENTAL SERVICE

Dental officers are entered for Naval service under similar C0:;’tions to those applying to medical officers. Information conK-conditions of service can be obtained from the Medical Deparr;-./of the Navy, Queen Anne’s Mansions, St. James’s Park, Los;"S.W. 1.

Royal Army Medical CorpsThere is, at the moment, a limited requirement for ti-

specialists, particularly ophthalmologists, otolaryngoka- -radiologists. In the main, however, the R.A.hi.C. w

applications from young recently qualified practitioners.Non-specialist Career66% of medical officers will be employed on sc’’

practitioner duties. After attending the junior officer cC’at the Royal Army Medical College, they serve 2 -’

officer in medical charge of a unit with concurrent payduties in a military hospital where they become con’-"with the soldier and his environment, the objects c’

475

Army, and the requirements from its medical service in peaceand war. They will, later, serve overseas where, as a regi-mental medical officer or in charge of troops and families,a reception station or small hospital, or in field medical unitsthey will be able to study the causation, prevention, andtreatment of tropical diseases, the effects of climate, &c. Ontheir return, they attend the senior officers’ course; the first21 2 months are spent in study at the Royal Army MedicalCollege, Millbank, and the next 3 months in a special post-graduate course at a London teaching hospital. At this stageofficers may opt to remain at general medical duties or takeup field training or junior staff appointments. For the moresenior ranks the requirements are a sound background ofclinical and preventive medicine to meet their advanced

responsibilities in the administration of the Army MedicalServices in peace and war.

Specialist CareerSpecialists are, subject to professional proficiency, employed

on specialist duties up to the rank of colonel. Thereafter theymay serve in this rank up to the .retiring age of 57 or may beselected for promotion to brigadier either in a specialist or non-specialist capacity. The process of selection for specialisttraining is carried out after the junior officers’ course, thoseapplicants who are most successful in the course examinationbeing accepted. Those accepted are provided with excellentopportunities to obtain higher qualifications and specialistexperience.Postgraduate TrainingThere are liberal arrangements for specialists and non-

specialists to undergo postgraduate training throughout theircareer.

Employment after RetirementAll suitable medical officers (specialist or non-specialist)

may be employed up to the age of 65 in appointments speciallyset aside for retired officers. Non-specialists are employedon general practitioner or medical administrative duties andspecialists on specialist duties.Conditions of ServiceAs conditions of service greatly affect a wife, married practi-

tioners considering an Army career are advised that theirwives should discuss these conditions with Army wives whohave served at home and overseas.The overseas tour is of 3 years’ duration. Families of officers

aged 25 or over can, in the case of most overseas stations,accompany the officer by sea or air. Local allowances are paidin certain overseas areas where the cost of living is greaterthan in the United Kingdom. Schools are normally availablelocally, and in the case of those with children between 11 and18 years left in the United Kingdom a tax-free educationallowance of up to E75 per year for the first child, E100 for thesecond child, and E125 for the third and subsequent children,is paid if they attend boarding-school, or E35 a year if theyattend day school and are placed in the care of a guardian.These allowances will also be payable for children under-going vocational and technical training. The facilities forsport and leave travel vary but are usually very good.A home tour, spent in U.K. or North-West Europe, lasts at

the moment 4-5 years. As a rule there is no difficulty inobtaining family accommodation or arranging schools. Theeducation allowance referred to above is, however, subjectto income-tax in the case of those serving in U.K., but not inBorth-West Europe.

It is the Army policy that all ranks should be given somemonths’ warning of an impending move. This is done asmuch as possible but cannot always be achieved-for example,the posting of an officer after the senior officer’s course may beinfluenced by his performance on the course and cannot bedecided beforehand, and emergencies may necessitate a suddenchain of appointments and reliefs.Married officers over 25 years of age are allowed, subject

to certain conditions, travel at public expense for their familyfrom duty station to duty station on posting, or to a selectedplace of residence if accommodation is not available at the

new duty station. Those serving on a commission of threeyears or over may also be eligible for refund of furniture-removal expenses, disturbance allowance of E40 or E20 (accord-ing to the type of accommodation occupied) designed to coverincidental expenses when the family are required to move forservice reasons, and, when serving overseas with their family,refund of furniture-storage charges.

Family accommodation provided by the Government is ata reasonable rent-furnished accommodation for a major is,for example, El 80 per year.The comradeship of the Army extends to wives and children,

but the wives of those interested will find out about this andthe advantages and disadvantages of an Army life far betterfrom other Army wives.Conditions of CommissioningThe normal maximum age is 33 but allowance is made for

those who have previously held commissioned rank in H.M.Forces on full pay. An antedate, counting towards pay andpromotion, may be allowed for 2 years spent in civilian practiceor hospitals. An additional period of up to 5 years may beallowed for specialist appointments held. An allowance is alsomade for previous commissioned service on full pay. Thisantedate counts towards the " reckonable service " mentionedbelow.

Promotion and PayDetails are given in the accompanying table. Iri addition the

following are payable:On appointment to a permanent commission, a taxable grant of E1500.Officers are entitled to an initial outfit allowance in addition to certain free

issues of clothing, so that they may provide themselves with the authorisedscale of uniform without expense to themselves. In addition, a tropical-kitallowance is granted to officers on first posting to stations for which tropicalkit is authorised. These allowances are tax-free. Relief from income-taxon necessary expenditure on maintenance of uniform, estimated at S40 ayear, is admissible annually.

Junior specialist pay........ C73 per yearSenior specialist pay E219 per yearQualification pay (for Staff College graduates) .. E63 to E127 per year

PROMOTION AND RATES OF PAY OF R.A.M.C. MEDICAL OFFICERS

Retired Pay, &c.For less than 20 years’ qualifying service, there is a tax-

free gratuity rising from E1000 at 10 years’ service to E2800at 19 years’ service.

Pensions are payable as follows on retirement at the agesand with the reckonable service stated:Major.... E625 for 22 years’ reckonable service at 53 years, plus

lump-sum grants of 1875.Lieut.-colonel.. E800 for 24 years’ reckonable service at 55 years, plus

lump-sum grant of E2400.Colonel.... E1000 for 26 years’ reckonable service at 57 years, plus

lump-sum grant of E3000.Brigadier.. E1150 for 28 years’ reckonable service at 59 years, plus

lump-sum grant of E3450.Major-general .. E1400 for 30 years’ reckonable service at 60 years, plus

lump-sum grant of E4200.Lieut.-general.. E1600 for 30 years’ reckonable service, on completion

of appointment, 4800.Deductions are made in the case of an officer whose reckon-

able service is less than stated above or who retired voluntarily2 or more years before his compulsory retiring age.

476

Retired-officer AppointmentsThese may be held from the date of retirement until the age

of 65. The annual salary ranks from El 130 to E1400, in additionto pension.

Further information may be obtained from the AssistantDirector-General, The War Office (A.M.D.2), London, S.W.I.

ROYAL ARMY DENTAL CORPS

Registered dental surgeons of British nationality or citizensof the Irish Republic who are liable for service under the NationalService Act may apply for short-service commissions for not lessthan 3 years on the active list, with a reserve liability up to 8 yearsfrom the date of their appointment. Those (both men and women)who are not liable for service may apply for short-service commissionsfor varying periods of between 2 and 8 years on the active list. Anantedate of seniority counting towards increments of pay and timepromotion may be granted for postgraduate civil professional experi-ence ; previous commissioned service in the Armed Forces is alsotaken into consideration. A tax-free gratuity is payable. Officers ordental surgeons (male) may be appointed to permanent commissionsdirect or at any time during the short-service or National-Serviceengagement. Until further notice, those so appointed will be paid aspecial grant of &1250 (taxable) after one year’s satisfactory service asdental officers. The period of their short-service commissions willreckon towards ultimate retired pay and service gratuity, but wil’.not entitle them to short-service gratuities. Dental surgeons who areeligible to apply may obtain full particulars and application formfrom the Under-Secretary of State, The War Office (A.M.D.6)London, S.W.1.

Royal Air Force Medical BranchThe Royal Air Force offers an attractive career to fully

registered men and women medical practitioners who are

British subjects or citizens of the Irish Republic. Normally,the upper age-limit for applicants is 33, but older applicantsmay be considered. Appointment is usually to short-servicecommissions for three, four, five, or six years in the first

instance, each of which may be extended to complete a maxi-mum period of eight years’ service. Exceptionally, suitablecandidates may be appointed to permanent commissions directfrom civil life. Short-service officers may apply for permanentcommissions at any time during their service.

Medical officers come into contact with flying and airevacuation of sick and wounded, as well as the clinical special-ties and the treatment of Service families. There are, inaddition, opportunities in aviation medicine, hygiene, andindustrial medicine.

For regular officers, antedates of seniority may be admissiblefor recognised civil experience. These antedates reckontowards pay, seniority, and promotion. The normal rank onappointment is flying-officer, with promotion to flight-lieu-tenant after one year’s reckonable service, to squadron-leaderafter eight years’ reckonable service, and to wing-commanderafter seven years’ satisfactory service in the substantive rankof squadron-leader. Officers recognised as R.A.F. specialistswill be promoted to the rank of group-captain after eight years’satisfactory service in the substantive rank of wing-com-mander, and to ranks above group-captain by selection. Pro-motion to group-captain and above for non-specialist officerswill be by selection.

Officers serving on permanent commissions may be allowedstudy-leave with full pay and allowances to take approvedpostgraduate courses, for which tuition fees on an approvedscale may be granted. Officers having experience or aptitudein a specialty may be employed on specialist duties and subse-quently earn recognition as junior specialists with additionalpay of 4s. per day and as Royal Air Force specialists withadditional pay of 12s. per day. Non-specialist medical officersbelow the rank of group-captain will be awarded additionalpay of 4s. per day on gaining a registrable diploma in publichealth, industrial health, or tropical medicine, provided thatin each instance the prescribed period of study occupied anacademic year.

Officers appointed to permanent commissions will receivea grant of E1500 (subject to income-tax) after one year’ssatisfactory service and they will be entitled to retired pay and

bther benefits after completion of service. Short-seme:officers will, on completion of their commissions, be paid atax-free gratuity at the rate of E200 for each year of satisfactor,service. Arrangements exist to preserve their superannuMmrights under the National Health Service (Superannuatior.Regulations, 1950.

Further information can be obtained from the Unda-Secretary of State for Air, Air Ministry, M.A.1, 1-6, Tavistoa.Square, London, W.C.1 (Euston 5040, ext. 310).

ROYAL AIR FORCE DENTAL BRANCH

Commissions are available in the Royal Air Force Dental Bran,:to candidates of either sex who possess a degree or licence in dentalsurgery of a British university or licensing board, and who a::

registered under the Dental Act in force in the United Kingdor,.,Dental officers in the Royal Air Force have plenty of scope for ilthe aspects of dentistry in a branch which trains its own technician,and maintains its own laboratories under senior dental officer;,Dental officers serving on short-service or National-Service com. ’,missions may apply at any time for appointment to permanent com- !missions. The length of the period on a short-service commissio-and the period required in the reserve on its completion is the sam,

Bas for medical officers. Similarly, dental surgeons may be grantedpermanent commissions if they can complete at least twenty year,’service qualifying for retired pay. Previous commissioned servicecounts for antedate of seniority rank on appointment, and terms 01promotion the same as for medical officers, while antedates for civilexperience in a recognised professional appointment are given on th: ifollowing basis, subject to a maximum antedate of seven years forsuch experience: first four years, in full; any later experience, in half,Candidates who hold specialist appointments may be allowed tohave their civil experience assessed on a different basis, but withinthe same maximum of seven years. A tax-free gratuity, at the rate or

E170 a year for each year of satisfactory active-list service, is payabi,to short-service officers on transfer to the reserve. Dental officer

appointed to permanent commissions are encouraged to pursue therstudies in postgraduate research and may be allowed up to seven

months’ study leave on full pay and allowances to take approvepostgraduate courses. Until further notice, a grant of E1250, subjecto income-tax, will be made after one year’s satisfactory commissionccservice in the dental branch, to officers appointed to permanentcommissions. Short-service or permanent-commission officers whhave the appropriate higher qualifications and the requisite expenm;:may be recommended for specialist appointments. Further inform,tion may be had from the Under-Secretary of State, Air MinistnM.A.6, 1-6, Tavistock Square, London, W.C.1 (Euston 504,ext. 106).

Health Services at Home

PUBLIC HEALTH

AMONG the divisions of the nation’s health services, pubL;health ranks next in size and importance to the genera’practitioner and hospital services and it offers a satisfactorycareer to the young doctor keen to work for the welfare of the

community as well as for the individual.Under the National Health Service Act of 1946, council

counties and county boroughs were designated " local hearauthorities " and had conferred upon them, and through therupon their medical officers of health, wide responsibilities forprovision of personal health services. These include a duty

provide clinics and other services for mothers and yourchildren, domiciliary midwifery, home nursing, demesne herhealth visiting, immunisation, vaccination, and ambularservices. Wide powers are also given to these authorities

prepare and administer schemes for the prevention of di’-and for the care and aftercare of sick persons. Recentlyconcepts have been developing in the mental-health seryand there will be considerable expansion in local-=;-authority responsibilities as the result of the recommendin the report of the Royal Commission on the Law rto Mental Illness and Mental Deficiency. In most countrycounty boroughs the medical officer of health is prinClpi.: medical officer and is thus responsible for the preventiveservices covering children of all ages. In some areas :-’coordination has been secured by placing the authority’s