Mandatory training for general practice in the United Kingdom To the editor: There are many medical graduates from the United Kingdom practising as general practitioners or family physicians in Canada who may wish to return to general practice in Great Britain in the National Health Service (NHS). These persons should be informed (or reminded) that the National Health Service Act of 1977 includes a section on mandatory training for general practice, which stipulates that physicians must have undertaken 3 years' postgraduate vocational training in that country, or equivalent "suitable experience". At present the regulations under the act are being discussed within the Department of Health and Social Security. It is unlikely that any part of the act will be implemented for about 18 months. The proposals are that 18 months after the regulations come into effect a physician wishing to become a general practitioner in the NHS will have to have undertaken at least 1 year's training in general practice. Three years after the operative date such a physician would have to have spent at least 1 year as a trainee in general practice, 1 year in educationally approved hospital posts in designated specialties and a further year in other approved posts. Physicians who have not had the prescribed experience may seek to have their training recognized as equivalent experience. Graduates from the United Kingdom practising in Canada will be able to submit details of their experience to the Joint Committee on Postgraduate Training in General Practice for approval as equivalent experience if they wish to return to practice in Great Britain after the act has been implemented. J.L. CHOUINARD
Coordinator Council on Medical Education Canadian Medical Association
The polio epidemic To the editor: From 1960 to 1965 I was involved in the safety testing of polio vaccines - both Salk and Sabin. At that time I predicted that unless there was continual vaccination of the "susceptible" population with the oral-type Sabin vaccine there would be a new epidemic of
polio. I am sorry that my prediction is just beginning to become reality. The random-shot clinics being established are useless. People who have had a "drink" or sugar cube previously are safe. Everyone who has been given Salk vaccine should immediately take oral vaccine, and those who have not been given Salk vaccine should get three Salk vaccinations at 2-week intervals and then a drink or a sugar cube. Poliomyelitis is too serious a disease to fool around with. The program I have outlined will ensure permanent immunity and at the same time overcome the possible danger of paralytic symptoms developing from Sabin vaccine (though it has never been proven that paralytic polio caused by any one of the three strains developed in any person following the administration of Sabin vaccine). The one person in several million in whom paralysis developed either had a disease unrelated to polio or had picked up an unrelated wild poliovirus for which the vaccine was not effective. ISADORE M. CASS, MD, I.cP[c] (PATH)
79 Old Forest Hill Rd.
Toronto, Ont.
quests perfectly.1 As to the Church's vehement disagreement with such treatment as electroconvulsive therapy (ECT), lobotomy and prolonged use of large doses of psychotropic drugs for the mentally ill, these methods are also falling more and more into disrepute in the rest of society. Psychosurgery has. all but disappeared and ECT is being used less and less. Especially in larger Canadian centres there is increasing diversity in culture, race and religion; this new pluralism is more likely to increase and spread to smaller centres than it is to be modified towards a more Anglo-Saxon cultural norm. In the future the Journal should aim at enlightening its readers with insights into new religious groups and diversified cultures, in a view to bettering relations between people, as opposed to solidifying barriers of prejudice. At the very least, articles could be verified for factual accuracy with the groups concerned. To quote the founder of the Church of Scientology, L. Ron Hubbard: "When in doubt, communicate". Scorr CARMICHAEL
Medicine and contemporary cultism To the editor: It was unfortunate that the article by Dr. Gordon H. Stephenson (Can Med Assoc 1 118: 1326, 1978) only sought to perpetuate old myths and ignored positive aspects of the new religions, especially in relation to medicine. For example, many of the concepts in the book Dianetics: the Modern Science of Mental Health, written by L. Ron Hubbard, were considered bizarre at the time of publication, 1950, whereas in contemporary society they are becoming more and more accepted, either directly or indirectly. Hubbard's book put forth the idea that unpleasant and dangerous prenatal experiences could affect a person later in life, an idea that has arisen over and over again in psychiatric and psychologic publications of recent years. At one time requests by Scientologists that no noise be made while their children were being delivered were greeted with amused tolerance by their doctors. Today the Leboyer method of delivery fulfils such re-
Church of Scientology Ottawa, Ont.
Reference 1. LOBOYER F: Birth Without Violence, Random House, Westminster, Md, 1975
To the editor: As both a general practitioner and a Scientologist I was dismayed by Dr. Stephenson's article. I take exception to his statement that "They [Scientologists] would like to control physicians to whom their adherents go." This is total nonsense. I see many Scientologists as patients and prescribe the necessary proven medical treatment as required, with no interference from the Church. On occasion I have had to refer these patients to specialists; there have been no complaints from my colleagues that the Church interferes in any way with their advised treatment. I ask that Dr. Stephenson get his facts correct before he has them printed in such a prestigious publication as the Journal. PAUL JACONELLO, MD
109 Dupont St. Toronto, Ont.
CMA JOURNAL/OCTOBER 21, 1978/VOL. 119 861
Coordinator Council on Medical Education Canadian Medical Association
The polio epidemic To the editor: From 1960 to 1965 I was involved in the safety testing of polio vaccines - both Salk and Sabin. At that time I predicted that unless there was continual vaccination of the "susceptible" population with the oral-type Sabin vaccine there would be a new epidemic of
polio. I am sorry that my prediction is just beginning to become reality. The random-shot clinics being established are useless. People who have had a "drink" or sugar cube previously are safe. Everyone who has been given Salk vaccine should immediately take oral vaccine, and those who have not been given Salk vaccine should get three Salk vaccinations at 2-week intervals and then a drink or a sugar cube. Poliomyelitis is too serious a disease to fool around with. The program I have outlined will ensure permanent immunity and at the same time overcome the possible danger of paralytic symptoms developing from Sabin vaccine (though it has never been proven that paralytic polio caused by any one of the three strains developed in any person following the administration of Sabin vaccine). The one person in several million in whom paralysis developed either had a disease unrelated to polio or had picked up an unrelated wild poliovirus for which the vaccine was not effective. ISADORE M. CASS, MD, I.cP[c] (PATH)
79 Old Forest Hill Rd.
Toronto, Ont.
quests perfectly.1 As to the Church's vehement disagreement with such treatment as electroconvulsive therapy (ECT), lobotomy and prolonged use of large doses of psychotropic drugs for the mentally ill, these methods are also falling more and more into disrepute in the rest of society. Psychosurgery has. all but disappeared and ECT is being used less and less. Especially in larger Canadian centres there is increasing diversity in culture, race and religion; this new pluralism is more likely to increase and spread to smaller centres than it is to be modified towards a more Anglo-Saxon cultural norm. In the future the Journal should aim at enlightening its readers with insights into new religious groups and diversified cultures, in a view to bettering relations between people, as opposed to solidifying barriers of prejudice. At the very least, articles could be verified for factual accuracy with the groups concerned. To quote the founder of the Church of Scientology, L. Ron Hubbard: "When in doubt, communicate". Scorr CARMICHAEL
Medicine and contemporary cultism To the editor: It was unfortunate that the article by Dr. Gordon H. Stephenson (Can Med Assoc 1 118: 1326, 1978) only sought to perpetuate old myths and ignored positive aspects of the new religions, especially in relation to medicine. For example, many of the concepts in the book Dianetics: the Modern Science of Mental Health, written by L. Ron Hubbard, were considered bizarre at the time of publication, 1950, whereas in contemporary society they are becoming more and more accepted, either directly or indirectly. Hubbard's book put forth the idea that unpleasant and dangerous prenatal experiences could affect a person later in life, an idea that has arisen over and over again in psychiatric and psychologic publications of recent years. At one time requests by Scientologists that no noise be made while their children were being delivered were greeted with amused tolerance by their doctors. Today the Leboyer method of delivery fulfils such re-
Church of Scientology Ottawa, Ont.
Reference 1. LOBOYER F: Birth Without Violence, Random House, Westminster, Md, 1975
To the editor: As both a general practitioner and a Scientologist I was dismayed by Dr. Stephenson's article. I take exception to his statement that "They [Scientologists] would like to control physicians to whom their adherents go." This is total nonsense. I see many Scientologists as patients and prescribe the necessary proven medical treatment as required, with no interference from the Church. On occasion I have had to refer these patients to specialists; there have been no complaints from my colleagues that the Church interferes in any way with their advised treatment. I ask that Dr. Stephenson get his facts correct before he has them printed in such a prestigious publication as the Journal. PAUL JACONELLO, MD
109 Dupont St. Toronto, Ont.
CMA JOURNAL/OCTOBER 21, 1978/VOL. 119 861
