Learning aedicine Requirements for entry

of experience, the inflexibility of age and specialisation, or merely a lack of knowledge? It is noticeable that the positive attitudes in general practitioner trainees are often based on an awareness or personal experience of a treatment-for example, of users who wished to train further in these therapies, more than half had received treatment themselves by an alternative method. The relative lack of interest in junior hospital doctors may reflect the different role of these techniques in the more technological and specialised hospital environment. It may also, however, show something of the different attitudes to medicine in these groups, with the primary care doctor more concerned with "holism." Though the term "holistic" has been coined to describe the whole person approach of alternative medicine, this is hardly a new idea in orthodox general practice-though current vocational training programmes have found a need to re-emphasise it. Indeed, alternative medicine is in grave danger of committing the orthodox error of overspecialisation, which it claims to reject. Instead of taking your headache to a neurologist, your anxiety to a psychiatrist, and your search for a tonic to the chemist, you now knock on the door of the acupuncturist, hypnotherapist, and health food store in your quest for health. The whole person deserves a whole doctor who can assess his whole problem and who can refer him to a specialist, orthodox or alternative, if required. Based on the data gathered here, it is clear that younger doctors view these methods not as alternative but as complementary to more orthodox approaches. The interest shown here is not being met in undergraduate curriculums or postgraduate training programmes. It might be argued, however, that doctors should educate themselves in these methods. About 2000 doctors have indeed been trained to some degree by the existing medical associations for hypnosis, acupuncture, manipulation, and homoeopathy, but this contrasts with the number of professional lay practitioners (about 10 000). Furthermore, if the number not in professional associations is included, there were about 27 800 lay practitioners in 19811 compared with the total number of general practitioners in Britain in 1982 of 29 800. It becomes obvious that the exclusion of these methods from medical training carries certain implications for the future.