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Registration. The first duty which a young practitioner has to perform after having received his medical qualification to practise is to have his name placed on the official Register of medical graduates and licentiates. This he does at any one of the offices of the General Medical Council in London, Edinburgh, or Dublin, either by personal call or letter. He must exhibit his credentials, his diploma or licence, and, on paying the sum of £5, his name is enrolled on the list of duly qualified medical men. No further sum requires to be paid unless he desires to register additional qualifications, which he does on payment of £1 for each one. It is necessary to give a permanent address in case of official communications being sent, and one must keep the registrar advised as to any change in one's address.

It is absolutely necessary for every medical man to enrol his name in the Medical Register, as this is the only proof which the law recognises that one has been duly qualified to practise medicine and surgery. Only after registration can a medical man sign legal certificates, such as those dealing with birth, death, cremation, mental deficiency, lunacy, vaccination, Factory Acts, Workmen's Compensation Acts, notification of infectious diseases, National Insurance

Acts, Old Age Pensions Acts, sick benefit, insurance and friendly societies, excusing of jurymen, passports, etc.

Only duly registered practitioners are entitled to sue for their fees in courts of law. They are also exempted from serving on all juries or inquests.

The General Medical Council was constituted by the Medical Acts of 1858 and 1886. It consists of thirty-six representative members, and has, as its duty, the supervising of medical education, the keeping up to date of the list of duly qualified medical practitioners (the Register), and the preparation of the official Pharmacopoeia. Twenty-six members represent universities and colleges, five are nominated by the King, and five are elected by members of the medical profession.

It acts as a court of justice also in medical matters. If any practitioner has been convicted of a felony or misdemeanour in England and Wales, or of any crime or offence in Scotland, or if the General Medical Council has found him guilty of infamous conduct in a professional sense, his name may be erased from the Medical Register, and he has then no legal standing as a medical practitioner. From this judgment there is no appeal.

"Infamous conduct in a professional respect " means any procedure which would be reasonably regarded by his professional brethren of good repute as disgraceful or dishonourable, as, for example :

(1) Any medical man associating himself with any medical aid association which systematically canvasses and advertises for patients.

(2) Advertising with a view to his own gain,

or of employing agents or canvassers for procuring patients (touting).

(3) Employing unqualified assistants to attend or treat patients.

(4) By his presence, countenance, assistance, or advice enabling an unqualified person to attend or treat any patient, or to grant certificates of death (covering); thus, giving an anæsthetic to a patient so that an unqualified dentist might do some dental work would constitute "infamous conduct."

(5) Granting untrue, misleading, or improper medical certificates.

(6) Associating with uncertified women practising as midwives and issuing certificates, notifications, or other documents so as to enable such women, on pretence that these women were under their direction, to attend cases of child-birth.

(7) Immoral relations with his patients.

(8) The employment of unqualified assistants in the sale of drugs or poisons in any medical hall or shop kept by a registered medical man.

Almost all the recognised colleges or medical or surgical bodies may strike the name of any of their licentiates off their list for conduct such as the above. They must, however, inform the General Medical Council at once of such proceeding.

Advertising of Oneself.-It is almost unnecessary to state that no medical practitioner with any regard to his own reputation would think of advertising himself or his methods of treatment in the lay press. Neither, it is to be hoped, would he take other methods of bringing his name prominently before the public as a medical or surgical practi

tioner, as, for example, by signing his name to bulletins in reference to the illness of some more or less well-known individual and allowing these to appear in public newspapers. This has been done, but unless in the case of royal personages it is a breach of medical ethics.

It is, however, pusillanimous to find fault with a medical man who allows his name to be published as on the staff of some hospital, infirmary or teaching body. The general public takes little interest in such notices, and few even read the list of names except medical students, for whose benefit they are printed.

Again, it is urged that medical men ought not to write letters or take part in discussions in the correspondence columns of the daily press under their usual signatures. It is ridiculous, however, to entitle this advertising. If the correspondence were of a controversial nature they might lose as many patients by their advocacy as they might gain others, though it is extremely doubtful if their epistles would have any influence on their practice. Of course, medical matters ought never to be discussed by medical men in the lay press, but surely medical men are not to be debarred from dealing with ordinary social questions in the usual way.

It would be a decided breach of ethics to notify in the public press that you had taken on a certain gentleman as assistant, or that you had assumed Dr. So-and-so as partner, or that you were retiring from practice and wished to intimate that Dr. A. T. had taken over your work and intended to continue it. All such purely personal matters ought not to be advertised. They ought to be intimated to your

patients by personal calls or by private circulars. It is usual for people in trade to publish such announcements, but surely professional people ought to avoid such public notices.

Certificates. As these are frequently taken as evidence in courts of law, it is necessary that the medical practitioner should exercise great discrimination in granting them and care in filling them up. Should he grant an untrue, misleading or improper certificate, he may be prosecuted before the ordinary criminal courts. The General Medical Council may also adjudge him guilty of infamous conduct in a professional sense, and may give directions to have his name erased from the Medical Register.

Notification of Births Act, 1907.-By this Act the birth of any child (born alive or dead after the seventh month of pregnancy) must be notified to the medical officer of health within thirty-six hours of its occurrence.

This duty lies on the father or on any person in attendance on the mother and who has been present in the house at the time or within six hours after the birth. The medical attendant is therefore included, and in several cases he has been summoned and even fined for not notifying the birth. (The penalty for default is 20s.) This risk being present, it has become the invariable practice of the medical man after having attended a confinement to fill up one of the forms (obtainable at the office of the medical officer of health) and return it at once. No fee is payable for this notification, but as it is done in the interests of child welfare, it is willingly performed by the medical attendant. Illegitimate

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