It's that time of year again. The new junior members of staff have arrived and the old anxiety emerges—are they well trained? In particular, are they properly trained in practical drug therapy and prescribing? We believe they may not be.

In July we drew attention, yet again, to what we and many others perceive to be a serious problem in British medicine—poor prescribing.^{w1 w2} We emphasised that deficiencies are not confined to the United Kingdom, and three days later the Institute of Medicine in the United States independently expressed similar concerns.^w3 The chairman of the medical academic staff committee of the British Medical Association later concurred,^w4 and the Healthcare Commission urged the NHS to improve prescribing.^w5

Evidence of poor prescribing in the UK is abundant. Effective treatments, such as angiotensin converting enzyme inhibitors for heart failure1 and …