A profession on probationBMJ 1998; 316 doi: https://doi.org/10.1136/bmj.316.7149.1991 (Published 27 June 1998) Cite this as: BMJ 1998;316:1991
- Colin Douglas, doctor and novelist
Colin Douglas reviews The Citadel—the controversial programme by Richard Horton
Medicine is a rough old trade. From doubtful origins in botany and violence, it has grown over the ages to biomedical respectability and considerable political clout. Now there are about 100 000 of us at it in the United Kingdom—(1);saints and scientists, sinners and soaks, together, of course, with the overwhelming nondescript residuum who qualify as “None of the above.”
We live off the state, spend about £45bn of its money each year, and in return practise the trade, trying to do as much good and as little harm as possible. Mostly. We work alone and in groups, in centres of excellence and of notoriety, under close supervision or none. We vary greatly. Very few of us have any clear idea of how we are doing professionally. We are not good at handling the failures of colleagues, far less our own. And traditionally we have tried to deal with the inevitable quota of misfortunes, scandals, and rascals in ways well meaningly devised to minimise professional embarrassment and public disquiet.
But all that seems to be changing now, and those who seek to lead and represent the profession face new challenges, the difficulties of which were teasingly explored by Richard Horton in an iconoclast's guide to the upper reaches of the British medical establishment. The Citadel, slotted in the decent obscurity of Channel 4 at 11 pm on a Thursday, …