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Whither grand rounds?
  1. Gerald Stern
  1. Correspondence to Dr G Stern, Emeritus Consultant Neurologist, University College Hospitals, London WC1, UK; geraldstern{at}googlemail.com

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“Laudator Temporis Acti”

Praiser of times past (Horace, Ars Poetica 173)

To be afflicted by the ‘withers’, much favoured by Victorian writers, and to include a Latin tag, indicates that the writer is aged but may enjoy the possible advantage of recalling a superficial history of teaching in our specialty. In the immediate postwar years—I hurriedly add World War II—and well before the current epidemic of postgraduate courses and study days, there was little formal training to become a consultant neurologist, certainly not in the UK. The first hurdle was to obtain membership of the Royal College of Physicians, regarded as the gateway towards consultancy. This could be an expensive gamble. Few passed at their initial attempt. It was necessary to accumulate sufficient marks at each stage to pass to the next. First written papers, then a clinical examination of patients, then a ‘path’ viva and thence to the final viva. About 300 justifiably anxious candidates sat the papers. Only about 30 finally passed. The unfortunates regarded their repeated contributions to the College of Physicians as a guilt (sic)-edged contribution to the College coffers. There were no multiple choice questions and parts of the papers included obligatory language translations, either modern French or German texts, or classical Greek or Latin. The presumption was that only well rounded candidates, preferably with a classical education, should aspire to be members of the Royal College.

Formal lectures were occasionally given. The clinical neurology section of the Royal Society of Medicine held infrequent evening meetings in London, which were well attended by aspiring neurologists from all over England. However, most teaching took place at the bedside. Established consultant posts were few and highly competitive and usually held by men of great ability. There was great competition to be appointed to a teaching hospital and …

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