Cooperation between health professionals from the United States and the Union of Soviet Socialist Republics. Conclusions from a trip to the Soviet Union.

The United States has long made its academic medical resources available to foreign medical graduates. Conspicuously absent from the number of foreign nationals, however, have been physicians, scientists, and educators from the Soviet Union. Under the new conditions of perestroika, Soviet medical professionals are seeking ways in which to open up broad collaboration with their American counterparts. Agreements are being sought between national organizations, between academic medical institutions, and for the exchange of individual scholars. Cooperation in the area of medical education is one of the distinctive bridges on the path to mutual understanding that will represent a strong link in the public diplomacy of the two superpowers. We recently had the opportunity to discuss in Moscow some of the issues with the U.S.S.R. Minister of Health and with the Pro-rector for International Programs of the Central Institute for Advanced Medical Studies, as well as with faculty members, young medical scientists, and medical students of the Moscow Medical Institutes. We describe briefly many of the similarities and some of the dissonances between our two health systems and set forth ideas for an exchange program in medical education.

The physician's oath and the prevention of nuclear war.

KIE: All graduating physicians in the U.S.S.R. take an oath that since November 1983 has included a pledge to work for peace and the prevention of nuclear war. The authors compare the Soviet oath with those taken by American physicians, none of which mentions nuclear war, and give reasons why the medical profession in the Soviet Union may be more sensitive to this issue than its American counterpart. They explore the rationale behind professional oaths and codes, and identify changes in how physicians in the United States regard their responsibilities vis-à-vis individual patients and the public. Arguing that nuclear weapons pose the greatest threat ever to public health, Cassel et al. propose incorporating a commitment to work to prevent their use into the oath taken by American medical school graduates.^ieng

A future pattern of psychiatric services and its educational implications: some suggestions.

Psychiatry has expanded rapidly as a medical discipline in the last two decades but has not always been able to recruit sufficient young doctors of ability to its ranks. In view of recent governmental and professional reports on future medical practice we set up a study group comprising members from academic, NHS, sub-specialty, community and in-training psychiatry to examine the present tasks, attractions and constraints within a career in psychiatry and propose possible improvements for further consideration. In marrying these views to foreseeable developments we are sensitive to the requirement to take into account both the needs of the community and the job satisfaction of the future psychiatrist. To this end we indicate briefly our views concerning the attractions that a career in psychiatry currently has for the good graduate and ways in which the provision of interest and stimulation, educationally and professionally, can be increased so as to attract psychiatrists of high calibre both to general adult psychiatry and to areas of the specialist services which are at present unpopular. Finally, we propose a pattern of psychiatric services which we believe will embody both a useful and an attractive specialized job and interesting educational goal for future medical practitioners.