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Medical officers must be brought back into teacher education if standards of fitness are to be kept up, says Robert Stewart

UNTIL the beginning of the last decade all teacher training institutions had a medical officer. This is no longer the case and no such person exists in the present day colleges, which have all acquired university status. To some extent the role of these former medical officers may have been taken over by non-medical staff, but the contribution made by these doctors in the past has not been fully recognised.

Among the professions teachers enjoy the unique position of having to be passed medically fit to embark on a course of training and, when this is completed, to be recommended medically fit for registration as a teacher. (It is surprising that there are no standards of fitness for those entering the medical or dental professions.) This process is a statutory requirement under the Teachers (Education, Training and Recommendation for Registration) (Scotland) Regulations 1993 and the General Teaching Council for Scotland is charged with carrying out this function.

Originally the reason for this medical examination was to prevent a teacher with undiagnosed tuberculosis from infecting pupils, but gradually other conditions were designated as possible hazards to children. A teacher with uncontrolled epilepsy or severe mental illness could be cited as possible examples.

The former medical officers of the Scottish teacher training colleges met annually to review these standards of fitness in the light of medical advances and through mutual discussion of difficult cases ensured that the medical standards for teacher training remained uniform throughout the college system.

The current position is very different with medical examinations being undertaken by general practitioners on a contractual basis. Questionnaires are completed by candidates and, given that there is an enthusiasm to teach, there is little bar to acceptance.

Unlike the old system, these doctors can have little knowledge of the teaching profession and have no opportunity for discussion of mutual problems. In one Scottish college five different doctors were employed at intervals to do this work last session.

Guidance for both candidates and doctors is given in a booklet produced by the GTC entitled Medical Standards. Frequent reference is made to "the medical officer of the institution" but no such person now exists. It is stated that the council intends to monitor the operation of these rvised standards. Just how this will be carried out is not specified.

The function of the former medical officers included an extensive lecture programme and it is not certain whether this is being maintained. Primary and secondary teachers in training received instruction regarding growth and development of children, health problems which teachers might meet in the classroom such as epilepsy, asthma or diabetes, human reproduction and birth control, sexually transmitted disease, and topical health problems such as Aids, alcohol and drug misuse.

Postgraduate teachers of the visually impaired and hard of hearing received appropriate instruction from the medical officer regarding the anatomy and physiology of the eye and ear. Social work students met someone from the medical profession with whom they would have to co-operate in their future work. In the case of overseas students on postgraduate courses it was recognised that they had a vital role to play in health education. They received instruction in this field from a medical officer with special qualifications in tropical medicine.

The presence of a medical officer and a medical department had other advantages. Students could receive family doctor services and contraceptive advice and staff were able to obtain emergency medical help and counselling. At Moray House College in Edinburgh, the medical department pioneered a series of biennial conferences to bring together senior members of the teaching profession and experts in various medical fields to discuss problems of mutual interest. These conferences proved very popular and many areas were explored together.

The demise of the medical officer in teacher education institutions may be an inevitable consequence of progress. The formal medical examination could be regarded as an expensive luxury, given the very few candidates who are rejected. A process of self-

assessment is now proposed and equal opportunities legislation and the rights of the handicapped must be fully respected.

Of paramount importance are the health and safety of children. It is surely right that teachers should be monitored by some means to ensure that they are fit and suitable persons to be placed in charge of children. Teacher education institutions have lost a small but loyal group of doctors who, by the very nature of their presence in the colleges, gained a peculiar insight into the problems of the profession.

Robert Stewart was medical officer at Moray House College from 1963-1991.

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