Where medical science and human behaviour meet.

Although we may be wrong about the details, we should try to imagine what the future holds for hospital consultants. The days of the independent consultant in the same post for 30 years are over, and there will be a change from "the" consultant to a few tiers of senior staff. Patients will increasingly demand to see specialists, so more specialists will be needed. As patients and their advocates become better informed the traditional rationing of clinical care to patients in Britain, such as restricting access to specialists, cannot continue. There is a current trend for evidence based health care, but the idea that each element of medical practice can be dictated by systematic evidence based research will prove to be naïve--such research informs practice rather than dictates it. Science will continue to act as the guide to medical practice but specialists will not be turned into a set of logical operators running programs designed by health planners.     

Environmental associations of abundance-weighted functional traits in Australian plant communities

Predictions of how vegetation responds to spatial and temporal differences in climate rely on established links with plant functional traits and vegetation types that can be encoded into Dynamic Global Vegetation Models. Individual traits have been linked to climate at species level and at community level within regions. However, a recent global assessment of aggregated community level traits found unexpectedly weak links with macroclimate, bringing into question broadscale trait–climate associations and implicating local-scale environmental differences in the filtering of communities. To further evaluate patterns in light of these somewhat contradictory results, we quantified the power of macro-environmental variables to explain aggregated plant community traits, taking advantage of new trait data for leaf area, plant height and seed mass combined with a national survey that records cover-abundance using consistent methods for a large number of plots across Australia. In contrast to the global study, we found that abundance-weighted community mean and variance of leaf area and maximum height were correlated with macroclimate. Height and leaf area were highest in wet (especially warm, wet) environments, with actual evapotranspiration explaining 30% of variation in leaf area and 26% in maximum height. Seed mass was weakly related to environment, with no variable explaining more than 5% of variance. Considering all three traits together in a redundancy analysis, the complete set of environmental variables explained 43% of variation in site-mean traits and 29% of within-site trait variance. While significant trait variation remains unexplained, the trait–environment relationships reported here suggest climatically-driven filtering plays a strong role in assembling these vegetation communities. Regional assessments using standardised species abundances can therefore be used to predict aspects of vegetation function. Our quantification of plant community trait patterns along macroclimatic gradients at continental scale thereby contributes a much-needed functional basis for Australian vegetation.     

Canadian medical schools before ACMC.

The earliest medical schools were established to supplement apprenticeship, the only route to practice available in colonial Canada. By 1885, eight medical schools were trying to accommodate the volume of new scientific information flowing from Europe. In 1910, when Flexner evaluated the schools against the Johns Hopkins model, some were woefully deficient, but by 1928 all had achieved Class A rating. The 1921 discovery of insulin in Toronto gave impetus to scientific research and, possibly, influenced the formation and funding of the National Research Council in 1934. Clinical specialization expanded, leading in 1929 to the establishment of the Royal College of Physicians and Surgeons of Canada to accredit training and certify graduates. The Association of Canadian Medical Colleges was formed at a meeting of deans to discuss a federal offer of funding and to accelerate the graduation of physicians for the war effort.     

Faculty development practices in Canadian medical schools.

Twelve Canadian medical schools that had an organized faculty development program were surveyed to evaluate the extent to which such programs were used and to estimate their effectiveness. Common practices included sabbaticals and programs designed to improve instructional skills. The main problems included underfunding, poor participation and inadequate instructor evaluation.