The Special Hospitals arouse public interest only on occasions of disaster or scandal and there are widespread misconceptions concerning their role. The purpose of this paper is to examine the clinical functions of the Special Hospitals and to critically discuss their medical remit.

I have been a member of the Southern Division Approval Panel since its inception in 1972. Thereafter I visited, with other panel members, two or three hospitals per year. I became Convener in 1978 and in my four years in office I visited over 35 hospitals, although these were not all separate visits. I look after a catchment area in South-East London, with all the in-patient services at Bexley Hospital. It is entirely my personal opinion that if I was not involved with a district service I probably would not have accepted the invitation to be a convener. I do not think I would necessarily have been a worse convener, but I might have been rather less credible.

In the Second World War there was a Royal Naval Unit for the assessment and rehabilitation of personality disorders in a remote part of the Cheviot Hills. The site is now submerged in the Kielder Reservoir.

The psychology and psychiatry of the nuclear arms race have been discussed in three main ways. One approach has looked at the possible psychological consequences for the surviving population of a nuclear war. These studies, which have covered a wide range of catastrophes, including the Hiroshima and Nagasaki bombs, Nazi concentration camps, as well as natural disasters such as floods and cyclones, all point in the same direction. When half or more of a person's social and physical environment are destroyed the effects on the human psyche are devastating. The phrase ‘the survivor syndrome’ has been used to describe the state of psychological shock and disablement which results in those that are left behind by the dead. Its effects outlive the physical sequelae of such disasters and are matched in longevity only by the slowly developing cancers which manifest themselves two or more decades after a thermonuclear explosion. These studies make the scouting-for-boys and cricketing atmosphere evoked by the British Government pamphlet ‘Protect and Survive’, or the recent Civil Defence exercise, Square Leg, seem remote from the likely psychological reality of a post-nuclear attack world.

The need for clear communication in medicine is often stressed, but of all aspects of medical communication probably the least attention is given to that between doctors themselves. The structure of the NHS and the mode of referral from general practitioners (GPs) to specialists mean that the quality of communication between GP and specialist has a strong influence on the way patients are managed and the standard of the care provided. Although it might seem preferable that contact between doctors should be on a face to face basis, this is often not possible. By far the most common mode of communication between GP and specialist is the letter.

There has been a recent upsurge of ‘educationalism’ in the field of psychiatry which, as a trainee, I would like to comment upon. The Cambridge conference on education and training (Bulletin, June 1982, 6, 105; 107) briefly considered the option of educational objectives as a way of planning, monitoring and assessing a training scheme. Others have called on the College to issue a syllabus for the MRCPsych Examination (Bulletin, November 1981, 5, 215), and Dr R. Symonds of the Southern Division has presented a syllabus for in-service training which is adapted from a Canadian model. All these suggestions suffer from drawbacks, but some are more appropriate to the needs of trainees than others. Each is trying to tackle the same problem: to fill in the educational gaps which all trainees have, some more than others, and which frequently go undetected until the exam. Such elementary skills as mental state examination and interview skills are often poorly taught.

The Court of Electors has recently approved the appointment of new Regional Advisers and their deputies. These are listed below. In order that College members may be acquainted with the duties of the Regional Advisers, guidelines are appended.

The third Trainees' Day of the Southern Division took place on 31 March 1982 and was held for the first time in the S.E. Region, at King's College Hospital. We chose topics which are often neglected in peripheral hospitals, but were disappointed to find that trainees from these hospitals were under-represented.

For the past 25 years the British Medical Association has held an annual film competition. In 1981, 98 films were entered and the following were among the successful ones.