The Pharmaceutical Journal
Vol 276 No 7401 p604
20 May 2006

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Spotlight on wayward medical students more
The Bard of Avon raises a fresh controversy more
Influence of industry more
Ancient hieroglyphs from New World among first examples of writing more

Spotlight on wayward medical students

A number of letters in the 27 April issue of the New England Journal of Medicine comment on an earlier report that showed a close association between unprofessional behaviour in medical school and subsequent disciplinary action by US state medical boards. Even among a control group of physicians who had not received disciplinary action, nearly 20 per cent were found to have behaved unprofessionally as medical students. It is pointed out that if unprofessional students are permitted to become unprofessional doctors a real crisis will have to be faced in the near future.

Medical students, critics observe, reflect society at large where ethical and moral standards are concerned. Yet, when schools and colleges are seen to abound in unethical behaviour that the rest of society seem to treat with tolerance, it is not surprising that medical students often exhibit a lack of professionalism. The educational world almost takes for granted internet plagiarism, falsification of examination results and computer-assisted cheating. Unless teachers and parents inculcate ethical values at an early age, medical training is unlikely to remedy the situation years later.

Schools should examine features that may foster undesirable behaviour and perhaps increase screening for mental illness among individuals who exhibit suspicious conduct. Features of unprofessional conduct reported in medical student studies are claimed to be remarkably similar to classic symptoms of major depression. Another possible connection is with the use of drugs or alcohol, which accounted for nearly 15 per cent of the violations leading to disciplinary action. Binge drinking and drug misuse are as common among medical students as among other adults.

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The Bard of Avon raises a fresh controversy

A commentary published in the 25 February issue of New Scientist brings attention to one more question to add to the many that surround William Shakespeare. Imaging techniques have shown that the Davenant bust now in London’s Garrick Club represents the same individual we see in portraits of Shakespeare. Moreover, a study of its facial features matches accurately with Shakespeare’s death mask belonging to the city of Darmstadt.

A researcher from the University of Mainz has asked a German criminal investigator to compare the bust with an engraving and two paintings, including the famous Chandos portrait, believed to be of Shakespeare. A forensic test used to test facial images to establish identity has demonstrated a close match of the eyes, nose and lips of the paintings and bust, and the conclusion is that the death mask is genuinely of Shakespeare. Laser studies have shown perfect matches between forehead, eyes and nose. Although the lips of the death mask are thinner than those on the bust, this could be due to natural shrinkage with loss of blood pressure. Some British experts remain unconvinced and it has been pointed out that many representations of Elizabethan men were touched up to make them look more intelligent and rich, hence they were not always true likenesses.

Some critics have argued that the bust’s resemblance may not be accurate since they suspect it was made some 142 years after the playwright’s death by the French sculptor Louis-François Roubiliac. But the researcher claims to have traced the history of the bust back to 1613, so Shakespeare could have commissioned it.

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Influence of industry

A note in the 22 April issue of the BMJ draws attention to the influence of the pharmaceutical industry on medical education and how this influences prescribing habits in the long run. The industry is enormously powerful in colouring the education of medical students and later in affecting their professional behaviour. A report has recently been published by the World Health Organization concerning the extent of commercially inspired education about the promotion of drugs in teaching facilities of pharmacy and medicine.

In February the Scottish Executive announced that it had plans to compile a public register of links developed between medical practitioners and organisations marketing drugs. More recently, in the US, Yale University has issued guidelines that cover the interaction between drug manufacturers and medical education and practice. The aspects covered in the guide include the provision of gifts, scholarships and funding, including free drug samples, and measures employed to support related educational events. Requirements are drawn up to ensure that relationships between doctors and industrial practices will be fully disclosed to the public gaze. The design of guidelines is intended as a way for recognising the sound principles of professionalism, integrity and public service as applied to the sphere of health activities within civilised society.

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Ancient hieroglyphs from New World among first examples of writing

An example of an early written record dating from about 300BC and attributed to the Maya culture, discovered in Guatemala, has been described by archaeologists from Texas and New Hampshire in the 3 March issue of Science.

Hieroglyphic writings dating from the late preclassic period (400BC to AD200) were unearthed from the ruins of San Bartolo, identified in 2001. With early wall paintings, they were buried within a pyramidical structure that had been partially exposed by illicit treasure hunters a few years before. Deeper tunnelling revealed other buildings substantially older. Excavations in 2005 brought to light rich polychrome murals, including the Maya maize god, and lines of hieroglyphic script.

Radiocarbon dating of five charcoal samples from sealed deposits pointed to a period between 300 and 200BC. A painted block bore a column of 10 hieroglyphs that seem to be the end of a longer sequence. They were painted in a thick black line on white plaster, along a faint pinkish orange stripe that may have been a guideline for the scribe. Some of the signs are vaguely pictorial, others abstract.

Evidence that the Maya people engaged in hieroglyphic writing at a much earlier date than had hitherto been believed raises the question of the relation between Maya writings and early scripts discovered in Mesopotamia, where writing systems were firmly established by about 400BC among a number of complex cultures.

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