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service, who might desire, or be required, to attend a course of instruc- tion while on leave of absence. The cost of tuition fees only for an eight weeks' course was stated at £11 12s., and that of tuition, board, and residence for the same term, at £30 17s. 4d. As these sums were not large, I took upon myself to bring the scheme into operation in anticipation of the concurrence of the Governments concerned, but that concurrence was in most cases readily given, though there was some difference of opinion and practice, more especially as regards payments in the case of doctors already in the Government service. 14. I noted in this circular that a school of tropical diseases had been recently established and excellently equipped at University College, Liverpool, and proposed that medical officers already in the service should have the option of receiving their instruction either in Liver- pool or in London, but added that newly-appointed officers would always be sent to the London school. I saw cause in the following year to reconsider this last decision, and to place the Liverpool school on the same footing as the London school, as regards newly- appointed officers also. To this point I will recur later on.
15. It has been found that urgent need for immediate medical aid in one or other of the Colonies from time to time, and especially during the continuance of the war in South Africa, has made it necessary to send out doctors who have not gone through the prescribed course at London or Liverpool, but such omissions are minimised as far as possible. It was found necessary, too, to call the attention of medical officers already serving in the Colonies, who might wish or be required to take a course of instruction while on leave, to the desirability of joining the schools at the beginning of a session. This was done by my circular despatch of 31st May, 1901.
16. I may here notice that, owing to the improvement in the supply of suitable candidates for the West African Medical Staff, steps are now being taken to establish a Reserve of medical officers for the West African Colonies and Protectorates, so that, on the occurrence of vacancies, it may be possible to send out with the minimum of delay doctors who have received a proper course of training in tropical medicine at the London or Liverpool Schools. It is proposed that the doctors selected for the Reserve shall be sent to one or other of the Schools for a full course of three months, that in addition to their fees for tuition, board, and lodging, they shall receive an allowance at the rate of 5s. a day for the period during which they are under instruction, and for a reasonable period between the end of the course and the date of embarkation for West Africa. It is also proposed that all doctors, whose fees are paid by Colonial Governments, shall, before proceeding to take up their appointments, be required to pass an examination, or to obtain a certificate of proficiency, which will show that they have profited by the instruction given to them, and in the event of their failing to qualify in this respect their appointments will not be confirmed, and they will be required to refund any payments made on account of their expenses. Similarly, doctors already in the Colonial service, who attend courses, will be required to refund the fees unless they are certified to have made good use of their time and opportunities at the School.
17. Between the 2nd October, 1899, and the 15th April, 1903, that is to say, during a period of about three years and a half, 292 students passed through the London School, viz.:
British Government Service:-
Colonial Office
Foreign Office
Indian Medical Staff
Royal Army Medical Corps
+
140
...
...
Royal Navy
British private students, missionaries, &c.
Foreign Government Service
Foreign private students
116
13
11
...
...
1
3
144
113
...
...
...
13
22
292
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