Letter to the Dean of a medical school

Dear Sir,

Training in toxicology for medical students

We are writing to medical schools to ask about the importance given to training in toxicology for new medical students.

The OP Information Network has for the past twelve years supported people, mostly farmers, exposed to organophosphates (OPs) in the course of their work and we have worked with scientists, doctors, politicians, academics and others to raise awareness of the nature of the poisoning from which these people suffer. You may also be aware of the research study carried out at the University of Lancaster that identified the high levels of toxic compounds found in a cross-section of the UK population. Many were older pesticides which could act synergistically with more recent ones. Toxin interactions have barely been examined in the UK.

OP sufferers who turn to their GPs for help, and who may subsequently be referred to consultants, have often expressed to us the disappointment they feel at the treatment they have received from the medical profession. We have been surprised by the number of doctors, consultants and GPs who have asked OP-exposed patients to request our organisation to provide them with scientific papers relating to the clinical effects of such exposure. This situation is obviously highly unsatisfactory.

In 1992 the British Medical Association published a report Pesticides, Chemicals and Health. In its section on the training of doctors, the report cites the results of a survey of 24 medical schools into the amount of time devoted to teaching toxicology: the survey found that the total time in a course for new medical students ranged between one and ten hours, and two of the schools provided no training at all. The report comments: "A teaching time of less than ten hours in an entire undergraduate course cannot equip a medical student to practise in this chemical age."

We would be grateful if you could provide us with answers to the following questions:

• What priority is given in your medical school to teaching the basic principles of toxicology, as well as in the science and law relevant to pesticides and in environmental and occupational health?
• How much time will be given to the training of medical students in toxicology?

The European Union is currently asking for in-depth studies of hundreds of toxic chemicals in common use in domestic, agricultural and horticultural contexts. Clearly the medical profession needs to make itself similarly aware of the possible effects on health of many chemicals which are in use by working people.

Yours sincerely