Bird fancier's disease.

1239 laboration with the Royal College of Radiologists.5 This refreshingly clear and concise report emphasises the vital part that nuclear medicine now plays in good medical practice and recommends that facilities should be made available in all district general hospitals if optimal medical care is to be available uniformly throughout the country. Facilities should be centralised under a properly trained clinician, who should have spent two years' training in a recognised department, says the report. It considers he should give about half his time to the specialty and be either a general physician, who could encompass the whole range of nuclear medicine techniques, or a radiologist, who would supervise nuclear medicine imaging and who would be well placed to integrate this with both old and the newer radiological methods and with ultrasound. In both instances help from non-medical scientists would be needed, not necessarily all on site. The intercollegiate report also gives sensible advice on training and accreditation of the clinician and-thank goodness-considers that no new examination is needed in nuclear medicine. Financial restraints will make all this difficult to implement, as they have done for a decade, but nevertheless the report points out (and several precise financial details are given) that the cost of these services is comparable with conventional radiological techniques and considerably cheaper than others, such as computed tomography and coronary angiography. No practising physician or surgeon would deny the need for such a service in every district general hospital. There seems to be a place, however, for more flexibility than envisaged in this report. The whole range of nuclear medicine services is now available in most of the tcaching centres in Britain, but in some these are fragmented and not yet under the direction of a fully trained consultant. This can be rectified as the present directors, mostly non-medical scientists, retire. Nevertheless, a similar comprehensive service is needed in all the other major medical centres, mostly in cities. These usually have a radio-therapy centre and other subregional specialties and ideally what they now need is a clinician who would give substantially all his time to nuclear medicine. Such fully committed consultants would require four years' training in the specialty as envisaged in this and the earlier intercollegiate report. In district general hospitals in smaller towns, by contrast, a radiologist trained in nuclear medicine would be the better option. In these hospitals there is no reason why …