32Accid Emerg Med 1997;14:392-397

WORLD WIDE WEB

Accident and emergency medicine- making waves

on the internet

John M Ryan, Clive Baldock, Ralph Lawson-Smith

AbstractThe internet is a communications andinformation tool which has recently en-tered the world ofaccident and emergency(A&E) medicine. It is a worldwide instru-ment facilitating the dissemination ofideas and clinical information in thespecialty. It is being embraced by all disci-plines involved in A&E medicine. Part Iintroduces the internet to those in A&Emedicine unfamiliar with this technology.It describes the varied resources of theinternet in A&E medicine and speculateson its future role. Part II supplies thereader with the necessary information toget on-line and explains some of the moretechnical aspects of the internet.(7 Accid Emerg Med 1997;14:392-397)

Keywords: internet; accident and emergency medicine

Royal Sussex CountyHospital, Eastern Rd,Brighton, UKJ M Ryan

Centre for Medical andHealth Physics,Queensland Universityof Technology,Brisbane, AustraliaC Baldock

Westmead Hospital,Sydney, AustraliaR Lawson-Smith

Correspondence to:Mr John M Ryan, Accidentand Emergency Department,Royal Sussex CountyHospital, Eastern Rd,Brighton BN2 5BE; email:J.M.Ryan(sussex.ac.uk

Accepted for publication28 May 1997

The internet is a worldwide electronic commu-nications system linking people through net-worked systems and computers. Previouslyavailable only to the government, the military,academia, and industry, it has now becomeavailable to the medical profession. It haspotential for linking millions ofpeople involvedin medicine worldwide and allowing them toshare information on a diverse range ofsubjects.The objective of this paper is to inform and

stimulate the reader to take up the challenge ofa new technology which will have an increasingrole in the A&E department of the future. Itexplores some of the resources on the internetavailable to A&E personnel and assesses thechallenges and potential threats that accom-

pany it. The reader with little or no knowledgeof the internet or its jargon may find it morehelpful to read part II of the paper first.

Part I-The historical development of theinternetThe internet has evolved into an ever expand-ing worldwide network of computers. Itsorigins were in an American military projectduring the late 1960s. It continued to developand in 1983 the next landmark was achievedwith the splitting of the Advanced ResearchProjects Agency network into a military and a

research network. New networks were devel-oped for the computer sciences and foracademic communities. In 1986 the NationalScience Foundation in the United Sates estab-lished five super computer centres whichformed a backbone for the internet as we havecome to know it today. Other countries simul-taneously developed computer networks whichsoon started to link up. This was followed by amassive increase in the numbers of operators oflinked networks coming on-line, and the intro-duction of the private and commercial sector.

In the early 1990s the power of the internetas a resource tool for medicine was recognised.Initially access to the internet was gainedthrough the UNIX system, an arduous com-munications system enabling communicationbetween a distant computer and one perma-nently connected to the internet. The develop-ment of the world wide web (WWXW) by theCern Institute in Geneva in 1989 was a majormilestone in the evolution of the internet andattracted the medical profession to the inter-net, recognising its power as a communicationstool and as an access tool to the "informationsuperhighway." The computer protocol usedby the Web, known as hypertext markuplanguage, has facilitated easy presentation oftext, graphs, tables, moving images, and evensound on one's personal computer.

In the United Kingdom, facilities wereprovided by such academic groups as JANET(the joint academic network) and MAILBASE,the UK's major electronic mailing list service.In 1995 hospitals started to publish on theinternet in the UK. Brighton Healthcare NHSTrust was the first trust to publish informationand included a linked web page on its A&Edepartment.' Others have since followed suit.The years 1988 to 1994 saw an increase of

4700% in registered internet hosts! Thenumber of doctors using the internet hasincreased dramatically as the medical profes-sion has begun to realise its potential for com-munication and continuing medical education,and its role in clinical support. Doctorsworking in A&E and in the emergency serviceshave identified the internet as a communica-tions tool and have developed specialised mail-ing lists such as Acad-AE-Med and Emed-L.

392

on May 27, 2020 by guest. P

rotected by copyright.http://em

j.bmj.com

/J A

ccid Em

erg Med: first published as 10.1136/em

j.14.6.392 on 1 Novem

ber 1997. Dow

nloaded from

A&E medicine on the internet

WHAT'S IN THE INTERNET FOR A&E MEDICINE?Accident and emergency medicineThe internet has the potential to become theplace where day to day discussion on emergencymedicine topics will take place. The "informationfootpath" as it is at present is rapidly becomingthe "information superhighway" that it undoubt-edly has the potential to become. Technology isnow available for A&E doctors from any numberof institutions to interact simultaneously over theinternet. They can share ideas, problems, andresearch on a one to one basis and also on a glo-bal level, by posting messages to newsgroups andmailing lists.The availability of information and the speed

of access to this information are the two great-est assets that the internet has to offer A&Emedicine. The ease of access and relativeaffordability are particularly valuable. How-ever, ignorance, and an inappropriate percep-tion that advanced computer literacy is aprerequisite, could retard the development ofthe internet in A&E medicine.

Accident and emergency traineesSeveral sites on the world wide web archivetheir case of the week. Other resources includeECG of the week, x ray of the week, and clini-cal photographs. Archiving of these cases ena-bles production of a tailored textbook of emer-gency medicine according to the needs ofindividual trainees. Book marking relevantWWW sites on one's browser or downloadingrelevant pages for reviewing off-line are twoeffective methods of accessing importanteducational material. Multimedia facilitatesaudible reproduction of croup and epiglottis, inaddition to simulated auscultations. The inter-net provides both a textbook and a videolibrary for A&E medicine, which can becontinuously upgraded. It is possible, forinstance, to download video footage of apercutaneous tracheostomy which can be cata-logued on one's own computer.A great number of North American emer-

gency departments now have WW sites, asdo an increasing number ofAustralian and UKdepartments. Doctors wishing to pursue fel-lowships in emergency medicine can use theinternet as an advertising notice board.2 Manysites on the internet offer information on toxi-cology and on paediatric and emergency medi-cal services fellowships. The "hospital website" allows access to information about anumber of A&E departments and resourcesavailable within these departments.Many sites are archiving medical material of

major interest to A&E trainees. For instance,DESIRE (development of a European service forinformation on research and education) hasestablished an orthopaedic information serverwhich is in the process ofscanning 60 000 ortho-paedic slides and publishing them on theinternet. PARACELSE is a server in clinical toxi-cology developed at the University of Grenoblewhich includes protocols for the management ofover 100 poisonings. It is updated weekly by amultidisciplinary team of toxicologists. MIDRIB(medical images digitised reference informationbank) is a joint project funded between St

George's Hospital Medical School and BristolUniversity and launched early in 1997. Itprovides a comprehensive collection of medicalimages for use in teaching and research.

Continuing medical education inA&E medicineThe internet has brought a new electronicinformation delivery system to A&E doctors.'Until recently continuing medical education(CME) has been provided by paper journals,textbooks, and medical conferences. A widerange of CME is available to the A&E doctor,which is convenient, affordable, and accessibleat the click of a button. Doctors can use a vari-ety of usenet newsgroups to update on areas ofadvanced emergency medicine. VariousWWWsites offer information about emergency sys-tems and the organisation of emergency medi-cal services in disaster areas and third worldcountries. Others link to many sites with A&Erelevance such as trauma, emergency medicalservices, and paediatric critical care.

Several learned societies relevant to A&Ehave their own WWW sites. It is possible fordoctors to browse through a calendar ofupcoming events and conferences around theworld and register for attendance.

Telemedicine is another resource providingCME on the internet. This can be particularlyuseful for A&E doctors based in rural areas,who can arrange to hold an interactive meetingwith other colleagues at remote sites at a prear-ranged time. Such CME programmes haverecently been described by a group of ruralgeneral practitioners in Wales.4

Academia and research in A&E medicineThe electronic journals homepage allowsaccess to a great number of medical journalsrelevant to A&E medicine on the day ofpublication.5 These include the British MedicalJ7ournal, the J7ournal of the American MedicalAssociation, and the Annals of Emergency Medi-cine. This is of particular benefit to doctorsworking overseas, where journals may takemany weeks to arrive by conventional mail. Atpresent no journal publishes its entire contentson the internet. Most journals publish only alist of contents or the text of leading articles.There is a copyright issue regarding electronicjournals which remains largely unresolved,although the British Library is currentlyundertaking research in this field.

Publishing on the internet is not withoutproblems. While undoubtedly there is anadvantage in the early and free disseminationof A&E literature, the possibility of publica-tions which have not been peer reviewed beingpublished on the internet is a real and danger-ous prospect. Benefits include the reduction ofpaper usage as a cost saving, the continuedexposure of a journal both nationally andinternationally, and bypassing difficulties expe-rienced by quality journals not yet recognisedby Medline. Issues of quality and regulation arebeing addressed as the development of elec-tronic journalism continues. This will hope-fully help in maintaining the prestige andrecognition of current paper journalism. Thepotential loss of income by journals from a

393

on May 27, 2020 by guest. P

rotected by copyright.http://em

j.bmj.com

/J A

ccid Em

erg Med: first published as 10.1136/em

j.14.6.392 on 1 Novem

ber 1997. Dow

nloaded from

Ryan, Baldock, Lawson-Smith

decrease in subscriptions is another realconcern, although payment by credit card overthe internet linked to password access mayprovide a financial solution.The possibility of collaborative research has

been made easier by the internet. Collection ofdata and downloading it to one designated siteis now a much easier option. Data entered intouser friendly electronic surveys at selectedA&E departments eliminates geographicalseparation as a barrier to conducting multiplesite studies. Electronic collection of data canallow real time statistical processing and ongo-ing depiction of study progression.

Sharing of information between like mindedA&E physicians has been made even easier byAcad-AE-Med, an academic A&E mailing list.This list is aimed at fostering research anddevelopment within A&E in the UnitedKingdom, although some members contributefrom other countries throughout the world.The recently established Society of the

Internet in Medicine is considering forming asubcommittee to advance the specialty furtheron the internet, particularly among Europeancolleagues. Formal academic decisions will bemade at MEDNET 97-the World Congressof the Internet in Medicine in Brighton.

Prehospital careAt a prehospital level there are many sites on theinternet where paramedics, ambulance techni-cians, emergency medicine volunteers, and firstaid workers can share experiences and communi-cate with each other on a worldwide basis.

Accident and emergency nursingThe internet acts as a forum for nurses workingin emergency medicine to interface withcolleagues on a national and internationallevel. The emergency nursing homepage offersa good source of relevant internet material.

Medical studentsThe internet, and theWWW in particular, can bea cost-effective system ofdeliveringA&E medicaleducation to undergraduates. Overseas emer-gency departments regularly advertise theirfacilities, which helps students arrange electives.Undergraduates can now avail themselves ofvarious tutorials in emergency medicine on theinternet. Several sites provide links to casescenarios in paediatric emergency care, radiol-ogy, and toxicology. Case of the week, cases fromgrand rounds, x ray of the week, and ECG of theweek are other popular sites. Clinical photo-graphs published on the internet are reproduc-ible with excellent quality.

Continuously improving the quality of un-dergraduate medical education requires com-bining new technologies with establishedteaching methods. Some universities have nowtaken the initiative in providing courses formedical students on the internet.6

The communityAccess to medical information in the home isunprecedented using the internet, and in thefuture the public may be better informed thanever on the management of common and eso-

teric medical emergencies. A recent case reportdocumented how a patient self diagnosed adeep vein thrombosis from the internet and selfpresented to his local A&E department.Following a brief admission he was dischargedwith a diagnosis of superficial thrombophlebi-tis only to return four days later with frankhaemoptysis and a pulmonary embolus.7

CURRENT VALUABLE MAILING LISTS, WEB SITES,AND NEWSGROUPSSubscribing to mailing lists relevant to A&Emedicine only takes a few clicks of a mouse but-ton, as does unsubscribing if one receives toomuch mail. Examples of popular mailing listsinclude lists on adult emergency medicine,critical care medicine, paediatric emergencymedicine, paediatric intensive care, wildernessmedicine, trauma, toxicology, and disaster medi-cine. The membership of E-MED-L, the emer-gency medicine discussion group, exceeds 1000.

Currently the University of Texas HealthScience Center's Department of EmergencyMedicine, in cooperation with a number of agen-cies, residencies and companies, maintains ahomepage on the internet with the intention ofputting the world ofemergency medicine at one'sfingertips. They have thoroughly embraced thenew electronic super highway and through theirhome page it is possible to share ideas and prob-lems on all aspects of A&E medicine withcolleagues all over the world.

Various other sites on the WWW shareinformation relevant to A&E medicine. Forinstance ACCRI (anaesthesia and critical careresources on the internet) is a weekly updatedweb site which provides a list of electronicresources of interest to anaesthesiologists andrelated specialties.

Louisiana State University Medical Centerhosts TraumaNET.8 This server acts as a linkto many other sites and as a navigational aid onthe internet for trauma providers to sitescovering all aspects of trauma care. There is adatabank of interesting patient managementcases in trauma and critical care.The Orthopaedic Links page maintained by

Clough in Ontario has 500 links in 20 differentheadings covering all aspects of acute and non-acute orthopaedics relevant to A&E medicine.At present it is in a growth phase and isexpanding rapidly.Other sites provide access to a directory of

associations in emergency medicine. There is alist of emergency medical residency pro-grammes in the United States. There areworldwide morbidity and mortality confer-ences and a site with information on the avail-ability of research grants. Further informationis available on prehospital care, legal aspects ofemergency medicine, and politics in emer-gency medicine. There is a new emergencymedicine electronic journal, GEMA, specificto the internet. Conference organisers postdetails of forthcoming conferences and it ispossible to read about the 1998 InternationalConference on Emergency Medicine to beheld in Vancouver, Canada.There are various usenet newsgroups where

topics of A&E relevance can be discussed.

394

on May 27, 2020 by guest. P

rotected by copyright.http://em

j.bmj.com

/J A

ccid Em

erg Med: first published as 10.1136/em

j.14.6.392 on 1 Novem

ber 1997. Dow

nloaded from

A&E medicine on the internet

Most of these are under the sci.* categoryincluding sci.med.radiology and sci.med.orthopaedics.

SECURITY ON THE INTERNET

The security of information transmitted on theinternet is suboptimal and there are no guaran-tees about confidentiality when dealing withindividual cases. The accuracy of documentsdistributed on the internet currently relies onthe integrity of those individuals posting them.A&E doctors who provide information on theinternet should be aware that the legalsituation surrounding publishing on the inter-net is largely unresolved.The NHS is having to address this problem

in developing a network for linking hospitalsthroughout the United Kingdom. It is recom-mended that A&E departments wishing toaccess the internet should do so with a standalone computer and not with one linked to thedepartment's computer system or the hospitalnetwork. A&E doctors using the internetshould be aware of the Data Protection Act.

WHAT IS THE FUTURE OF THE INTERNET IN A&EMEDICINE?There have been many speculations about thefuture of the internet in medicine which areapplicable to A&E medicine. We may forinstance soon see the demise of journals as weknow them, although some restrictions willinevitably be placed on the transmission ofunrefereed and non-peer-reviewed medicalreports. Plans already exist for the introductionof electronic peer review.Communications systems will undoubtedly

develop further and the role of the internet inA&E medicine, education, research, and clini-cal practice is set to expand. It is likely, givencurrent trends, that the numbers of individualand corporate participants on the internet willcontinue to rise. It can be expected, with theintroduction of the NHS web, that all A&Edepartments in the United Kingdom will soonhave their own home pages.The internet will enable rapid dissemination

of information from responsible bodies such asthe British Association for Accident and Emer-gency Medicine and the Faculty of Accidentand Emergency Medicine. Guidelines andstatement papers will be published on theinternet and will be easily accessed as all A&Edepartments become computerised. Medline,available freely on the internet, is easilyaccessed for the latest information in the prac-tice of evidence based medicine.There is little doubt that this major advance

in communications is here to stay. Its use in theworld of A&E medicine as an education tool isset to go from strength to strength, and there isa strong argument to be made for those of us inA&E medicine to adopt the internet ineveryday practice. It is unlikely to go away, sothe sooner it is adopted by all involved in A&Emedicine the greater is the likelihood of itspotential being realised.

Part IH-What do I need to access theinternet?The internet is now available to anyone with apersonal computer, a modem, and a telephoneline. It is owned by no one person or group;however, controllers of various networks whichallow access to the internet usually command afee for providing a service.

For the home user the prerequisites foraccessing the internet are a telephone line, acomputer, a modem, and an account with aservice providerA modem is a small box which is connected to

the computer and the telephone line. Modemscome in various speeds commonly known as 9.6,14.4, and 28.8 kdlobaud, referring to the speed atwhich messages can be transmitted. The higherthe number the faster the transmission. Any per-sonal computer will access the internet, but froma practical viewpoint anytiing less powerful thana 386 is not worthwhile.To link to the internet it is necessary to

access and have an account with a serviceprovider. Service providers regularly advertisein computer magazines, or friends who are onthe internet may be able to recommend theirown service provider. They may charge for thelength of time you use their service or they maylevy a standard monthly charge for theirservice. They supply the necessary software toget started and usually offer an excellent backup technical service to advise on teethingproblems. The service provider will supply youwith an address which becomes your personal-ised address on the internet. It will usuallyincorporate the address of the service providerand allow you to choose your own identity andprotected password for entry into an account.Many hospitals have links to academic insti-

tutions or universities which have their ownserver. It is becoming increasingly possible forinstitutions that are involved with medical edu-cation to link up with their host university'sserver at little or no cost.

WHAT RESOURCES CAN IT PROVIDE?The principal components of the internetinclude the world wide web, email, news-groups, FTP (file transfer protocol), Telnet,and Gopher.

World wide webThe world wide web is a system whichconnects millions of computers worldwide andallows them to share information and mediastored on these computers. The web partdescribes the links that exist between a compu-ter and available resources such as documents,graphics, and photographs. Undoubtedly it isthe advent of the world wide web that has ledto the phenomenal interest in the internet. Ithas removed the difficulties experienced withbasic and advanced computer terminology,allowing one easy access to other people's workpublished on the web. Access to the web isachieved through a software system known as abrowser supplied by the service provider, and isas easy as point and click with a mouse. Theinitial page one sees on clicking onto the webbrowser is termed the homepage. Typing in the

395

on May 27, 2020 by guest. P

rotected by copyright.http://em

j.bmj.com

/J A

ccid Em

erg Med: first published as 10.1136/em

j.14.6.392 on 1 Novem

ber 1997. Dow

nloaded from

396 Ryan, Baldock, Lawson-Smith

address of a web site known as the uniformresource locator (URL) on the browser'shomepage takes you directly to that site orhomepage. A good WW browser such asNetscape or Internet Explorer incorporates allthe features of email, the WWW, newsgroupsand FTP in one simple integrated package.

emailUse of email allows for the almost instantexchange of electronic messages to an A&Ecolleague anywhere in the world who has anaccount on the internet. Software provided bythe service provider allows you to log in at theclick of a key to the host computer, that is, theservice provider's computer. All one needs todo to send an instant message is to type themessage, the destination email address, andpress enter. In addition to a message, apreviously prepared document or graphics canbe sent with the message as an attachment.

Mailing lists are systems of sending onemessage to many people simultaneously. Theycontain members who have declared a particu-lar interest in that list. Mailing lists aremanaged by listservers and it is necessary tosubscribe (without charge), initially by sendinga message to the listserver requesting inclusionin the list. Subsequently one receives an emailof all messages sent to that list by contributors.

NewsgroupsNewsgroups are forums where people with acommon interest can share information using aspecial newsreader software. Notices can beplaced on a newsgroup, termed posting, using asoftware programme such as Usenet. Thissoftware is readily supplied by one's serviceprovider. The advantage over mailing lists isthat it allows participants to decide which arti-cles they want to read and when. Newsgroupsprovide one of the best ways of sharing clinicalproblems with others on a worldwide basis.The possibilities have been dramatically dem-onstrated by the recent case of a 21 year oldChinese student. A friend posted a messageabout her acute illness on the internet whichled to over 400 replies and a consensus that shehad thallium poisoning. This was confirmedfollowing the appropriate investigations andshe improved with treatment.9

File transfer protocolFTP involves moving files from one computerto another over the internet. It allows for trans-

fer of documents, photographs, and even com-puter software from thousands of sites on theinternet.

TelnetThis is a communications protocol that allowsaccess to the resources of remote computers,often at libraries and universities. It also enablesone to access email from a remote computer ter-minal while away from home or abroad.

GopherThis is an information browser which allowssearching of databases, reading of text files, anddownloading of files to a user's hard drive.

CONCLUSIONSSeveral textbooks are readily available in mostbookstores, which take one through accessing theinternet step by step.'0 The rapid growth of theinternet is being paralleled by the expansion ininternet software which is making access easier.The difficulties which beginners have experi-enced over the last few years in accessing theinternet have now largely been resolved and mostpeople with just a basic knowledge of computerscan be up and running on the internet within amatter of hours.

It should be noted that the internet is adynamic technology which is constantly devel-oping new techniques and expanding re-sources. Some of the comments in this paper,while valid at the time of writing, may not bevalid when going to press as the internetcontinues to stride forward in the area of A&Emedicine. In particular the uniform resourcelocators given below may change, a timelyreminder that for all its benefits the internetlacks permanence.

1 Baldock C. Experience of a local hospital with the Internet:Brighton Health Care NHS Trust WWW pages. Mednet96-European congress of the Internet in MedicineBrighton, October 1996.

2 Hart RG, Barbosa J. Emergency medicine residencybrochure on the Internet. Acad Emerg Med 1996;3:386.

3 Pallen M. Guide to the Internet. BMJ 1995;311:1626-30.4 Groves-Phillips S, Wynn-Jones J. Telemedicine and the

Internet: their role in continuing medical education.Mednet 96 European Congress of the Internet in Medicine.

5 Kassirer JP, Angell M. The Internet and the journal. N EnglJ Med 1995;333:1709-10.

6 Vanzyl AJ, Cesnik B. The Internet and its role in teachingmedical informatics to undergraduates. Medinfo 1995:1154-7.

7 Ryan J. A clot in the system. Emerg Med 1996;8: 188.8 Block EFJ, Mire EJ. Trauma on the Internet: early

experience with a world wide web server dedicated totrauma and critical care J Trauma 1996;41:265-70.

9 Craft N. No touch technique. BMJ 1996;312:318-9.10 McKenzie B. Medicine and the Internet. Oxford: Oxford Uni-

versity Press, 1996.

Appendix

Mailing lists relevant to A&EAcad-ae-med: academic accident and emergency medicine discussion groupmailbase@mailbase.ac.ukEmerg-L: Adult emergency medicine discussion group. Listserv@VM.Marist.eduPed-Em-L: Paediatric emergency medicine discussion group

Listserv@brownVM.brown.eduCCM-L: Critical care medicine. Listserv@ UBVM.cc.Buffalo.edu.Emed-L: Adult emergency medicine discussion group. Listserv@itsa.ucsf.edu

To subscribe, send a message to the address, typing: "subscribe 'list name' (your name)" in thebody of the message

on May 27, 2020 by guest. P

rotected by copyright.http://em

j.bmj.com

/J A

ccid Em

erg Med: first published as 10.1136/em

j.14.6.392 on 1 Novem

ber 1997. Dow

nloaded from

A&E medicine on the internet

Newsgroups ofA&E relevancesci.med.emergencysci.med.cardiologysci.medalt.disasters.miscsci.med.orthopedicssci.med.radiologymisc.emerg-services

Homepages and URLs with A&E relevanceThe BMJ: http://www.bmj.com/Wilderness medicine: EMS http://wwwwemsi.on.ca/The Hospital Web: http://neuro_www.mgh.harvard.edu/hospitalweb.nclkEmergency medicine residencies: http://wwwuth.tmc.edu/uth_orgs/emer_medlbookmarl.htmlPrehospital care sites: http://rmstewart.uthscsa.edu/emergnedsites.htmlMedline: http://www.healthgate.com/HealthGate/gate/free/American College of Emergency Physicians: http://www.acep.org/Emergency nursing: http://www.hooked.net/-ttrimble/enw/index.htmlGEMA: http://gema.library.ucsf.edu:8081/Trauma homepage: http://rmstewart.uthscsa.edu/The University ofArizona Center for Research: http://www.ahsc.arizona.edu/aemrc/aemrcl.shtmlVancouver international conference: http://www.interchange.ubc.ca/emerg_vh/7th.htmlFirst aid online: http://www2.vivid.net/-cicely/safety/Emergency medical services and nursing links: http://www.cris.com/-seaox/nurse.htmlECG interpretation: http://www.med.ufl.edu/medinfo/baseline/HN1 1 7.htmlOrthopaedics link page: http://www.netshop.net/-cloughs/orthlink.htmlPARACELSE: http://alpesmed.ujf-grenoble.fr/paracelse/paracelse.htmlACCRI: http://www.eur.nl/FGG/ANEST/wright/index.html

Alison Gourdie Memorial ScholarshipApplications are invited for the Alison Gourdie Memorial Scholarship. Thisaward, to the value of £1250, is made annually to facilitate travel and/or research inthe furtherance of emergency medicine. It is open to training grade doctors andconsultants within five years of their appointment, and to any occupational groupinvolved in the delivery of emergency care.

Application forms are available from the Faculty of Accident and EmergencyMedicine, The Royal College of Surgeons of England, 35 Lincoln's Inn Fields,London WC2; tel 0171 405 7071. Closing date for applications 31 October.

397

on May 27, 2020 by guest. P

rotected by copyright.http://em

j.bmj.com

/J A

ccid Em

erg Med: first published as 10.1136/em

j.14.6.392 on 1 Novem

ber 1997. Dow

nloaded from