Methods of appointment of honorary medical staff had changed little for over 40 years.
Appointments were made by the Hospital Board every two years, and there was no certainty of reappointment.
During the 1920s, both the Board and the medical staff expressed a wish to improve both the method of appointments,
and also to have more security of tenure for those appointed. Discussions were extended to the question of the
structure of the honorary medical staff. A new category of appointment was created, that of Honorary
Assistant Physician or Surgeon. The concept here was that these posts would be available to younger and
less experienced graduates for the purpose of gaining hospital experience, and at the same time providing assistance to
the Honorary Senior Physicians and Surgeons. Additionally, there was the expectation that when senior
positions became available, they would be filled from within the assistant ranks.
The Board retained the sole right to make all appointments, but agreed to the concept of having one or more
advisors involved in the selection process. By 1932, a Medical Appointments Committee had been established,
comprising the Chairman of the Board, another Board member, the Medical Superintendent, the Pathologist, and representatives of the
Colleges of Surgeons and Physicians. Any recommendations made by this committee were subject to approval
by the full Board.
The number of non-resident stipendiary medical staff increased during this period. By 1937, they comprised
a Pathologist, a Tuberculosis Officer, an Orthopaedic Surgeon, Radiologists, a Radiotherapeutist, Anaesthetists, and
VD Officers.
In 1922, a new post was created to assist the Medical Superintendent by taking over responsibility for the 'medical
patients'. Initially, this role was essentially that of 'Medical Registrar'. In 1928, the
position title was changed to 'Medical Registrar and Assistant Medical Superintendent' but in 1933, it was decided
that this dual role was too much for one person.
The 'Assistant Medical Superintendent' position eventually developed into the 'Director of Clinical Services'. Until
1939, one of the roles of the Assistant Medical Superintendent was to "exercise general supervision over the
workings of the Casualty and Outpatient Departments".
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