Voices

CMA News 2000;10(7): 2

• History lesson
• Hey smokers, clean up your act!

Re: "A voice from abroad" (CMA News, May 2)

There is a long history explaining the predicament that Paras Naik finds himself in. Many years ago, in Ontario, the licensing authority recognized 2 categories of applicants. One group included graduates of (largely) American schools, Canadian schools, most of those from the UK, Australia, South Africa, Malta and several others. In other words, graduates from schools with the traditions of the English speaking world.

These were schools using the teaching methods, literature etc. that could be inspected and accredited. Many of the internationally recognized teachers and authors came from these schools and background. The second category included graduates from other than the above.

Then came the era of the human rights tribunal. These quasi-judicial lay bodies raised the bogeyman of "discrimination" and it was their considered opinion that a graduate from a military academy in outer Siberia was as worthy as one from Glasgow (or Toronto). The fact that we had no way of assessing credentials and training around the world didn't mean a thing to these non-medical people. So, it came about that the College of Physicians and Surgeons of Ontario finally accepted that USA & Canadian graduates would qualify as a group and the rest of the world would be grouped into a separate box.

I was a member of the College council at that time and sat on the registration committee. I am still proud of a brief that I wrote outlining the logic of the earlier categories and warning against this watering down of our academic requirements. I argued, to no avail, that a graduate from Edinburgh, Manchester, London, Liverpool, etc. did not belong in category 2. I was not talking about discrimination, but rather about graduates from a common background, a common ethos and a common teaching tradition.

Paras Naik presents a good case with some worthwhile suggestions. I hope I've explained how this all came about. I hope that as a Canadian, graduating from a "category 2" school (imagine Glasgow being in that category!) he may still somehow earn the right to be considered qualified to work in Canada.

M.L. Mador, MD
Past president
College of Physicians & Surgeons of Ontario

[Contents]

I am fully in support of increasing the price of cigarettes and therefore agree in principle with Senator Colin Kenny's proposed levy on each carton (CMA News, May 2). I have two other suggestions that may help

Our office adopted a section of road in Kelowna that our staff and their families clean twice a year. On each occasion we pick up anywhere from 2000 to 3000 cigarette butts on "our" 1km section of road. Clearly, the biggest polluters are cigarette smokers who toss their butts on the road.

Since the concept of a deposit on items that constituted major polluters is well established — beer cans, bottles, pop cans — I believe a 10-cent deposit should be charged on every cigarette butt. This would increase the costs of a package of cigarettes while also encouraging people to clean up the environment. The deposit system's positive features include both raising tobacco prices and forcing tobacco companies to take responsibility for the mess their product makes of our roadsides. At 10 cents per butt, the deposit system could also create an excellent fundraising opportunity for schools and charities.

My second suggestion is similar to the recently introduced legislation to force tobacco companies to put highly visible illustrations and warning messages on their packages. I have suggested for years that since most of cigarette advertising is aimed at increasing brand recognition, all cigarette brands should be sold in identical plain packaging with aggressive warnings and images explaining and illustrating the multiple health hazards caused by the product. Brand identification would only be permitted in small print on the front and back of the package. No other logos, colour formations or product identification would be allowed. Since the Charter of Rights and Freedoms allows tobacco companies to include brand names and company colours, the inside of each package could contain brand information. I believe this would have a marked effect on decreasing the effectiveness of advertising, since all packages would look identical on the shelf.

We must all take action to reduce the effect of cigarette advertising and to minimize the number of teens and young people who take up smoking. Every effort within the law is worthwhile.

Wm. Arkinstall, MD
Kelowna, BC

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© 2000 Canadian Medical Association