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Trish Greenhalgh and Brian Hurwitz maintain my observations on medical training and the quotes from their 1998 book are out of date (Letters, É«ºÐÖ±²¥S, February 2). My point was about the balance of the curriculum and the culture that can pervade it. Of course there have been changes, but my research and other in-depth studies suggest continuing serious problems. Many inner-city GPs in my work - including recently qualified and those involved in medical education - were critical of the relative neglect of psychosocial perspectives and the emotional aspects of being a doctor. Simon Sinclair's recent Making Doctors also revealed a deep-seated cultural antipathy towards examining "internal mental events".

Linden West
University of Kent