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In 1815, when barbers were surgeons and quacks peddled their ineffective wares to the trusting sick, the Worshipful Society of Apothecaries became the first official body empowered to license medical practitioners. The society still runs a qualifying examination, through the United Examinations Board, and also offers a number of postgraduate diploma examinations such as the ever popular Diploma in the History of Medicine and the recently introduced Diploma in the Medical Care of Catastrophes. The Diploma in Genitourinary Medicine came about in the early 1970s when several senior venereologists lobbied for a postgraduate qualification to be made available to the specialty and, rebuffed by the Royal College of Physicians, approached the Apothecaries' Society. The first Diplomas in Venereology were awarded in 1974 under the stewardship of Drs Catterall, Dunlop, Fluker, King, and Nicol.
For many years the diploma examination included a clinical section with “long” and “short” cases, a viva voce, an essay paper, and multiple choice questions. This format of examination will be familiar to generations of doctors as the arbitrary nature, and sometimes questionable content, of clinical and viva examinations went unquestioned by the medical profession for many years. As a Liverpool undergraduate in the 1970s, when an appreciable number of syphilitic survivors from a once thriving dockland era were still alive, I remember being drilled on the clinical signs of tabes dorsalis, not because such patients presented frequently for care but because of the likelihood of such a case appearing in medical finals. Later, as a medical registrar tasked with finding suitable cases for final year examinations, I came to appreciate the value of patients with stable health and reliable clinical signs. Later still, after working for some years in genitourinary medicine without seeing a single case of tabes dorsalis present de novo, I was bemused to …