"We were going to have an award for the ugliest person in the year," said Andy, one of the organisers ofBirminghamMedical School'sfinal-yeardinner. "But we decided it was a bit unkind, so we've gone for who's going to have the ugliest progeny, instead."

You can't beat medical students for tact and sensitivity. Each year, those graduating at Birmingham celebrate their descent into doctorhood with 72 hours-worth of drinking, conversation and charades at an unsuspecting leisure retreat situated in the West Midlands.

This year the venue was The Belfry, and I was honoured to be invited as after-dinner speaker. This is not an easy task, as any dean will tell you, but I reached the microphone before the Lowenbrau had kicked in and managed to get off relatively unscathed. Which is more than I can say for Big Steve Wiggans (prospective father of the ugliest progeny in the year).

There's an award for just about everyone in the year, ranging from "Person of the opposite sex you would most like to catheterise" to "Person most likely to have ECT for intractable depression" to "First in detox". There's a "Dresses like a grandmother" award, a "Singularly most irritating Christian in the year" award and an "I wear trousers up to my nipples" award. And let's not forget the "I'm too lazy to piss in the toilet" award and the "Most self-talked about phallus" award.

To be fair, all awards are decided by democratic vote, though the committee has reserved the right to protect those winners who find ritual humiliation in front of 200 of their peers a little hard to handle. Big Steve Wiggans is not the ugliest person in the year - he came second but got promoted because, unlike the real winner, he didn't mind being teased.

Those not au fait with medical ways often find the humour a bit harsh - how can doctors care for patients if they're so unpleasant to each other? - but most of the students seem to revel in it and, in my three years of observing these dinners, there have been quantum leaps in compassion.

The "Slag of the year" award from two years ago has, for example,thankfullybeen ditched, although there is still one for "The biggest politically correct tits ever".OK, it's only a modest improvement, but not bad when you consider that medical attitudes change at the speed of a glacier. Men, too, come in for plenty of flack, especially those who share their problems. One foolishly asked his housemates: "What's that second hole in the end of your knob for? You know, there's one that you pee out of, but what's the other one for?" The poor man actually had two holes in his penis, which is a recognised medical complaint, though whether he got any help is unclear. What he did get was pride of place in the year book, ritually released at the final year dinner.

From day one, sexual humiliation is a particular forte of medical schools. There is still the odd surgeon who sticks his endoscope up the female students' dresses, but even without the help of consultants, the students do a pretty good job of humiliating each other.

Perhaps the most common spoof freshers lecture is to introduce a mature student as a professor in genito-urinary medicine. He (it is usually a he) delivers an entirely credible lecture with gut-churning slides showing sexually-transmitted diseases.Afterwards,he announces that he is conducting research into the sexual habits of medical students and asks for their help in a show of hands. He also insists that every student closes his or her eyes to ensure the answers remain strictly confidential.

He then asks the students to raise their hands to correspond with the number of sexual partners they've had: who has never had a sexual partner?/ who has only ever had one?/ who has had more than one?" and so on. Amazingly, the majority of students conform and, with their eyes closed, don't realise that whenever they raise their hands, they are photographed for distribution around the medical school, with caption: "Hello and welcome to Simon Smith. Number of sexual partners, 10."

In Birmingham, there's even a special noticeboard for the virgins. Students crossed off as they lose their label.

So what sort of doctors does this produce? Surprisingly good ones. During the three years I have spent teaching communication skills at Birmingham, very few students have been totally dysfunctional, mostwereempathic,and nearly all could make the distinction between how you behave in front of patients and what you do in the privacy of your own bar. It seems incongruous, but perhaps you can be a compassionate doctor, have a sick sense of humour and enjoy humiliating your colleagues. That's my excuse, anyway.