"What's the commonest cause of vaginal discharge?"


Yes, it's Medical School Revue time again, and this little beauty comes courtesy of Bristol University. The show, to be fair, does not concentrate exclusively on that small area in-between the femurs and slightly in front of the coccyx, but takes on a broader canvas. For a start the title, The Administrator, hints more at satire than smut. In a parody of The Terminator, the show switches between medical training in 1998 and 2020 ("a great year for opticians"), and paints a bleak picture of the future. "Throughout the land there is an academic abyss.

Medical training has been reduced from five years to a one-year NVQ in an attempt to save money. And there are dark forces at work within a crumbling NHS. Every ward is lined with carnage, admission to hospital has become a death sentence. And all because of ... THE ADMINISTRATORS ...

This was, perhaps, a tad harsh on hospital administrators, who have become the whipping boys and girls of the reformed NHS. True, there are some macho managers kicking around the NHS with all the empathy of a dead skunk, but there are many more working their butts off to do a good job. Indeed, the problems of medical training have far more to do with conflicts among doctors themselves. Medical education is given such low kudos within the profession compared to research that those who dedicate themselves to it are seen as irrelevant academic lightweights. Some of the most gifted student teachers are forced out of work in the endless drive to get a good research rating, and the many millions of pounds that should be ring- fenced for education get tied up elsewhere.

Still, it's easier (and safer for your career) to point the finger at administrators than your own kind, and the students came up with a neat conspiracy theory. Medical training is being deliberately butchered to create incompetent doctors who in turn butcher their patients who obligingly die quickly and cheaply, leaving much more money for the bureaucrats. It sounds far- fetched, but when I worked a hundred hours a week in the NHS, I believed it. "Politicians kill far more people than doctors," I used to yell in the privacy of the casualty department. Of course, that was when the Tories were in. Things can only get better under nice Mr Blair and his happy band of carers.

Or perhaps not. The show kicks off in 2020 with the incompetent exploits of two new house-officers, Novac and Goode (geddit?!) who, thanks to the new curriculum, "only spent half an afternoon on the leg". When a critically ill patient arrives, they're asked about their resuscitation skills, "Is it one blow for every five compressions?" "Good. And then what?" "I dunno. That's just my sexual technique." Boom boom. To the rescue comes Professor Connor, who rallies his fellow consultants to fight The Administrators for the return of the traditional medical training. The presumption here was that old curriculum I went through (five years of irrelevant factual overload plus ritual humiliation) produces better doctors than the new one they're going through (less hard facts, more patient contact and touchy- feely stuff). As a lecturer in communication skills, I hope it isn't true.

The No 1 Administrator, a Blofeld lookalike with a cat called Mr Floppy, decides to sort out Professor Connor by sending a robotic female medical student back to 1998, to get Connor kicked off the medical course. Without a Hollywood special effects budget, the T1000 Administrator has to make do with a piece of Bacofoil strapped to her face. Still, it looked convincing to me. As Connor stumbles through his degree, there is a brilliant observation of the psychiatry multi-disciplinary team as children's TV presenters, and a great piss-take of personal tutors, who are supposed to guide and support students but sometimes never even meet them. And I, too, appeared as a sad, ginger lecturer who's desperate to make it in television. "Did you know, I'm Channel 5's top anchorman?" "Is that with a silent double- you?"

How I laughed. Medical finals were accurately portrayed as a game of The Crystal Maze - ("Do you want a clinical skills game or a case history mystery") - and the marking was equally random. Overall, however, the show was hugely reassuring. The fact that so many students had found the time to write ("we did it during the Public Health lecture block"), rehearse and perform such a slick clever show in the middle of their degrees gives me hope for patients. What makes empathic, communicative, wise doctors has more to do with what they do out of hours than in the library, and on this showing, the future's bright. Unless they all try to make it in television.