Thursday, 14 August 2008


Today I carried out a medical examination on a young lad who is soon to emigrate to the United States with his family. In order to enter the education system there he requires proof of vaccination and medical supervision. And so it was that I found myself filling in a form for the New York City Department of Health and Mental Hygiene.

My patient was charming and a credit to his family. He appeared adequately healthy and mentally hygienic. He had even washed behind his ears. The examination was easy, but completing the form was slightly more difficult. First I got the dates the wrong way round as the months have to go before the days, 08/14/08 instead of 14/08/08. Then I had to convert his weight from kilograms to pounds and his height from centimetres to inches. It seemed odd that the most technologically advanced nation in the world should still be using British Imperial measurements to monitor its children. Fortunately my metric measurements came in handy for calculating his BMI, as I presume this was wanted in kilograms per square metre (normal range 20 - 25) and not pounds per square inch (normal range 0.028 - 0.036). Although this latter unit of BMI might catch on, since even a clinically obese person could say “my BMI is only 0.04” which sounds hardly worth mentioning.

Having finally completed the form it occurred to me that I should have put crosses (“check” marks) in the appropriate boxes and not ticks. But I expect the NYCDHMH will know what I mean, and with luck they will also accept my GMC number as evidence that I am a proper doctor. I don't have an MD, since that is a higher degree in the UK which only a few academic doctors receive. Like most British GPs I'm just a plain ordinary Bachelor of Medicine, although many of us have also passed the membership examination of the Royal College of General Practitioners.

Britain and the US may be two nations divided by a common language, but our medical professions also seem to have a few differences.


Anonymous said...

Fear not, "check marks" are ticks!

PhD scientist said...

Hmm. Just be grateful they didn't ask for his lipid levels in mg/dL, doc.

By repute the Permanent Residency (Green card) medical form that applicants have to fill in is another example of these idiosyncratic differences, with certain diseases being referred to by different common names. (The applicant used to, and probably still, have to fill in a long list of check / tick boxes to answer "No" to "Have you ever had....")

The one I remember one of my (British) friends commenting on was "Hansen's disease", which appeared with no mention of the word "leprosy".

Anonymous said...

My health check form for Swaziland included the doctor having to certify that I was not a congenital idiot. He checked this by turning to me (and he was in a bit of a grumpy mood at the time because some wires had been crossed about booking the medical) and barked out 'are you an idiot?'

I think my startled response cheered him up a bit (the rectal examination consisted of 'you've not got any problems down there have you? It's far too early in the morning for that sort of thing')

Dr Andrew Brown said...

DocJock: Thanks for the reassurance. :-)

PhDSci: I believe they also use mg/dL in France.

I suppose you could work on the assumption that if you don't recognise the name of the disease then you haven't got it.

Disgruntled: I love your story, I can just imagine it happening. Shades of James Robertson Justice! "What's the bleeding time!?"

Anonymous said...

My in-laws were required to prove that their children had had their chickenpox vaccine before starting school in the States. Fortuately they had a nice GP who was prepared to look at my sister-in-law's blurry photos and confirm that, indeed, all the children looked rather spotty and then to write in the form that they had all had chicken pox. One reason why maybe it IS worth taking your pox-ridden child to the GP.....

Dr Andrew Brown said...

GeePeeMum: I think we did varicella serology on this lad.