Nice Journal! I have held licences and medical professional association memberships in four provinces and one state with plenty of journals to review. I received my first copy of your journal today, and I was very impressed with the cover, the contents being on the next page without a lot of hunting for them, the interesting articles, and the thoughtful opinions.

I particularly appreciated Dr Falk’s article on “Who needs medicare?” [BCMJ 2002;44(10):547-550 [9]]. After living in the US for 5 years, I purchased catastrophic health insurance for $2000 per year and found that more cost-effective than the “Cadillac” coverage even after my wife had emergency surgery and paying an additional deductible one year. It is unfortunate that the expensive Romanow report with all its resources didn’t appear to carefully evaluate “out-side-the-box” type of ideas such as this. If we are truly going to re-evaluate health care in this country, we need to look at every option thoroughly.

I also liked Dr Sutter’s “Learning and teaching medicine” [BCMJ 2003;44(10):554-555 [10]]. I have had the opportunity to learn in a variety of medical school environments as divergent as University of Toronto and McMaster University. I appreciated having learned by systems and disciplines before moving on to more problem-based learning. It was obvious that I had a more complete understanding of the systems than those coming from a problem-based approach. However, the problem-based approach helped further integrate my knowledge and ability to learn in the future. Dr Sutter is quite right in that time is crucial to integrate this knowledge. I wish I had more time in my training with all the specialists to learn the spectrum of disease presentations better and to develop a better feel for the clinical diagnosis and the limitations of diagnostic testing. Fortunately, experience after graduation has certainly helped.

Keep up the good work.

—Ronald Cridland, MD
Kelowna