Editorials
354 Knowing when to say "no" on the student elective
355 The fake letter
356 Hostility and the heart
357 Treating medically unexplained physical symptoms

News
358 Devolution and Scottish medical schools Final year fee waived Calcium supplements Device helps paralysed hands and fingers Smoking takes its toll in the the Third World US hospitals cut training posts

Education
361 Will Superman walk again?
363 Clicking joints
364 Mature entrants to medicine
365 Net.philes
366 Recent advances: General surgery
369 Clinical lesson: Stress, the brain, and mental illness
375 An "ecological" approach to the obesity pandemic

Papers
379 Duration of cognitive dysfunction after concussion, and cognitive dysfunction as a risk factor: a population study of young men
383 The beefburger injury: a retrospective survey
384 Validation of a regional drug misuse database: implications for policy and surveillance of problem drug use in the UK

Life
385 Elective report: Manali, India
386 The not-so-secret-diary of a medical student
387 Career in neonatology
388 Life as a student panellist
389 Interview with a medical student
390 Obituaries
390 Out There

Letters
391 Is first aid training for medical students adequate? Euthanasia should not be based on feelings Adis to x ray films Communication and academic ability Incompetent junior doctors or lack of training? Benefits of hospital work experience Surfers headache? Correction: Mulube Retraction of letter

Soundings
393 Stereo typing
393 The answers are out there somewhere

Personal view
394 The final prognosis

Art & Reviews
395 Oxford Clinical Mentor
395 The Diving Bell and the Butterfly

353 Minerva

Editor's choice
If you are lucky enough to be one of the medical students going on elective next spring you will be starting to lay down plans now, raising money, buying flight tickets, and finding yourself a place to stay. But even for those with all the best laid plans, there will still be surprises in store. For Kevin Mollock the surprise was to find that he was the only doctor on call in a chaotic Indian hospital (p 385). The plans you make about your future can be shattered if you become seriously ill. Medical student Peter Boys (p 394) was diagnosed as having a brain tumour. He tells us how his horizons were reduced from planning his future career to getting to the bathroom on his own. Dominique Bauby, former editor in chief of the French edition of Elle magazine , had his world torn apart when he suffered a brain haemorrhage that left him the use of only one eyelid. He showed an extraordinary feat of careful planning when he managed to dictate a book, which is reviewed in this issue by Emma Nicholls (p 395). Neonatologist Peter Hope (p 387) warns that planning ahead is not always a good thing, as career paths rarely follow rational decisions. He tells how he discovered the joys of his job through a string of apparently random events.