On safari from the patient zoo

How refreshing to find Peter Richards, of the rapidly evolving Imperial College School of Medicine (THES, July 7), questioning "how far a large school was good for undergraduate teaching".

The battleground for the public health priorities in the Health of the Nation is fiercest in primary care health centres, and here, rather than the specialist acute hospital, is where medical students might have their eyes opened to preventative medicine. However, there are a wide range of under-used teaching resources in the community. Patients with very long-term, multifaceted needs attending day hospitals often introduce nursing and therapy students to rehabilitationconcepts, and it would boost interprofessional understanding if more medical students also shared this experience of complex "case management". I will know that Professor Richards's "greater range of expertise" has truly arrived when I see a clinical lecturer taking small group teaching into a local authority residential home or day centre. This will be the difference between traditional teaching about the natural history of disease in "a patient zoo" or leading students on a safari.

WOODY CAAN Behavioural scientist Head of research and development Lifespan Healthcare NHS Trust