Drop out rate in medical schools seems reasonable

Table 1-Number of laboratories (n = 103) making tests for H pyloni available to gastroenterologists, other hospital doctors, and general practitioners (GPs) Other hospital Test Gastroenterologists doctors GPs Urea breath test only (13C or 14C, or both) 7 4 4 Urea breath test and serum assay 14 4 1 Serum assay only 53 57 59* Near patient test only 1 1 1 Total offering service 75 66 65 No service offered 28 37 38 *Two further laboratories offered serum tests to fundholding GPs only.all.Fourteen planned to introduce a noninvasive test within the next 12 months, though six would be restricting this service to hospital doctors.Many of the guidelines on managing dyspepsia that emanate from secondary care advise that the success of eradication treatment should be confirmed by a laboratory test.However, the urea breath test, which is most suitable for this, was provided to gastroenterologists by only 20% ofthe laboratories and to general practitioners by only 8%.Some gastroenterology units have their own facilities for urea breath tests and make these available to general practitioners on an ad hoc basis.Near patient testing kits can also be bought by general practitioners.These alternative sources are unlikely to have an appreciable impact on the overall availability to general prac- titioners of tests for Hpylori.The restricted availability of non-invasive tests for H pylori limits both the effective use of gastroscopy services and the implementation of management guidelines for peptic ulcer disease.These tests, particularly urea breath tests, should be more widely available, and they should be as accessible to general practitioners, who manage 90% of peptic ulcer disease, as they are to gastroenterologists.