THE DUTIES, NUMBERS, AND QUALIFICATIONS OF MEDICAL OFFICERS APPOINTED TO A PENAL ESTABLISHMENT ARE DETERMINED BY THE INSTITUTION'S ROLE AND SIZE, WHICH VARY FROM SMALL DETENTION CENTERS TO TOP SECURITY ESTABLISHMENTS. THE MAIN AREAS OF MEDICAL WORK WITHIN A PENAL ESTABLISHMENT, REGARDLESS OF ITS SIZE, INCLUDE RECEPTION PROCEDURES, PROVISION OF GENERAL MEDICAL CARE, INVESTIGATON OF INMATES, PREPARATION AND SUBMISSION OF REPORTS, AND ADVICE TO THE HOME OFFICE AND THE GOVERNOR. THE PRISON PHYSICIAN SHOULD REMEMBER THAT ONLY A SMALL PROPORTION OF THOSE INMATES WHO ASK TO SEE THE DOCTOR ARE IN NEED OF MEDICAL ATTENTION. PRISONERS USE MEDICAL TREATMENT AREAS AS PLACES OF COMMUNICATION WITH ONE ANOTHER AND AS A MEANS TO AVOID WORK. ANOTHER FORENSIC PSYCHIATRIST SUGGESTS THAT PHYSICIANS AND PSYCHIATRISTS HAVE FAILED TO PLAY A SIGNIFICANT PART IN THE MANAGEMENT OF PENAL INSTITUTIONS AND SHOULD MAKE AN EFFORT TO INCREASE THEIR PARTICIPATION. BECAUSE THE PRISON MEDICAL OFFICER IS PARTICULARLY VULNERABLE TO THE PROCESSES OF INSTITUTIONALIZATION, HE HAS AN ETHICAL RESPONSIBILITY TO STRUGGLE AGAINST THE PERVASIVE POWERS OF THE INSTITUTION. IF A PHYSICIAN IS NOT ACTING AS AN INDIVIDUAL'S PERSONAL PHYSICIAN, HE SHOULD CLARIFY HIS ROLE. THE PHYSICIAN SHOULD NOT ASSUME THAT THE PATIENT WILL APPRECIATE THE SIGNIFICANCE OF DIVIDED LOYALTIES. FINALLY, ANOTHER PARTICIPANT OBSERVES THAT THE PRACTICAL CONSTRAINTS ON THE PRISON MEDICAL OFFICER ARE LESS PRONOUNCED IN THE AREA OF PHYSICAL MEDICINE THAN IN THE SPHERE OF PSYCHOLOGICAL UNDERSTANDING AND PSYCHIATRY. (LWM)