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A number of school choice advocates claim that there is a research consensus indicating that vouchers for private schools lead to higher academic achievement. The authors review and critique these local studies of voucher programs, contrasting them with findings from larger-scale analyses of nationally representative samples of public and private schools, which illuminate patterns that appear to undercut the assumption of superior private school performance that is a premise of voucher programs. The authors note limitations inherent in different methodological approaches to this question, focusing on the shortcomings of randomization as an exclusive "gold standard" for research on the issue of achievement in school choice plans. The concluding discussion reconsiders the question of a consensus, highlighting the emerging research environment that bypasses traditional review processes and emphasizes instead the promotion of ideas to support policy agendas.

Letters, which may not necessarily be published in full, should be restricted to not more than 250 words. When relevant, comment on the letter is sought from the author. Due to production schedules, it is normally not possible to publish letters received in response to material appearing in a particular issue earlier than the second or third subsequent issue. wider curriculum. The skills of the doctors providing training should also meet minimum standards. The doctors should be centrally funded for this role (at present in the UK nurses and pharmacists sometimes have to pay for themselves, or defer training until one of the small number of bursaries becomes available). In some states in the USA, pharmacists are certified by the same board as physicians, which aids local acceptability.Overall, there is a clear rationale to extend prescribing rights.While it needs continued evaluation, where it has been introduced it seems to have improved access, been liked and, on the evidence of a small number of case studies, been effective. Extending prescribing rights is also logical. The burden of knowledge associated with medicines is vast and expanding, so it makes sense to share the task of prescribing while retaining an integrated system of care.The role of the doctor is in a transition akin to that which theatre went through in the last century. The doctor's role has been like that of the great Victorian 'actor-managers' -controlling the whole show, making all the key decisions and being centre stage in the action. Medicine is getting too complex for that model to survive. Doctors should move to the equivalent of the theatre director of today. They can set direction, strategy and priorities, working with teams of colleagues, including non-medical prescribers.

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