re contact. They also have need of interisland boat transport for referral] when necessary. They usually work out of one of the existing clinics on the islands although these clinics need not be elaborate or extensively equipped. The health assistants on the Marshall Islands have been fortunate to have an active continuing education program offered by Mr. Arata Nathan from Ebeye and Mr. Alex Keju from Majuro. It is recommended that these MEDEX continue in their work of continuing education. Qualified health assistants after a period of work with good recommendations may become candidates Approximately 10 for of training the in younger the medical health assistant assistants are course. presently qualified to be upgraded to medical assistants. 3. Medical Assistants A mid level practitioner functions between the level of a health assistant or community health worker and that of a medical officer or medical doctor. He works under different titles based on the name given by the particular school under which he was trained. Between 1975-1978 a few Medex were trained by the University of Hawaii as part of a Trust Territory Pacific Island-wide medical training program. Medex are mid level pratitioners who have had two years of training beyond high school. Today there are 10-12 Medex who are working in the Marshalls, most at the central facilities at Majuro and Ebeye as physician extenders, supervisors of special programs hypertension, and in the public health clinics at the hospital. were trained specifically to work in the outer islands under i.e. They the supervision of Medical Officers by radio but this plan has not been realized because of multiple factors. Those who are working seem to be highly competent and motivated though somewhat discouraged because of lack of support. A training program of similar level is ongoing at present in the School of Medicine at the University of the South Pacific in Suva, Fiji, where they are called Medical Assistants. A proposed program of training offered by the new campus of the University of the South Pacific in Honiara, Solomon Extension Practitioners. Islands has chosen the name of Health For the sake of clarity the name of medical assistant will be used here as this is a commonly used designation in many countries of the world.