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This paper describes the children seen during a typical morning session in a London girls' comprehensive school. Although many of the problems are similar to those encountered in general practice, it is argued that these children, who give rise to considerable anxiety among teaching staff, would not present to their family doctors. The way in which they are managed requires particular skills and an understanding of the complicated interaction between adolescents, their families, and their educational environment. With the move towards primary care child health surveillance, and the appointment of consultant community paediatricians, the future of the school health service is under debate.