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US graduates lured by primary care
US graduates lured
US medical school graduates are turning their backs on high-status subspecialties and are heading for careers in general practice, according to the Association of American Medical Colleges. The data come from the Association’s annual questionnaire in which graduating medical school seniors are surveyed on various issues, including the areas in which they : intend to pursue their careers. The fall and rise in popularity of generalist options for physicians in the USA are shown in the figure. In 1992, dwindling medical graduate interest in general practice hit an all-time low of 14-6%; since then, interest has climbed steadily to a current 27-6%. Percentages shown here
approval
The US Food and
Drug Administration’s Oncologic Drugs Advisory Committee has recommended that docetaxel be approved for treatment of patients with locally advanced
83 85 87 89 919395 General
practice
makes
a
good recovery ,
to
between 1983 and 1995. Taken from Association of Amencan Medical Colleges 1983-95 Medical School Graduation
cancer
that
promotes microtubule assembly and premicrotubule depolymerisation, thus blocking cell division. The panel’s decision to require that patients have normal liver-enzyme tests was in response to data indicating that patients with raised aminotransferase and alkaline phosphatase blood levels had more severe side-effects.
Questionnaire.
Air pollution has only small Swift asthma effect in UK
Michael
McCarthy
"keyhole" surgery evaluation urged for UK
independent inquiry into minimalsurgery and its implications for the UK has expressed concern at footdragging over evaluation of these surgical techniques. It points out that the "window of opportunity" for such trials might be short because of the tendency for new surgical methods to be quickly picked up in clinical practice. The report cautions that "There is thus a danger that unless further evaluative trials are given a higher priority, the opportunity will be lost and the techniques will become widely used despite the lack of formal An
access
assessment". The report (Minimal Access ["Keyhole"] Surgery and its Inaplications ISBN 1-897941-95-1) was published by the Parliamentary Office of Science and Technology last week. POST provides
News in brief Germany
Docetaxel, which is chemically related taxol, is an antimicrotubule agent that
vents
graduates intending to pursue: By contrast, interest in internalgeneral family practice, general internal medicine subspecialties cardiology and medicine, and general paediatrics. Of gastroenterology has been on the wane. these three, it is family practice that has expanded the most, from 9% in 1992 to 15-7% this year.:Sarah Ramsay
rejects
non-heart-beating
donors The German Federal Medical Council has (Bundesarztekammer) announced that organs from non-heartbeating donors (NHBD, see Lancet, April 29, p 1064 and 1067-70) without brain death should not be used for transplantations in German hospitals. :
: independent information and analyses on : science issues of concern to parliament. : POST undertook the current project because of concerns over the "potential : safety, cost, and logistical implications of : the rapid and largely uncontrolled adop: tion of some [minimal-access surgery]
!
procedures in the UK". Besides indicating the need for more : : comprehensive appraisal of the use of ,
minimal-access surgery in UK hospitals, the report also points out that it is still unclear how surgeons who qualify under newly emerging minimal-access training programmes can be encouraged to participate satisfactorily in continuing medical education to ensure their continued
competence. Sarah
Ramsay
Australian team gets large NIH grant Prof John Eisman and his team at the Garvan Insitute of Medical Research in Sydney have received a grant of A$600 000 for 3 years from the US National Institutes of Health for researching the role of a calcitrol-receptor gene in osteoporosis. The Garvan’s 1994 5-year grant from the Australian National Health and Medical Research Council averaged A$583 000 a year.
Fatwa on organ donation in UK The Israeli-FDA arrangement Israel has Muslim Law (Shariah) Council UK has become the third country to sign issued a fatwa (religious verdict) giving an accord with the US Food and Drug official approval for organ donation (see Administration the results of Lancet July 29, p 303). : its clinical trials recognising on the same basis as those Kyrgystan loses WHO vote The WHO undertaken in the US. An earlier agreehas stripped Kyrgystan of its vote on . ment with Switzerland was cancelled account of its debt of some US$800 000 by the FDA while that with Sweden on its national subscription.: continues.
!
1154
metastatic breast
tests.
Percentage of medical school graduates intending to enter family practice, general internal medicine, and general padiatncs
cover
Vivien Choo
or
progressed during anthracycline-based therapy or has relapsed during anthracycline-based adjuvant therapy, but only in those patients with normal liver-enzyme has
,
The rise in prevalence of asthma in the UK over the past 30 years is unlikely to be due to an increase in outdoor air pollution, concludes a committee set up by the Depatment of Health (Asthma and Outdoor Air Pollution, ISBN 0-11-321958-X). The Committee on the Medical Effects of Air Pollutants had been asked to advise on the relation of non-biological air pollution to the time trends and geographic pattern of asthma in the UK, the role of air pollution in aggaravating existing asthma, and recommendations for further work. The committee found laboratory evidence that air pollution could potentially : contribute to the initiation of asthma but there was no firm epidemiological or other backing for this evidence. The epidemiological evidence suggesting that air pollution could provoke asthma attacks or aggravate existing chronic asthma showed that the effect, if any, was small and unimportant compared with that of factors such as infections and allergens. Where a cause has been found for asthma epidemics, it has always been an increase in aeroallergen levels. Although most of the few studies published on the effect of exposure to traffic on asthma showed a consistent, albeit modest, association with asthma prevalence in children, it was not clear whether the effect was due to an increase in the initiation or provocation of asthma. The committee concluded that although air pollution is a plausible explanation for the link, socioeconomic and other environmental factors could also play a role.
recommends of docetaxel
FDA panel
by primary care
US medical school graduates are turning their backs on high-status subspecialties and are heading for careers in general practice, according to the Association of American Medical Colleges. The data come from the Association’s annual questionnaire in which graduating medical school seniors are surveyed on various issues, including the areas in which they : intend to pursue their careers. The fall and rise in popularity of generalist options for physicians in the USA are shown in the figure. In 1992, dwindling medical graduate interest in general practice hit an all-time low of 14-6%; since then, interest has climbed steadily to a current 27-6%. Percentages shown here
approval
The US Food and
Drug Administration’s Oncologic Drugs Advisory Committee has recommended that docetaxel be approved for treatment of patients with locally advanced
83 85 87 89 919395 General
practice
makes
a
good recovery ,
to
between 1983 and 1995. Taken from Association of Amencan Medical Colleges 1983-95 Medical School Graduation
cancer
that
promotes microtubule assembly and premicrotubule depolymerisation, thus blocking cell division. The panel’s decision to require that patients have normal liver-enzyme tests was in response to data indicating that patients with raised aminotransferase and alkaline phosphatase blood levels had more severe side-effects.
Questionnaire.
Air pollution has only small Swift asthma effect in UK
Michael
McCarthy
"keyhole" surgery evaluation urged for UK
independent inquiry into minimalsurgery and its implications for the UK has expressed concern at footdragging over evaluation of these surgical techniques. It points out that the "window of opportunity" for such trials might be short because of the tendency for new surgical methods to be quickly picked up in clinical practice. The report cautions that "There is thus a danger that unless further evaluative trials are given a higher priority, the opportunity will be lost and the techniques will become widely used despite the lack of formal An
access
assessment". The report (Minimal Access ["Keyhole"] Surgery and its Inaplications ISBN 1-897941-95-1) was published by the Parliamentary Office of Science and Technology last week. POST provides
News in brief Germany
Docetaxel, which is chemically related taxol, is an antimicrotubule agent that
vents
graduates intending to pursue: By contrast, interest in internalgeneral family practice, general internal medicine subspecialties cardiology and medicine, and general paediatrics. Of gastroenterology has been on the wane. these three, it is family practice that has expanded the most, from 9% in 1992 to 15-7% this year.:Sarah Ramsay
rejects
non-heart-beating
donors The German Federal Medical Council has (Bundesarztekammer) announced that organs from non-heartbeating donors (NHBD, see Lancet, April 29, p 1064 and 1067-70) without brain death should not be used for transplantations in German hospitals. :
: independent information and analyses on : science issues of concern to parliament. : POST undertook the current project because of concerns over the "potential : safety, cost, and logistical implications of : the rapid and largely uncontrolled adop: tion of some [minimal-access surgery]
!
procedures in the UK". Besides indicating the need for more : : comprehensive appraisal of the use of ,
minimal-access surgery in UK hospitals, the report also points out that it is still unclear how surgeons who qualify under newly emerging minimal-access training programmes can be encouraged to participate satisfactorily in continuing medical education to ensure their continued
competence. Sarah
Ramsay
Australian team gets large NIH grant Prof John Eisman and his team at the Garvan Insitute of Medical Research in Sydney have received a grant of A$600 000 for 3 years from the US National Institutes of Health for researching the role of a calcitrol-receptor gene in osteoporosis. The Garvan’s 1994 5-year grant from the Australian National Health and Medical Research Council averaged A$583 000 a year.
Fatwa on organ donation in UK The Israeli-FDA arrangement Israel has Muslim Law (Shariah) Council UK has become the third country to sign issued a fatwa (religious verdict) giving an accord with the US Food and Drug official approval for organ donation (see Administration the results of Lancet July 29, p 303). : its clinical trials recognising on the same basis as those Kyrgystan loses WHO vote The WHO undertaken in the US. An earlier agreehas stripped Kyrgystan of its vote on . ment with Switzerland was cancelled account of its debt of some US$800 000 by the FDA while that with Sweden on its national subscription.: continues.
!
1154
metastatic breast
tests.
Percentage of medical school graduates intending to enter family practice, general internal medicine, and general padiatncs
cover
Vivien Choo
or
progressed during anthracycline-based therapy or has relapsed during anthracycline-based adjuvant therapy, but only in those patients with normal liver-enzyme has
,
The rise in prevalence of asthma in the UK over the past 30 years is unlikely to be due to an increase in outdoor air pollution, concludes a committee set up by the Depatment of Health (Asthma and Outdoor Air Pollution, ISBN 0-11-321958-X). The Committee on the Medical Effects of Air Pollutants had been asked to advise on the relation of non-biological air pollution to the time trends and geographic pattern of asthma in the UK, the role of air pollution in aggaravating existing asthma, and recommendations for further work. The committee found laboratory evidence that air pollution could potentially : contribute to the initiation of asthma but there was no firm epidemiological or other backing for this evidence. The epidemiological evidence suggesting that air pollution could provoke asthma attacks or aggravate existing chronic asthma showed that the effect, if any, was small and unimportant compared with that of factors such as infections and allergens. Where a cause has been found for asthma epidemics, it has always been an increase in aeroallergen levels. Although most of the few studies published on the effect of exposure to traffic on asthma showed a consistent, albeit modest, association with asthma prevalence in children, it was not clear whether the effect was due to an increase in the initiation or provocation of asthma. The committee concluded that although air pollution is a plausible explanation for the link, socioeconomic and other environmental factors could also play a role.
recommends of docetaxel
FDA panel
by primary care