Random Samples

Science  14 Mar 1997:
Vol. 275, Issue 5306, pp. 1571
  1. Population Control for Docs

    The U.S. government should move to rectify what threatens to be “a serious oversupply of physicians” by reducing the number of hospital residencies subsidized by the federal government and by no longer paying for the training of foreign nationals. So says a statement by six medical groups, including the American Medical Association and the Association of American Medical Colleges (AAMC). The recommendations are likely to be hashed over in congressional hearings on the budget of Medicare, which subsizes most residency training. The “Consensus Statement on the Physician Work Force,” issued on 28 February, notes that while medical schools have been turning out about 17,500 new doctors a year, first-year residencies now number 25,000 because of swelling numbers of international medical graduates. It says the country doesn't need all those doctors and can't afford to train them. The doctors' statement proposes that the number of government-supported positions be cut from 25,000 to something closer to the number of yearly U.S. medical graduates. Foreign nationals, 3000 of whom start residencies each year in U.S. hospitals, would be particularly affected: They would have to pay for their training. Jordan Cohen, head of the AAMC, notes that this would make for fewer U.S. physicians because a third of foreign doctors—who normally are required to return home for 2 years after finishing their residencies—are obtaining waivers enabling them to stay. Many doctors who came to the U.S. for their residencies are unhappy about the statement. Panos Fortounis, an internist at the Kingston Community Health Center in Kingston, N.C., argues that many like himself are serving in regions that U.S. graduates often avoid: “If it weren't for me and two others [with waivers on their visas], this clinic wouldn't exist,” he says. He adds that “We're not training in high-competition specialties” but in lesser paying fields, such as family medicine. The physicians' manifesto downplays the contribution of foreign nationals to underserved regions, asserting that “a higher proportion of U.S. graduates than foreign graduates ends up in permanent practice in rural America.” Bruce Vladeck, head of the Health Care Financing Administration (HCFA), home of Medicare, sympathizes with foreign doctors' objections, saying, “I don't think it's appropriate to target reductions just on foreign nationals.” However, he says there has been a “widely understood consensus” that training posts need trimming. In fact, HCFA has just launched a demonstration project in New York State teaching hospitals that offers them financial incentives to shift some of the functions usually done by residents to other health care professionals.

  2. Women Not Shortchanged in Trials?

    Four years ago, Congress, in response to pressure from women's groups and others, told the U.S. National Institutes of Health to take measures to assure that women and minorities are fully included in clinical trials. Amid some strong rhetoric—such as First Lady Hillary Clinton's reference to “the appalling degree” to which women were excluded from trials—NIH quickly set up an Office of Research on Women's Health. It also launched a giant study of postmenopausal women, the Women's Health Initiative.

  3. Popeye the Miner

    Like a miner in a collapsed shaft, the blind mole rat often finds itself digging in tunnels with scant oxygen. How does it compensate? The animal is extraefficient at getting oxygen to its muscles, scientists are finding. Physiologist Ewald Weibel, of the University of Bern in Switzerland, and colleagues have been studying how species adapt to extreme environments, such as deserts or caves. They became intrigued by mole rats, which “have to work very hard to dig their burrows,” Weibel says. “It's an extreme constraint.”


    Team members obtained several specimens from the dean of blind mole rat studies, Israeli comparative physiologist Eviatar Nevo. They ran the creatures on a treadmill and put them through a battery of tests to measure oxygen consumption and its diffusion to the muscles. It turned out that, compared to white rats, the mole rats had about a 30% greater capillary density in their muscles. And while mole rats have less muscle mass than white rats do, they have almost a 50% higher density of mitochondria, the oxygen-processing mechanisms in muscle cells. Moreover, Weibel says, the mole rats are built like miniature Popeyes, with most of their muscle mass up front. The animal uses its head, neck, and forearms “like a powerful shovel,” says Weibel, who reports on the work in the 4 March Proceedings of the National Academy of Sciences.

    Mole rat experts give Weibel's study thumbs up. “In my opinion, the work is interesting and novel,” says Chris Faulkes of the Institute of Zoology in London. Faulkes, a specialist in African mole rats, cautions that findings from blind mole rats don't necessarily apply to other species.

  4. Burning Up the Citation Logs

    The Institute for Scientific Information (ISI) in Philadelphia has come out with its latest rankings of the world's “hottest” papers published over the last 2 years. Using a Hot Paper algorithm based on numbers of citations and the prestige of journals in which papers are published, ISI determined that the hottest researcher is Roger J. Davis, a Howard Hughes Medical Institute investigator at the University of Massachusetts, Worcester. “I was a bit surprised,” says Davis. “When I got a call from them [ISI], I thought it was a joke.” He and his colleagues have churned out 11 much-cited papers on signal transduction–specifically on a new type of pathway for chemical signals that tell cells to proliferate.

    Mad cows are responsible for the number-one “red hot” research paper in 1996. Garnering 69 citations was “A new variant of Creutzfeldt-Jakob disease in the UK,” published in The Lancet last April by R. G. Will and colleagues at Western General Hospital in Edinburgh, U.K.

  5. Shot in the Arm for AIDS Vaccine

    The National Institute of Allergy and Infectious Diseases last week announced a program designed to inject new life into AIDS vaccine development by pouring $6 million into grants for pursuing novel, high-risk ideas.

    The INNOVATION Grant Program for Approaches in HIV Vaccine Research, as it's called, is the creation of the AIDS Vaccine Research Committee. Headed by Nobel Prize-winner David Baltimore, of the Massachusetts Institute of Technology, the committee met for the first time on 17 February. The grants, each worth $150,000 over 2 years, will fund research in three areas: the surface protein of the AIDS virus, the development of better animal models, and strategies for maximizing the immune response to HIV. Proposals are due by 23 May.

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