The American journal of medicine
-
To quantitate the impact of the recommendations contained in the Council on Graduate Medical Education (COGME) Fourth Report on the position distribution in internal medicine residency and fellowship programs and to recommend alternative position allocations for discussion. ⋯ The recommendations contained in the COGME Fourth Report would substantially reduce the number, and significantly alter the current distribution, of residency positions. The output goals of 50% generalist careers are met by an increase in career-bound generalist positions in all three generalist specialties. The limitation of total positions to the goal of 110% of 1993 U.S. graduates comes predominantly through reduction of specialty/subspecialty career-bound positions. Internal medicine residency and subspecialty fellowship positions and programs would be significantly altered by these recommendations. The reductions in internal medicine occur predominantly in loss of positions not currently destined for careers in internal medicine and in subspecialty fellowship positions. These reductions are partially offset by an increase in the complement of residents who are destined for careers in general internal medicine.
-
Comparative Study
Plasma interleukin-6 and C-reactive protein levels in reactive versus clonal thrombocytosis.
Evaluate the discriminatory value of plasma interleukin-6 or C-reactive protein levels in clonal thrombocytosis compared with those in reactive thrombocytosis. ⋯ An elevated interleukin-6 level is rare in uncomplicated clonal thrombocytosis and suggests reactive thrombocytosis. However, an isolated normal value has little discriminatory value. Measurement of C-reactive protein level may be used as a less expensive surrogate for measurement of interleukin-6. Repeatedly low levels of both interleukin-6 and C-reactive protein are most consistent with clonal thrombocytosis.