Perspective

Extensively Drug Resistant Tuberculosis

by Raviglione and Smith, NEJM, February 15 2007, Vol 356 (7)

Beyond the existence of multidrug-resistant tuberculosis, the most resilient strain of tuberculosis, extensively drug-resistant (XDR) tuberculosis, is increasingly making its presence known. The misuse of second-line drugs has fueled a global health problem whose solution-new classes of anti-tuberculosis drugs-may not appear for at least several more years. In light of this dearth of tools against XDR tuberculosis, what are clinicians to do?

Health Policy Report

Medicaid Revisited

by Iglehart, NEJM, February 15 2007, Vol 356 (7)

Fluctuating with the economy, Medicaid has once again landed itself under scrutiny. Federal spending alone for Medicaid is projected to total about $2.8 trillion over the next eight years. Such daunting numbers have prompted the creation of the Deficit Reduction Act, which aims to slash federal expenditures on Medicaid by $26.4 billion in the next decade. Even prior to the approval of the act, payments have been consistently reduced–and have been impacting the willingness of physicians in accepting new Medicaid patients.

Special Article

Religion, Conscience, and Controversial Clinical Practices

by Curlin et al., NEJM, February 8 2007, Vol 356 (6)

Despite being legal, many medical procedures may be personally objectionable to certain health professionals. In addition, would physicians refer patients to another professional willing to perform the requested procedure? Do they feel obligated to present all options? While the answer remains unclear as to whether physicians are obligated provide these treatments, a survey done by the authors sheds light on the attitudes and practices of physicians towards controversial medical procedures.

Pathways in Medicine

Allergy and Immunology

Dealing with one of the most complicated systems in the human body, the immune system, the field of Allergy and Immunology has some added challenges. Physicians and physician scientists from the University of Colorado Health Science Center and the National Jewish Medical Research Center share their experience in residency, in research, and ultimately in a career dedicated to expanding and applying our understanding of immunology, such as with inflammation, innate immunity, pharmacogenetics and disease heterogeneity.

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Pathways in Medicine

The MD/PhD

Historically separated by a philosophical and intellectual rift, clinical practice finally marries scientific research in the physicians who also pursue Ph.D. training. With the explosion of discoveries in the natural sciences in the past few decades came a tremendous opportunity for translational research on human disease. MD/PhD programs across the country cater to students fascinated by both medicine and research and train physician-scientists prepared to bridge the gap between the lab and the clinic. While the lengthy education offers certain disadvantages and the dual-sided career is difficult to balance, many physician-researchers find their careers intensely rewarding.

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Advice to the Next Generation

• What are some things to look for when choosing a medical school?
• Other than "helping people," what are some other aspects of a doctor's job?

» Other Questions and Answers

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