Next Generation: An Introduction to Medicine and Clinical Research

Selected Papers from the NEJM		NextGen Special Features
The following are free links to NEJM articles through the Next Generation. Perspective Cesarean Delivery and the Risk-Benefit Calculus by JL Ecker and FD Frigoletto, Jr., NEJM, March 1 2007, Vol 356 (9) The authors analyze the possible factors involved in the increasing numbers of physicians who opt for cesarean delivery over the traditional vaginal birth. They examine both the soundness of the reasoning that justifies such a trend as well as the need to educate patients about the real risks and benefits involved in the choice of delivery method. Sounding Board Ethical Challenges Posed by the Solicitation of Deceased and Living Organ Donors by DW Hanto, NEJM, March 8 2007, Vol 356 (10) In exploring the ethics of patients directly soliciting donations of organs from willing strangers, Douglas Hanto advocates the controversial position that organ donors and their families should not be allowed to choose what to do with the organs. Instead, he proposes forcing all donors to donate to the recipient at the top of the organ transplant lists except in those cases where a pre-existing emotional relationship exists (such as between family members). Clinical Implications of Basic Research Structural Variation in the Human Genome by JR Lupski, NEJM, March 15 2007, Vol 356 (11) Recently, biologists have found that individuals actually have many large-scale rearrangements in their genomes, such as deletions, inversions, or duplications that can affect gene fragments or even entire genes, and not just single point mutations. This "structural variation" affects the regulation of many different genes, and Dr. James Lupski explores the clinical implications of these large rearrangements.		The following interviews and articles are exclusive to the Next Generation. Free Standing Perspective Healthcare Gone Digital Dr. Ming Shing Chiu finds it difficult to balance his personal relationship with his patients and the increasing burdens of HMO rules, especially now with electronic recordkeeping. Though electronic records ultimately benefit the patient, Dr. Chiu explores an unintended side effect which future doctors would be prudent to be wary of. » More "Free Standing Perspective" Articles Free Standing Perspective Educating Innovators Throughout history, innovation has been an integral–if less emphasized–element of the physician's job description. Many great medical advances like asepsis and anaesthesia were in fact pioneered by doctors. Today, though, the environment in which they must innovate has been greatly transformed by both the rapid specialization of scientific research and regulations from agencies like the FDA. As a result, a handful of academic medical centers have taken the lead in educating future physician-innovators, offering focused curricula that forge stronger cross-institutional connections with the medical device industry. » More "Free Standing Perspective" Articles Free Standing Perspective Healthcare Outreach in Ethnic Communities Diagnosing and treating ethnic communities is no easy task. In order to effectively treat diseases, physicians and community outreach workers must navigate the complex web of details created by factors such as the languages, cultures, and the specific, relevant details of the diseases. Programs for treating hepatitis B and asthma within the Asian and Pacific Islander (API) communities of large cities illustrate important approaches and common difficulties in treating ethnic communities. » More "Free Standing Perspective" Articles 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 Next Generation Now Monthly! The Next Generation is now publishing at the beginning of every month! The next issue arrives May 1.

Selected Papers from the NEJM

NextGen Special Features

The following are free links to NEJM articles through the Next Generation.

Perspective

Cesarean Delivery and the Risk-Benefit Calculus

by JL Ecker and FD Frigoletto, Jr., NEJM, March 1 2007, Vol 356 (9)

The authors analyze the possible factors involved in the increasing numbers of physicians who opt for cesarean delivery over the traditional vaginal birth. They examine both the soundness of the reasoning that justifies such a trend as well as the need to educate patients about the real risks and benefits involved in the choice of delivery method.

Sounding Board

Ethical Challenges Posed by the Solicitation of Deceased and Living Organ Donors

by DW Hanto, NEJM, March 8 2007, Vol 356 (10)

In exploring the ethics of patients directly soliciting donations of organs from willing strangers, Douglas Hanto advocates the controversial position that organ donors and their families should not be allowed to choose what to do with the organs. Instead, he proposes forcing all donors to donate to the recipient at the top of the organ transplant lists except in those cases where a pre-existing emotional relationship exists (such as between family members).

Clinical Implications of Basic Research

Structural Variation in the Human Genome

by JR Lupski, NEJM, March 15 2007, Vol 356 (11)

Recently, biologists have found that individuals actually have many large-scale rearrangements in their genomes, such as deletions, inversions, or duplications that can affect gene fragments or even entire genes, and not just single point mutations. This "structural variation" affects the regulation of many different genes, and Dr. James Lupski explores the clinical implications of these large rearrangements.

The following interviews and articles are exclusive to the Next Generation.

Free Standing Perspective

Healthcare Gone Digital

Dr. Ming Shing Chiu finds it difficult to balance his personal relationship with his patients and the increasing burdens of HMO rules, especially now with electronic recordkeeping. Though electronic records ultimately benefit the patient, Dr. Chiu explores an unintended side effect which future doctors would be prudent to be wary of.

» More "Free Standing Perspective" Articles

Free Standing Perspective

Educating Innovators

Throughout history, innovation has been an integral–if less emphasized–element of the physician's job description. Many great medical advances like asepsis and anaesthesia were in fact pioneered by doctors. Today, though, the environment in which they must innovate has been greatly transformed by both the rapid specialization of scientific research and regulations from agencies like the FDA. As a result, a handful of academic medical centers have taken the lead in educating future physician-innovators, offering focused curricula that forge stronger cross-institutional connections with the medical device industry.

» More "Free Standing Perspective" Articles

Free Standing Perspective

Healthcare Outreach in Ethnic Communities

Diagnosing and treating ethnic communities is no easy task. In order to effectively treat diseases, physicians and community outreach workers must navigate the complex web of details created by factors such as the languages, cultures, and the specific, relevant details of the diseases. Programs for treating hepatitis B and asthma within the Asian and Pacific Islander (API) communities of large cities illustrate important approaches and common difficulties in treating ethnic communities.

» More "Free Standing Perspective" Articles

Advice to the Next Generation

» Other Questions and Answers

Next Generation Now Monthly!

The Next Generation is now publishing at the beginning of every month! The next issue arrives May 1.

The Next Generation is an independent online publication produced in collaboration with Editors of the New England Journal of Medicine. All content referencing the New England Journal of Medicine is copyrighted property of the NEJM and the Massachusetts Medical Society. All rights reserved on original content by the Next Generation.

The Next Generation (NextGen) seeks to broaden perspectives in medicine for everyone, from premedical and medical students to general readers, by connecting them to current physicians and clinical scientists. It is published every month by Harvard College undergraduates in collaboration with editors of the New England Journal of Medicine.