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. Original Article Human Papillomavirus DNA versus Papanicolaou Screening Tests for Cervical Cancer by MH Mayrand et al., NEJM, October 18 2007, Vol 357 (16), 1579-88 The sexually-transmitted human papillomavirus (HPV) is a necessary factor in almost all cases of cervical cancer, and early detection can ward off serious complications. While the Pap smear is the most common test worldwide, testing for DNA of HPV may be superior in sensitivity. Dr. Mayrand and colleagues report the first screening round comparing DNA testing and Pap testing in parallel and finds DNA testing more sensitive for detection of cervical cancer. Perspective Guilty, Afraid, and Alone—Struggling with Medical Error by T Delbanco and SK Bell, NEJM, October 25 2007, Vol 357 (17), 1682-3 Medical error creates an agonizing experience for patients, family members, and clinicians alike, and feelings of guilt or blame hinder closure and forgiveness. Dr. Delbanco describes cases of medical error and perspectives from all sides. He then suggests that honest and direct communication may be the best antidote, especially when doctors are paralyzed by shame or fear of legal repercussions, and patients and families struggle to understand their situation fully. Special Article We Can Do Better—Improving the Health of the American People by SA Schroeder, NEJM, September 20 2007, Vol 357 (12), 1221-8 United States healthcare has been ridiculed for spending the greatest amount per capita yet achieving mediocre health results. In this special article, Dr. Shroeder of UCSF suggests that the greatest opportunities to improve health lie in improving personal behavior and addressing the health of the poor. He then speculates that lack of social advocacy for the poor and the laissez-faire health system encourages poor health outcomes.		The following interviews and articles are exclusive to the Next Generation. Tutorials in Medicine Managed Care Organizations In the jargon-laden field of managed care organization, getting enough basic knowledge as tools to start understanding the field often seems daunting. In this second installment to series on the management of health care, we tackle the history of the industry's development, the flavors of health maintenance organizations, and other aspects to this dominant model in the US health care system. » More "Tutorials in Medicine" Articles Free Standing Perspective Taking a Medical History in Las Terrenas Cardiovascular disease (CVD) is a major public health problem in many developing countries, including the Dominican Republic. In this small nation in the Caribbean, widespread poverty makes it difficult for many families to maintain healthy diets or lifestyles, and this creates risk for CVD. In this article, Rachel Anderson describes her experiences as a medical student working on a cardiovascular health census in the Dominican town of Las Terrenas, in the northern province of Samaná. » 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 December 1.

Selected Papers from the NEJM

NextGen Special Features

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

Original Article

Human Papillomavirus DNA versus Papanicolaou Screening Tests for Cervical Cancer

by MH Mayrand et al., NEJM, October 18 2007, Vol 357 (16), 1579-88

The sexually-transmitted human papillomavirus (HPV) is a necessary factor in almost all cases of cervical cancer, and early detection can ward off serious complications. While the Pap smear is the most common test worldwide, testing for DNA of HPV may be superior in sensitivity. Dr. Mayrand and colleagues report the first screening round comparing DNA testing and Pap testing in parallel and finds DNA testing more sensitive for detection of cervical cancer.

Perspective

Guilty, Afraid, and Alone—Struggling with Medical Error

by T Delbanco and SK Bell, NEJM, October 25 2007, Vol 357 (17), 1682-3

Medical error creates an agonizing experience for patients, family members, and clinicians alike, and feelings of guilt or blame hinder closure and forgiveness. Dr. Delbanco describes cases of medical error and perspectives from all sides. He then suggests that honest and direct communication may be the best antidote, especially when doctors are paralyzed by shame or fear of legal repercussions, and patients and families struggle to understand their situation fully.

Special Article

We Can Do Better—Improving the Health of the American People

by SA Schroeder, NEJM, September 20 2007, Vol 357 (12), 1221-8

United States healthcare has been ridiculed for spending the greatest amount per capita yet achieving mediocre health results. In this special article, Dr. Shroeder of UCSF suggests that the greatest opportunities to improve health lie in improving personal behavior and addressing the health of the poor. He then speculates that lack of social advocacy for the poor and the laissez-faire health system encourages poor health outcomes.

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

Tutorials in Medicine

Managed Care Organizations

In the jargon-laden field of managed care organization, getting enough basic knowledge as tools to start understanding the field often seems daunting. In this second installment to series on the management of health care, we tackle the history of the industry's development, the flavors of health maintenance organizations, and other aspects to this dominant model in the US health care system.

» More "Tutorials in Medicine" Articles

Free Standing Perspective

Taking a Medical History in Las Terrenas

Cardiovascular disease (CVD) is a major public health problem in many developing countries, including the Dominican Republic. In this small nation in the Caribbean, widespread poverty makes it difficult for many families to maintain healthy diets or lifestyles, and this creates risk for CVD. In this article, Rachel Anderson describes her experiences as a medical student working on a cardiovascular health census in the Dominican town of Las Terrenas, in the northern province of Samaná.

» 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 December 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.