Factors associated with choosing a primary care career.

The factors influencing the career choices of medical students need to be understood so that the proportion of physicians entering primary care-defined as family practice, general internal medicine, general pediatrics, and general obstetrics and gynecology-can be increased. We sent a questionnaire to 474 University of California, San Diego (UCSD), School of Medicine alumni (classes of 1974, 1978, 1982, 1986, and 1990) inquiring about demographics, personal and medical school factors, and level of debt. A total of 351 alumni responded (74% response rate), and 327 of them were engaged in direct patient care (38% in primary care). Respondents who were older, female, an underrepresented minority, from a rural background, and who chose their specialty before medical school were significantly more likely to enter primary care. The primary care group was influenced by factors unrelated to the medical school environment, such as personal social values, whereas the top 3 factors rated by the non-primary care group were directly related to school environment. Many of the respondents in primary care reported that the environment at UCSD was antagonistic toward primary care. From 1974 to 1990, more students had debt and their total debt increased, although debt had little or no influence on specialty choice.

A distant upstream site involved in the negative regulation of the Escherichia coli ompF gene.

The two-component regulatory system, OmpR-EnvZ, of Escherichia coli K-12 regulates the expression of the major outer membrane porin protein, OmpF. OmpR is a DNA-binding protein which acts as both an activator and a repressor to control ompF transcription. In this article, we describe a new OmpR-binding site that is located between 384 to 351 bp upstream from the ompF start point of transcription. Inactivation of this site by insertion of a 22-bp fragment prevents the repression of ompF expression conferred by the dominant negative mutation, envZ473. On the basis of the location of this binding site, the presence of bent DNA in the ompF regulatory region (T. Mizuno, Gene 54:57-64, 1987), and the fact that mutations altering integration host factor result in constitutive ompF expression (P. Tsui, V. Helu, and M. Freundlich, J. Bacteriol. 170:4950-4953, 1988), we propose that the negative regulation of ompF involves a DNA loop structure.