The Medical Education Commission report on trends in graduate medical education 2001.

The state of Louisiana Medical Education Commission offers the second publication in the Journal of Louisiana State Medical Society on Graduate Medical Education (GME) in Louisiana. The four previous annual reports of the Commission have provided data to focus on trends in size, status, proportions, and issues on GME. The Commission was established by Act 3 of the 1997 Louisiana Legislature. This summary report for 2001 provides the detailed and updated data on all GME residents and fellows in Louisiana for the last academic year. The presentation of data and trends poses three questions for analysis. First, what are the trends in Graduate Medical Education in Louisiana for total residents and fellows? Second, how do these trends relate to the size, status, and proportions of Graduate Medical Education in Louisiana and as compared to the United States? Third, where do these trends lead to the future in predictions and recommendations for Graduate Medical Education in Louisiana? The 4-year trend in the total number of Graduate Medical Education filled positions has been relatively consistent, with some recent increases in primary care residency positions, especially in Family Medicine and Medicine/Pediatrics. These increases will plateau as current trends on new program formation stabilize, requiring emphasis on recruitment and factors promoting recruitment for GME in the state of Louisiana. The state of Louisiana has participated proportionately relative to population in the growth of medical education in the last century and compares favorably with other states and the nation. Louisiana has exceeded national averages in the increases in primary care programs and residents and in the retention of trainees in practice sites in the state.

Projecting physician supply at a state level: physicians in Louisiana in 2001 and 2006.

BACKGROUND: Many studies predicting physician supply are based on national statistics, which may not be applicable at the state level. METHODS: To facilitate meaningful planning of future physician supply in our state, we developed a conservative, population-based projection of the total number of generalist and specialist physicians who will practice in Louisiana per 100,000 population in 2001 and 2006. RESULTS: Our projections, which err toward our goal of overestimating physician supply, indicate that the total physician number per 100,000 population in Louisiana will rise from the current level of 139 to 162, then to 186, in 2001 and 2006, respectively. The number of primary care physicians will rise from 52 to 59, then to 67, and specialists from 87 to 103, then to 119, in 2001 and 2006, respectively. These numbers are well within the range of need reported in several widely published demand scenarios used for comparison. CONCLUSION: In planning future policies on physician supply, states should develop their own projections rather than simply extrapolating national data to their individual situations.

The physician workforce in Louisiana, 1994: the quantity of doctors, residents, and fellows.

Health care system reform raises many issues for doctors, patients, and all components of the system: professional practice, health careers education, and medical research. This report was prepared to identify trends in the medical workforce and to quantify for 1994 the number of licensed physicians in Louisiana, the number of residents and fellows, their institutional locations and the types of educational programs. The yearly publication of the Louisiana State Board of Medical Examiners was utilized for physician numbers, and the 1994 house officer data was contributed by the several institutions with residency and fellowship educational programs. Of the 9031 licensed physicians located in Louisiana in 1994, 1769 were residents or fellows in educational programs. Over the four years from 1990 to 1994, total licensed physicians in Louisiana, including house officers in educational institutions, increased slowly from 8386 to 9031, a rate of 1.78% per year.

Aspirin and recurrent hyphema after blunt ocular trauma.

Recurrent hyphema after traumatic blunt injury to the eye is associated with a more serious prognosis than that occurring from the initial trauma, resulting in a higher risk of glaucoma, corneal staining, surgical intervention, poor visual acuity, and enucleation. Risk factors associated with the development of recurrent bleeding are not well defined, but recent evidence suggests a high association with concurrent aspirin ingestion. Of 25 consecutive patients with hyphemas (20 males and five females, ranging in age from 2 to 53 years), 12 took aspirin after the initial trauma and seven had recurrent hyphemas. Platelet aggregation determinations in these seven patients showed defects associated with aspirin. Only one of 13 patients without aspirin intake had recurrent bleeding.

Kinetics of protein adsorption and immunological reactions at a liquid/solid interface by ellipsometry.

The adsorption of bovine serum albumin and the subsequent reaction with it of rabbit anti-bovine serum albumin at a saline solution/gold interface are observed in vitro by ellipsometry. By suitable choice of protein concentrations, the processes of adsorption and immunological reaction can be followed in detail by an ordinary null ellipsometer. A simple kinetic model for the formation of a monolayer of protein at the saline solution/gold interface provides adequate explanation for the experimental results. It is shown that ellipsometry is capable of providing information on molecular dimensions, molecular diffusion velocities and adsorption rates.