Healt Briefs -4 --:1_x; 1,*v I

CorrectionsPolio vaccineAn article in the AAP News

Special Sec-tion, "'Me U.S. Im-munizationCrisils," August 1991,incorrectly quoted Jan Drutz,M.D., FAAP. Thepoio epidemicoccurred in thie early 1950s. TheSabin polio vaccine was 'intro-ducedinthemid 1950s. Churcheswere -among thie sites where 'it-munization drives were held:

Forum datesAn article in the August 1991

AAP News incoffectly identifiedthe dates for the 1991 AAP An-nual Chapter Forum. The forumwill be held Sept. 20 to Sept.,22, semont,- -Il..-

"Children First"questionsAn article i'n the August 1991

AAP News, "AAP officialsanswer access proposal ques-tions," contained a typographicaleffor. The second paragraph inthe answer to question number4 should read, "Children Firstalso provides federal subsidies tostates for children and pregnantwomen in families with low-wage workers who have theirinsurance paid by the state ad-ministered insurance fund. Thesesubsidies will ensure that costswill be covered 'if the growth 'inpayroll is less thian thie increasein program costs."1

Member ApplicantListThe Member Applicant List in

the August 1991 AAP News in-correctly listed, several AAPchapters under AAP DistrictVIII-West that should havebeenlisted under AAP District VII-South Central. District VII-SouthCentral includes: Alabama;Arkansas; Lousiana; Miss'iss'ippi; Oklahoma; and Texas.District VIII-West includes:Alaska; Arizona; Colorado;Hawaii; Idaho; Montana;Nevada; New Mexico; Oregon;Unifonned Services West; Utah;Washington; Wyoming; Alberta;and Britsh Columbia.AAP News regrets the errors.

Ifyyou spot an error inAAP News,please contact the editor at (800)433-9016, ext. 7875.

How students pay formedical school

Average Debt01 t II ...........o

a 1990= $461,224-*1980= $10,631

* 1990 figure is a 77% in-crease.

Median Tuition

Ways of Funding MedicalSchool

By Rebecca LangAAP News Intern

Clue. to dyslexia foundResearchers have found thiat the

brains of dyslexic persons are fun-damentally different from the brainsofnonnal readers, according to a studysupported by the National Institute ofChild Health and Human Development(NICHD).--

This report, published in the April1991 Archives of Neurology, andothers may help discover thie causesofdyslexia so it can be diagnosed early.Some researchers believe as many as12 percent ofU.S. students, or I millionchildren, might suffer from dyslexia,the report states.

Researchers, led by Ranjan Duara,M.D., and Herbert Lubs, M.D., bothof the University of Miamil (F;lorida)

School of Medicine used magneticresonance imaging (MRI) to depictbrain structure in 21 people withi dys-lexia and in 29 nonmal readers.

The researchers studied the sizesof the left and right brailn hemispheres,and found thiat te left hemispheresof nonmal readers is larger than theirright hemispheres. But in dyslexics,the rear portion of the left hemisphereis smaller or thie same size as te rearpart of the right hemisphere, accordingto the report.

In a similarstudy, researchers foundthiat size reduction in thie left hemi-spheres of dyslexics is most prominentat the rear of the brain, in an areaknown as the planum temporale. Re-searchers also found that the planumtemporale is greater on the right side,of thie brain in dyslextcs. They found

See Health Briefs, p. 15

.08Q

CO

Medical schools have continued to'raise teir tuitions each year, des'pitethe fact that tuition is a small partof total school revenues. Medicalschool students are expected to keeppaying thie increasing prices, and thiissteady increase worres medicaleducators, physicians and the students,accord'ing to a. special report in teAug. 8 New England Joumlal ofMedicine.

In 1990, med'ical school graduatesended up withi an average debt of$46,224, a 77 percent increase since1980, according to the article.' The rateof increase in tuition and fees is notintended to coverthewosts ofeducaiion.During te 1988-1989 school year,only 4.5 percent of revenue was eamedfrom tuitilon and fees, according tothe report

"Althiough all sources of revenueare important, tuition and fees doi notrepresent a major source of revenuefor medical schools, nor are their levelsset primarily to pay for thie costs ofeducatilon," researcher Robert Hughes,Ph.D., and his colleagues stated.

About 90 percent of medical stu-dents today rece'ive some kind offinancial aid, includ'ing scholarshipswithout practice obligations, scholar-ships wilth practice obligations (suchas the National Health Service COIPS)and loans, according to the report.

The number ofscholarships offeredthrough thie National Health ServiceCorps ha-s declined substantially,making financial aid a choice betweenscholarshilps with obligation in theanned forces or loans.

Ttle researchers of the report raiseconcems about the effect of increasingmedical school debts, and propose thatit might influence the types of peoplewho enter the profession.

"The increasing debt conveys theimplilcit message that medical schoolis only for the well-to-do or those will-

ing to borrow large amounts of moneyto finance 'their education,'! the re-searchers stated. "For thie first time inseveral decades, -the question ofwhether one should choose medicineas a career is being openly debated."

Once students decide to attendmedical school, medical educatorsworry that thiey treat their educationmerely as "job training" instead of "apreparation for professional respon-sibility," according to the article.

However, high debt load mightcause students to question the qualityof teir schools, the report states. Theresearchers also surmised that studentsmigt allow ec9nomic constderationsto afect their futures, including choos-ing where to work and under whattenns they will-work.

"An oft-noted concem is thiat debt-influences physicians to select higher-paying specialties, exacerbating themaldistribution between primary careand the specialties even further," Dr.Hughes wrote. "'Yet wit minor ex-ceptions, studies of this question haveshown no systematic relations."

The article proposes that medicalschools control the tuition increases,and that federal and state govenuentsattempt to reinstate a period of service.In thie past, physicians were subject toserving in the armed services or thePublic Health Service, including the In-dian Health Service, the NationalInstitutes forHealth and theEpidemiol-ogy Intelligence Service of thie Centersfor Disease -Control.

The report suggests starting thisprogram again so "doctors could meetthie healthi and medical care needs ofour underserved population in ex-change for a tuition-free medicaleducation."

For copies of the report, contact:Robert Wood Johnson Foundation,College Rd., P.O. Box 2316, Prin-ceton, NJ 08543.

1989-90 -Public = $5,8101989-90 Prvate=$17,794Since 1960, Public has in-creased 277%; Private hasincreased 403%.

.

obligations:with service

National Health Service Corpsa 1979-80 $49.8 million =

54.4% of all scholarshipswith serv'ice obligations.

* 1988-89 $1.2 milli'on=2.1% of all scholarshipswith service obligations.

Armed Forces HealthProfessions

1979-80 $32.6 million=35.6% of all scholarshipswith service obligations.*1988-89 $55.9 million=95.6% of all scholarships.with service obligations.

Loans* 1974-75 loans accounted

for 56.4% of financial aid.* 1988-89 loans accounted

for 77.3% of financial aid.

Source: Th7e Now EnglandJoumal ofMedidne*Are We Aortgaging the Medical Profession?"August 8, 1991.

IanDD

S

Significant deb loads narrovwgraduates'Icareer choices