SGIM

FORUMSociety of GeneralInternal MedicineTO PROMOTEIMPROVED PATIENTCARE, RESEARCH,AND EDUCATION INPRIMARY CARE ANDGENERAL INTERNAL MEDICINE Volume 26 • Number 5 • May 2003

SGIM ESSENTIALS &HOW SGIM CAN ENHANCEYOUR CAREEREllen F.T. Yee, MD, MPH, Susana Morales, MD, and Pamela Charney, MD

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Contents1 SGIM Essentials & How SGIM Can

Enhance Your Career

2 2003 NRMP Results: ContinuedChallenges for Primary Care

3 President’s Column

4 The Whole Pie—On the Fragmentationof General Internal Medicine

4 Research Funding Corner

5 2003 Southern SGIM held in New Orleans

5 Genetic Nondiscrimination Protection:A Legislative Imperative

11 Classified Ads

SGIM is an organization regarded bymany as our academic “home andfamily.” The future of SGIM is de-pendent on having new members becomeinvolved in the further development andevolution of our Society. This article pro-vides background information whichhopefully will help those considering vol-unteering step forward. SGIM is commit-ted to increasing in all ways the diversityof our leadership.

The structure of SGIM has substan-tially evolved since its initial creation bya handful of generalists as the Society forResearch and Education in Primary CareInternal Medicine (SREPCIM) in 1978.Our Society has focused on the improve-ment of patient care, education, and re-search in primary care and general inter-nal medicine. Our Washington, DC of-fice is led by an Executive Director andeight full time staff members. A descrip-tion of our current administrative struc-ture is helpful to those interested in be-coming more active in the Society.

Our current national administrativestructure includes volunteer officers andpaid professional staff who are organizedinto an Executive Committee and Coun-cil. There are three senior officers (Presi-dent, Secretary and Treasurer) who meetas the Executive Committee with thePast-President, Future-President, either aFuture Secretary or Treasurer and our Ex-ecutive Director, David Karlson. The Ex-ecutive Committee reports to the SGIMCouncil which also includes six at-large

members, the Editors of the Journal ofGeneral Internal Medicine and SGIMForum, Liaisons for Regional Activitiesand the Association of Chiefs of GeneralInternal Medicine and the members of theExecutive Committee. The Councilmeets monthly by telephone and at leasttwice annually in person, including onceat the annual meeting. All members ofCouncil also serve as Liaisons to specificCommittees. Each region has its own lead-ership structure, and each of the seven re-gions holds annual elections and has a re-gional meeting. The Executive Committeeratifies all Committee and Task ForceChairs, often with nominations from Coun-cil members and Regional leaders.

Financially, income to support SGIMcomes from registration fees for the na-tional meeting, annual dues and then con-tributions. About half of our over 3,000active members attend the national meet-ing, which is a higher attendance thanmost national societies. Additional fiscalsupport comes from royalties, charges forcontracts and national meeting exhibits,member list sales and Forum Newsletterads. Some financial support comes fromthe pharmaceutical industry. The SGIMCouncil has recently developed a newexternal funds policy.

Involvement in SGIM makes a differ-ence for members by enhancing professionalcareers and providing opportunities forresearch, clinical, and educa-tional devel-opment. This participation can lead to

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SGIM FORUM

2003 NRMP Results: ContinuedChallenges for Primary CareEugene Rich, MD, Mark Liebow, MD, and Jim Woolliscroft, MD.

Match Day is an anxious butexciting event for the 14,000US medical school seniorswaiting to learn where they will be fortheir momentous next step in the 7–10year process of physician education. The2003 Match results are in, and showcontinuation in the alarming downwardtrend of interest in primary care bygraduating medical students. Only 1226new graduates will enter Family Practiceresidency programs in July 2003, 9.2%of all US students entering internshipsthrough the NRMP, down from 10.3%(1399 students) in 2002. This continuesthe decline in US senior medicalstudent interest in primary care thatstarted in the later 90’s. In 1999, 2015US students matched into familypractice training (15% of medicalschool graduates). The decrease hasbeen even more dramatic in the numberof US graduates entering internalmedicine residencies specificallydedicated to primary care training. Only192 (1.4%) senior medical studentsmatched to primary care internalmedicine residency positions in March2003, down from 347 (2.5%) in 1999.Internal medicine residency programsoverall fared somewhat better, butreason for concern remains. 2590 seniormedical students matched to an internalmedicine internship position (19.4% ofUS graduates). This number is downfrom 2738 students in 2002, and 2863(21% of US senior students) in 1999.More internal medicine internshippositions were filled through the Matchthis year , however, at a three-year highof 4462, (24% of all PGY-1 positionsfilled), thanks to continued stronginterest in internal medicine training byinternational medical graduates.

Senior student interest in Pediatricsimproved slightly over the worrisomeshowing of last year. 1596 graduatingstudents matched into pediatrics

internships this year, up from 1563 onthe previous Match Day. In 1999,almost 13% (1742) of graduatingseniors entered training in Pediatrics.Combined medicine-pediatrics resi-dency programs are not drawingincreasing numbers of medical students.Only 258 seniors selected this careerpath through the Match in 2003, adecrease from 347 in 1999. Not surpris-ingly, the number of medicine–pediat-rics positions offered in 2003 is down to385, from a high of 446 in 2000.

So if primary care-oriented intern-ship positions are down this year, intowhat specialties are these US seniormedical students going? More studentsmatched into preliminary medicine andpreliminary surgery programs again thisyear. The “hospital based” specialties ofanesthesiology, pathology, and radiologyas well as general surgery, orthopedicsurgery, and neurosurgery also had morepositions filled through the Match.Psychiatry has also continued a three-year trend of increased student interest.In July 2003, 597 new graduates willbegin residencies in psychiatry, up from481 in 2000.

These data from the “Match,” aswell as anecdotal reports from internalmedicine residency program directors ofincreasing proportions of programgraduates seeking subspecialty training,have substantive implications for thefuture of General Internal Medicine.The dialogue stimulated by the reportfrom SGIM’s “Task Force on Definingand Promoting the Domain of GeneralInternal Medicine” will be both timelyand important to our discipline. SGIM

SOCIETY OF GENERAL INTERNAL MEDICINEOFFICERS

PRESIDENT

JudyAnn Bigby, MD • Boston, MAjbigby@partners.org • (617) 732-5759

PRESIDENT-ELECT

Michael Barry, MD • Boston, MAmbarry@partners.org • (617) 726-4106

IMMEDIATE PAST-PRESIDENT

Martin F. Shapiro, MD, PhD • Los Angeles, CAmfshapiro@mednet.ucla.edu • (310) 794-2284

TREASURER

Eliseo Pérez-Stable, MD • San Francisco, CAeliseops@medicine.ucsf.edu • (415) 476-5369

SECRETARY

William Branch, MD • Atlanta, GAwilliam_branch@emoryhealthcare.org • (404) 616-6627

COUNCIL

Christopher Callahan, MD • Indianapolis, INccallaha@iupui.edu • (317) 630-7200

Kenneth Covinsky, MD, MPH • San Francisco, CAcovinsky@medicine.ucsf.edu • (415) 221-4810

Susana R. Morales, MD • New York, NYsrm2001@mail.med.cornell.edu • (212) 746-2909

Eileen E. Reynolds, MD • Boston, MAereynold@caregroup.harvard.edu • (617) 667-3001

Eugene Rich, MD • Omaha, NErichec@creighton.edu • (402) 280-4184

Gary E. Rosenthal, MD • Iowa City, IAgary-rosenthal@uiowa.edu • (319) 356-4241

Harry P. Selker, MD, MSPH • Boston, MAhselker@lifespan.org • (617) 636-5009

Ellen F. Yee, MD, MPH • Albuquerque, NMeyee@unm.edu • (505) 265-1711 Ext. 4255

EX OFFICIORegional CoordinatorJane M. Geraci, MD, MPH • Houston, TXjmgeraci@mdanderson.org • (713) 745-3084

Editor, Journal of General Internal MedicineJournal of General Internal MedicineJournal of General Internal MedicineJournal of General Internal MedicineJournal of General Internal MedicineEric B. Bass, MD • Baltimore, MDebass@jhmi.edu • (410) 955-9871

Editor, SGIM ForumSGIM ForumSGIM ForumSGIM ForumSGIM ForumMelissa McNeil, MD, MPH • Pittsburgh, PAmcneilma@msx.upmc.edu • (412) 692-4886

HEALTH POLICY CONSULTANT

Robert E. Blaser • Washington, DCrblaser@mail.acponline.org • (202) 261-4551

EXECUTIVE DIRECTOR

David Karlson, PhD2501 M Street, NW, Suite 575Washington, DC 20037

KarlsonD@sgim.org(800) 822-3060(202) 887-5150, 887-5405 FAX

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PRESIDENT’S COLUMN

SGIM

FORUM

Published monthly by the Society of General Internal Medicine as a supplement to the Journal of General Internal Medicine.SGIM Forum seeks to provide a forum for information and opinions of interest to SGIM members and to general internists andthose engaged in the study, teaching, or operation for the practice of general internal medicine. Unless so indicated, articles do notrepresent official positions or endorsement by SGIM. Rather, articles are chosen for their potential to inform, expand, andchallenge readers’ opinions.SGIM Forum welcomes submissions from its readers and others. Communication with the Editorial Coordinator will assist theauthor in directing a piece to the editor to whom its content is most appropriate.The SGIM World-Wide Website is located at http://www.sgim.org

SGIM IS HOMEJudyAnn Bigby, MD

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SGIM has been the perfect home forme for twenty years. I have feltwelcomed, supported, and vali-dated. The organization has providedtremendous opportunities, mentorship,and a host of friendships with colleaguesacross the country. Even in these times,SGIM remains a vital organization. Ibelieve that every member and prospec-tive member can find the same supportfrom SGIM that I have found and holdas important in my own career develop-ment.

SGIM is welcomingWhat is special about the receptionmembers receive from the organization?For me it was the nature of the nationaloffice to reach out to new members,note people with different skills andnew points of view, and to find ways forthem to contribute. The annualmeeting is another place where new andjunior members can thrive as volunteersand as innovators by introducing a newinterest group, presenting innovativeresearch or educational efforts. Oppor-tunities to serve on important SGIMcommittees abound.

SGIM is supportive Much of the mentorship I havereceived throughout my career has comefrom my direct interactions with SGIMleaders and other colleagues. Newopportunities exist for formalmentorship including long-termmentorship. Informal mentorship existsthrough workshop discussion andinformal meetings in the hallways at theannual meeting. The SGIM Minoritiesin Medicine Interest Group and theWomen’s Caucus have consistentlyprovided support for professionaldevelopment for their constituents.

ValidationAcademic general internal medicine is a

relatively newspecialty thatsome academi-cians still puzzleover. By defini-tion our members’interests andexpertise arebroad as theyrelate to improv-ing primary care,fostering research, and supportingeducation. SGIM has provided opportu-nities for individuals to explore andmaster the work that general internistsdo in all arenas. As the organization hasincreasingly recognized members’contributions to the Society and to thefield of general internal medicine ingeneral, the stature of academic generalinternal medicine has grown. In this

way general internists havebeen validated as impor-tant contributors toacademic medicine.

New Challengesfor SGIMAs the only organizationthat exclusively supportsacademic general inter-nists, SGIM faces many

challenges. SGIM must do more toidentify ways to address the root causesof dissatisfaction of academic generalinternal medicine clinicians, research-ers, and educators, while making sure toaddress the unique concerns of womenand minorities. The Society cannot dothis in isolation, ignoring the plight ofgeneral internists in the community.

EDITOR

Melissa McNeil, MD, MPH • Pittsburgh, PAmcneilma@msx.upmc.edu • (412) 692-4886

ASSOCIATE EDITORS

James C. Byrd, MD, MPH • Greenville, NCbyrdja@mail.ecu.edu • (252) 816-4633

Joseph Conigliaro, MD, MPH • Pittsburgh, PAjoseph.conigliaro@med.va.gov • (412) 688-6477

Giselle Corbie-Smith, MD • Chapel Hill, NCgcorbie@med.unc.edu • (919) 962-1136

David Lee, MD • Boise, IDlee.david@boise.va.gov • (208) 422-1102

Mark Liebow, MD, MPH • Rochester, MNmliebow@mayo.edu • (507) 284-1551

P. Preston Reynolds, MD, PhD, FACP • Baltimore, MDpprestonreynolds@comcast.net • (410) 939-7871

Valerie Stone, MD, MPH • Boston, MAValerie_Stone@mhri.org • (617) 726-7708

Brent Williams, MD • Ann Arbor, MIbwilliam@umich.edu • (734) 647-9688

Ellen F. Yee, MD, MPH • Albaquerque, NMeyee@unm.edu • (505) 265-1711 Ext. 4255

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SGIM FORUMACGIM COLUMN

The Whole Pie—On the Fragmentationof General Internal MedicineRobert Centor, MD

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The field of general internalmedicine has become sick.Division chiefs all see this.Amongst many threats (includingreimbursement rates and articlesbelittling generalist physicians), thelatest threat to general internal medi-cine, in my opinion, is the hospitalistmovement.

I must provide these disclaimers.First, I spent a year doing renal research(after residency) and quit my renalfellowship. Second, by almost anycriteria, I am an academic hospitalist (5months attending on the VA wards

each year). Third, I spoke at the recentSociety for Hospital Medicine (SHMformerly NAIP) meeting in a “Meet theProfessor” session.

General internal medicine is awonderful profession. Unfortunatelydecreasing numbers of practicinggeneral internists agree with thatsentence.

As I have said often in public (seemy address in the July Forum), generalinternal medicine leaders wiselyembraced the concepts of primary care,but allowed the field to be mislabeled asprimary care internal medicine. Theproblems that the primary care label hascaused are not our doing. I doubt thatmany in our field could have antici-pated these problems. Nonetheless, weare left to address the current state ofaffairs.

The thesis that I proposed is thatgeneral internal medicine includes the

provision of primary care for patients,but is more than primary care alone.Primary care currently has an unfortu-nately narrow definition (at least frominsurers and other payers). The dictio-nary defines primary care—“Themedical care a patient receives uponfirst contact with the health caresystem, before referral elsewhere withinthe system.” Nowhere in this definitiondoes the comprehensive nature ofgeneral internal medicine fit.

The April SGIM Forum in anarticle titled, “The Future of GeneralInternal Medicine,” addresses this issue.

“Recommendation 2:The domain of generalinternal medicine shouldcontinue to be both deepand broad-ranging fromproviding or supervisinguncomplicated primarycare to deliveringcontinuous care topatients with multiple,

complex, chronic diseases. As theprincipal provider for adults, generalinternists need to have skills in gynecol-ogy, dermatology, orthopedics, otolaryn-gology, psychiatry, and the internalmedicine subspecialties.”

General internists traditionallyhave treated both inpatients andoutpatients. They provide comprehen-sive, complex care, involvingsubspecialists as necessary for specificconsultation. General internistsspecialize in understanding the spec-trum of disease and the interactionsamongst multiple diseases, thus provid-ing comprehensive care—from firstcontact care to general prevention tocomplex disease management. Mostgeneral internists chose our fieldbecause of its comprehensive andcomplex nature. As residents, we enjoythe spectrum of internal medicine—

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Research FundingCornerJoseph Conigliaro, MD, MPH

Selected career development awardsin general internal medicine forjunior faculty and fellows were compiledby the SGIM Research Committee. Amore complete listing can be found athttp://www.sgim.org/careerdevelopment.cfm.

Mentored Clinical Scientist Award(K08) and Mentored Patient-OrientedResearch Career Development Award(K23)Mentor-based; 3 to 5 years salary andresearch support. Deadline: February 1,June 1, October 1.http://grants.nih.gov/grants/guide/pa-files/PA-00-003.htmlhttp://grants.nih.gov/grants/guide/pa-files/PA-00-004.htmlAHRQ—offers K08 only and is espe-cially interested in patient safetyhttp://grants.nih.gov/grants/guide/pa-files/PA-00-010.htmlhttp://grants.nih.gov/grants/guide/notice-files/NOT-HS-02-001.html

VA Career Development ProgramMentor-based; two 3-year programs forup to 6 years of full salary support.Deadline: February 15, August 15 withapproved letter of intent (due Novem-ber 1, May 1)http://www.hsrd.research.va.gov/for_researchers/professional_development/career_development/

NIH Minority Supplement AwardMentor-based; salary and researchsupport for up to 4 years; applicationsubmitted by PI of parent grant, whichmust have at least 2 years of remainingsupport. Deadline: any timehttp://grants.nih.gov/grants/guide/pa-files/PA-01-079.html

National Cancer Institute MentoredPatient-Oriented Research for

Many general internists findproviding both outpatient andinpatient care a financiallyunacceptable luxury.

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2003 SOUTHERN SGIM HELD INNEW ORLEANSCarlos Estrada, MD, MS and Karen DeSalvo, MD, MPH

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Genetic Nondiscrimination Protection: ALegislative ImperativeP. Preston Reynolds, MD, PhD

The Southern SGIM meeting wasthe largest ever, with 215 attendees! Twenty-one institutions fromacross the Southeast were representedby faculty, fellows, houseofficers, andmedical students. We are particularlydelighted at the incredible number offuture SGIM members who attendedthe meeting (Program and ClerkshipDirectors/ Division Chiefs: ThankYou!). Great educational, networking,mentorship and socializing opportuni-ties were enjoyed by all. The MardiGras parades and rain had minimalimpact on the flow of the meeting.

Many thanks for the countlesshours devoted by the program commit-tee and reviewers in coordinating ourlargest meeting yet. (Shawn Caudill,University of Kentucky, Abstracts; BenClyburn, MUSC, Workshops; JeannineEngel, Vanderbilt, Vignettes; SamehBasta, Eastern Virginia Medical School,CME; Terry Shaneyfelt, University ofAlabama at Birmingham, Secretary-Treasurer).

We had several first time featuresthis year. Presentations in the clinicalvignette and abstract sessions were allelectronic using LCD projectors. Weheld a lunchtime panel discussiontargeting trainees entitled, “Careers inGeneral Internal Medicine.” Partici-pants included a clinician researcherfrom UAB, Stefan Kertez, a clinicianeducator also from UAB, Lisa Willet, ahospitalist from Ocshner, SteveDeitelzweig, and a community-basedfaculty physician, Richard Diechmann.Cedric Bright of Duke Universityspearheaded the first SSGIM meeting ofthe Minorities in Medicine Interestgroup.

We received twice as many abstractsubmissions as in the prior year and 40were presented in themed sessions. Arecord 69 vignettes were presented aswell. New this year was a poster session

where trainees presented 12 posters. Avideotape feedback to the plenarysession presenters was continued.Sushma Komakula, Emory University,received the Outstanding ResidentPresenter Award; Eric Wallace, Univer-sity of Alabama at Birmingham, wonthe Best Vignette Award; and, CarlosEstrada, East Carolina University, wonthe Best Abstract Award. Ten work-shops were presented on diverse topicsincluding teaching scholarship, hyper-tension and scientific writing. We werealso pleased to see an award given fromSAFMR/SSCI to Mukta Panda,University of Tennessee.

Officers elected for 2003–2004 are

Donald Brady, Emory University,President; Elisha Brownfield, MedicalUniversity of South Carolina, Presi-dent-Elect; and Jane O’Rorke, Univer-sity of Texas Health Sciences Center atSan Antonio, Secretary-Treasurer. TheS-SGIM Clinician Educator Awardwent to Paul Haidet, Baylor University.

We look forward to anothersuccessful and enjoyable meeting inNew Orleans next spring. See you nextyear! SGIM

Carlos Estrada, MD, MS, is Past-President of East Carolina University andKaren DeSalvo, MD, MPH, is ProgramChair at Tulane University.

After eight long years of advocacy,genetic nondiscrimination legisla-tion is slated to become center stage inthe Senate Health, Education, Laborand Pensions (HELP) Committee ifCommittee Chair, Senator Judd Gregg(R-NH) has his way.

The need for individual protectionagainst health insurance and employ-ment discrimination with regard togenetic testing results came to nationalattention over a decade ago. In the mid-1990s, the NIH found over 32% ofeligible women when offered genetictesting for breast cancer refused testingbecause of concerns about healthinsurance discrimination and loss ofprivacy. In response, the NIH-Depart-ment of Energy Ethical, Legal andSocial Implications Working Group andthe National Action Plan on BreastCancer convened a meeting to developan action plan. Their leadership andadvocacy on behalf of high-risk women

resulted in legislative proposals begin-ning in 1998 that would protect allindividuals from disclosure of genetictesting results to and use by employersand health insurers whether private orHMO.

The first step in securing privacy ofgenetic testing results came with theHealth Insurance Portability andAccountability Act of 1996 (HIPPA).HIPAA 1) prohibits excluding anindividual from group coverage becauseof past or present medical problems,including genetic information; 2)prohibits charging a higher premium toan individual than to others in thegroup; 3) limits exclusions in grouphealth plans for preexisting conditionsto 12 months, and prohibits suchexclusions if the individual has beenpreviously covered for that conditionfor 12 months or more; and 4) statesexplicitly that genetic information in

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SGIM FORUM

This JGIM Education Issue hopes to publish in the range of 20 peer-reviewed articles. We have assembled a distinguished, specialEditorial Board to advise on the format and direction of the Educational Issue, as well as highly qualified Associate Editors andReviewers, who will assist in reviewing articles and determining those to be published.

This Education Issue provides an opportunity for young faculty members to begin their careers as educational scholars, and tohave their work reviewed by distinguished educators in SGIM. In accordance with this philosophy, there will be an effort toprovide suggestions to authors of submitted manuscripts to improve their submission, perhaps in view of publication in this issue,or perhaps in an effort to provide a mentoring role to young faculty members for future publication.

Those members of SGIM presenting posters or abstracts at the 2003 National Meeting in Vancouver, BC should consider submit-ting a manuscript as an Educational Innovation or as a Brief Report to describe their work and make it available to others.

William T. Branch, Jr. MD David Kern, MD, MPHEditor, JGIM Educational Issue Editor, JGIM Educational IssueCarter Smith, Sr. Professor of Medicine Co-Director, Division of General Internal MedicineVice Chairman for Primary Care Johns Hopkins Bayview Medical CenterDirector, Division of General Medicine Associate Professor of MedicineEmory University School of Medicine Johns Hopkins University Johns Hopkins University

SIX TYPES OF SUBMISSIONS WILL BE CONSIDERED:

CALL FOR SUBMISSIONSJGIM EDUCATION ISSUE

The Society of General Internal Medicine (SGIM) invites submissions to the inaugural edition ofits Education Issue of the Journal of General Internal Medicine (JGIM). Papers should be submittedfollowing JGIM’s current procedures between June 1 to August 1, 2003. All submissions will bepeer reviewed. We conceive this to be a highly innovative, new type of education issue, especiallydesigned to meet the needs for Society members, who are clinician-educators, for learning abouteducational innovations and reports of advances in medical education that may be important anduseful to their work.

1. Educational InnovationsNo longer than 2,000 words. No more than 2 tables or figures.A focused bibliography, not exceeding 30 references. Innova-tions should be organized with:◆ an unstructured Abstract, of less than 100 words◆ an Introduction, describing the rationale, historical perspec-

tive, and goals for the innovation◆ a Description, describing in detail the medical educational

innovation◆ an Evaluation, giving, if available, evaluation of the im-

pact and effects of the innovation◆ a Conclusion, describing the importance and particular use-

fulness of the innovation along with a brief review of whatthe paper adds to existing published work or projects.

2. Brief ReportsNo longer than 1500 words. Formatted as follows:Abstract, unstructured; Introduction, as described for Educa-tional Innovations. Methods, in standard format; Results instandard format; and Discussion, also in standard format. Nomore than 2 tables or figures and 20 references. We conceiveBrief Reports to be short descriptions of original research, butthey do not necessarily need to be multi-institutional studies orrandomized trials.

3. PerspectivesNo longer than 3000 words and 4 tables or figures. Brief ab-stract required (100 words). Written to provide the author’sviews or ideas regarding an important educational issue.

4. ReviewsNo longer than 4,000 words, these should be either traditionalor systematic reviews of important medical education topics.The abstract of 250 words of less should be structured.

5. Resource PapersMeant to be summaries of resources, for example, of curricularmaterials, funding sources for medical education, opportunitiesfor special training in medical education; they should be con-cise and useful to the clinician-educator. Brief abstract required(100 words).

6. Recommendation / GuidelinesNo longer than 3,500 words. Maximum of 3 tables. Systemati-cally developed, evidence-based or consensus guidelines formedical education practice. Brief abstract required (100 words).

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great personal and professional satisfac-tion and mutual benefit for bothmembers and the organization. Re-cently, Steve Schroeder writing in theSGIM Forum asked, “What Have IDone For SGIM Lately?”1 and encour-aged involvement in SGIM’s Make aDifference Campaign (a tax-deductiblefinancial contribution is one of manyways to support SGIM).

Here are 10 additional ways tobecome active in SGIM:

1. Mentors: get one or be one. Atthe National Annual Meetings, SGIMoffers One-On-One mentoring opportu-nities to discuss issues related toprofessional development. Residents,fellows, and junior faculty are encour-aged to sign up for a mentor and seniorfaculty are encouraged to mentor. Thisprogram offers the opportunity to speakpersonally with someone outside ofone’s own facility or region. Includedamongst the stellar mentoring list areSGIM presidents, foundation presi-dents, council members, policy makers,activists, Chiefs of Medicine, celebratedclinician teachers and educators, andmany dedicated academic faculty. Anew longitudinal mentoring program isbeing developed to extend beyond theannual meeting. Finally, the SGIMResearch Mentorship Program, (2000–2001) program provided grants to juniorfaculty planning research careers, andmid-career faculty desiring to increasetheir research role. The InitialMentorship Awards allowed mentorsand mentees who live at some distancefrom each other to develop a researchagenda and discuss specific researchprojects. Follow-up Awards allowedpilot research projects for the initialgrant recipients.

2. Get Involved with RegionalActivities. The eight regions—Califor-nia (Northern and Southern), MidAtlantic, Midwest, Mountain West,New England, Northwest, Southern,and Texas Chapter—each have uniquecharacteristics and meetings. Regionalactivities provide leadership, network-ing, and learning opportunities. Re-

gional Presidents,Membership Chairs, andTreasurers are electedpositions. The regionalmeetings are outstandingvenues for members, including juniorfaculty, to present their work and helpwith meeting planning. The RegionalResident Presentation Awards is a newprogram conceived by Jane Geraci, MD,current Ex-Officio Coordinator forRegional Activities. The award entitlesthe highest rated resident presentationfrom each SGIM regional meeting to bepresented at the National meeting. Atthe inception of this program last year,one award recipient from each regionreceived a paid trip to the Nationalmeeting in Atlanta (travel, registrationfee, and accommodations), where theypresented their work and received aplaque in recognition of their achieve-ment.

3. Volunteer for the AnnualProgram Committee. The AnnualProgram is the largest committee withover 200 volunteer reviewers. TheSGIM President selects a ProgramChair, who then selects a Co-Chair.The Annual Program Committeemembers are a dedicated group whowork tirelessly for no pay to present astellar National meeting. Precourses,workshops, and abstract submissions arepeer-reviewed by SGIM volunteermembers. Obviously, a large number ofpeer reviewers are needed! To sign up, avolunteer form is included with theAnnual Meeting Program, or you maycontact committee chairs (listed on theSGIM website), or the SGIM office.The success of the Annual meeting isheavily dependent on SGIM memberattendance and volunteerism.

4. Join a Committee. There are 12committees and Task Forces examining:Communications, Continuing Medicaleducation (CME), Development,Education, Ethics, Finance, HealthPolicy, Membership, Nominations,Regional Activities, and Research.These groups are identified throughstrategic planning to meet members’

needs and goals. Leadership is appointedby the President and Council. Chairsare listed on the SGIM website(www.sgim.org), with email linksavailable. Contact the chairs if you areinterested in joining a committee. MostCommittees meet by phone monthlyand require some additional timecommitment beyond the phone calls.

5. Join or Start an Interest Group:The number of Interest Groups (n=34)has grown to reflect the diverse interestsof SGIM members. Most will meet atthe Annual meeting. To date, allInterest Groups have been accommo-dated in the Annual Meeting schedule(a 100% acceptance rate). These groupsare an excellent way to network withother members with a similar passion.Members are encouraged to submit orjoin interest groups as a way to getinvolved with SGIM. Examples ofgroups include: Health Policy, Minori-ties in Medicine, Women’s Caucus, PartTime Careers, Geriatrics, PhysiciansAgainst Violence, Academic GeneralInternal Medicine in Latin America,AIDS, Anticoagulation/Thromboembo-lism, Evidence Based Medicine, FellowsForum, Fellowship Program Directors inInternal Medicine, Gay and LesbianHealth, Hospitalists, Medical Consulta-tion, Women’s Health Education.While some Interest Groups only meetat the National Meeting, many areactive year-round.

6. Publish. SGIM’s two publica-tions, JGIM (Journal of General InternalMedicine) and the SGIM Forum offermembers opportunities in the publish-ing and reviewing arena. Members canvolunteer to become reviewers. ContactEric Bass (JGIM editor) or MelissaMcNeil (SGIM Forum editor) for moreinformation about reviewing andpublishing. JGIM also offers a creativewriting contest for poetry and pose.

SGIM ESSENTIALScontinued from page 1

SGIM offers One-On-Onementoring opportunities…

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SGIM FORUMSGIM ESSENTIALScontinued from previous page

SGIM IS HOMEcontinued from page 3

Contact and contest information can beaccessed through the SGIM website.

7. Volunteer to be an Up to DatePeer Reviewer. SGIM members whohave used Up To Date can informallyoffer comments and suggestions forchapters by going to the SGIM website,Professional Development, and Up toDate Peer Review. If you would like tobe a formal peer reviewer, information isavailable in the December 1999 issue ofthe SGIM Forum. Reviewers must havecontent knowledge in the area theyreview. The reviewer cluster can be sente-mail through the SGIM web site link.

8. Become an Advocate. SGIM’sHealth Policy Committee has nineclusters to address different healthpolicy areas. Learn about each cluster’sobjectives and contact cluster membersthrough the SGIM website. The clustersinclude Access to Care, Health ServicesResearch Funding, Health SystemsReform, Human Rights, Managed Care,Medicare/GME Funding, Primary Care,Title VII (Health Professions Educa-tion) , and VA Medical Research.

9. Networking is Critical toCareer Success! From contacts formedthrough SGIM activities, diversecollaborations are possible. Earlymembers of the Women’s Caucuspartnered to write a review paper onHypertension in Women subsequentlypublished in the Annals of InternalMedicine.2 Some faculty have revieweda topic, presented at SGIM and thensubsequently published. 3-4 Facultypromotion usually requires letters fromoutside a candidate’s institution, andSGIM contacts can be an importantprofessional sources for letters.

New organizations are also createdthrough networking. Approximatelytwo years ago, a group of Chiefs ofGeneral Internal Medicine met at theNational SGIM Meeting to discusssignificant mutual needs and interests.During this exploratory meeting it wasevident that the position of DivisionChief had increased greatly in complex-ity while many in the position had nospecific training or peer group to learn

from. A need to develop a formalorganization for Chiefs of GeneralInternal Medicine was identified, andfrom this, The Association of Chiefs ofGeneral Internal Medicine (ACGIM),was created.

10. Read the SGIM Forum andthe website: Visit the website. Cur-rently, Jeff Jackson, MD, MPH ischairing the communications commit-tee and he is working to make the website even more useful to members. Grantand research opportunities, job listings,residency and fellowship directories,and contact information are all listed onthe web site. The SGIM Forum pub-lishes a research funding corner as wellas job opportunities.

We hope to see you at an upcomingSGIM meeting, and encourage you toget involved with SGIM. This organiza-tion is built on the passion and interest

of its members. SGIM

References1. Schroeder S. What has SGIM done forme lately? SGIM Forum 2002; 25(2): 1.2. Anastos K, Charney P, Charon RA,Cohen E, Jones CY, Marte C, SwiderskiD, Wheat ME, S Williams. The Women’sCaucus, Working Group on Women’sHealth of the Society of GeneralInternal Medicine. Hypertension inWomen: What is really known? Annalsof Internal Medicine 115–(287–293).August 15, 1991.3. Walsh ME, Wheat ME, Freund K.Detection, evaluation and treatment ofeating disorders. J Gen Intern Med 2000;15: 577-590.4. Ryden J, Blumenthal PD ed. PracticalGynecology. ACP Women’s Health BookSeries. 2002. American College ofPhysicians. Philadelphia Pa.

The Task Force on the Domain ofGeneral Internal Medicine has madeseveral recommendations for ensuringthe future of general internal medicinewhile maintaining the core values ofgeneral internists. The recommenda-tions deal with clinical practice,education of residents and practicingclinicians, and research. Some of therecommendations are bold and willgenerate heated debate related toresidency training, financing of clinicalpractice, and management of informa-tion between doctors and patients.

In the year to come we as anorganization will tackle these difficultissues in collaboration with otherorganizations representing internalmedicine. We must do this in thecontext of the declining interest ininternal medicine among graduates ofAmerican medical schools, the femini-zation of primary care and the need topromote diversity in the internalmedicine workforce and within theleadership of internal medicine. SGIMcan be a leader by supporting activities

to identify and describe models ofpractice and academic administrationthat support satisfaction among primarycare internists. By engaging in thisprocess SGIM can better identify andmeet the professional needs of itsmembers, reinvigorate professionalismin medicine, continue to promotediversity within the organization, ensurethe professional development of allpotential leaders, forge collaborationswith other organizations, and foster neweducational endeavors. The organiza-tion must integrate efforts to addresscareer satisfaction across the organiza-tion and through each of its majoractivities. I believe this effort willpromote, not only the growth of theorganization, but also the growth ofgeneral internal medicine and of a newgeneration of diverse primary carephysicians committed to the core valuesof SGIM.

Join the Council and me on thisjourney. Speak your mind, volunteeryour talents, and tell us what you need.Make SGIM your home. SGIM

9

THE WHOLE PIEcontinued from page 4

continued on next page

from the outpatient setting, to thehospital, to the ICU.

As payment for office visits hasdeteriorated—forcing either markedlyreduced income, or unacceptably shortvisits—so have the pressures on outpa-tient practice increased. Many generalinternists find providing both outpa-tient and inpatient care a financiallyunacceptable luxury.

Out of this conflict betweenoutpatient and inpatient care, thehospitalist movement has arisen. Thehospitalists have filled a void in healthcare. Hospital care has become morecomplex and time consuming. Hospitaladministrators and insurers like thelogic and economy of hospital carespecialists. Graduating residents oftenlike the lifestyle that hospital medicineoffers. They also see the hospitalist as anatural extension of their residencyexperience. With these forces acting,the hospitalist movement has expandedand thus the outpatient practice optionhas become a reality for many internists.

SHM has encouraged this newdichotomy—specialty defined bylocation. While I understand why weare moving in this direction, I continueto worry about the implications for thefield. Who are the true general inter-nists: the hospitalists, the officists, orthe decreasingly common hybridpractice, which all practicing internistshad in previous decades?

I worry about how this fragmenta-tion will affect general internal medi-cine. Most GIM divisions include allthree practice options. As divisionchiefs struggle with varied facultypractice patterns, these changes areredefining general internal medicine.

How do we unite thesedisparate practices?What signals are wesending to residents?

I wonder whetherthis role fragmentation iscontributing to themalaise in our field.Why would residentschoose general internal

medicine, when we have such difficultydefining the field? I see three differentpractice patterns confusing trainees.Many larger communities almost forceone to choose between hospital andoutpatient practice.

We are struggling with redefining

the absence of a current diagnosis ofillness shall not be considered a preex-isting condition.

HIPPA did not, however, 1)prohibit an insurer from denyingcoverage to individuals seeking healthinsurance in the individual marketbased upon genetic information; 2)prohibit the use of genetic informationas a basis for charging exorbitantpremiums for health insurance toindividuals seeking coverage in eitherthe individual or group market; 3) limitthe collection of genetic information byinsurers and prohibit insurers fromrequiring an individual to take a genetictest; and 4) limit the disclosure ofgenetic information by insurers.

These holes in HIPPA havebecome glaring oversights as progress onthe Human Genome Project proceededto completion of the full sequence ofthe human genome in April 2003.Anticipating this scientific achieve-ment, the 107th Congress saw significantactivity with several genetic privacybills introduced in both the Senate andHouse of Representatives. In March2002, Senator Olympia Snowe (R-ME)introduced a bill, S. 1995, “Genetic

Information Nondiscrimination Act of2002” that included an employmentsection, revised insurance provision andupdated definitions. Senator MinorityLeader Tom Daschle (D-SD) introducedhis own bill, S. 318. In the House,Louise Slaughter (D-NY) introduced abill similar to that of Senator Daschle,HR 602. By the close of last Congress,HR 602 had 266 co-sponsors; yetdespite this strong support, the bill wasnot taken up for vote.

The need for genetic nondiscrimi-nation legislation was addressedforcefully by President Bill Clinton in2000 with Executive Order 13145 thatprovided protection against geneticdiscrimination to all federal employees.In addition, 41 states have enactedlegislation on genetic discrimination inhealth insurance, and 31 states ongenetic discrimination in the work-place. President George Bush hasexpressed support for passage of geneticnondiscrimination legislation.

Senator Gregg, Committee Chair ofHELP, stated recently he wants to seegenetic privacy legislation passed thissession of Congress and accordingly

general internal medicine training.However, we should first consider howtheir practice will look when they finishtraining. As we allow the redefinition ofgeneral internal medicine, ones view ofthe field becomes hazy.

Both ACGIM and SGIM areconsidering this problem. I hope thatwe can preserve and define the field.Perhaps we cannot resist the economic,medical and political forces causingthese modifications. I hope that we canmaintain the practice balance thatgeneral internists want and desire. I stilllove general internal medicine; I lovethe whole pie, not just a smallpiece! SGIM

LEGISLATIVE IMPERATIVEcontinued from page 5

As division chiefs struggle withvaried faculty practice patterns,these changes are redefininggeneral internal medicine.

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SGIM FORUMRESEARCH FUNDING CORNERcontinued from page 4

LEGISLATIVE IMPERATIVEcontinued from previous page

Underrepresented MinoritiesSimilar to K23 mechanism describedabove except provides up to $30,000 inresearch support per year and applicantmust have at least two mentors.http://minorityopportunities.nci.nih.gov/mTraining/K23.htmlhttp://grants1.nih.gov/grants/guide/pa-files/PAR-03-006.html

National Heart, Lung and BloodInstitute Mentored Minority FacultyDevelopment Award (K01)Similar to K08/K23 described aboveexcept provides up to $30,000 inresearch support per year, supports up to5% of mentor’s effort and applicationdeadline is June on a year-by-year basis.http://grants1.nih.gov/grants/guide/rfa-files/RFA-HL-02-022.html

Robert Wood Johnson GeneralistPhysician Faculty AwardMentor-based; $75,000 per year for 4years for salary and research support.Applicant nominated by medicalschool. This award is being discontin-ued after the 2003 competition.Deadline: Septemberhttp://www.gpscholar.uthscsa.edu/gpscholar/FacultyScholars/index.html

Robert Wood Johnson MinorityMedical Faculty DevelopmentProgramMentor-based; $65,000 per year forsalary and $26,350 per year for researchfor four years. Deadline: March.http://www.mmfdp.org/

Pfizer/American Geriatrics SocietyPostdoctoral Fellowship for Researchon Health Outcomes in GeriatricsMentor-based; $65,000 per year of salarysupport for 2 years. Deadline: EarlyDecemberhttp://www.healthinaging.org/research/pfizer2003.php

Paul Beeson Physician FacultyScholars in Aging ResearchMentor-based; salary and researchsupport of $450,000 for 3 years. Dead-

line: Novemberhttp://www.afar.org/beeson.html

American Cancer Society CancerControl Career Development Awardsfor Primary Care PhysiciansMentor-based; three years with progres-sive stipends of $50,000, $55,000, and$60,000 per year. Deadline: October 1http://www.cancer.org/docroot/res/content/res_5_2x_cancer_control_career_development_awards_for_primary_care_physicians.asp?sitearea=res

Greenwall Faculty Scholars Programin BioethicsMentor-based; 50% salary support up toNIH salary cap guidelines and benefitsfor 3 yearsDeadline: 3-page letter of intent due inDecember, with full invited applicationsdue in Februaryhttp://medicine.ucsf.edu/greenwall/

Pfizer/Society for Women’s HealthResearch (SWHR) Scholars Grants forFaculty Development in Women’sHealthMentor-based; three year salary andresearch support up to $65,000 per year.Deadline: mid Decemberhttp://www.physicianscientist.com/scholars_programs/womens_health.html

American Diabetes Association CareerDevelopment AwardsFive years of salary and research supportup to $150,000 per year; providesadditional $25,000 per year for first twoyears for equipment and supplies.Deadline: January 15, July 15http://www.diabetes.org/main/profes-sional/research/forms.jsp

Please contact joseph.conigliaro@med.va.gov for any comments, sugges-tions, or contributions to thiscolumn. SGIM

Senator Daschle has resubmitted hisformer bill, now S. 16 into the 108thCongress. The critical elements of anylegislation are protection of individualsfrom being required to undergo genetictesting by health insurers and the use ofthis information in individual and grouprating; protection of individuals fromuse of genetic testing information byemployers in hiring, promotion, and jobplacement; protection against disclosureof genetic testing information byemployers or health insurers that is notdirectly related to payment of claims orthe provision of medical services, andmeans for compensation for damages ifindividuals are harmed because offailure to keep genetic informationconfidential.

If you are interested in learningmore about this important health policyissue, see: http://thomas.loc.gov/home/thomas/html where you can read thetext of bills introduced in the past fiveCongresses; see www.genome.gov orcontact Tim Leshan, Senior PolicyAnalyst in the NIH-National HumanGenome Research Institute,leshant@mail.nih.gov; or visit theSGIM website where you can review asample letter that you can send to yourSenator or Representative via SGIM’snew e-advocacy. SGIM

Dr. Reynolds serves as the Chair,Human Rights Cluster, SGIM HealthPolicy Committee and the SGIM Liaison,National Coalition for Health ProfessionalEducation in Genetics

V I S I TT H E

S G I MW E B S I T E

http://www.sgim.org

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ASSOCIATE CHIEF OF STAFF, RESEARCHAND DEVELOPMENT. The Department of Vet-erans Affairs, Edward Hines Jr. Hospital is recruit-ing for an Associate Chief of Staff (ACOS) forResearch and Development overseeing Hines andthe VA Medical Center North Chicago Program.Hines VA is highly affiliated with the StritchSchool of Medicine of Loyola University of Chi-cago. VAMC North Chicago is affiliated with theChicago Medical School. As one of the most di-verse in the VA system, the Hines/N. Chicago re-search program includes nearly 500 active researchprograms and over 150 investigators. The researchrelated studies are conducted utilizing more thanapproximately 150,000 square feet of modern fa-cilities. Included are studies in cancer, nephrology,cardiology, endocrinology, pulmonary, infectiousdisease, neurosciences, surgery and the full rangeof biomedical research in addition to a Coopera-tive Studies Program Coordinating Center, a HealthServices R&D Field Program, and a Nonprofit Re-search Corporation. Funding for 2002–03 will ex-ceed $18 million from VA, NIH and other privateand public sources. The ACOS for Research is chal-lenged to provide the vision, leadership and man-agement for further growth and development ofthese programs within the context of the emerg-ing, competitive, health care environment. Candi-dates possessing an MD or PhD must also hold thescientific, research and academic credentials toqualify for an appointment at Loyola University’sStritch School of Medicine. Equally important is acandidate whose communication, administrativeand leadership skills are sufficient to implement astrategic plan for a research program, which inte-grates the strengths of our university affiliates withthose of the hospitals. The ACOS is expected tohave an established track record of extramural fund-ing and continue an active research program. HinesVA Hospital is located 10 miles west of Chicago’sMagnificent Mile in the near west suburbs withready access to mass transportation and highwaysin and out of the city. Qualified candidates shouldsubmit a letter of interest and curriculum vitae notlater than April 15, 2003 to David Hecht, MD,Chairman, ACOS for R&D Search Committee,Hines VA Hospital, P.O. Box 1490, Hines, IL60141. It is intended that a candidate will be cho-sen not later than June 1, 2003.

CLINICIAN-EDUCATOR. TULANE UNIVER-SITY SCHOOL OF MEDICINE. The Section ofGeneral Internal Medicine at the Tulane Univer-

sity School of Medicine is seeking a clinician-edu-cator at the level of Instructor or Assistant Profes-sor in the clinical track. The individual will join agrowing Section that has clinical, educational andinvestigative interests in hypertension, ambulatorycare delivery, and travel medicine. Responsibilitieswill be devoted to ambulatory clinical practice withthe opportunity to provide inpatient resident su-pervision at Tulane University Hospital and Clinic.Position will remain open until qualified candidateis selected. Send CV and the names and phonenumbers of three references to: Karen B. DeSalvo,MD, MPH, Chief, Section of General InternalMedicine SL-16, Tulane University School of Medi-cine, 1430 Tulane Avenue, New Orleans, LA70112-2699. AA/EOE.

DIVISION CHIEF, GENERAL INTERNALMEDICINE. Continuum Health Partners, Inc. isthe parent company of Beth Israel Medical Center,St. Luke’s Hospital, Roosevelt Hospital, Long Is-land College Hospital, and New York Eye & EarInfirmary. We provide the leadership that bringstogether outstanding clinical resources, reinforcesstrong service traditions and attracts world-re-nowned physicians—ensuring the highest qualityof care for our patients. The Beth Israel MedicalCenter: Division Chief, General Internal Medi-cine—Petrie Division: Oversee clinical, teachingand research activities of this new division of Gen-eral Internal Medicine. Division will be comprisedof an inpatient hospitalist group that assumes pri-mary care responsibility for approximately 4,000 pa-tients annually, a large group of voluntary internists,as well as outpatient teaching and private InternalMedicine practices in a modern ambulatory carecenter. The candidate is expected to have strongclinical and administrative skills, as well as a recordof accomplishment in teaching and research. Pleasesend your resume to: Dr. Stephen G. Baum, Chair-man, Department of Medicine, Beth Israel Medi-cal Center, 16th Street and 1st Avenue, 20 BairdHall, New York, NY 10003. Fax: 212-420-2912.EOE M/F/D/V. Women and minorities are encour-aged to apply. www.WeHealNewYork.com

FELLOWSHIP, CLINICAL RESEARCH. The Di-vision of Substance Abuse at Albert Einstein Col-lege of Medicine and Montefiore Medical Center,Bronx, NY, offers a NIH-funded two-year fellow-ship program to prepare physicians completing resi-dency in internal medicine, family medicine, orpsychiatry for research careers in substance abuse.Program emphasis on individual mentoring by ex-perienced drug abuse researchers and clinical workwith drug users. Fellows will participate in the Clini-cal Research Training Program at AECOM and becandidates for Masters Degrees. Inquiries to Dr. JuliaArnsten, Director, Clinical Addiction Research andEducation Program, Montefiore Medical Center,111 East 210 Street, Bronx, NY, 10467,jarnsten@montefiore.org.

GENERAL INTERNIST WEST LOS ANGELES.The VA Greater Los Angeles Healthcare System isrecruiting a temporary full-time General Internist

for the position of Clinician-Educator in the Am-bulatory Care Line and the Division of GeneralInternal Medicine. The incumbent would work pri-marily in the outpatient primary care setting in anenvironment that includes non-physician provid-ers (Nurse Practitioners and Physician Assistants)with some inpatient responsibilities, namely at theVA West Los Angeles Healthcare Center. Thisposition includes responsibility for delivery of di-rect patient care, teaching internal medicine train-ees and medical students, and on-going scholarlyactivity in an enriched environment that promotesprofessional excellence. Candidates must be Board-Certified/Board Eligible in Internal Medicine andmust qualify for a faculty position at the AffiliateUniversity. U.S. Citizenship is required. Interestedcandidates send CV and three (3) references toChonette Taylor, Human Resources Specialist(10A2-CT), West Los Angeles VA Medical Cen-ter, 11301 Wilshire Blvd., Los Angeles, CA 90073,(310) 478-3711 ext. 43186. Qualified applicantswho apply by April 30, 2003 will receive first con-sideration. Position is subject to random drug test-ing. Direct Deposit is required. This agency pro-vides reasonable accommodation to applicants withdisabilities. If you need reasonable accommodationsfor any part of the application and hiring process,please contact our facility. The decision on grant-ing reasonable accommodation will be made on acase-by-case basis. The Department of VeteransAffairs is an Equal Opportunity Employer.

RESEARCHERS, GIM/PRIMARY CARE. TheUniversity of Colorado Health Sciences Center isrecruiting for a full-time faculty position at theAssistant or Associate Professor level. Requirementsinclude ABIM certification in internal medicine,completion of a GIM fellowship (or equivalent re-search training), and successful initiation of an in-dependent research program. 50%–80% protectedtime for research is available, with opportunitiesfor mentorship of research fellows, clinical teach-ing, and practice at University Hospital. Denverprovides an excellent collaborative environment forprimary care based clinical epidemiology and healthservices research in disadvantaged populations,managed care, and rural health. Applications willbe accepted until the position is filled. Candidatesshould reply with a CV to Jean Kutner, M.D., In-terim Division Head, Division of General InternalMedicine, University of Colorado, Box B-180, 4200E. 9th Avenue, Denver, CO 80262 or emailJean.Kutner@uchsc.edu. University of ColoradoHealth Science Center is committed to equal op-portunity and affirmative action.

Positions Available and Announcementsare $50 per 50 words for SGIM members and$100 per 50 words for nonmembers. Thesefees cover one month’s appearance in theForum and appearance on the SGIM Web-site at http://www.sgim.org. Send your ad,along with the name of the SGIM membersponsor, to tractonl@sgim.org. It is assumedthat all ads are placed by equal opportunityemployers.

CLASSIFIED ADS

Society of General Internal Medicine2501 M Street, NWSuite 575Washington, DC 20037

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Executive Director: David Karlson, PhDKarlsonD@sgim.org

Director of Operations: Kay OvingtonOvingtonK@sgim.org

Director of Membership: Katrese PhelpsPhelpsK@sgim.org

Member Services Administator: Shannon McKennaMckennaS@sgim.org

Director of Regional Services: Juhee KothariKothariJ@sgim.org

Director of Education: Sarajane GartenGartenS@sgim.org

Who’s Who in the SGIM National Office

Director of Communications: Lorraine TractonTractonL@sgim.org

Director of Development: Bradley HousetonHousetonB@sgim.org

Director of Finance/Administration: Karen LencoskiLencoskiK@sgim.org

ContentsSGIM Essentials & How SGIM Can Enhance Your Career 2003 NRMP Results: Continued Challenges for Primary CarePresident’s ColumnThe Whole Pie—On the Fragmentation of General Internal MedicineResearch Funding Corner2003 Southern SGIM held in New OrleansGenetic Nondiscrimination Protection: A Legislative ImperativeClassified Ads