RPS Newsletter January 2011
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In This Issue:
Preventive Medicine 2011
Food Safety Legislation
Supreme Court Resident Ruling
Prevention Spotlight

Preventive Medicine 2011 to Offer Career Development Sessions

by Clarence Lam

Are you a Preventive Medicine resident who is graduating soon and looking for your first job after residency?Or perhaps you are interested in exploring the variety of opportunities available in beginning a career in preventive medicine?If you are looking for career advice and have not registered for Preventive Medicine 2011, the Resident Physicians Section (RPS) Governing Council strongly encourages you to consider attending the conference.


In addition to meeting other preventive medicine colleagues and learning more about the various fields of study within the specialty, there are several career development sessions planned specifically for medical students, residents, and young physicians.In the first session, moderators will lead panel discussions on career options and pathways for physicians in the public, private, international, and academic sector.A second session invites guest speakers Dr. David Satcher (former U.S. Surgeon General) and Dr. Kenneth Cooper (founder of the Cooper Aerobics Center) to talk about their past experiences and career choices.A final session traces the lifecycle of a Preventive Medicine career through discussions career transitions, negotiations, and development goals.


A social event for the evening of Friday, February 18 has been organized by the Medical Student, Resident, and Young Physician Sections of ACPM to allow attendees to network, swap experiences, and share advice.More information on this will be available as the meeting draws closer.


Registration for Preventive Medicine 2011 is still open.Resident members of ACPM can register at a reduced rate-that is more than 50% less than other attendees-by visiting the conference website at

New Food Safety Legislation Signed Into Law

By Charlie Preston

The Food Safety Modernization Act (FSMA) was signed into law on January 4, 2011, and represents the most significant change to food safety since the Great Depression. Each year, 48 million people suffer from food-borne illness, around 100,000 are hospitalized, and nearly 5,000 die. The law combats this scourge in 3 major ways: 1) by focusing on prevention, 2) by improving detection and response tools, and 3) by enhancing the safety of imported food.


The law represents a major shift in the way that food safety is handled in the United States. For the first time ever, the Food and Drug Administration (FDA), the agency that regulates all foods except meat, poultry, and eggs, will have the authority to put into place prevention controls throughout the continuum of food production. This is a shift away from reacting to outbreaks and towards preventing them from occurring in the first place. Specifically, the law requires that food processors identify hazards in their production lines and develop plans to mitigate these hazards.


The law also provides better tools to detect and respond to food safety threats. For example, food production facilities are to be inspected according to a risk-based methodology. Factors like history of prior violations, previous compliance of the facility, and the rigor of the hazard analysis plan will be considered in this assessment. In response to any detected problems, the FDA has new authority to force a recall of tainted foods.


Finally, the law addresses the increasing amount of food imported into the United States. Now, more than 15% of the US food supply, including 80% of all seafood, is brought in from overseas. To assure its safety, the law gives FDA the authority to require that domestic importers verify that the food coming from suppliers is safe. It increases inspections of foreign food facilities and it builds capacity of foreign governments to improve safety conditions. To help with these activities, the law mandates the FDA to establish international offices. Some of these offices are already up and running, in countries such as China and India, where many imports come from.


The Congressional Budget Office estimated that funding for the new law will necessitate $1.4 billion over 5 years. There are already rumblings that in such a budget-constrained environment, funding won't fully materialize. If you want a safer food supply, and you believe in a prevention-oriented approach, urge your lawmakers to appropriate this money. For more information on the law, go to:

Supreme Court Rules Residents Must Pay Social Security Taxes

by Samuel Peik

The United States Supreme Court recently delivered a ruling on the caseMayo Foundation for Medical Education and Research, et al. v. United States.The Court ruled by an 8-0 majority, with one justice recused, in favor of the IRS.The IRS had interpreted the regulations to mean that residents working over 40 hours were subject to FICA (Social Security) withdrawals.The tax was originally put into law in 1935, but amended in 1939 to create a student exemption.The Mayo Clinic, supported by hospitals and academic centers, had argued that residents should be regarded as students and therefore are exempt.


The Supreme Court ruling was fairly narrow in scope, defining residents as employees and not students for the purpose of Social Security tax collection.It is unclear how this classification as a 'worker' instead of 'student' will affect future legal cases.For example, there is some debate whether this will affect the petition for OSHA to regulate resident work hours instead of ACGME.


An estimated total of $700 million in annual taxes was at stake in the ruling.This equates to roughly $4000 per resident (varying by salary), which represents a substantial economic burden on residents.Residents will, however, also accrue credit towards Social Security by paying FICA taxes.For more reading, the following NEJM article provides a good summary of the case:

Prevention Spotlight

by Samuel Peik

This section provides a brief overview of current clinical preventive recommendations, including the United States Preventive Services Task Force (USPSTF) as well as other pertinent national organizations.This month's topic is on HIV screening in primary care settings.

USPSTF (released 2005)

Adolescents and adults at increased risk for HIV infection
  • A (strongly recommend)

Adolescents and adults NOT at increased risk for HIV infection

  • C (no recommendation for or against)

Centers for Disease Control and Prevention (CDC) (released 2006)
HIV testing in health-care settings

  • Recommended for patients in all health-care settings
  • High risk screened at least annually
  • Opt-out screening (separate consent not required)
  • Prevention counseling not required

Pregnant women

  • Included in routine prenatal screening panel
  • Opt-out screening (separate consent not required)
  • Repeat screening in third trimester in areas of high HIV rates

Collegeof Physicians (released 2008)

  • Routine screening for HIV
  • Clinicians determine need for repeat screening on individual basis

For more on the USPSTF recommendations, visit their website at

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