Background: Graduates of the 7-year undergraduate medical curriculum in Taiwan are often deficient in clinical skills. Aims: To implement and assess a programme of accelerated clinical education. Method: The Department of Primary Care Medicine at the National Taiwan University College of Medicine implemented a programme shortening the undergraduate clinical curriculum from 3 to 2 years and giving students more clinical responsibility. Students were prepared for clinical rotations with a 1-month clinical skills course. Core clinical rotations were redesigned to be more participatory. The programme included 1 year of a postgraduate, rotating residency. Self-selected students with adequate grades, recommendations and performance on an interview participated in the programme. None of them dropped out. Results: Compared with their traditionally instructed cohorts, graduates of the accelerated programme ($10% of each class) were more likely to pass national boards (100% versus 80-97%) and were rated as more proficient on 9 of the 10 different clinical performance parameters (p < 0.01 by sign test). Sixty-nine percent reported being satisfied or very satisfied with the programme. Conclusion: A pilot programme of accelerated medical education at National Taiwan University that included clinical skills instruction, mentor-style classes and active learning techniques resulted in satisfactory outcomes for the students selected for the programme.

In order to study the possible mechanisms of atherosclerotic changes involving the saphenous vein graft in coronary bypass surgery, endothelial cells were cultured from human saphenous vein and used in experiments. The intimal surface of human saphenous vein was treated with collagenase followed by mechanical scraping with a surgical scalpel. The endothelial cells obtained were cultured in M 199 medium supplemented with 20% human serum. In experiments, different ambient pressures (either normal or increased at 100 mmHg) and oxygen tensions (either 20% or 5.3%) were applied to the cultured endothelial cells to study the effects on cell proliferation. Four experiments were performed. It was found that the growth rate of endothelial cells was constantly and significantly decreased in high ambient pressure. Increase in oxygen did not significantly affect cell growth. The culture condition closest to the venous environment rendered best cell growth. It is concluded that growth rate of cultured endothelial cells derived from human saphenous vein can be affected by changes in ambient pressure. The changes may play some role in the pathogenesis of bypass graft atherosclerosis.