BACKGROUND Anemia is an early indicator of many diseases, yet blood donors with low hematocrit (Hct) often receive inadequate information about its medical importance. We sought to understand the types of information that are and should be provided to these donors. STUDY DESIGN AND METHODS Two companion studies were performed. The first investigated blood center practices for care of donors with low Hct including deferral length, information provided, and cutoff values used when referring donors for medical attention. The second was a randomized prospective pilot study comparing behavior of deferred donors receiving an “older” pamphlet providing a list of iron-rich foods or a “newer” pamphlet providing descriptions of common causes of anemia and advice for seeking medical attention. RESULTS More than 70% of centers defer donors for 1 day. Only 6% defer donors for more than 2 weeks. Most centers provide written and/or verbal information about low Hct. Only 35% have a cutoff value defining significant anemia that requires additional medical attention. In the study of donors with low Hct, significant disease was identified within 3 months after deferral in 2 of 104 subjects: metastatic lung cancer and acute lymphocytic leukemia. Only donors receiving the newer pamphlet reported that it “definitely improved” their ability to speak with their doctor about anemia. CONCLUSIONS The diagnosis of anemia in blood donors may be an indicator of significant undiagnosed disease. There are wide variations in how centers care for and educate donors with anemia. Donors with anemia should be provided improved and consistent educational information.

This study begins to explore whether there is a link between medical students' professional identity development and their specialty choice. Through an online survey, third-and fourthyear students at a US medical school were asked to identify the curricular, extracurricular, and personal experiences they felt influenced their professional identity development, and which of nine known considerations influenced their specialty choice. In 141 responses (68% return rate), students most frequently identified experiences involving humans -as cadavers, patients, colleagues, mentors, and role models -as contributing to their professional identity development. Of the nine contributors to specialty decisions, students highlighted intellectual interest, patient contact, procedural skills, lifestyle, and career opportunities. Narrative responses to both questions consistently emphasized the value of emotionally positive clerkship experiences, patient encounters, role models, and mentors. The abundance and consistency of these responses suggest that positive interpersonal and clinical experiences may influence both professional identity development and specialty choice.