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The results of any workforce model are highly dependent on the underlying assumptions used, and differing assumptions represent the major differences between most workforce projections. 21 We designed our workforce model to allow easy access to all the major model parameters. Sensitivity analysis can be performed by using a button, slider, or dial to adjust input variables and thus model projections. For this study, we evaluated the effect of changes in the following: the rates of retirement andor a mandatory retirement age for all generalist physicians; census projections; the number of IMGs entering the generalist workforce; and the number of GME graduates entering generalist careers. We compare our estimates of future generalist supply to four alternative benchmarks: COGME's lower estimate of generalist need (60 per 100,000), COGME's upper estimate of generalist need (80 per 100,000), a region with a relatively low generalist supply (Houston, 54 per 100,000), and a region with a relatively high generalist supply (Philadelphia, 98 per 100,000). The two regional benchmarks were selected to reflect the substantial regional variation in the current supply of generalists; estimates of the generalist supply for benchmark regions were derived from our work with the Dartmouth Atlas of Health Care.

A total of about 223,000 people were affected by the spill and 180 persons in Sangana died in March 1980 as a result of factors related to the pollution. Over 300 fishing ports were impacted and many sea foods were killed or tainted.]