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1.1. Biopsies of uterine cervices during a period of approximately 22 years revealed 237 gland cell carcinomas; 127 (53.6 per cent) were primary in the cervix arising from glands or surface epithelium or both.2.2. The majority (30.8 per cent) of secondary carcinomas represented extension from the endometrium. Other primary sites were, in order of decreasing frequency, the ovary, colon and rectum, breast, and urinary tract.3.3. Ten examples of noninfiltrative gland cell carcinoma were encountered. Three of these represented in situ change in endocervical glands and in one instance there was also a squamous cell carcinoma in situ. Seven lesions consisted of carcinomatous change in endocervical polyps without infiltration of the cervix proper.4.4. The primary infiltrative gland cell carcinomas (110 cases) comprised 5.5 per cent of all infiltrative carcinomas arising in the uterine cervix.5.5. The average age of the patients with infiltrative gland cell carcinoma of the cervix was 53 years, with a range of 21 to 76 years. The average age for squamous cell carcinoma was 47 years and for gland cell carcinoma of the endometrium 59 years.6.6. The gestational histories of patients with primary gland cell carcinoma of the cervix were more closely allied to those of patients with endometrial carcinoma than to those with squamous cell carcinoma. The symptoms resembled those for squamous cell carcinoma but the duration of symptoms was appreciably longer.7.7. Structural and cytologic features permitted the recognition of distinctive patterns of growth in gland cell carcinoma of the cervix: adeniform, medullary, muciferous, papillary, acanthoid, and scirrhous. Two carcinomas in young women were of mesonephric origin.8.8. In situ change at the margins of infiltrative carcinomas was an important criterion in assigning origin to the cervix and was found in 43 per cent of cases.9.9. The majority of patients with gland cell carcinoma of the cervix were treated with radiation in a manner employed for squamous cell carcinoma of the cervix. The over-all 5 year survival rate for gland cell carcinoma was 29.9 per cent as compared with 40.1 per cent for squamous cell carcinoma and 54.3 per cent for gland cell carcinoma of the endometrium.10.10. A definite correlation was found between histologic pattern of growth and survival. The best results occurred with papillary carcinoma (57 per cent), followed by adeniform (30 per cent), muciferous (20 per cent), and medullary (14 per cent). The poorest prognoses were observed for acanthoadenocarcinoma (9 per cent) and scirrhous type (0 per cent).11.11. In 7 patients with primary infiltrative gland cell carcinoma of the cervix, there were second separate and distinct carcinomas in the uterus; 5 patients had infiltrative squamous cell carcinoma of the cervix and 2 had gland cell carcinoma of the endometrium. Six of these were synchronous and one metachronous.

In August 1965, a long-standing affiliation between the Department of Obstetrics and Gynecology of the University of Michigan and the Departments of Obstetrics and Gynecology of several community hospitals with residency programs was strengthened. The program directors began to meet monthly to discuss mutual problems, the teaching programs for staff and residents were improved and expanded, and students were encouraged to elect rotations in clinical obstetrics-gynecology in the community hospitals. The effect of this program on the number of residents and their quality, as measured by changes in numbers of foreign graduates and performances on examinations, is described.

In 1947, the Department of Postgraduate Medicine of the University of Michigan established a new system of resident education which made the facilities of the Medical Center available to selected community hospitals. The intent of the affiliations was to supplement the clinical teaching in internal medicine, obstetrics and gynecology, and surgery by offering additional work in specially designed courses at the University. Since 1965, a planning committee of representatives from the Departments of Obstetrics and Gynecology of the Affiliated Hospitals and the University Hospital and the Directors of Medical Education has met regularly to discuss problems of residencies in general and to develop a combined program designed to improve resident education in our own institutions. The functions of the committee include the identification of inadequacies, the implementation of corrective measures, and the development of experimental programs. The results of our first 32 months of operation are described.