California and the director of the division of community medicine who is a recognized expert in the epidemiology of cancer in the South Pacific. They have expressed an interest in further detasls of the short and long term goals of the program. In addition, we have discussed the possibility of academic affiliations for training in tropical medicine, family practice, field medicine, preventive medicine and for training of paramedical personnel, i.e., Medex, nurse-practitioners. In addition, since the new Marshall Islands Government is in the process of contracting with a Seventh Day Adventist Health Maintenance Organization, we visited Loma Linda University, the academic base for this group. In discussions with the dean of the medical school and the dean of the school of health, we emphasized our desire to establish e close cooperative effort in delivering primary care for the Marshallese. We inquired if Loma Linda University would be interested in an academic collaboration using faculty and staff on the field trips. They indicated interest in this suggestion and will present the concept to University administration. In addition, we had a preliminary meeting with Dr. Don Parlia (Professor of Pathology at UCLA) who is one of the senior consultants in the Marshall Islands Study and was actually present in the USN evacuation task force in 1954. He has remained in close association with the program throughout its 25 years and indicated he would be willing to discuss and additional cooperative effort between the Department of Energy, Brookhaven National Laboratory and UCLA. mo ial expansion of the program and the concommitant identification of a significant thyroid surgical cases, it was felt advisable to begin a preliminary search CA) tional Laboratory surgical units. Our present arrangements for medical work ups and use the services evaluation and Case Western Reserve of Brookhaven (Cleveland) rv surgery. Because of severe climati¢ conditions this seriously limits the number of months ving the year during which we are able to treat the Marshallese. A warm west coast facility would give us a great deal more flexibility. 90TT18b