Part Ⅰ Writing (30 minutes)

　　Directions: For this part, you are allowed 30 minutes to write a short essay entitled College Students on the Job Market. You should write at least 150 words following the outline given below.

　　1.当今大学生面临着严重的就业压力

　　2.这一现象的产生有多方面的原因

　　3.解决的办法

　　College Students on the Job Market

　　_____________________________________________________________________________

　　Part I Writing

　　【写作思路】

　　本文是关于对某种社会现象的讨论，探讨其原因，并提供解决问题的方案。毕业生就业压力大，是目前比较热门的话题，媒体、社会以及学生本人都会时不时的讨论，所以文章难度不是很大。文章开篇提出就业压力大的问题，毕业生越来越多，而就业市场却保持稳定，两者之间的不平衡，导致毕业生面临越来越大的就业压力。第二段讨论出现这种问题的原因。第一方面，从宏观上来看，整个世界的经济危机影响了就业市场;第二方面，从学校招生来看，热门专业人数过多，结果供过于求，而冷门专业学生很少，结果供不应求。第三段针对第二段的原因，探讨相应的解决方案。从政府的角度出发，要尽可能的采取各种手段帮助经济恢复，帮助学生就业;从个人角度出发，要学会自主选择，不追潮流，学习自己感兴趣的，努力提高自身素质，增强竞争能力。

　　【参考范文】

　　More and more graduates are going out of universities and entering into the society every year while the demand on the job market remains stable. The college students are facing greater and greater pressure in job-hunting.

　　There are many reasons behind the current phenomenon. To begin with, the economy has been confronted with depression in recent years on a global level, and it takes time for the worldwide economy to recover. What's more, there is an element of irrationality in the enrollment of the campuses. Some hot majors have enrolled too many students, and many people compete for one position after graduation, whereas the majors with little attention have few students, and more graduates are needed than the campus can supply.

　　The solution to this problem lies with both the government as a whole and the individual in specific. The government takes whatever measures possible to help the economy recover and to create more job opportunities for the applicants. And for the individual students, it is better to study what they are interested in and to gain experience through practice, thus better prepared for the society.

　　Part ⅡReading Comprehension (Skimming and Scanning) (15 minutes)

　　Directions: In this part, you will have 15 minutes to go over the passage quickly and answer the questions on Answer Sheet 1. For questions 1-7, choose the best answer from the four choices marked A), B), C) and D). For questions 8-10, complete the sentences with the information given in the passage.

　　Will Electronic Medical Records Improve Health Care?

　　Electronic health records (EHRs) have received a lot of attention since the Obama administration committed $19 billion in stimulus funds earlier this year to encourage hospitals and health care facilities to digitize patient data and make better use of information technology. The healthcare industry as a whole, however, has been slow to adopt information technology and integrate computer systems, raising the question of whether the push to digitize will result in information that empowers doctors to make better-informed decisions or a morass of disconnected data.

　　The University of Pittsburgh Medical Center (UPMC) knows firsthand how difficult it is to achieve the former, and how easily an EHR plan can fall into the latter. UPMC has spent five years and more than $1 billion on information technology systems to get ahead of the EHR issue. While that is more than five times as much as recent estimates say it should cost a hospital system, UPMC is a mammoth network consisting of 20 hospitals as well as 400 doctors' offices, outpatient sites and long-term care facilities employing about 50,000 people.

　　UPMC's early attempts to create a universal EHR system, such as its ambulatory electronic medical records rolled out between 2000 and 2005, were met with resistance as doctors, staff and other users either avoided using the new technology altogether or clung to individual, disconnected software and systems that UPMC's IT department had implemented over the years.

　　On the mend

　　Although UPMC began digitizing some of its records in 1996, the turning point in its efforts came in 2004 with the rollout of its eRecord system across the entire health care network. eRecord now contains more than 3.6 million electronic patient records, including images and CT scans, clinical laboratory information, radiology data, and a picture archival and communication system that digitizes images and makes them available on PCs. The EHR system has 29,000 users, including more than 5,000 physicians employed by or affiliated with UPMC.

　　If UPMC makes EHR systems look easy, don't be fooled, cautions UPMC chief medical information officer Dan Martich, who says the health care network's IT systems require a "huge, ongoing effort" to ensure that those systems can communicate with one another. One of the main reasons is that UPMC, like many other health care organizations, uses a number of different vendors for its medical and IT systems, leaving the integration largely up to the IT staff.

　　Since doctors typically do not want to change the way they work for the sake of a computer system, the success of an EHR program is dictated not only by the presence of the technology but also by how well the doctors are trained on, and use, the technology. Physicians need to see the benefits of using EHR systems both persistently and consistently, says Louis Baverso, chief information officer at UPMC's Magee-Women's Hospital. But these benefits might not be obvious at first, he says, adding, "What doctors see in the beginning is that they're losing their ability to work with paper documents, which has been so valuable to them up until now."

　　Opportunities and costs

　　Given the lack of EHR adoption throughout the health care world, there are a lot of opportunities to get this right (or wrong). Less than 10 percent of U.S. hospitals have adopted electronic medical records even in the most basic way, according to a study authored by Ashish Jha, associate professor of health policy and management at Harvard School of Public Health. Only 1.5 percent have adopted a comprehensive system of electronic records that includes physicians' notes and orders and decision support systems that alert doctors of potential drug interactions or other problems that might result from their intended orders.

　　Cost is the primary factor stalling EHR systems, followed by resistance from physicians unwilling to adopt new technologies and a lack of staff with adequate IT expertise, according to Jha. He indicated that a hospital could spend from $20 million to $200 million to implement an electronic record system over several years, depending on the size of the hospital. A typical doctor's office would cost an estimated $50,000 to outfit with an EHR system.

　　The upside of EHR systems is more difficult to quantify. Although some estimates say that hospitals and doctor's offices could save as much as $100 million annually by moving to EHRs, the mere act of implementing the technology guarantees neither cost savings nor improvements in care, Jha said during a Harvard School of Public Health community forum on September 17. Another Harvard study of hospital computerization likewise determined that cutting costs and improving care through health IT as it exists today is "wishful thinking". This study was led by David Himmelstein, associate professor at Harvard Medical School.

　　The cost of getting it wrong

　　The difference between the projected cost savings and the reality of the situation stems from the fact that the EHR technologies implemented to date have not been designed to save money or improve patient care, says Leonard D'Avolio, associate center director of Biomedical Informatics at the Massachusetts Veterans Epidemiology Research and Information Center (MAVERIC). Instead, EHRs are used to document individual patients' conditions, pass this information among clinicians treating those patients, justify financial reimbursement and serve as the legal records of events.

　　This is because, if a health care facility has $1 million to spend, its managers are more likely to spend it on an expensive piece of lab equipment than on information technology, D'Avolio says, adding that the investment on lab equipment can be made up by charging patients access to it as a billable service. This is not the case for IT. Also, computers and networks used throughout hospitals and health care facilities are disconnected and often manufactured by different vendors without a standardized way of communicating. "Medical data is difficult to standardize because caring for patients is a complex process," he says. "We need to find some way of reaching across not just departments but entire hospitals. If you can't measure something, you can't improve it, and without access to this data, you can't measure it."

　　To qualify for a piece of the $19 billion being offered through the American Recovery and Reinvestment Act (ARRA), healthcare facilities will have to justify the significance of their IT investments to ensure they are "meaningful users" of EHRs. The Department of Health and Human Services has yet to define what it considers meaningful use

　　Aggregating info to create knowledge

　　Ideally, in addition to providing doctors with basic information about their patients, databases of vital signs, images, laboratory values, medications, diseases, interventions, and patient demographic information could be mined for new knowledge, D'Avolio says. "With just a few of these databases networked together, the power to improve health care increases exponentially," D'Avolio suggested. "All that is missing is the collective realization that better health care requires access to better information—not automation of the status quo." Down the road, the addition of genomic information, environmental factors and family history to these databases will enable clinicians to begin to realize the potential of personalized medicine, he added.

　　1. In America, it is slow to adopt information technology because —————.

　　A) the funds invested by the government is not enough in the past

　　B) EHRs have received less attention of the public in the past

　　C) whether it will be useful to doctors or not is doubtful

　　D) UPMC knows how difficult it is to digitize the hospital

　　2. The University of Pittsburgh Medical Center (UPMC) —————.

　　A) is the first medical center to adopt information technology

　　B) satisfy the requirement of the government on information technology

　　C) spent less money on information technology than it was estimated

　　D) attempted to created a universal EHR system, but met some difficulties

　　3. The health care network’s IT systems require a lot of effort to ensure it can communicate with one another mainly because —————..

　　A) the integration among different system is largely up to the IT staff

　　B) UPMC is like many other health care organizations in the United States

　　C) UPMC makes EHR systems look easy

　　D) UMPC began digitizing some of its records in 1996

　　4. The success of the EHR program is decided by —————..

　　A) the fact whether the information technology is available or not

　　B) the fact how well the doctors are trained to use the information technology

　　C) not only the presence of the technology but the doctor’s training on technology

　　D) the fact whether physicians can see the benefits of using EHR systems

　　5. The most important reason of most hospitals being reluctant to adopt EHR system is that —————.

　　A) the cost is too high for the hospital to afford

　　B) physicians are unwilling to adopt it

　　C) there is a lack of staff with adequate IT expertise

　　D) doctor worry about its negative influence on patients

　　6. According to the study led by David Himmelstein through health IT —————.

　　A) it is possible to cut the costs of the hospital

　　B) it is possible to improve the health care

　　C) it ensure neither cost saving nor improvement in care

　　D) it could save as much as $100 million annually

　　7. The hospital’s managers prefer to —————.

　　A) spend money on an expensive piece of equipment than on information technology

　　B) charge patients access to the information technology as a billable service

　　C) purchase the information technology to improve the health care of the hospital

　　D) invest more money on the training of the physicians to charge patients more money

　　8. Jha said the mere act of implementing the technology guarantees ______________________.

　　9. D'Avolio says the investment on lab equipment can be made up by_____________________.

　　10. Databases of vital signs, images, laboratory values, medications, diseases, interventions, and patient demographic information could be ____________________.