People often ask how we come up with ideas for the articles that appear in Yale Medicine. There’s no easy answer to that question. Ideas might come from a chance conversation, a tip from a scientist or clinician, or a writer’s familiarity with a beat. We observe, discern patterns, develop a hypothesis, then look for information to confirm or deny that hypothesis—like scientists, we sometimes find ourselves following a path that leads nowhere. For this issue we had an abundance of important breaking news stories with significance not just for the medical school, but for the university and New Haven.In August we learned that President Richard C. Levin would be stepping down after 20 years at the helm of the University. Two months later the Yale Corporation unanimously chose Provost Peter Salovey as his successor.In September came the news, long anticipated, of Yale-New Haven Hospital’s acquisition of the Hospital of Saint Raphael. Over the years we’ve covered the history of medical care in New Haven and the evolution of the city’s various hospitals through mergers and acquisitions. Now only one hospital remains in the city.And both feature stories attest to a new age in medicine. The ENCODE project, in which Yale faculty played a key role, has advanced knowledge of those regions of the genome derisively called junk DNA, even though it’s been known for years that they are vibrant and active areas of the genome. And the School of Medicine and Yale-New Haven Hospital have begun to implement an electronic medical record (EMR) format that is expected to revolutionize not just the practice of medicine but medical research as well.Finally, in our student pages we explore a phenomenon we’ve been observing for a few years now—more and more students are opting to stay on for a fifth year at the School of Medicine. The reasons why may surprise you.