April 28th, 2014
Cynicism in Medicine
Akhil Narang, M.D.
“Are you more or less cynical than when you started residency?” This was the question my Program Director asked our senior internal medicine residents at a recent dinner with Dr. Bob Wachter. If you aren’t familiar with Dr. Wachter, he is widely acclaimed as the “Father of Hospital Medicine” and a renowned champion of patient […]
January 13th, 2014
Reflections of a New Attending
Akhil Narang, M.D.
During my year as a Chief Resident, I have the privilege to attend on the general medicine service for 8 weeks. I recently completed 4 weeks and, as expected, found myself in an entirely new realm of patient care and accountability. I would be remiss without recalling a few of the pivotal lessons and poignant moments […]
September 27th, 2013
Duty Hour Reform Revisited
Akhil Narang, M.D.
Discussions of resident duty hour reforms reached the point of ad nauseam a few years ago. Everyone had their say – Program Directors (“In 2003 we instituted an 80-hour work week, in 2011 we switched to 16 hour shifts, what’s next – online residencies!?”), senior residents (“What? I have to write H&Ps again? I don’t […]
September 11th, 2013
Oral Anticoagulation, Part I: Direct Thrombin Inhibitors
Akhil Narang, M.D.
When I started residency 4 years ago, warfarin was really the only choice of anticoagulation widely used for prevention of stroke in patients with atrial fibrillation (AF) and in patients with venous thromboembolism (VTE). Despite knowing about the coagulation cascade for decades, only recently have viable alternatives to warfarin become available. In this post, I hope […]
August 23rd, 2013
Teaching Ultrasound to Internal Medicine Residents
Akhil Narang, M.D.
Welcome, everyone! I am thrilled at the prospect of sharing with you my thoughts on issues that pertain to residency training during the current academic year. I recently attended the Fundamentals of Critical Care Ultrasound course hosted by the Society for Critical Care Medicine (SCCM). It was well attended by a mix of intensivits, anesthesiologists, and […]