Insights on Residency Training

April 5th, 2014

Learning to Unlearn and Other Advanced Skills

Paul Bergl, M.D.

In my transition from pure learner (i.e., the med student role) to teacher-learner (i.e., the attending), I’ve actually found myself focusing more on the learner than the teacher part of my dual existence.  Strong learning seems to be requisite to strong teaching, and I am realizing that succeeding on the next level requires some extra […]

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February 11th, 2014

Do Quality Initiatives and the Patient Safety Movement Threaten Resident Autonomy?

Paul Bergl, M.D.

Recently, our residency program had the excellent fortune of hosting Dr. Bob Wachter as a visiting speaker. Dr. Wachter is considered a pioneer in the hospitalist movement and has built his career around inpatient quality and safety. During lunch with Dr. Wachter, some of our residents, and hospitalist faculty, we discussed the topic of resident […]

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January 8th, 2014

Cancer 2014 — A Modern Spin on a Tragic Diagnosis

Paul Bergl, M.D.

At first glance, no diagnosis seems more terrible than cancer. Although it remains a huge killer in the developed world, cancer has also taken on new meanings in modern medicine. As an ordinary person, I certainly fear the word and would dread the diagnosis. Cancer. It has such a damning and unforgiving ring to it. After […]

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December 11th, 2013

Making Value-Based Decisions About Ordering Tests

Paul Bergl, M.D.

As Dr. David Green reported this week in NEJM Journal Watch, the American Society of Hematology is the latest society to comment on appropriate and cost-conscious care in the ABIM Choosing Wisely campaign. I’ve followed the Choosing Wisely campaign closely and have been using it on the wards and in clinic as academic ammunition. A specialist society’s […]

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November 25th, 2013

I Think I’ve Seen This One Before: Learning to Identify Disease

Paul Bergl, M.D.

Nothing puts more fear into the heart of an internist than a dermatologic chief complaint. And for good reason: we have very little exposure to the breadth of the field. To us, all rashes seem to be maculopapular, all bumps are pustules… or was that nodules? It’s not that we internists don’t care about the skin […]

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November 14th, 2013

The Google Generation Goes to Med School: Medical Education in 2033

Paul Bergl, M.D.

This past week, I attended the annual AAMC meeting where the question, “What will medical education look like in 2033?” was asked in a session called “Lightyears Beyond Flexner.” This session included a contest that Eastern Virginia Medical School won by producing a breath-taking and accurate portrayal of 2033. I encourage you to view the […]

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November 7th, 2013

Is the Overwhelming “Primary Care To-Do List” Driving Talented Residents Away?

Paul Bergl, M.D.

In my 3 years of residency, the nearly universal resident response to outpatient continuity clinic was a disturbing, guttural groan. I recognize that many aspects of primary care drag down even the most enduring physicians. But I have also found primary care — particularly with a panel of high-risk and complex patients — to be a welcome […]

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October 3rd, 2013

Choosing Words Wisely

Paul Bergl, M.D.

“What do you think, Doctor?” For a novice physician, these worlds can quickly jolt a relatively straightforward conversation into a jumble of partially formed thoughts, suppositions, jargon, and (sometimes) incoherent ramblings. Even for simpler questions, the fumbling trainee does not have a convenient script that has been refined through years of recitation. Thus, many conversations that […]

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September 16th, 2013

Medical Interns – Not at the Bedside, but Not to Be Blamed

Paul Bergl, M.D.

This past week in NEJM Journal Watch General Medicine, Abigail Zuger reviewed an article from the Journal of General Internal Medicine by Lauren Block et al. in which researchers examined how medical interns spend their time. The results from this time motion study might be concerning but are not unexpected. The investigators found that interns […]

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September 3rd, 2013

Benefits and Perils of Following the Literature Too Closely

Paul Bergl, M.D.

As a resident, probably the most common piece of feedback one receives is, “Read more and expand your clinical knowledge base.” This critique is a standard and generic piece of feedback to encourage the younger generation to never quit in the endless pursuit of knowledge. As our erudite attendings know, medical knowledge always evolves and […]

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