Insights on Residency Training

February 18th, 2021

The Human Side of Medicine — Grieving the Loss of Our Patients

Masood Pasha Syed, MBBS

“The life of the dead is placed in the memories of the living” — Marcus Tullius Cicero Growing up in a family of physicians, I was exposed early to healthcare from the provider side. Some days, my father would come home late after a long surgery with an unanticipated complication or an unexpected outcome and would […]

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November 3rd, 2017

Uncuffing Medicine from Guidelines

John Junyoung Lee, MD

During my first Cardiology fellowship interview, Dr. Schevchuck, one of the cardiologists on the admissions committee, opened the interview with the following question: “Guess how many guidelines there are in the United States?” If you are reading this and you are planning on applying to a cardiology fellowship too, I have done some homework for you. […]

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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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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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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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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 […]

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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 […]

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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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August 19th, 2013

Managing Hypertension – Not as Easy as It Once Seemed

Paul Bergl, M.D.

Hypertension… As a medical student, I never really understood the fuss over it. Practicioners had an excellent and concise guide in the JNC-7 to handle all of the major aspects of this disease. The JNC-7 guidelines were algorithmic, and a helpful table of compelling indications for antihypertensive agents couldn’t make life any easier. I soon realized […]

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August 13th, 2013

Broad Is Best? The Culture and Etiquette of Antibiotic Selection in the Training Environment

Paul Bergl, M.D.

Friends and colleagues, welcome to the new academic year! I am delighted to be a chief resident blogger for NEJM Journal Watch for the coming year. Without further ado, let’s discuss residents’ use of antibiotics. Antibiotic selection can either be one of the most anguishing or most mindless decisions that an internal medicine resident makes. For […]

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