Insights on Residency Training

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 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 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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August 28th, 2013

Vaccination Against Pertussis – Is It Worth the Trouble?

Paul Bergl, M.D.

 “Four out of four!” exclaimed a proud PGY1 as she handed me the billing sheet for her last patient in continuity clinic. “Four out of four?” asked I. “Yes, I gave all of my patients their updated Tdap today,” she boasted. As her preceptor, I commended her for her commitment to routine health maintenance — you know, the supposedly […]

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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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May 24th, 2013

The MICU Rotation — Oh, no!

Jonathan Schwartz

After a well-received post last week that focused on a commonly asked question I have fielded this year, I thought another common question would make for an excellent topic this week.  We’ll focus on the MICU rotation from the resident (and, potentially, the medical student) perspective. The MICU can be one of, if not the most, daunting […]

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February 16th, 2012

What’s New in Medicine

Heidi Zook, MD

Staying up to date with the most recent advances in medicine is a challenge and a necessity if we want to offer patients the best care possible. That being said, being a physician is one of the busiest careers and finding free time to read journals is not exactly easy. That’s where Journal Watch comes […]

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November 1st, 2011

A Little Advice Goes a Long Way

Heidi Zook, MD

In an effort to get in shape, I decided to start working out with a personal trainer. Before the training sessions started, we met to talk about my general health. When it comes to health, I feel like I know what I’m doing — I’m a physician! Of course I know how to eat healthy […]

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October 20th, 2011

Shifting Times

Gopi Astik, MD

Anyone involved in academic medicine probably is aware of the new ACGME duty-hour restrictions that went into effect  on 7/1/2011. For those of you who aren’t, the new guidelines state that PGY1 residents cannot work for longer than 16 hours straight. If they do work longer, they require strategic uninterrupted naps. The restrictions on PGY2 […]

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