HIV and ID Observations

September 10th, 2025

When Required Learning Modules Surprise You (In a Good Way)

Like most clinicians, I have a checkered history with required online learning modules. You know the drill: click play, get lectured in monotone about hand hygiene or fire safety, then spend the next 8 minutes desperately searching for the fast-forward button, hoping it’s not disabled. My personal low point (or high point, depending on your […]

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August 22nd, 2025

On the Internet, Nobody Read My First Blog

In 2007, during the boom in online blogging, and right before the economy crashed, a medical education company contacted me and three other ID doctors to write a blog about HIV. The pitch was irresistible — write something about HIV on a regular basis (they didn’t say what), and we’ll promote it widely. Oh, and […]

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August 6th, 2025

Does the Fact That AI Is Brilliant at Writing “Learning Objectives” Prove They’re Not Really Needed?

Recently, I was invited to speak at a primary care conference on a terrific topic: “Can’t Miss Diagnoses in ID for the PCP.” Love it. So many great examples come to mind — endocarditis, Lemierre syndrome, vertebral osteomyelitis, acute HIV. A wonderful opportunity to teach about the “rare but there” diagnoses hidden among everyday outpatient […]

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June 27th, 2025

The Mystery of the Isolated Hepatitis B Core Antibody, Solved

(A post inspired by years of doing eConsults, an extremely common query about hepatitis B testing, and the latest BritBox series, “Core Antibody Confidential,” starring a grizzled detective with a faded suit and a haunted past.) Your electronic medical record lists “deficiencies” in health care maintenance for one of your patients, so you order hepatitis […]

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April 30th, 2025

On-Service ID Link-o-Rama — Osmosis Edition

First-year ID fellows this time of year bring a lot to inpatient consult rotations. Years of high-volume inpatient care have sharpened their clinical instincts, and at this point they have an impressive fund of ID knowledge. Plus, the fellow on our current rotation gets along great with everyone — patients and consulting clinicians alike — […]

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November 18th, 2024

Marking a Social Media Mass Migration — Until the Next One

Periodically my wife and I will have a bunch of trainees (medical students, or residents, or ID fellows, or a mix) over to dinner. Seated around a big table, with no time-crunch of rounds, pagers, or EPIC orders, we can all get to know one another in this more relaxed setting. Plus, they get free […]

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October 30th, 2024

The Riveting Conclusion of How PCP Became PJP

Before I get back to the saga of Brave New Name — How PCP Became PJP and Why It Matters, allow me to share that I had some trepidation about publishing this thing. A deep dive down a hole with very high-risk for tularemia exposure (see what I did there?), it veered off topic more than […]

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October 22nd, 2024

Brave New Name — How PCP Became PJP and Why It Matters

In the pre-E**n M**k era of the site then known at Twitter, I posted a poll about a very important debate in clinical Infectious Diseases: That’s right. Nearly 900 people took the time, energy, and clicks to weigh in on the critical question of what to abbreviate the well-known opportunistic infection in immunocompromised hosts. Fifteen […]

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September 6th, 2024

Five Reflections after Attending on General Medicine This Year

Here are five things that occurred to me after a stint on General Medicine this year, where (per our department’s wise policy), I was paired with an experienced and excellent hospitalist to oversee two medical residents, three interns, and two medical students. #1:  Energy. Medical house officers radiate positive energy. Yes, it was summertime, and […]

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February 20th, 2024

Variability in Consult Volume Is a Major Contributor to Trainee Stress — What’s the Solution?

Back when he was program director of our ID fellowship, Dr. David Hooper would give the applicants a description of our program. One of the key parts was his estimating the workload — in particular, the number of new consults per day. “We average three to four consults a day,” he said. “But there’s a […]

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