February 2009 E-Newsletter

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Medical Student Perspectives: Time Management during Medical School

In the past two years, I have taken two of the most important oaths of my career. First, I was commissioned as an officer in the United States Air Force, and a few months later I took the Hippocratic Oath. Not only do I tackle the prescribed national medical curriculum, but I also undergo an additional 800 instructional hours specific to my military medical officer training. Most medical students find the standard curriculum demanding enough of both their time and energy without having to be responsible for significantly more material. As a result, I have had no choice but to sharpen my time management skills in order to be successful in my coursework.

Upon entering medical school, it seems that all students are in a constant race against time. As students, we learn to survive on minimal sleep to capitalize on our wakeful hours. However, a demanding workload and not enough time to do it in is a situation not unique to medical students. Physicians have an average of 10-15 minutes per patient, stacks of paperwork, and family obligations waiting at home. Effective time management is essential to our profession. A few simple time management strategies will help us as students and as budding physicians.

Know Thyself
Most medical students feel that they would do more if they only had the time. Time is a precious commodity as a student, but sometimes we spend time ineffectively without even realizing it. Try this for one week: record a daily log of activities from waking up in the morning to going to bed at night – and be honest. It is surprising how much time is spent on the phone, in front of the television, or even napping. Most people will be surprised to find how much time goes unaccounted. Remember, every extra half hour counts.

Triage
If you can rattle off last week’s lecture in your sleep but cannot make conversation about much else, you may have a serious problem. Living on schoolwork alone is similar to only including one food group in your diet – it is not only monotonous, but also unhealthy. Before getting out of class, make a list of what you need to accomplish that day. A visual reminder of what you have to do is helpful when planning a schedule. You should list activities from most essential to least important, while being realistic about free time for meals and short breaks. Too often, students neglect personal needs to make time for studies. Make time each day to do something you enjoy, even if only for 15 minutes. Though it may eat away from study time, a daily workout, for example, can make you more focused and efficient. We learn that regular exercise has many health benefits, including the release of natural endorphins and improved sleep quality at night. If you find that your energy level is low, no matter how much you sleep, it might be time for a change in routine.

Cut Yourself Some Slack
Even if you have time management down to a science, you are not a machine. Some days are harder than others: your car could break down, there might be a family emergency, or you may feel run down. Sometimes the frustration of not being able to follow your schedule to the tee takes precious energy away and leaves us feeling like failures. Whatever the reason, we have to be able to forgive ourselves for falling off course every once in a while, in hopes that a break will allow us to get right back into the swing of things.

Science fiction writer Frank Herbert once said, “There is no secret to balance. You just have to feel the waves.” Do not forget that you are entering a profession which requires daily sacrifice and impacts everyone differently. Time management is a skill worth learning early on as a student because it will be necessary as a physician. Like medicine, it is a skill that comes with practice. If practiced correctly, it will allow you to find a balance between things you must do and the things you should do in your busy life.

Lavanya Viswanathan, M.S., 2LT, USAF
Military Representative, ACP Council of Student Members
Representative, American Association of Medical Colleges
Uniformed Services University of the Health Sciences, 2011
Email: Lavanya.Viswanathan@usuhs.mil

Check out more volunteer opportunities.

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My Kind of Medicine: Real Lives of Practicing Internists: Deborah Rhodes, MD

Deborah Rhodes, MD

In the 80s, Deborah Rhodes was a bit of an anomaly—having a lifetime aversion to hairspray, she never sported Big Hair, and she had no desire to work on Wall Street. As college friends and acquaintances eagerly pursued banking and other popular career choices, Dr. Rhodes held back. “That was the beginning of the ‘It’s all about me’ generation,” she says, “but I wasn’t that interested in money or prestige. When I eventually decided to pursue medicine, I went into it for what I would later know as the feeling I get when I get a card from patients saying how their interaction with me made all the difference. That’s the best part of the job.” Dr. Rhodes gets several cards each month—a testament no doubt to her excellence as a physician, as well as her contagiously cheerful personality but most likely to the simple fact that Dr. Rhodes just really likes her job.

Baptism by Fire
In New York City, armed with a history degree from Harvard and a complete lack of direction, the 22-year-old Dr. Rhodes found herself floating aimlessly in a sea of possibility. She didn’t know what she wanted to do, so she took a position with a temp agency. But instead of being frustrated by her indecision, the fun-loving Dr. Rhodes embraced it. “I was having a ball!” she jokes, “but I knew eventually I’d have to get a real job.” When she got an interview to assist with the development of a non-profit agency helping elderly New Yorkers connect with the public services they needed, she was hooked. The man funding the agency needed help cutting through red tape and handling daily operational requirements. The job seemed like it was a perfect fit for Dr. Rhodes and the interview was going well until he dropped the bomb. “After two hours of questions, he stopped and told me that he wasn’t going to offer me the job because he was certain I’d get bored. What I needed to do, he said, was go to medical school. I was stunned, but before I could object, he actually picked up the phone and called the dean at Bryn Mawr College. ‘I am sitting here with a young woman who needs to start premed,’ he said. ‘How do we make this happen?’ He wouldn’t give up!” she remembers, “He even made sure that they Fedexed the application to me.”

Once in medical school at Cornell University Medical College in New York City, Dr. Rhodes knew she had to find something she would enjoy doing day in and day out for the rest of her life, and that’s when she chose internal medicine. “Internal medicine gives you the chance to do a little bit of everything, and that’s what I wanted. It was perfect for me.”

More Than A Motto
The Mayo Clinic is the first and largest integrated, not-for-profit group practice in the world. More than 3,300 physicians, scientists and researchers and 46,000 allied health staff work at Mayo, at sites in Rochester, Minnesota, Jacksonville, Florida, and Phoenix, Arizona. Collectively, the three locations treat more than a half million people each year. At Mayo in Rochester, Dr. Rhodes splits her time between research, teaching, and clinical care. Her research work evaluating women at increased risk of breast cancer has been a career highlight. Along with a nuclear physicist and a number of radiologists, she studies a new gamma camera for breast imaging. The device has the ability to detect small cancers in dense breast tissue, and thus may be better suited than mammography for screening and evaluating high-risk women.

“It’s really exciting to build something from the ground up,” she says, “This imaging technique has the ability to detect up to three times as many cancers as mammography.” Dr. Rhodes and her colleagues have been working on the research for seven years, attracting the attention of the profession and national media. She says finally seeing it come to fruition has been wonderful. “It takes time to do something really important that genuinely has a chance of changing outcomes,” she says. “It’s the kind of thing that takes a large investment of time, work, and patience, but it is so worth it for me.” She also directs a fellowship program and edits Mayo’s Department of Medicine clinical newsletter. She loves the diversity of her job and says being an internist allows her to do it all. “Every day is different. I am constantly learning. I like getting up in the morning because I love being able to do all of the different things that I do—teach, research, see patients—and my background as an internist allows me to do it.”

A Christmas Angel
When she’s not working on research or teaching, Dr. Rhodes practices what Mayo refers to as “executive health.” As she explains, the concept is an accelerated form of general medicine, or the way physicians might like to practice internal medicine in an ideal setting. “We try to compress the initial stuff as much as we can—communicating with the patients before they arrive to see what they need. What Mayo does best is provide integrated care that’s very efficient,” she says. “It’s really a wonderful place to practice.” “At some other medical centers, the goal of career advancement seems to be to get away from patient care….I don’t understand that. What I love about being an internist is that you are involved in every aspect of your patients’ lives. You feel like you can genuinely make a difference.”

It’s this sincere desire to treat her patients with dignity and respect that makes her a favorite among them, and it was probably what a patient of hers was counting on recently when she called Dr. Rhodes a week before Christmas in near despair. The patient’s mother had been told she had cancer that had metastasized to her spine, but the primary site of the cancer was unknown. She was in excruciating pain, and wanted a second opinion on what to do next. Dr. Rhodes got on the phone and right away a team of colleagues at the Mayo Clinic in Jacksonville stepped up to the plate and offered their help, squeezing time in between appointments to see the woman on Christmas Eve. By the end of the day, they had reached a conclusion. “It took us a while to figure it out— in the end we found that she didn’t have cancer at all, but that her spine was badly compressed,” she explains. “She underwent a minimally invasive spinal procedure to treat the compression, and she got to go home on Christmas, with no cancer and no pain.” The woman later wrote Dr. Rhodes a note. It read, “You’re my angel.” Dr. Rhodes offers a more humble explanation. “Making a difference for people, being a good physician—it’s not about being brilliant, it’s about getting involved.”

For the one-time city girl turned researcher, happiness is a way of life. She is a “glass half full” person and the only thing she seems to struggle with is trying to juggle it all. Her husband, whom she met in their fourth year of medical school, is a tremendous support. “He’s made a lot of sacrifices for me. A lot of why and how I’ve been able to be there for my patients and colleagues at Mayo is because I have such a good partner,” she says. They have two daughters, ages six and ten. Dr. Rhodes, once a serious musician, enjoys playing the violin and piano with them. The family also skis together, but unlike playing the violin, skiing is something Dr. Rhodes admits to having little mastery of. And even though she still might be scared to go down the intermediate slope, she does it anyway with a smile on her face.

Check out previous articles as physicians share what motivated them to become physicians as well as why they chose their particular type of practice.

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Internal Medicine Interest Group of the Month: The University of Chicago Pritzker School of Medicine

pritzker

The University of Chicago Pritzker School of Medicine's Internal Medicine Interest Group leadership. From L to R: Shashank Sinha, MSIV; Jim Woodruff, MD, FACP Internal Medicine Residency Program Director; Vineet Arora, MD, FACP Associate Program Director; Erin Cobain, MSIV; and Jami Rothe, MSIV.


The University of Chicago matriculated its first class of medical students in 1927 and was renamed the Pritzker School of Medicine in 1968. Our Internal Medicine Interest Group (IMIG) was started in 2003. In the last year, the organization has increased its visibility on the university campus as well as in the greater Chicago area by strengthening ties with the ACP Northern Illinois Chapter leadership. Currently, we have an executive board comprised of several senior student leaders (Faraz Ahmad, Stuart Chen, Erin Cobain, Ann Laake, Jami Rothe, Shashank Sinha, and Kelly Snider), as well as representatives from each medical school class, that meet on a monthly basis to discuss and plan upcoming events for the organization. Jim Woodruff, MD, FACP; Vineet Arora, MD, FACP; Jeanne Farnan, MD; and Tracie Wilcox, MD, our faculty advisors, provide generous guidance and support to foster our dual mission: a) inform and educate our members regarding the specialty of internal medicine and its subspecialties and b) promote communication among members and faculty through mentoring, career advising, and networking opportunities.

We are very proud of our 2008-2009 agenda, which includes the following events:
1) Pritzker Morning Report is a quarterly simulation of resident report that introduces first- and second-year medical students to a typical medical complaint, such as chest pain and shortness of breath, and helps students develop basic clinical reasoning skills. A University of Chicago Chief Resident serves as our faculty discussant.
2) Career Development Seminar Series empowers students to explore internal medicine and its plethora of subspecialties (such as Cardiology, Gastroenterology, Pulmonary and Critical Care) via lecture by faculty members who present clinical vignettes and provide descriptions of their career path as well as information about their day-to-day activities.
3) IMIG at Pritzker Social Rounds provided a unique opportunity to formally launch our academic year and recruit more than 60 Pritzker students as new ACP members. Our aforementioned IMIG faculty advisors (see photo) hosted Pritzker Social Rounds, a social gathering for Pritzker medical students of all classes.
4) Medicine Morning Rounds enables first- and second-year medical students to shadow a third- or fourth-year medical student on the wards, allowing them to gain early exposure to clinical medicine as well as develop mentoring relationships with their peers.
5) The First Annual IMIG Chicago Networking Event, coordinated in conjunction with the ACP Northern Illinois Chapter leadership, will provide a unique networking opportunity in February 2009 for program directors, fellows, residents, and medical students in internal medicine. All proceeds will go directly to the Imerman Angels, a charitable organization that pairs cancer survivors with cancer fighters.
6) Internal Medicine Residency Panel Discussion provides an informal forum following the residency match for fourth-year medical students to answer questions from lower classmen regarding the application and interview process for internal medicine residency programs.
7) The Third Year Reflection Session provides third-year medical students an opportunity at the conclusion of their third year to share and discuss experiences, challenges, and triumphs as a clinical clerk in an informal venue.

We have watched the organization grow immensely over the last year and are looking forward to our remaining events.

Erin Cobain, Jami Rothe, and Shashank Sinha
Co-Directors, Internal Medicine Interest Group
The University of Chicago Pritzker School of Medicine, 2009
Emails: ecobain@uchicago.edu, jrothe@uchicago.edu, shashank@uchicago.edu

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Winning Abstracts from the 2008 Medical Student Abstract Competition: Non-specific Interstitial Pneumonia, Suspect The Unexpected

Authors: First Author: J Benjamin Robbins, Student; Second Author: Wael El Maraachli, Member

Introduction
Idiopathic Interstitial Pneumonias can be divided into several subcategories. Some of these subcategories carry a very grim prognosis: 10 year survival of less than 10% in the case of Usual Interstitial Pneumonia. Others which are steroid-responsive, such as Non-specific Interstitial Pneumonia (NSIP), have a 10 year survival of more than 60%. The formidable task of deciphering amongst these subtypes, therefore, becomes paramount.

Case Presentation
A 64-year-old woman presented to her physician with worsening shortness of breath and a productive cough. CXR showed bibasilar infiltrates and she was provided unspecified antibiotics with only partial resolution of her symptoms. Two months later, she presented to the same physician with worsening dyspnea on exertion and a dry, nonproductive cough. She was given a 10-day course of trimethoprim-sulfamethoxazole double strength with no improvement of her symptoms. Two weeks later, a 20-day regimen of the same antibiotic was begun. However, her dyspnea worsened and her exercise tolerance became severely compromised over the next week. This prompted an ER visit, where she was found to be hypoxic. On admission, she was tachypneic, and her oxygen saturation was 88% on room air. There were no signs of hypervolemia. Lung examination revealed fine inspiratory and expiratory rales from mid lungs to bases. An ABG revealed a partial pressure of oxygen of 61mm Hg on room air with an elevated alveolar-arterial oxygen gradient of 49 mm Hg. A CXR showed bilateral basilar infiltrates. Chest CT showed bilateral ground-glass opacities and bilateral basilar alveolar-filling defects. An echocardiogram and a workup for atypical pneumonias were both benign. Collagen vascular disease labs were remarkable for Rheumatoid Factor of 18, ESR 36, CRP 2.0, and ANA titer of 1:80, with the rest of the markers all within normal limits. Bronchoalveolar lavage showed no tumor cells. A transbronchial biopsy revealed organizing pneumonia and cellular interstitial pneumonia, but contained insufficient tissue to make a definitive diagnosis. A wedge biopsy showed prominent cellular interstitial pneumonia with only a minor component of organizing pneumonia leading to the diagnosis of NSIP. The patient recently began a trial of steroids.

Discussion
Dyspnea and cough are two of the most common complaints faced by internists. In this situation, these common complaints led to the diagnosis of an uncommon condition. This case illustrates the importance of having a high index of suspicion for idiopathic interstitial pneumonia in a patient with persistent dyspnea and cough. It further demonstrates the difficulty in teasing out the proper subtype of idiopathic interstitial pneumonia. Internists faced with similar cases should consider the benefit of a chest CT with potential biopsy, which could lead to an earlier diagnosis of a potentially treatable condition.

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Subspecialty Careers: Highlights about Careers in Internal Medicine: Hospital Medicine/Hospitalists

The Discipline
The national association for hospitalists, Society of Hospital Medicine, defines hospitalists as “physicians whose primary professional focus is the general medical care of hospitalized patients.” 95% of hospitalists are trained in internal medicine and 5% in family medicine.

Procedures
The scope of hospitalist practice may include the care of general medical patients and co-management of surgical cases, palliative care, and intensive care unit (ICU) patients. Common procedures are arthrocentesis, lumbar puncture, paracentesis, thoracentesis, and vascular access.

Training
Although fellowship training is currently not required of hospitalists, more than 20 fellowship programs exist. They are typically one to two years in length and offer additional certifications in public health, quality improvement and clinical research.

Certification
No certification currently exists for hospitalists.

Training Positions
Fewer than 50 hospital medicine fellowships are available annually.

Practice
In hospitalist practice, 34% are employed by hospitals, 20% employed by academic institutions, 20% by management companies, 20% by medical groups and the remainder in hybrid arrangements.

Major Professional Societies

  • Infectious Diseases Society of America

    • 66 Canal Center Plaza, Suite 600
    Alexandria, VA 22314
    (703) 299-0200

    http://www.idsociety.org

Major Professional Societies

Major Publications

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Advocacy Brief: Health Provisions in the Stimulus Package

The President signed the $787 billion economic recovery package on February 17, 2009. It included what many consider a “down payment” on health reform. A significant chunk of the package -- some $87 billion -- would go toward helping states fund their Medicaid programs. Another $10 billion goes to the National Institutes of Health and $700 million goes to the Agency for Healthcare Research and Quality. The package also includes funding to provide incentives to promote the use of electronic health record technology (EHRs).

Of particular interest to medical students and residents is the $500 million in funding that has been allocated to go toward health professions training programs through scholarships, loan repayment, and grants to training programs for equipment, considered a vital component in the quest to expand the nation's pool of primary-care physicians. Specifically, $300 million is allocated for the National Health Service Corps (NHSC) and $200 million is to be allocated to "all the disciplines trained through the primary care medicine and dentistry program, the public health and preventive medicine program, the scholarship and loan repayment program, the scholarship and loan repayment programs authorized in Title VII (Health Professions) and Title VIII (Nurse Training) of the PHS Act.

For the latest on the College’s advocacy efforts and what is going on in Washington, check out Bob Doherty’s Advocacy blog.

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Did You Know ACP Medical Student Members attend Internal Medicine 2009 for free?

ACP’s annual meeting, Internal Medicine 2009, will be held in Philadelphia, PA, from April 23-25, 2009. Internal Medicine 2009 is the premier scientific meeting for internal medicine and features over 250 scientific sessions and is free for ACP Medical Student Members. For details regarding the meeting, including information on discounts, housing and travel arrangements, visit: Internal_Medicine_2009.

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MKSAP for Students 4 Question 1

A 26-year-old woman is evaluated in the office for amenorrhea. Her last menstrual period was 3 months ago, and three home pregnancy tests have been negative. She has no other symptoms and takes no medications. Menarche occurred at age 12 years, and her menstrual cycle had been regular until 3 months ago. Upon further questioning, she recounts weekly headaches and occasional galactorrhea on breast palpation.

Physical examination, including neurologic examination and deep tendon reflexes, is normal. A pregnancy test is negative, and the prolactin level is 1665 ng/mL.

Which of the following is the most likely cause of this patient's hyperprolactinemia?

A. Chronic renal failure
B. Pregnancy
C. Primary hypothyroidism
D. Prolactin-producing pituitary tumor

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MKSAP for Students 4 Question 2

A 63-year-old man with chronic alcoholism has a 2-day history of fatigue and confusion. For the past 2 weeks, he has had fever and myalgias for which he is taking acetaminophen. Last week, he felt so ill that he stopped consuming alcohol. He has no history of injection drug use, blood transfusions, or known exposure to anyone with hepatitis.

On physical examination, temperature is 37.4 °C (99.3 °F). Findings include spider angiomata, mild splenomegaly, no hepatomegaly or ascites, and disorientation with asterixis.

Laboratory Studies

Hemoglobin 15 g/dL
Platelet count 91,000/µL
Aspartate aminotransferase 8124 U/L
Alanine aminotransferase 6557 U/L
Total bilirubin 1.2 mg/dL
Direct bilirubin 0.8 mg/dL
Creatinine 1.8 mg/dL
Ammonia 103 µg/dL

A peripheral blood smear is normal.

Which of the following is the most likely diagnosis?

A. Acetaminophen hepatotoxicity
B. Alcoholic hepatitis
C. Herpes simplex virus hepatitis
D. Thrombotic thrombocytopenic purpura

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MKSAP for Students 4 Answer 1

Answer: D: Prolactin-producing pituitary tumor

This patient presents with classic symptoms of a prolactinoma, i.e., amenorrhea and galactorrhea. Although the differential diagnosis for hyperprolactinemia is extensive, the most likely diagnosis in this patient is a prolactin-producing pituitary adenoma. It is critical to rule out pregnancy, as this is the most common physiologic reason for an elevated prolactin level. However, this patient is unlikely to be pregnant because she has had multiple negative pregnancy tests. Additionally, since she is otherwise healthy, it is unlikely that chronic renal failure is a cause of her elevated prolactin concentration. Two key clinical features that suggest a prolactinoma include the presence of headaches and a very high prolactin level. In general, prolactin levels greater than 100 to 200 ng/mL in a nonpregnant woman usually suggest a tumor instead of another cause.

Primary hypothyroidism is also important to consider, especially in women (who have a higher incidence of hypothyroidism than men). Primary hypothyroidism causes an elevation in prolactin concentration because thyrotropin-releasing hormone stimulates both thyroid-stimulating hormone and prolactin production from the pituitary gland. However, the most likely diagnosis for hyperprolactinemia in this patient is a pituitary tumor because she has had negative pregnancy tests, does not take any medications, has no symptoms to suggest chronic renal failure or hypothyroidism, and has a prolactin level >200 ng/mL.

Bibliography
1. Schlechte JA. Clinical practice. Prolactinoma. N Engl J Med. 2003;349:2035-41. [PMID: 14627789] [PubMed]

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MKSAP for Students 4 Answer 2

Answer: A, Acetaminophen hepatotoxicity

The most common causes of aminotransferase values >5000 U/L are acetaminophen hepatotoxicity, hepatic ischemia, and hepatitis due to unusual viruses such as herpes simplex virus. Because of depleted glutathione stores, patients with chronic alcoholism are at risk for developing acetaminophen hepatotoxicity when taking acetaminophen at lower doses than those necessary to cause liver damage in patients who drink alcohol moderately or not at all. Given this patient's clinical history, acetaminophen hepatotoxicity is the most likely diagnosis, and N-acetylcysteine is the most appropriate treatment. Although N-acetylcysteine is most effective if administered within 24 hours of acetaminophen ingestion, it can generally be given to patients who later develop hepatotoxicity.

This patient does not have alcoholic hepatitis, since this disease rarely causes aminotransferase values >400 U/L. Herpes simplex virus hepatitis is very unlikely because it occurs most often in pregnant or immunosuppressed patients and causes fever, aminotransferase values >5000 U/L, and often skin lesions. Thrombotic thrombocytopenic purpura (TTP) could account for this patient's fever, thrombocytopenia, mental status changes, and renal insufficiency. However, this patient has no evidence of the microangiopathic hemolytic anemia that is characteristic of TTP.

Bibliography
1. Lee WM. Drug-induced hepatotoxicity N Engl J Med. 2003;349:474-85 [PMID: 12890847] [PubMed]

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Succeed on your IM Clerkship Rotation!

ACP continues to help students prepare for clinical rounds and the end-of-rotation examination with the fully revised and updated Internal Medicine Essentials for Clerkship Students 2 and MKSAP for Students 4! Available individually or as a set, these fully integrated new editions ensure success on the IM Clerkship rotation! Check it out.

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Attend the Fifth Annual Internal Medicine Residency Fair

The Fifth Annual Internal Medicine Residency Fair will be held during ACP’s national scientific meeting, Internal Medicine 2009, on Saturday, April 25th. We have acquired a better location and time slot for the Residency Fair this year, which will be held from 11:30 a.m. to 1:30 p.m. in Exhibit Hall B of the Pennsylvania Convention Center, next to the Medical Student-Associate Poster Area and the action on the Exhibit Hall Floor.

At the Residency Fair, you will learn about internal medicine residency programs throughout the United States, while you gather essential information about the residency application process and the Match. You will also have the opportunity to practice your networking skills while introducing yourself to internal medicine residency program staff and meeting fellow medical students.

You may register for Internal Medicine 2009 online. If you have questions about the Residency Fair please e-mail Membership Development at mbrdev@acponline.org.

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Articles for Medical Students from ACP Internist and ACP Hospitalist

ACP Internist (formerly ACP Observer)

  • Heart failure, statins take center stage at AHA conference
    By Jessica Berthold
    Heart failure, headphones, statins and self-care were just some of the research topics presented at the annual American Heart Association Scientific Sessions conference.
  • A silent syndrome with serious side effects
    By Jessica Berthold
    Polycystic ovary syndrome can cause infertility, diabetes and/or metabolic syndrome, and distressing physical symptoms like hirsutism and alopecia. Fortunately, once internists recognize the symptoms the condition can be managed effectively.

ACP Hospitalist

  • Teaming up to fight superbugs
    By Susan FitzGerald
    The battle with drug-resistant bacteria has evolved into an all-out war in many hospitals, and fighting back with newer drugs no longer seems like the best defensive strategy. Instead, hospitals are deploying multidisciplinary teams to spread the word about prevention through judicious use of antibiotics.
  • Statin use in the acute care setting
    By Ethan Cumbler, ACP Member
    An expert summarizes best practices.

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Join Now: Sign-up today and begin enjoying the benefits of ACP Medical Student Membership.

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Your voice in these surveys is very important to ACP and enables us to continue to produce the high-quality publications that you expect.
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