July 2012

Medical Student Perspectives: Revealing Unfortunate News

As quickly as I had read the report my attending said, "Our patient is coming in today and I would like you to discuss the results with her." He paused and went on to say, "This encounter is vital for you as a student to experience. You will learn more today than you probably will this entire rotation." I could not believe what I had just heard. A feeling of inadequacy fell over me. I asked myself how I would be able to do it.

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My Kind of Medicine: Real Lives of Practicing Internists: Kristina Krohn, MD, Stanford-NBC News Global Health and Media Fellow

Dr. Kristina Krohn's initial interest in practicing medicine internationally stemmed from her parents' work with the Peace Corps in Africa. As a child, Dr. Krohn was always interested in math and science. She jokes that when she was ten years old she wanted "to be a surgeon in sub-Saharan Africa." Dr. Krohn was born and raised in Minnesota, in a small town of around 12,000 residents. She attended Macalester College in St. Paul, Minnesota where she received her Bachelor's Degree in biology. While attending Macalester College, she met several friends who were applying to medical school and many who were in their residencies. "They told me to make sure that going into medicine was exactly what I wanted to do, because otherwise I would be unhappy with the time and commitment it takes to become a physician. It was one of those things where there was nothing else besides medicine that I could imagine myself doing that would make me happy."

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Internal Medicine Interest Group of the Month: University of Colorado School of Medicine

The field of internal medicine presents a vast number of career opportunities for people with diverse personalities and interests. It can be daunting for a medical student to navigate the field and its subspecialties alone. The Internal Medicine Interest Group (IMIG) at the University of Colorado School of Medicine (CUSOM) aims to guide our classmates through the maze of career paths within internal medicine in hopes of helping some of them find a treasured career as an internist upon completion of their training.

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Ask the Program Director: Submit your questions today!

Ask the Program Director is a feature that focuses on providing medical students practical advice to help you navigate the process of obtaining a residency position in internal medicine. Issues covered include things like CV development, writing a personal statement, the Match process, residency program interviews, and more. Do you have a question for program directors?

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Advocacy Update: The Supreme Court and the Affordable Care Act: Milestone or Detour on the Road to Universal Coverage?

The Supreme Court's decision to uphold the Patient Protection and Affordable Care Act (Affordable Care Act, or ACA) may correctly be viewed as a milestone on the path to universal coverage, especially considering the 32 million uninsured persons who would have lost the opportunity to obtain coverage if the court had overturned the entire law. Yet, the Court's surprising decision to allow states to opt out of expanding Medicaid could result in coverage looking a bit like Swiss cheese, with big gaps for the most vulnerable, rather than the seamless expansion of coverage originally expected.

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Winning Abstracts from the 2012 Medical Student Abstract Competition: Pulmonary Hypertension 15 Years Following Aspergillus Empyema: Case Report and Review of the Literature

Pulmonary arterial hypertension (PH) is a devastating condition that results in small vessel fibrosis and destruction. There are numerous potential etiologies, and treatment of PH is based on the World Health Organization (WHO) Classification System. Group 5 of the WHO Classification System includes PH with unclear multifactorial etiologies such as hematologic disorders, metabolic disease and sarcoidosis.

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Subspecialty Careers: Pulmonary Disease

From the word pulmo, Latin for "lung." Pulmonary medicine is the diagnosis and management of disorders of the lungs, upper airways, thoracic cavity, and chest wall. The pulmonary specialist has expertise in neoplastic, inflammatory, and infectious disorders of the lung parenchyma, pleura and airways; pulmonary vascular disease and its effect on the cardiovascular system; and detection and prevention of occupational and environmental causes of lung disease. Other specialized areas include respiratory failure and sleep-disordered breathing.

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In the Clinic: Smoking Cessation

In the Clinic

According to the U.S. Centers for Disease Control and Prevention (1), 21% of American adults (44.5 million people) and 22% of American high school students (3.75 million people) smoke cigarettes. Although per capita tobacco use in the United States has decreased dramatically since the 1950s, it is unlikely that the United States will reach the Healthy People 2010 objectives of reducing smoking prevalence to less than 12% in adults and less than 16% in youth (2). Tobacco use is an even bigger public health threat in many regions outside of the United States. Many people who smoke wish that they could stop, but quitting is difficult and failure is common.

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In the Clinic is a monthly feature in Annals of Internal Medicine that focuses on practical management of patients with common clinical conditions. It offers evidence-based answers to frequently asked questions about screening, prevention, diagnosis, therapy, and patient education and provides physicians with tools to improve the quality of care. Many internal medicine clerkship directors recommend this series of articles for students on the internal medicine ambulatory rotation.

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Highlights from ACP Internist® & ACP Hospitalist®

Test Yourself: From the MKSAP case studies

A 27-year-old woman is evaluated in the emergency department for a 2-day history of diffuse headache, fatigue, and gingival bleeding on brushing her teeth. She is otherwise healthy. She is alert and oriented but reports having a headache. Petechiae that had gone unnoticed by the patient are visible on the lower extremities. What is the most appropriate next step in management?

Asking questions to better understand

Apps for newbies: If used wisely, technology can help new hospitalists
Learn how to make the most of mobile technology.

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