May 2013

Medical Student Perspectives: I'm a Parent and a Medical Student

I am a third-year medical student, and I have four school-aged children. In general, I have found being a parent while in medical school to be more good than bad. It does require a bit of juggling, a lot of support, and the willingness to be less than perfect (that one has been tough). Read on to find out some of the "special" challenges faced by students who are also parents.

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My Kind of Medicine: Real Lives of Practicing Internists: Fatima Cody Stanford, MD, MPH

Born and raised in Atlanta, Dr. Stanford says she remembers always wanting to be a doctor. When she was just three years old, a great aunt asked her if she was going to grow up and be a nurse, to which the young Fatima replied, "not nurse, doctor." For Dr. Stanford, academic achievement was a goal instilled in her at an early age by her maternal grandmother who tutored her so well in her pre-school years she was able to skip first grade. Her father, a fine artist, and her mother, a corporate director with Macy's encouraged their daughter's passion for learning and introduced her to their physician friends who became her early mentors.

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IMIG Update: Apply for funding by June 1

Don't let your internal medicine interest group miss out on valuable funding for 2013-2014! Early bird applications are due by June 1, 2013. Visit www.acponline.org/imigapp and apply today.

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Winning Abstracts from the 2013 Medical Student Abstract Competition: A Bundle Approach to Improving Opioid Treatment of Chronic Non-Cancer Pain in a Primary Care Setting

This project evaluated Plan-Do-Study-Act (PDSA) methodology in changing opioid prescribing practice to comply with state legislation while monitoring its effect on aberrant behaviors.

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Subspecialty Careers: Sports Medicine

The discipline of sports medicine primarily concerns itself with the emergency assessment and care of acutely injured athletes, diagnosis, treatment and management of common sports injuries and illnesses, management of medical problems of the athlete, rehabilitation of ill and injured athletes, and exercise as treatment.

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In the Clinic: Low Back Pain

In the Clinic

Low back pain has a lifetime prevalence of nearly 80% and is the fifth most common reason for physician visits in the United States (1). It is also costly, accounting for a large and increasing proportion of health care expenditures without evidence of corresponding improvements in outcomes (2). Most low back pain is due to nonspecific musculoskeletal strain, and episodes generally resolve within days to a few weeks with self-care. Up to one third of patients, however, reports persistent back pain of at least moderate intensity 1 year after an acute episode, and 1 in 5 report substantial limitations in activity (3). Because low back pain is common, chronic, and can lead to substantial disability, it is important that physicians be proficient with its evaluation and management.

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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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What's the diagnosis?
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Highlights from ACP Internist® & ACP Hospitalist®

Rheumatology: Early interventions overlooked in OA
Osteoarthritis has been somewhat neglected, according to a recently formed consortium that's advocating for more proactive diagnosis and intervention. Earlier screening and a less reactive approach might head off some of the worst of the functioning difficulties and related treatment costs.

Do work hours reduce medical errors?
I have supported medical education reform advocating that medical residents and interns should not be worked to exhaustion and yet be expected to administer high quality and compassionate care to ill patients. I had believed that somnambulating medical interns were more likely to harm patients with careless care. I believed that this was true because it seemed entirely self-evident.

Test Yourself: From the MKSAP case studies
A 55-year-old man is evaluated in the emergency department after experiencing fever and chills yesterday evening and bilateral arm pain and a rash on the upper extremities upon awakening this morning. The patient ate raw oysters from the Gulf Coast 3 nights ago. He was recently diagnosed with hemochromatosis. Which pathogen is most likely causing the patient's current findings?

Q&A: Michelle Mourad, MD, ACP Member: Time to teach
Everybody believes somebody should do it, but nobody has the time to figure out whose job it is. Such is the problematic status of patient discharge education.

Cover Story: The prescription for pain management
Physicians can wield considerable influence to ease the suffering of patients in pain, starting with identifying the optimal drug and administering it before pain escalates.

Your Practice: Yes, sickle cell is a pain: Tips and programs for improving inpatient sickle cell care
For most patients, dealing with pain will be a temporary issue. For sickle cell patients, it's a lifetime struggle.

Test Yourself: MKSAP quiz on sickle cell anemia
These cases and commentary, which address sickle cell anemia, are excerpted from ACP's Medical Knowledge Self-Assessment Program (MKSAP16).

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