Failing the Boards—What Happens When the Board Fails Itself?
Play episode · 48 min

When trying to administer its qualifying examination during the COVID-19 shutdowns, the American Board of Surgery failed. Jo Buyske, MD, president and chief executive officer of the American Board of Surgery, discusses what went wrong and what they are doing to fix it.

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Association Between Resident Physician Training Experience and Program-Level Performance on Board Examinations

GeriPal - A Geriatrics and Palliative Care Podcast
GeriPal - A Geriatrics and Palliative Care Podcast
Alex Smith and Eric Widera
Palliative Care for non-cancer illness: Podcast with Kieran Quinn and Krista Harrison
In this week's podcast we talk with Kieran Quinn, author of a systematic review and meta-analysis of palliative care for non-cancer illness, published in JAMA. We also talk with Krista Harrison, first author of an accompanying editorial. JAMA editors cut out some of my favorite parts of Krista's editorial, possibly because they were more like a blog post than a JAMA editorial. (I was senior author; go figure how it ended up reading like a blog post!) So here is the submitted introduction, unedited: "As with many people’s best ideas, inspiration struck in the shower. Dr. Balfour Mount, a urologic-cancer surgeon at the Royal Victoria Hospital in Quebec, Canada, needed a name to differentiate a new hospital-based service he created for people with serious life-threatening illness from Dr. Cicely Saunders’ English hospice programs. Dr. Mount coined the term “palliative care” to connote the core goals of the service: to improve quality of life and to mitigate sources of distress. The field of palliative care was born. The year was 1975. Forty-five years later, palliative care retains its central focus on improving quality of life for people living with serious, life-limiting illnesses and their families by addressing physical and psychological symptoms, social and spiritual needs, and aligning patient and family values with available care options." In our podcast, we talk about the surprising finding in Keiran's study that palliative care for noncancer illness was associated with a modest improvement in symptoms, reduced hospitalization and emergency department use, increased advance care planning but not improved quality of life. How can palliative care, since inception designed to improve quality of life, not improve quality of life? Listen to the podcast to find out! -@AlexSmithMD
49 min
The Curbsiders Internal Medicine Podcast
The Curbsiders Internal Medicine Podcast
Matthew Watto MD, Stuart Brigham MD, Paul Williams MD
#239 Sinusitis: It’s Not That Tricky
A runny nose won’t have you running in circles this cold season with our fantastic overview of rhinosinusitis in all its forms! We discuss etiology and presentation of viral versus bacterial rhinosinusitis, practical counseling tips for guiding patients on nasal irrigation, and working up chronic rhinosinusitis! Our guest is the fabulous Dr. Dink Jardine, a general otolaryngologist, Commander in the US Navy, and Director for Professional Education (DPE) and Designated Institutional Official (DIO) at Naval Medical Center Camp Lejeune (NMCCL). Listeners can claim Free CE credit through VCU Health at http://curbsiders.vcuhealth.org/ (CME goes live at 0900 ET on the episode’s release date). CME Survey! Help us improve our CME! This survey will serve the purpose of creating a better experience for VCU Health and Curbsider’s Podcast users. It is conducted by VCU Da Vinci Students in the Masters of Product Innovation Program. The results of this survey will teach us insights on how we can provide an opportunity to improve your podcasting experience. We will not spam you in anyway, and your information will remain anonymous, as this data will be used for research purposes only. Show Notes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME! Credits * Written and Produced by: Paul Williams MD, FACP, Beth Garbitelli * Cover Art: Kate Grant MBChb, MRCGP * Infographic by: Beth Garbitelli * Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP * Editor: Molly Heublein MD (written materials); Clair Morgan of nodderly.com (audio) * Guest: Dink Jardine, MD Sponsors: National Internal Medicine Day Help ACP celebrate National Internal Medicine Day on October 28th. Visit https://www.acponline.org/NIMD20 to learn how you can show your internal medicine pride. Be sure to tag @ACPInternists and use the hashtags #NationalInternalMedicineDay, #IMProud, and #IMEssential. VCU Health CE The Curbsiders are partnering with VCU Health Continuing Education to offer FREE continuing education credits for physicians and other healthcare professionals. Visit curbsiders.vcuhealth.org and search for this episode to claim credit. See info sheet for further directions. Note: A free VCU Health CloudCME account is required in order to seek credit. Time Stamps * Sponsor – National Internal Medicine Day, The American College of Physicians * Sponsor - VCU Health Continuing Education * 00:30 Intro, disclaimer, guest bio * 03:00 Guest one-liner, Favorite failure, Pick of the Week*: Still Life by Louise Penny * Sponsor – National Internal Medicine Day, The American College of Physicians * 09:30 Case 1 - Acute Viral Rhinosinusitis * 10:40 Rhinosinusitis vs. Sinusitis * 14:20 Physical exam in rhinosinusitis * 20:40 Counseling patients about viral vs. bacterial infection * 22:56 Sinus regimen/nasal irrigation - “Is there a sinus toilet” * 27:10 Intranasal fluticasone and other intranasal medications * 29:40 Rhinitis medicamentosa * 30:40 Nasal spray positioning * 33:50 Case 1 - Double Sickening * 37:40 Worst case scenarios from rhinosinusitis * 40:40 Antibiotic treatment for bacterial rhinosinusitis * 43:20 Failed improvement on antibiotics? Second-line options * 49:30 Case 2 - Chronic rhinosinusitis * 52:28 Etiology of chronic rhinosinusitis * 53:33 Making a diagnosis of chronic rhinosinusitis * 55:25 Treating chronic rhinosinusitis * 58:40 Vasomotor rhinitis * 60:40 Sinus irrigation counseling and tips (YouTube) * 65:30 Case 3 - Allergic Rhinitis * 70:13 Oral medications for allergic rhinitis; Chronic allergic/non-allergic rhinitis * 73:51 Take-home points Links* * Still Life: A Chief Inspector Gamache Novel by Louise Penny, Chief Inspector Gamache series * “Dr. Adappa and Dr. Palmer teach you How to do Nasal Irrigation” https://www.youtube.com/watch?v=Br928VfiC1M *The Curbsiders participates in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising commissions by linking to Amazon. Simply put, if you click on our Amazon.com links and buy something we earn a (very) small commission, yet you don’t pay any extra. Goals Listeners will develop an approach to the diagnosis and management of rhinosinusitis. Learning objectives After listening to this episode listeners will... * Classify rhinosinusitis, including acute, chronic, bacterial, and viral. * Discuss the microbiology and pathophysiology underpinning rhinitis and sinusitis. * Differentiate the presentation and management of acute bacterial and acute viral rhinosinusitis. * Develop an approach to the diagnosis and management of allergic rhinosinusitis. * Recognize and manage patients with non-allergic rhinitis. * Discuss the role of antibiotic therapy and surgery in the management of rhinosinusitis. Disclosures Dr. Jardine reports no relevant financial disclosures. The Curbsiders report no relevant financial disclosures. Citation Williams PN, Garbitelli B, Jardine D, Heublein M, Watto MF.. “#239 Sinusitis: It’s not that tricky.” The Curbsiders Internal Medicine Podcast. https://thecurbsiders.com/episode-list Final publishing date October 26, 2020. Tags sinus, sinusitis, rhinitis, acute bacterial, rhinosinusitis, bacterial, viral, virus, nose, chronic sinusitis, ENT, primary care, assistant, care, doctor, education, family, FOAM, FOAMim, FOAMed, health, hospitalist, hospital, internal, internist, meded, medical, medicine, nurse, practitioner, professional, primary, physician, resident, student
1 hr 15 min
Bedside Rounds
Bedside Rounds
Adam Rodman, MD, MPH, FACP
58 - The Original (Antigenic) Sin
The COVID-19 pandemic laid bare the racial health disparities in the United States, with markedly increased mortality especially among Blacks and Native Americans. In this episode, Tony Breu and I discuss the conception of race, racism, and the social determinants of health through three historic plagues in the United States -- from yellow fever in New Orleans, to poliomyelitis, and finally the early days of HIV/AIDS -- and what lessons we can draw for COVID-19. Along the way, we’ll discuss the unique social capital afforded by acclimation, immunity passports, the concept of the “original antigenic sin,” and constitutionalism and eugenics. This presentation was performed live at the annual meeting of the Massachusetts American College of Physicians, and is only lightly edited. SOURCES: * Monath TP, Yellow fever: an update. Lancet Infect Dis. 2001 Aug;1(1):11-20. doi: 10.1016/S1473-3099(01)00016-0. * Kallas EG, D'Elia Zanella LGFAB, Moreira CHV, Buccheri R, Diniz GBF, Castiñeiras ACP, Costa PR, Dias JZC, Marmorato MP, Song ATW, Maestri A, Borges IC, Joelsons D, Cerqueira NB, Santiago E Souza NC, Morales Claro I, Sabino EC, Levi JE, Avelino-Silva VI, Ho YL. Predictors of mortality in patients with yellow fever: an observational cohort study. Lancet Infect Dis. 2019 Jul;19(7):750-758. doi: 10.1016/S1473-3099(19)30125-2. Epub 2019 May 16. Erratum in: Lancet Infect Dis. 2019 Nov;19(11):e370. PMID: 31104909. * Blake LE, Garcia-Blanco MA. Human genetic variation and yellow fever mortality during 19th century U.S. epidemics. mBio. 2014 Jun 3;5(3):e01253-14. doi: 10.1128/mBio.01253-14. PMID: 24895309; PMCID: PMC4049105. * Jelili Ojodu, MPH1, Mary M. Hulihan, MPH2, Shammara N. Pope, MPH2, Althea M. Grant, PhD2,, MMWR, Incidence of Sickle Cell Trait — United States, 2010. * IthaMaps, Haemoglobin Epidemiology. https://www.ithanet.eu/db/ithamaps?country=GR * Serjeant GR, The natural history of sickle cell disease. Cold Spring Harb Perspect Med. 2013 Oct; 3(10): a011783. * Hamosh A, FitzSimmons SC, Macek M Jr, Knowles MR, Rosenstein BJ, Cutting GR. Comparison of the clinical manifestations of cystic fibrosis in black and white patients. J Pediatr. 1998 Feb;132(2):255-9. doi: 10.1016/s0022-3476(98)70441-x. PMID: 9506637. * Gershman KD et al, Yellow Fever Vaccine & Malaria Prophylaxis Information, by Country. CDC. * Kofler N and Baylis F, Ten reasons why immunity passports are a bad idea. Nature 21 May 2020. * NASEM, National Academies Release Framework for Equitable Allocation of a COVID-19 Vaccine for Adoption by HHS, State, Tribal, Local, and Territorial Authorities. * Schmidt H et al, Covid-19: how to prioritize worse-off populations in allocating safe and effective vaccines.BMJ 2020; 371 doi: https://doi.org/10.1136/bmj.m3795 (Published 05 October 2020). * Siegal FP, Lopez C, Hammer GS, Brown AE, Kornfeld SJ, Gold J, Hassett J, Hirschman SZ, Cunningham-Rundles C, Adelsberg BR, et al. Severe acquired immunodeficiency in male homosexuals, manifested by chronic perianal ulcerative herpes simplex lesions. N Engl J Med. 1981 Dec 10;305(24):1439-44. doi: 10.1056/NEJM198112103052403. PMID: 6272110. * Lushniak BD, Surgeon General’s Perspectives. Public Health Rep. 2014 Mar-Apr; 129(2): 112–114. * Booske BC et al, “Different Perspectives For Assigning Weights to Determinants of Health,” University of Wisconsin Population Health Institute. * Marc LG et al,HIV among Haitian-born persons in the United States, 1985–2007, AIDS. Author manuscript; available in PMC 2011 Aug 24. * Rogers N, Race and the Politics of Polio: Warm Springs, Tuskegee, and the March of Dimes. Am J Public Health. 2007 May; 97(5): 784–795. * Curran JW and Jaffe HW, AIDS: the Early Years and CDC’s Response. MMWR. * Olivarius Kathryn, Immunity, Capital, and Power in Antebellum New Orleans. The American Historical Review, Volume 124, Issue 2, April 2019, Pages 425–455,
56 min
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