Background: Balancing attending supervision with resident autonomy is intended to ensure patient safety while allowing trainees to gain graduated competency and independence upon completion of residency. ACGME work-hour restrictions have increased attending supervision, but its effect on resident education and autonomy is unclear. In order to better understand the underlying tensions and contributing factors to [...]

Background: UChicago Medicine (UCM) Office of Operational Excellence (OE) uses an institutional Leadership model called “Engage, Evolve, Excel” (E3L) to improve care delivery with lean, six sigma, and patient centered values. The E3L model focuses on the four domains of value creation, patient-centered care, respect for people, and continuous improvement. A hallmark feature of E3L [...]

Case Presentation: A 75 year old woman with past medical history of hypothyroidism presented with weakness and the sensation of “large folds of skin” on the bottom of her feet. Pertinent physical exam findings included conjunctival pallor, nonspecific diffuse abdominal tenderness, and hyperpigmented macules of the dorsal finger tips and soles, which were also new [...]

Case Presentation: A 49-year-old healthy man presented to the emergency department with a two-year history of left inguinal pain that had been increasing in frequency and severity, to the point where he experienced difficulty with ambulation. He denied fevers, chills, weight loss, weakness or numbness in the extremity. Physical exam revealed a palpable left groin [...]

Case Presentation: 25-year-old male with a past medical history of von Willebrand disease, thrombocytosis presented to an outside hospital (OSH) with acute onset chest pain. An EKG there showed ST-segment elevation in anterior leads after which he was emergently taken to the cardiac catheterization laboratory. He was found to have an left anterior descending (LAD) [...]

Case Presentation: 63y old female with history of CHF, HTN, and hypothyroidism presented from primary care physician’s office for lab abnormalities. Review of systems was positive for decreased urine output, fatigue, and sinus congestion. Vitals were within normal limits and physical exam was non-contributary. Lab workup was significant for hypokalemia (2.9) and elevated Cr (4.0). [...]

Case Presentation: Introduction:Hiatal Hernia is a common condition. Hiatal hernias rarely cause cardiac symptoms such as dyspnea and chest pain. Here we present an extremely rare case of a giant hiatal hernia causing typical chest pain and actual ST-segment elevations in inferior leads of EKG. Case ReportThis is a case of 76-year-old female who presented [...]