Case Presentation: A 59-year-old Caucasian male eight months post liver transplant on Tacrolimus and Prednisone and one month post COVID-19 infection presented to our hospital with progressive weakness. Ten days prior to presentation he noted paresthesias of bilateral upper and lower extremities. This progressed to distal 4/5 weakness in all extremities, dysphagia, dysarthria, severe lower [...]

Case Presentation: Reversible posterior leukoencephalopathy syndrome (RPLS) is characterized by a combination of clinical symptoms and radiographic findings. Clinical signs range from headaches and visual disturbances, to more classic seizures.1 Radiologic findings usually include vasogenic edema in the white matter of the posterior lobes of the brain, especially occipital and parietal.2 Multiple etiologies have been [...]

Case Presentation: A 28-year-old man with ulcerative colitis treated with adalimumab presented with headache, fever and sinus symptoms that progressed over two weeks to neck stiffness, “clouded” thinking, and intermittent left arm and facial numbness. On physical examination, he had normal cardiorespiratory findings. He had mild nuchal rigidity but an otherwise normal neurologic examination. CT [...]

Background: Microaggressions are subtle, indirect words or actions that create hostility, communicate disrespect, or imply a sense of exclusion. Over time, these microaggressions can contribute to physician burn-out and negatively impact well-being. Although studies have found that a majority of physicians have been subjected to these deleterious comments by patients, many physicians have never received [...]

Background: Managing clinical deterioration in hospitalized patients is a major component of patient care. When medical students transition to residency, they are expected to manage patients who acutely decompensate in rapid response scenarios, often without dedicated training or exposure on their clerkship rotations. Simulation center training (SIM) has been utilized to help trainees recognize and [...]

Background: At many academic institutions, medical students in their last year of training participate in transition-to-residency (TTR) courses. At our institution, our TTR course includes residency-specific tracks including one for students transitioning into Internal Medicine. Purpose: Despite the frequency of cross-cover care, studies note that this skill is not often formally taught, and most incoming [...]

Background: Newly graduated advanced practice providers (APP) face numerous hurdles in hospital medicine which may hinder the independent practice of APPs. APPs are tasked with assessing, diagnosing, beginning treatments, and discussing recommendations from various specialists with patients and their families. Despite overlapping responsibilities with physicians, there is wide variation in how APPs are prepared, both [...]

Background: A core ability of a capable Internal Medicine resident is ability to manage inpatient emergencies like arrhythmias and cardiac arrest. However, between 30-35% of first-year residents at our residency program fail their first attempt at an arrhythmia and cardiac arrest simulation exam, and more than 75% report not feeling confident by the end of [...]

Background: The scope of Point-of-Care Ultrasound (POCUS) use in hospital medicine continues to expand. Despite the noted benefits in diagnostic accuracy, the use of POCUS in hospital medicine is varied. A prospective study of hospitalists in 2022 showed that diagnostic POCUS use has increased nationally for cardiac, pulmonary, and abdominal applications. The most common barrier [...]

Background: Discrimination towards trainees is a pervasive problem and surveys show that it is often perpetrated by patients (1,2). Trainees are especially vulnerable to discriminatory behavior, with negative impacts on their education and wellbeing (3,4). Fellow clinicians, including faculty and advanced practice providers (APPs), play an important role in managing these issues and ensuring a [...]