Background: Health care policy is currently under scrutiny due to health care reform, yet in our experience the majority of house staff have insufficient opportunity to learn about the environment they will soon be practicing medicine in. The ACGME attempts to address this through the Systems-based practice competency, but further guidance is lacking. Purpose: Our [...]

Case Presentation: A 52-year-old female with a medical history of chronic sinusitis and recurrent pneumonia secondary to granulomatous disease presents with new onset AKI, worsening fatigue, malaise, weight loss, and transaminitis. She was given Solu-medrol, transitioned to prednisone with improvement. Chest X-ray revealed a patchy airspace opacity in the right middle lobe, concerning for pneumonia [...]