Background: Graduate medical education (GME) comprises residents and fellows being trained at a hospital but also providing essential patient care. At academic hospitals, residents and fellows are often the front-line physicians and an integral part of the interprofessional team. The Accreditation Council for GME (ACGME) requires annual participation by residents and fellows in quality improvement [...]

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: Recently, the Association of American Medical Colleges (AAMC) and the Accreditation Council for Graduate Medical Education (ACGME) put forth their latest expectations of residents using Entrustable Professional Activities (EPA). Furthermore, prompted by an interest in improving the health of the population, enhancing the experience and outcome of the patient, and reducing the per capita [...]

Background: Residents in Internal Medicine have traditionally taken electives that prepare or position them well for fellowships. Another purpose of elective time during residency is to expose the learner to career opportunities. As Hospital Medicine grows as a specialty, more training programs are offering electives for residents in this field. However, most elective descriptions that [...]

Background: Point-of-care ultrasonography (POCUS) is a real-time, diagnostic modality increasingly utilized by clinicians at bedside to obtain critical, potentially life-saving information. The benefits of becoming familiar and facile with POCUS have become so clear in recent years that numerous residency programs across specialties have intentionally incorporated ultrasound-focused education into their standard curricula. Furthermore, some medical [...]

Background: New ACGME Core requirements require active resident engagement in patient safety. Our institution’s most recent AHRQ Culture of Safety survey revealed poor ratings from residents for closed-loop feedback on event reports they had submitted. Since hospitalists are well-positioned to foster improvement in the culture of safety, we developed an interprofessional intervention in response. Purpose: [...]

Background:  While many institutions train housestaff to mitigate hospital hazards, few have exploited the crucial concept of situational awareness (i.e. mindfulness of the patient environment) to teach patient safety. One method to promote situational awareness is through the embedding of safety and low-value care hazards into simulation-based training exercises. Purpose: To assess incoming interns’ ability [...]

Case Presentation: A 51-year-old man with seropositive rheumatoid arthritis (RA) and chronic intra-abdominal arterial aneurysms attributed to RA-associated vasculitis presented with a one-day history of right upper quadrant abdominal pain and melena. His vital signs were within normal limits. Notable laboratory studies included hemoglobin 6.1 g/dL, total bilirubin 1.4 mg/dL, AST 161 U/L, ALT 217 [...]

Background: As the landscape of health care access and delivery has changed over the past 10 years, areas of coding, documentation, denials management, appeals, and reimbursement have become more confusing to navigate for most physicians delivering direct patient care. The physician advisor is an experienced physician who understands the rules and regulatory issues involving patient [...]

Background: Point-of-care ultrasound training programs (POCUS) have proliferated, but the best method of skills assessment remains unclear. Most published testing protocols assess only image acquisition and interpretation. In a clinical scenario, recognizing an indication for POCUS, selecting the appropriate exam, integrating findings with the other data from the case, and formulating a differential diagnosis and [...]