Case Presentation: A previously healthy 4-year-old female born in Mexico was sent to the emergency department for elevated blood pressures noted at her routine outpatient clinic visit. On arrival, her blood pressure was 161/126. The patient reported polydipsia, polyuria, and weight loss. Her initial physical exam was unremarkable and her vitals were otherwise within normal [...]

Background: Physician burnout is a previously described and increasingly studied phenomenon that affects all fields of medicine to varying degrees. The Maslach Burnout Inventory (MBI) has been the historical gold standard for assessing burnout, but multiple new methods have been developed in recent years as greater attention is being paid towards physician wellness and burnout. [...]

Background: Lumbar puncture and paracentesis are core competencies in internal medicine, but residents frequently report discomfort performing these procedures unsupervised. Simulation-based training (SBT) has previously been shown to improve resident performance of lumbar punctures on patients, but outcomes after paracentesis SBT have only been assessed on simulators. We hypothesized that SBT would improve internal medicine [...]

Background: Obesity is associated with many cardiopulmonary comorbidities independently associated with worse health outcomes in acute illness, yet the physiological mechanisms potentially making obese patients more susceptible to COVID-19 remain uncertain. Adiposity-derived immunosuppression, increased thrombogenic potential, and predilection towards inflammatory hyperreactivity have all been postulated as potential mediators of this phenomenon. Yet, the most obvious [...]

Case Presentation: A 47-year-old woman with lupus presented with one week of urinary frequency and dysuria. Over the prior year, she had pelvic pain, night sweats, 20 pounds of unintentional weight loss, and eight episodes of pan-susceptible E. coli urinary tract infections (UTIs), each successfully treated. Her chronic medications were prednisone, hydroxychloroquine, and azathioprine.A computed [...]

Background: Since 1951, medical television dramas have impacted how the public views, understands, and learns about the medical profession. Previous studies have examined how these shows depict topics such as cardiopulmonary resuscitation; other studies have shown that medical television dramas influence viewers’ perceptions of the healthcare profession. Our particular area of interest is that of [...]

Background: Resistance in learning (RIL) defines a set of attitudes or behaviors demonstrated by learners in an educational setting that result in decreased learning. Literature describes the etiology as multifactorial, including learning environment, characteristics of the learner, and teaching style. Hospitalists often use quality improvement methodology, such as PDSA cycles to improve the clinical care [...]

Case Presentation: A 60-year-old woman with no past medical history presented for evaluation of progressive dizziness with associated right-sided hearing loss. On exam, a fluctuant right occipital scalp abscess was noted. CT of the head was suspicious for mastoiditis. She underwent incision and drainage and was subsequently discharged with oral Amoxicillin-clavulanate. Her symptoms persisted for [...]

Background: Despite advances in pharmacologic care for side effects of Hematopoietic stem cell transplant, patients often suffer from long hospitalizations, multiple side effects including fatigue, insomnia, nausea, anxiety, and poor sleep. Non-pharmacologic treatments for side effects of therapy are attractive adjuncts due to a low side effect profile. Purpose: To develop, implement and evaluate a [...]

Background: Many academic hospitalists begin their careers directly after residency and are expected to become teaching attendings without additional training or experience. Early attendings must quickly learn how to balance autonomy and supervision, advance patient care, and educate a wide spectrum of learners. Although tools such as faculty development workshops or peer observation programs are [...]