March 2011

My Kind of Medicine: Real Lives of Practicing Internists: Real Lives of Practicing Internists: Terry Jerome Hundley, MD, FACP, Grace Hundley, MD, and Will Hundley

Internal medicine at the University of South Alabama College of Medicine in Mobile, Alabama is a Hundley family affair. Terry Jerome Hundley (T.J.), M.D., FACP,serves as an Assistant Professor of Medicine and Director of the Internal Medicine Clerkship. His wife, Grace Hundley, M.D., is Assistant Professor of Medicine, and teaches courses on pediatrics as well as internal medicine. T.J.'s younger brother, Will Hundley, is also a fourth year medical student at University of South Alabama College of Medicine, and is pursuing a residency in internal medicine.

Internal Medicine Interest Group of the Month: University of Hawaii John A. Burns School of Medicine

The Internal Medicine Interest Group (IMIG) at the University of Hawaii John A. Burns School of Medicine (UH JABSOM) was founded in 2006. Since its inception, it has been one of the most active and largest student interest groups at the school. Even before our IMIG was founded in 2006, UH JABSOM had won ACP Medical School Awards for student membership ranging 58-74.5% of the student body. The founding of IMIG in spring 2006 has resulted in record high levels of ACP student membership, ranging 77-83%. Our goals are to provide medical students with information about careers in internal medicine, foster communication with faculty, connect students with shadowing and research opportunities, and improve clinical skills and knowledge applicable to internal medicine.

Ask the Program Director

I have often been asked my career goals or where I see myself in 20 years. How vague or specific of an answer is appropriate? For example, would an appropriate response be "I see myself at a large academic institution where I can teach, do research and service work" or must I be as specific as "I would like to sub-specialize in GI"?

Feature: Clinical Skills Review Course at Internal Medicine 2011

Students can prepare for the USMLE Step 2 Clinical Skills Examination by participating in the Waxman Clinical Skills Center Step 2 Practice tutorials. These workshops consist of four stations that simulate the experience of the USMLE Step 2 Clinical Skills Exam. Professional teaching patients (standardized patients) will present you with common problems and provide expert feedback on your history and physical examination skills, communication skills, and written note.

Commentary Corner: Morbidity and Mortality of the "Physical Examination"

After two months of vacation, I was looking forward to something educational. Even though my vacation was not yet over, I found myself in the auditorium of the old college building on the third Thursday of the month for the routine departmental Morbidity and Mortality conference.

Winning Abstracts from the 2010 Medical Student Abstract Competition: Spontaneous Calcific Coronary Embolus From A Degenerative Calcific Aortic Valve: A Rare Cause Of Acute STEMI

A 79-year-old man presented with 3 hours of substernal chest pain. The patient had no prior history of chest pain or coronary artery disease. His pulse was 74 and his blood pressure was 104/70. Cardiovascular exam was notable for a grade II/VI mid peaking systolic ejection murmur at the upper sternal border and a soft second heart sound.

Subspecialty Careers: Interventional Cardiology

From the Latin word intervenire, "to come between," Interventional Cardiology is the branch of Cardiology responsible for catheter-based interventions in the management of ischemic heart disease, congenital heart disease, and acquired valvular disease.

In the Clinic: Deep Venous Thrombosis

Venous thromboembolism (VTE) is a relatively common and potentially life-threatening condition that affects approximately 100 persons per 100 000 per year in the United States (1). About one third of patients with VTE present with features of pulmonary embolism (PE), and two thirds present with features of deep venous thrombosis (DVT). Treated DVT has an excellent prognosis. The probability of fatal PE is 0.4% and the probability of nonfatal thromboembolism is 3.8% over a 3- to 6- month treatment period (2).

More

In the Clinic is a monthly feature in Annals of Internal Medicine that focuses on practical management of patients with common clinical conditions. It offers evidence-based answers to frequently asked questions about screening, prevention, diagnosis, therapy, and patient education and provides physicians with tools to improve the quality of care. Many internal medicine clerkship directors recommend this series of articles for students on the internal medicine ambulatory rotation.

Advocacy Update: 2011 ACP Health Policy Interns Selected

ACP is pleased to announce that David H. Slade, a third-year medical student at Southern Illinois University and Morganna Freeman-Keller, DO, an Internal Medicine resident at the University of Florida have been selected as the College's Health Policy Interns for 2011.

Internist Articles

Learning to parry patient requests
Negotiating the doctor-patient relationship requires understanding what a patient expects from treatment, instead of outright saying "no." There are easier ways to sort out what a request really means, and how to quickly address the real underlying issue.

Simple tools, teamwork manage depression in primary care
Embedding mental health professionals directly into a primary care setting threatens to add complexity to primary care's already hefty 'to do" list. Clinics that have accomplished that task explain how not only it was easier than expected, but it adds tremendous benefits to the practice.

Hospitalist Articles

Publishing your QI project: Enlist mentors, colleagues to help navigate the path to a polished manuscript. How do you know if your quality improvement project is a candidate for publication?

Student Hospitalist: Hospital medicine in South America