February 2011

My Kind of Medicine: Real Lives of Practicing Internists: Karen DeSalvo, MD

Dr. DeSalvo is an Internist and Associate Professor at Tulane University School of Medicine.

Feature: Primary Care Progress Engages Trainees in Transformation of Primary Care

Students, trainees and clinicians at academic medical centers across the country have launched a new national organization dedicated to engaging local communities to promote primary care, innovate in care delivery and prepare the next generation of leaders in primary care.

Internal Medicine Interest Group Update

The 2010-2011 IMIG recruitment period closed at the end of December, with 42 schools reaching the 30% participation goal for Student Membership. The 135 medicals schools with an ACP sponsored IMIG program recruited a total of 2,873 new student members and an additional 1,713 student members were recruited at schools without an IMIG program.

Winning Abstracts from the 2010 Medical Student Abstract Competition: A Benign Cause of Neck Swelling In The HIV Patient

The combination of multiple parotid cysts with diffuse cervical lymphadenopathy suggests the diagnosis of benign lymphoepithelial cysts of the parotid gland, a condition that may herald the diagnosis of HIV. Antiretroviral therapy for this condition may be curative.

Subspecialty Careers: Nephrology

The commonly encountered conditions in nephrology include disorders of fluid, electrolyte, and acid-base balance. Other problems include disorders involving the glomerulus, asymptomatic urine abnormalities, tubulointerstitial disorders, renal vascular diseases, renal failure, nephrolithiasis, tubular defects, and infections and neoplasms of the kidney, collecting system, and bladder. The nephrologist must understand how systemic diseases affect the kidneys, and recognize the potential toxicities of various therapeutic and diagnostic agents.

In the Clinic: Nephrolithiasis

As many as 13% of men and 7% of women in the United States will have at least 1 kidney stone. Recent evidence suggests that the prevalence of kidney stones is increasing (1), perhaps because they are associated with hypertension, diabetes, obesity, chronic kidney disease, and the metabolic syndrome (2, 3). Between 1994 and 2000, outpatient visits for stone disease increased by 40%, and office visits increased by 43%. Stones recur frequently, with 50% of patients having a second stone within 5 years of the first one, and 80% having a second stone within 20 years.

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: If you don't speak for Internal Medicine, who will?

ACP's continued success on Capitol Hill greatly depends upon year-round grassroots support from the College's more than 7,000 Key Contacts. Key Contacts e-mail, call and meet with their members of Congress on issues of importance to medical students, internists and their patients, and report the results back to ACP.

To enroll as a Key Contact, ACP members are not required to have existing relationships with their members of Congress. ACP gives them the tools necessary to develop and maintain relationships. The program is open to all membership categories.

Internist Articles

On the alert for a quiet killer
Patients developing sepsis may go undiagnosed because the early symptoms can be subtle or suggest other disorders.

M&M conferences get swept up in QI trend
M&M conferences now increasingly focus on the underlying causes of errors and what can be learned from them.

How many are too many for CT scans?
As many as one-third of the 70 million imaging tests ordered during the year may not be needed. Experts attempt to determine whether repeated radiation scanning doses could prove potentially yet unintentionally harmful.

Lack of kidneys for transplant raises debates
A shortage of transplantable organs has led to previously unthought-of issues that entangle ethics, policy, costs and clinical complications. Internists now must consider transplant tourists, long waits and "donation chains" as factors in their patient counseling.

Ask the Program Director

IMpact is developing a new feature that will focus on providing medical students practical advice to help them navigate the process of obtaining a residency position in internal medicine. Issues to be covered include CV development, writing a personal statement, the Match process, residency program interviews, and more.

At this time, we are collecting questions and issues that medical students would like addressed by program directors, program coordinators, clerkship directors and chief residents. We will then recruit volunteers to answer those questions in a series of monthly columns that will be included in upcoming newsletter editions.

Answers to your questions will begin starting next month. It's not too late to submit your question for a future issue of IMpact.

Virtual Dx^SM - Interpretive Challenges from ACP

We are pleased to announce our newest form of self assessment education, Virtual DxSM is an online-only program that uses images and studies to challenge your diagnostic ability in a way that no textbook can. See it for yourself here: Virtual Dx ^SM - Interpretive Challenges from ACP.