I loved my endocrinology block in medical school. It was one of my favorite units. One hormone acts on another gland, which either induces a positive feedback releasing its successor hormone or a negative feedback blocking its predecessor. It was step-by-step. It was straightforward. I loved the material so much that I reached out to an endocrinologist to shadow her. I wanted to see the power of what we were learning ...

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One day, I was full of moderate despair, overworked, befuddled by the EHR with a tinge of burnout, staring at my computer, I treated myself to something I’ve not done before. It was my 62nd birthday that day, and I gave myself a birthday present. Before rising from that swivel chair, I had written down on a sticky pad the day that would be my retirement date, exactly one year ...

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In mid-February, thousands flocked to the opening of Black Panther, a highly anticipated film for a multitude of reasons. The most salient of these is its depiction of an African king as Marvel’s and cinematic screen’s first culturally-affirming black superhero. In fact, Black Panther’s success is due to its emergence as a counter-narrative to painful and dysfunctional representations of black life. By normalizing the presence of black royals, diplomats, and ...

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Too often, residents want you to address something, so they don't have to — except for infectious problems where they putz around with antibiotics until lunchtime on Friday, then call ID. For me, one example seemed rather routine: a diabetic with another medical illness. It wasn't terribly well defined in the hospital records, but included atrial fibrillation and congestive failure at presentation. At day nine, with pressure from the DRG lady ...

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Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 62-year-old woman is evaluated for an incidentally discovered left adrenal mass. Two weeks ago, the patient was evaluated in the emergency department for diffuse abdominal pain and vomiting. A CT scan was obtained that was normal except for the adrenal mass. Three hours after presentation to the emergency ...

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As a medical student, I have big shoes to fill. I feel that void in my foot-space at all times. These shoes are expensive, and they are monstrously huge. We’re talking circus-clown, Shaquille O’Neal, Andre the Giant shoes. I feel awkward in these size 24s. I’m stumbling and scuffing them, but I’m not even close to calling it quits. These shoes are staying on. I am trying as hard as ...

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Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 27-year-old woman is evaluated for management of her type 1 diabetes mellitus. She was diagnosed 10 years ago. She has no known complications from her diabetes. She eats a healthy diet and exercises an average of 60 minutes per day in the evening. She takes insulin glargine and ...

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Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 64-year-old man is evaluated for his quarterly diabetes care follow-up visit. Point-of-care HbA1c level is not at goal for this patient, who has high function, long life expectancy, few comorbidities, good support, health literacy, and access to care. Medical history is significant for hypertension, hyperlipidemia, and obesity. His family history ...

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As doctors, we simply want to spend more time with our patients. As a doctor for 13 years, and someone who now recruits doctors as a large part of my job, I’m witnessing the battle for more time with patients wage on, but there are no winners. Patients are waiting longer for hurried appointments. We spend more of what little time we have, prescribing and referring out because we’re racing ...

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Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 40-year-old woman is evaluated for amenorrhea of 4 months' duration. She has had weight gain, facial hair, alopecia, and debilitating fatigue. Her medical history is significant for psoriasis. She seems to be gaining weight in her face, abdomen, and neck. She also bruises easily. Her only ...

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