{"title":"Implementation of a Longitudinal Personal Finance Curriculum into Resident Medical Education.","authors":"Arohi Saxena, Rakhee K Bhayani, Fahd A Ahmad","doi":"10.14423/SMJ.0000000000001802","DOIUrl":"https://doi.org/10.14423/SMJ.0000000000001802","url":null,"abstract":"<p><strong>Objective: </strong>Residents frequently graduate medical school with a significant amount of debt and low financial literacy. Historically, there has been a lack of standardized, longitudinal financial education curriculum to educate residents about important financial principles. Our objective was to design and implement a longitudinal curriculum to cover a variety of personal and professional finance topics relevant to Pediatrics and Internal Medicine residents.</p><p><strong>Methods: </strong>Beginning in 2016, we integrated four lectures per year on personal and professional finance into the noontime curriculum for Internal Medicine and Pediatrics residents at Washington University School of Medicine with topics repeating over a 3-year cycle. We distributed surveys to residents to evaluate the program during its first 4 years; however, we halted collection in 2020 with the transition to a virtual/hybrid model during the coronavirus disease 2019 pandemic. The knowledge and behavior survey contained both Likert scale questions (1 = strongly disagree, 2 = disagree, 3 = neither agree nor disagree, 4 = agree, 5 = strongly agree) and dichotomous yes/no questions assessing certain behaviors and knowledge.</p><p><strong>Results: </strong>A mean of 80 out of 240 (33%) total residents (standard deviation 17) attended each lecture yearly between 2016 and 2020. The mean postlecture survey response rate was 16% (standard deviation 8.1%). Analysis of first-year survey data showed significant improvements in knowledge domains related to employment contracts, negotiation, and physician practice structures. The qualitative feedback was overall positive, and several trainees commented on the relevancy of the physician-led sessions.</p><p><strong>Conclusions: </strong>We successfully integrated a longitudinal personal finance curriculum into resident medical education to support personal and professional development throughout the stages of their career.</p>","PeriodicalId":22043,"journal":{"name":"Southern Medical Journal","volume":"118 3","pages":"150-154"},"PeriodicalIF":1.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143543479","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Hanna Waltz, Lilianne Kaminski, Kyndall Dye-Braumuller, Matthew Haldeman, Emily Owens Pickle, Melissa S Nolan
{"title":"α-Galactose Syndrome Cases within the Prisma Health System, South Carolina.","authors":"Hanna Waltz, Lilianne Kaminski, Kyndall Dye-Braumuller, Matthew Haldeman, Emily Owens Pickle, Melissa S Nolan","doi":"10.14423/SMJ.0000000000001799","DOIUrl":"https://doi.org/10.14423/SMJ.0000000000001799","url":null,"abstract":"<p><strong>Objectives: </strong>Humans can develop a vector-associated allergy to galactose-α-1,3-galactose (α-gal) a polysaccharide found in mammalian meats and by-products, resulting in α-gal syndrome (AGS). <i>Amblyomma americanum</i> tick bites have been implicated in AGS development in the United States, but the AGS clinical burden in South Carolina is not well understood. Because <i>A. americanum</i> is the predominant tick species in the state and large AGS cohorts exist in neighboring states, the potential for AGS clinical cases in South Carolina exists. Increased understanding of high-incidence geographical clusters is critical for clinical and public education given the potential for severe anaphylaxis.</p><p><strong>Methods: </strong>We conducted a 5-year retrospective chart abstraction of AGS patient cases serologically confirmed within the state's largest healthcare system to characterize this condition in South Carolina's Upstate and Midlands regions.</p><p><strong>Results: </strong>From October 2017 to February 2023, 50 patients were serologically diagnosed as having AGS within the Prisma Health system. Cohort demographics were mostly older, White males, and Black patients were significantly underrepresented in the AGS caseload (<i>P</i> = 0.0004). Immunosuppressing comorbidities and cooccurring allergies were common.</p><p><strong>Conclusions: </strong>This article presents the first clinical AGS case series in South Carolina, warranting further clinical and public education and a need for continued clinical research on this emerging tick-associated condition.</p>","PeriodicalId":22043,"journal":{"name":"Southern Medical Journal","volume":"118 3","pages":"161-166"},"PeriodicalIF":1.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143543538","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Adam Cohen, Jersey Burns, Martina Gabra, Alex Gordon, Nicholas Deebel, Ryan Terlecki, Katherine L Woodburn
{"title":"Performance of Chat Generative Pre-Trained Transformer on Personal Review of Learning in Obstetrics and Gynecology.","authors":"Adam Cohen, Jersey Burns, Martina Gabra, Alex Gordon, Nicholas Deebel, Ryan Terlecki, Katherine L Woodburn","doi":"10.14423/SMJ.0000000000001783","DOIUrl":"https://doi.org/10.14423/SMJ.0000000000001783","url":null,"abstract":"<p><strong>Objectives: </strong>Chat Generative Pre-Trained Transformer (ChatGPT) is a popular natural-language processor that is able to analyze and respond to a variety of prompts, providing eloquent answers based on a collection of Internet data. ChatGPT has been considered an avenue for the education of resident physicians in the form of board preparation in the contemporary literature, where it has been applied against board study material across multiple medical specialties. The purpose of our study was to evaluate the performance of ChatGPT on the Personal Review of Learning in Obstetrics and Gynecology (PROLOG) assessments and gauge its specialty specific knowledge for educational applications.</p><p><strong>Methods: </strong>PROLOG assessments were administered to ChatGPT version 3.5, and the percentage of correct responses was recorded. Questions were categorized by question stem order and used to measure ChatGPT performance. Performance was compared using descriptive statistics.</p><p><strong>Results: </strong>There were 848 questions without visual components; ChatGPT answered 57.8% correct (N = 490). ChatGPT performed worse on higher-order questions compared with first-order questions, 56.8% vs 60.5%, respectively. There were 65 questions containing visual data, and ChatGPT answered 16.9% correctly.</p><p><strong>Conclusions: </strong>The passing score for the PROLOG assessments is 80%; therefore ChatGPT 3.5 did not perform satisfactorily. Given this, it is unlikely that the tested version of ChatGPT has sufficient specialty-specific knowledge or logical capability to serve as a reliable tool for trainee education.</p>","PeriodicalId":22043,"journal":{"name":"Southern Medical Journal","volume":"118 2","pages":"102-105"},"PeriodicalIF":1.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143068043","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Firearm Shootings: A Serious Public Health Issue.","authors":"Steven Lippmann","doi":"10.14423/SMJ.0000000000001781","DOIUrl":"https://doi.org/10.14423/SMJ.0000000000001781","url":null,"abstract":"","PeriodicalId":22043,"journal":{"name":"Southern Medical Journal","volume":"118 2","pages":"140"},"PeriodicalIF":1.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143068038","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Increasing Communication about Fall Risk and Prevention between Internal Medicine Residents and Older Adults.","authors":"Mary L Thomas, Yulu Pan, Christopher D Jackson","doi":"10.14423/SMJ.0000000000001786","DOIUrl":"https://doi.org/10.14423/SMJ.0000000000001786","url":null,"abstract":"<p><strong>Objectives: </strong>More than one in four older adults fall yearly, but fewer than half inform their doctors. As such, medical trainees must gain experience assessing fall risk in older adults. Studies exploring how often residents initiate these assessments and which interventions effectively increase this frequency are needed. The objective of our study was to determine whether a reminder survey increases the frequency and proportion of resident-initiated fall risk and prevention discussions between Internal Medicine residents and older adults.</p><p><strong>Methods: </strong>This quantitative pre- and postintervention study used an anonymous survey distributed to residents within one urban Internal Medicine resident clinic. For 1 week, residents were exposed to Stopping Elderly Accidents, Deaths, and Injuries fall risk assessments completed by patients 65 years and older to stimulate fall risk and prevention discussions. Residents completed the same survey 3 months after intervention withdrawal.</p><p><strong>Results: </strong>Postintervention, there was a statistically significant increase in the proportion of resident-initiated fall risk and prevention discussions (43% vs 81%, <i>P</i> = 0.03). Although not statistically significant, residents reported initiating fall risk (14% vs 19%, <i>P</i> = 1) and fall prevention (3.6% vs 19%, <i>P</i> = 0.25) discussions more frequently, and fewer residents reported forgetfulness as a barrier to having these discussions (57% vs 44%, <i>P</i> = 0.59).</p><p><strong>Conclusions: </strong>Exposure to the Stopping Elderly Accidents, Deaths, and Injuries fall risk tool is a promising reminder intervention to increase the frequency and proportion of resident-initiated fall risk and prevention discussions; however, larger multisite studies are needed to assess the statistical significance of these findings.</p>","PeriodicalId":22043,"journal":{"name":"Southern Medical Journal","volume":"118 2","pages":"114-117"},"PeriodicalIF":1.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143068040","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Alice Hamilton, Caroline Sachse, Elisa Sottile, Rafik Jacob
{"title":"Enhancing Medical Education for the Care of Patients with Intellectual and Developmental Disabilities: The Role of Specialized Training and Early Exposure.","authors":"Alice Hamilton, Caroline Sachse, Elisa Sottile, Rafik Jacob","doi":"10.14423/SMJ.0000000000001782","DOIUrl":"https://doi.org/10.14423/SMJ.0000000000001782","url":null,"abstract":"","PeriodicalId":22043,"journal":{"name":"Southern Medical Journal","volume":"118 2","pages":"111-113"},"PeriodicalIF":1.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143068036","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Anika Annoor, Mariya Rahman Marzan, Raisa Binte Iqbal, Aysha Ferdausi, Arowa Yasmeen, Parisa Tarannum, Preethi John
{"title":"Alpelisib-Induced Hyperglycemia in <i>PIK3CA</i><sup>+</sup> Breast Cancer Patients.","authors":"Anika Annoor, Mariya Rahman Marzan, Raisa Binte Iqbal, Aysha Ferdausi, Arowa Yasmeen, Parisa Tarannum, Preethi John","doi":"10.14423/SMJ.0000000000001791","DOIUrl":"https://doi.org/10.14423/SMJ.0000000000001791","url":null,"abstract":"<p><p>Alpelisib is a phosphatidylinositol 3-kinase inhibitor approved by the US Food and Drug Administration for the treatment of hormone receptor-positive metastatic breast cancer with <i>PIK3CA</i> (phosphatidylinositol-4,5-bisphosphate 3-kinase catalytic subunit α) mutation. In recent years a number of adverse effects have been observed to be associated with this therapy, the most notable of which is hyperglycemia. A literature search was conducted to include case studies, case series, systematic reviews, and meta-analyses within the last 10 years that evaluated patients with <i>PIK3CA-</i>mutated hormone receptor-positive, human epidermal growth factor receptor 2 negative metastatic breast cancer. Hyperglycemia was a notable adverse effect that was found in the majority of patients without preexisting diabetes mellitus. Patients with hyperglycemia were in the high-risk groups of advanced age, prediabetes mellitus or history of insulin resistance, increased body mass index, increased blood monocyte count, and increased hemoglobin A1c (glycated hemoglobin). Hyperglycemia was manageable with antihyperglycemic agents and dose modification/discontinuation of alpelisib with no severe progression. Other notable adverse effects were rash, stomatitis, diarrhea, pneumonitis, reduced appetite, elevated liver enzymes, nausea, fatigue, and rare reports of diabetic ketoacidosis. This literature review aims to highlight the incidence and risk factors of alpelisib-induced hyperglycemia in greater depth.</p>","PeriodicalId":22043,"journal":{"name":"Southern Medical Journal","volume":"118 2","pages":"97-101"},"PeriodicalIF":1.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143068034","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Medications That May be Contributing to Your Patient's Weight Gain.","authors":"Jason Powell, James Taylor","doi":"10.14423/SMJ.0000000000001792","DOIUrl":"https://doi.org/10.14423/SMJ.0000000000001792","url":null,"abstract":"<p><p>Nearly 42% of adults in the United States are considered obese. Although there are a number of contributing factors to obesity, one sometimes overlooked contributor to weight gain is medications. Within many classes of medications that may affect weight, the degree of weight gain varies. Although factors such as efficacy, cost, interactions, and adverse effects play a role in selecting a medication, the effects on weight also should be considered in those who are overweight or obese. This article reviews some of the classes of medications used in the outpatient setting that may affect weight to provide a guide to clinicians.</p>","PeriodicalId":22043,"journal":{"name":"Southern Medical Journal","volume":"118 2","pages":"122-127"},"PeriodicalIF":1.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143068042","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Radhika J Kothadia, Kaustubh G Joshi, Richard L Frierson, Coleton King
{"title":"Effect of COVID-19 on Emergency Department Visits for Suicidal Ideation and Suicide Attempts among South Carolina Youth.","authors":"Radhika J Kothadia, Kaustubh G Joshi, Richard L Frierson, Coleton King","doi":"10.14423/SMJ.0000000000001789","DOIUrl":"https://doi.org/10.14423/SMJ.0000000000001789","url":null,"abstract":"<p><strong>Objectives: </strong>Evidence suggests that the coronavirus disease 2019 pandemic negatively affected children's mental health (MH). The emergency department (ED) is often the first point of contact with a physician for youth who are experiencing suicidal thoughts and behaviors. Population-level reports of ED utilization in South Carolina for suicidal ideation (SI) and suicide attempts (SAs) during the pandemic are lacking. This study compares trends in ED visits for SI and SAs among youth in South Carolina ages 5 to 24 years, before (ie, March-December 2019) and during (ie, March-December 2020) the coronavirus disease 2019 pandemic.</p><p><strong>Methods: </strong>We examined 16,906 deidentified patient records from the South Carolina Revenue and Fiscal Affairs Office. Dispositional outcomes, type of insurance, ED utilization, and mortality also were reviewed.</p><p><strong>Results: </strong>The total number of ED visits for SI or an SA decreased during the pandemic, but the percentage of MH-related and total ED visits attributed to SI and SAs relative to other conditions increased. The pandemic negatively affected youth with preexisting utilization of EDs for MH reasons, SI, and SAs, but also those without prior ED visits for these reasons. Many youths who presented to an ED during the pandemic for SI or SAs had subsequent ED visits for MH concerns, SI, or an SA.</p><p><strong>Conclusions: </strong>The percentage of MH- and SI/SA-related visits increased during the pandemic. These data underscore the need for adequate MH services in EDs and increased access to outpatient MH resources to reduce the strain on EDs during public health emergencies.</p>","PeriodicalId":22043,"journal":{"name":"Southern Medical Journal","volume":"118 2","pages":"85-90"},"PeriodicalIF":1.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143068035","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Shelby Cate Hodges, Juan J Gordillo, Mathew Hargreaves, Maxwell Harrell, Clay Rahaman, Eugene Brabston, Thomas Evely, Aaron Casp, Amit M Momaya
{"title":"Undervaluation of Perioperative Work for ACL Reconstruction by Relative Value Scale Update Committee Methodology in a Single Surgeon's Practice.","authors":"Shelby Cate Hodges, Juan J Gordillo, Mathew Hargreaves, Maxwell Harrell, Clay Rahaman, Eugene Brabston, Thomas Evely, Aaron Casp, Amit M Momaya","doi":"10.14423/SMJ.0000000000001787","DOIUrl":"https://doi.org/10.14423/SMJ.0000000000001787","url":null,"abstract":"<p><strong>Objectives: </strong>The purpose of this study was to determine the accuracy of the Relative Value Update Committee (RUC) and Centers for Medicare & Medicaid Services current times and work relative value units (wRVUs) for the perioperative work involved in anterior cruciate ligament (ACL) reconstruction by directly timing perioperative tasks as they occur in real time.</p><p><strong>Methods: </strong>The RUC was contacted to obtain a list of perioperative tasks and the corresponding times allotted for the tasks involved in arthroscopically aided ACL reconstruction (Current Procedural Terminology code 29888). The tasks that occurred both inside and outside the operating room were timed by the attending physician as the event occurred. The time for each task was then multiplied by its respective Centers for Medicare & Medicaid Services-assigned intensity coefficient to calculate the wRVU. Calculated and allotted wRVUs were compared for accuracy.</p><p><strong>Results: </strong>The tasks timed in this study were allotted 100 minutes by the RUC and a total wRVU value of 2.026. Our study found that these tasks took 132.1 minutes and had a total wRVU value of 2.713. The overall time it takes to perform perioperative tasks in arthroscopically aided ACL surgeries is underestimated by 32.1 minutes, which results in an undervaluation of the total wRVU value by 0.687.</p><p><strong>Conclusions: </strong>The perioperative wRVU assigned by the RUC underestimates the amount of time assigned to perform the required tasks. The RUC should consider using prospective times collected by physicians to calculate a more accurate wRVU. In addition, the RUC should consider how modern patient care practices and requirements have increased the intensity of work for physicians.</p>","PeriodicalId":22043,"journal":{"name":"Southern Medical Journal","volume":"118 2","pages":"118-121"},"PeriodicalIF":1.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143068044","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}