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Palliative Care
Published in Kathleen Benton, Renzo Pegoraro, Finding Dignity at the End of Life, 2020
Palliative care, by contrast, is an interdisciplinary specialty focusing on improving the quality of life for patients with serious illnesses and their families. There is no anticipated survival requirement, and patients may continue all life-prolonging and disease-directed treatments (Kelley & Morrison, 2015). Palliative care is an integrated program that involves medicine, social work, nursing, chaplaincy, and other resources as appropriate (Breitbart, 2014; Centeno et al., 2018; EN: Palliative Care, 2004; Kelley & Morrison, 2015). First recognized as a subspecialty by the American Board of Medical Specialties in 2006, palliative medicine requires an additional year of fellowship after completion of a residency in any of eight medical specialties (Centeno et al., 2018; Kelley & Morrison, 2015; The Joint Commission, 2011).
Becoming a Pathologist
Published in Jeremy R. Jass, Understanding Pathology, 2020
Anatomical pathology is based on the use of the microscope to examine wafer thin sections (about half the thickness of a single red blood cell) to achieve a diagnosis on behalf of a living patient. A diagnosis is reached rather in the same way that an art expert distinguishes a genuine Rembrandt from a forgery — by. careful examination supported by education and experience. The central importance of the discipline of anatomical pathology rests upon the provision of an accurate diagnosis. Diagnosis is the hub around which all subsequent therapeutic decisions turn. Medicine is often described as a blend of art and science, and as a medical subspecialty pathology might be perceived similarly. However, I would argue that pathology leans much more towards being a science than an art and its practice is characterised by a meticulous and highly organised approach. It is the key to the success of Western medicine, providing the entire paradigm for the classification (see Table 1), understanding and diagnosis of disease, and has no rivals in any alternative system of medicine.
Education and professional development
Published in Michael Kidd, Cynthia Haq, Jan De Maeseneer, Jeffrey Markuns, Hernan Montenegro, Waris Qidwai, Igor Svab, Wim Van Lerberghe, Tiago Villanueva, Charles Boelen, Cynthia Haq, Vincent Hunt, Marc Rivo, Edward Shahady, Margaret Chan, The Contribution of Family Medicine to Improving Health Systems, 2020
Michael Kidd, Cynthia Haq, Jan De Maeseneer, Jeffrey Markuns, Hernan Montenegro, Waris Qidwai, Igor Svab, Wim Van Lerberghe, Tiago Villanueva, Charles Boelen, Cynthia Haq, Vincent Hunt, Marc Rivo, Edward Shahady, Margaret Chan
Most important is the development of a cohort of committed educators with specific training and skills in the core principles of primary care, including both generalists and subspecialists. Generalists with this training become core faculty of a family medicine department, and the primary clinical supervisors of learners in the ambulatory setting. Subspecialists with this training develop skills to adapt their curricula and training methods to better match the needs of the primary care provider, incorporating elements of the primary care principles into their subspecialty training modules for their family medicine trainees.
Matching into competitive surgical residencies: predictors of success
Published in Medical Education Online, 2023
Jacob S Nasser, Anthony R Artino, Terry Kind, Xuejing Duan, Angela P Mihalic, Katherine Chretien
Costs associated with residency applications and away rotations in surgical subspecialities have been investigated in the literature and evidence shows that the costs for applying to certain surgical subspecialties is higher than other subspecialties [13,16,20,29,30]. Specifically, Gordon et al. used the Texas STAR database to compare the costs of students applying to competitive surgical residencies, and the authors found application costs to vary depending on subspeciality and geographic region [20]. Tese findings highlights the need to develop strategies to reduce variation in the costs of residency applications and limit costs overall. Away rotations may represent substantial financial burden for students applying to certain specialties, presenting an opportunity to develop strategies to combat the high costs associated with residency applications. For example, research indicates that some students may pay as much as $2,500 to perform away rotations [28]. Given the potential advantages of away rotations, as highlighted in the current study, it is important to ensure that these experiences are available to all students, regardless of their financial status or resources available at their home institution. For example, strategies may be adopted by host and welcoming institutions to provide low-resource students the opportunity to attend an away rotation or reap similar benefits. Such strategies may include stipends, food allowances, complementary housing, among other methods [26,28,31].
Role of hospitalists in Japan for heart failure in the elderly: single center retrospective cohort study
Published in Hospital Practice, 2023
Yohei Kanzawa, Naoto Ishimaru, Toshio Shimokawa, Saori Kinami, Yuichi Imanaka
In Japan, general medicine physicians are defined by the Japanese Society of Hospital General Medicine as those who are trained in the treatment of a range of diseases and conditions while maintaining a subspecialty. Perceived benefits include the ability to make diagnosis for previously undiagnosed patients in a timely manner, to manage patients appropriately, and the ability to work smoothly with other specialists. If patients have multiple comorbidities, especially elderly patients, there is increased concern over the capability of specialist physicians to provide comprehensive and effective management [7]. The hospitalist system has still not been fully established in Japan, but the quality of care from general medicine physicians has been noted in a number of reports [8,9]. For example, the number of hospitalization days for pneumonia and cerebral infarction were reported to have been reduced by 17% by the presence of general internal medicine (GIM) physicians compared with a prior period without GIM physicians [8]. It was considered especially effective for the generalist to treat patients with consideration of their social circumstances and comorbidities, rather than a specialist attempting to treat issues outside of their range of specialization. Hospitalist systems have been shown to provide beneficial comprehensive systemic management of aspiration pneumonia, another major contemporary issue in community hospitals in Japan [9]. While quality of care specific to patients with heart failure has been shown by the American hospitalist system [10,11], there have been no Japan-based studies in this patient group.
A single-institution review of lacrimal gland biopsies between 1962 and 2017
Published in Orbit, 2023
Catherine J. Choi, Ann Q. Tran, Apostolos G. Anagnostopoulos, Henry W. Zhou, David T. Tse, Sander R. Dubovy
The lacrimal gland is a non-encapsulated eccrine gland located in the superotemporal orbit. Due to its unique anatomical structure consisting of an orbital lobe and a palpebral lobe separated by the levator aponeurosis, conditions affecting the lacrimal gland can present as both an eyelid and an orbital disorder. A wide range of benign and malignant processes can affect the lacrimal gland and a number of previous case series have been published (Table 5). Each study was limited by the inherent differences in the referral patterns and the specifics of subspecialty care at each practice, as well as the types of clinical and pathological data available. While the current study is no exception, this is the largest case series of lacrimal gland biopsies based on an ocular pathology database with comprehensive clinical and histopathologic data. Focusing on the nuances of language used in pathology reports provides for additional insight into the importance of clinical correlation and the goals and limitations of biopsies.