The Southern Medical Journal is the official, peer-reviewed journal of the Southern Medical Association. It has a multidisciplinary and inter-professional focus that covers a broad range of topics relevant to physicians and other healthcare specialists.
SMJ // Browse the Southern Medical Journal
SMJ Article | Original Article
Implementing a Patient-Reported Outcomes Survey for Transgender and Gender-Diverse Patients at a Gender Health Clinic in the US Deep South
Objectives: Approximately 1.6 million Americans identify as transgender and gender diverse (TGD), yet health outcomes research focused on TGD patients is lacking. This gap persists despite significant health disparities experienced by TGD patients, including high rates of depression and suicidality. In clinical settings, patient-reported outcomes surveys (PROS) can pinpoint immediate...
SMJ Article | Original Article
Experiential Mentorship Skills Training: The Effect on Real-Life Mentoring
Objective: The purpose of this study was to assess the use of effective peer mentoring skills by residents after participating in an experiential training session. Methods: Physical Medicine and Rehabilitation resident physicians were taught communication skills useful for mentoring conversations and practiced them in an experiential workshop. They were surveyed...
SMJ Article | Original Article
Disability Related to Carpal Tunnel Syndrome May Be Greater Than Related Chronic Hand Conditions
Objectives: This study used a novel patient disability assessment, the Mississippi Qualitative Hand Pain Questionnaire (MQHPQ), to compare carpal tunnel syndrome (CTS) with other hand pain diagnoses (non-CTS) and then to the levels of impairment in the American Medical Association (AMA) Guides to the Evaluation of Permanent Impairment (ie, AMA...
Posted in: Rheumatology and Orthopedics28
SMJ Article | Perspectives
Potential Impact of Lower Federal Loan Availability on Medical Education in Appalachia
The passage of House of Representatives (HR) One, or the "One, Big, Beautiful Bill Act," brings official changes to students' ability to borrow federal loans. The federal Graduate Plus Loan will sunset, leaving medical students with unsubsidized loans as the primary federal borrowing option, capped at $50,000 per year and...
SMJ Article | Original Article
Evaluation of the Efficacy of Artificial Intelligence-Based Screening for Diabetic Retinopathy in a Predominantly Non-White Population
Objective: To evaluate the diagnostic accuracy of Luminetics Core, a Food and Drug Administration-cleared artificial intelligence-based screening system, in the detection of diabetic retinopathy (DR) in a predominately non-White population and identify potential shortcomings in clinical implementation that should be addressed to mitigate disparities in health care. Methods: Data were...
SMJ Article | Original Article
Comparing Speed and Accuracy of Artificial Intelligence Large Language Models on the Orthopedic In-Training Examination
Objectives: Large language models (LLMs), such as Open AI's Chat Generative Pre-Trained Transformer (GPT)-4 and Google Gemini, have gained significant attention for their ability to process complex language patterns and are being used increasingly in fields such as medicine, where they assist in learning, collaboration, and patient care. Although prior...
Posted in: Rheumatology and Orthopedics28
SMJ Article | Perspectives
Balancing Relief and Risk: Managing Chronic Low Back Pain in Patients with Opioid Use Disorder
Chronic low back pain and opioid use disorder often occur together, creating clinical situations that are complex and emotionally charged. Low back pain remains a common cause of disability and a major contributor to opioid prescribing. Although guidelines recommend exercise and other non-opioid treatments as first-line care, patients with co-occurring...
SMJ Article | Special Section
SMA's 6th Annual Physicians-in-Training Leadership Conference Abstract Presentations
The following abstracts were accepted and presented during Southern Medical Association's 6th Annual Physicians-in-Training Leadership Conference that took place February 21, 2026 at Clemson School of Nursing in Greenville, South Carolina.
SMJ Article | Original Article
Don’t Wait to Talk about Weight: A 2-Hour Interactive Curriculum Improves Medical Student Skills with Weight Management
Objective: The goal of this curriculum was to increase medical students' knowledge of obesity medicine as well as their comfort with and confidence in communication skills related to weight management by using a standardized patient (SP) encounter.Methods: We developed and evaluated a two-part weight management curriculum that used a synchronous...
SMJ Article | Original Article
Social Pressure: How Early Social Context Shapes Career Interest in Medicine
Objectives: Despite increased attention toward improved diversity in medicine, access to the profession continues to be limited. In fact, strides made in racial and socioeconomic diversity in the medical profession remain slow, with certain groups even losing ground. Although the literature on career choice in general is significant, the unique...
SMJ Article | Original Article
Association between Main Pancreatic Duct Size, Comorbidities, and Fistula Formation after Whipple Procedure for Pancreatic Cancer
Objective: Studies have associated abnormally dilated or constricted main pancreatic duct (MPD) diameter sizes in postproximal pancreatectomies (Whipple procedures) with postoperative complications. As such, we studied the clinical factors associated with both abnormally dilated or constricted MPD diameters and perioperative factors that may influence postoperative pancreatic fistula formation. Methods: We...
Posted in: Gastroenterology49 Pancreatic Disease2
SMJ Article | Original Article
Diagnostic Utility and Clinical Implications of Inpatient Fecal Occult Blood Testing
Objective: The objetive was to evaluate the utility of inpatient and emergency department (ED) fecal occult blood testing (FOBT) and its association with downstream healthcare utilization and costs. Methods: This was a retrospective cohort study of adult patients (18 years and older) who underwent FOBT in the ED or inpatient...
SMJ Article | Original Article
Perspectives on Contraceptive Research for Individuals with Increased Thrombosis Risk: A Qualitative Exploration of Patients and Clinicians
Objectives: Although most progestin-only contraceptives are generally considered safe for most patients at increased risk of arterial and venous thrombosis, patients and clinicians may be wary of their use based on limited studies. Large prospective contraceptive studies with primary data collection would improve the evidence base for people at increased...
Posted in: Family Planning & Reproductive Health17
SMJ Article | Original Article
Trends in Reported End-of-Life Concerns after the Legalization of Physician-Assisted Suicide
Objectives: Understanding the concerns that motivate requests for assisted dying (euthanasia or assisted suicide) is essential for understanding these practices. Our objective was to determine whether there are significant trends in end-of-life concerns cited in requests for physician-assisted suicide (PAS) in Oregon and Washington. Methods: We estimated regressions using data...
SMJ Article | Review Article
Aprocitentan: A New Option for Resistant Hypertension and Its Place in Patient Care
Hypertension affects approximately 47.7% of US adults, with higher rates observed in men (50.8%) compared with women (44.6%). Risk factors and characteristics such as age, family history, race, and ethnicity also can increase the risk of developing high blood pressure and can make treatment more difficult. Aprocitentan is the first...
Posted in: Hypertension11
SMJ Article | Perspectives
The Five Essential Concepts of Developmental Medicine: A Medical Paradigm for People with Developmental Disabilities
Developmental disabilities and neurodevelopmental disorders (NDDs) are lifelong conditions that present complex medical challenges, particularly as individuals transition from pediatric to adult health care. Although these disorders typically manifest in cognitive impairment, motor dysfunction, seizures, and behavioral dysregulation, the degree of these symptoms can vary widely. This article introduces a...
Posted in: Neurology18
SMJ Article | Original Article
Impact of Temperature Variation on Patients with Acute Severe Asthma
Objective: Acute severe asthma (ASA) is associated with a heightened risk of death. The influence of ambient temperature on in-hospital mortality and healthcare utilization for patients with ASA is poorly characterized. Methods: Using the National Inpatient Sample, we compared adults hospitalized with ASA in the northeast with southern regions of...
Posted in: Pulmonary Disease19
SMJ Article | Perspectives
α-Gal Syndrome in the South: Why We Need Treatment Trials, Not Just Tick Prevention
α-Gal syndrome (AGS), a tick bite-associated allergy to mammalian meat, affects an estimated 450,000 Americans, with the highest prevalence concentrated in the US South and Southeast. The lone star tick (Amblyomma americanum), ubiquitous across the region, transmits AGS sensitization, making reexposure nearly inevitable for outdoor workers and residents. Current management...
Posted in: Allergy and Immunology11 Anaphylaxis1
SMJ Article | Original Article
Prostate Cancer Screening Shared Decision Making and Prostate-Specific Antigen Testing in Black and Non-Black Men in Primary Care in South Carolina
Objective: Black men experience disproportionate prostate cancer mortality compared with men of other races. As of 2018, major guidelines concur that all men make informed decisions about whether to be screened for prostate cancer after a discussion with their clinician. The objectives of this study were to determine the frequency...
Posted in: Prostate Disorders4
SMJ Article | Acknowledgment
Joint Effect of Paternal and Maternal Age on the Prevalence of Low Birth Weight in the United States
Objective: Prior studies of the effect of father's age on the risk of low birth weight (LBW, infant weight < 2500 g) have been inconclusive. In addition, previous investigators have not conducted a detailed analysis to determine whether paternal age (PA) interacts with maternal age (MA) on the outcome of...
Posted in: Obstetrics and Gynecology87 Pregnancy35
