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
Projections for Urogynecologic Surgeries in the United States, 2025–2060
Objectives: Using the most recent US population projections data, we sought to update the estimated number of women who will undergo surgery for stress urinary incontinence (SUI) and pelvic organ prolapse (POP) in the United States from 2025 through 2060. We hypothesize that the number of pelvic floor surgeries will...
Posted in: Obstetrics and Gynecology89
SMJ Article | Original Article
Use of Nitrous Oxide during Labor in an Academic Medical Center in a Rural State
Objectives: This study examined the use of inhaled nitrous oxide as a pain management option during labor. Nitrous oxide offers a noninvasive, self-administered pain relief option that allows patients greater autonomy compared with other methods such as epidural analgesia or intravenous opioids. Its effectiveness and patient satisfaction remain a debated...
Posted in: Obstetrics and Gynecology89
SMJ Article | Original Article
The Aftermath of Hurricane Helene: Orthopedic Injury Epidemiology at a Level I Trauma Center
Objectives: Hurricane Helene was one of the most devastating natural disasters in US history, with 249 known fatalities and damages exceeding US$75 billion. This study evaluates the impact of Hurricane Helene on orthopedic injury epidemiology and patterns at a level I trauma center. Methods: A retrospective review was conducted of...
Posted in: Rheumatology and Orthopedics30
SMJ Article | Review Article
When HbA1c Lies: Recognizing and Managing HbA1c-Glucose Discordance in Clinical Practice
Hemoglobin A1c (HbA1c) remains a cornerstone of glycemic assessment in diabetes mellitus care, yet discordance between HbA1c and measured glucose values is common in clinical practice. Failure to recognize this discordance can lead to inappropriate treatment escalation, increased hypoglycemia risk, and patient distress. This article reviews the biological and clinical...
Posted in: Endocrinology, Diabetes, and Metabolism22
SMJ Article | Review Article
Continuous Glucose Monitoring in Primary Care: A Practical, Multidisciplinary Review of Data Interpretation and Billing Updates
Continuous glucose monitoring (CGM) offers real-time and longitudinal insights into glycemic patterns, time in range, and hypoglycemia. Adopting CGMs into practice can improve clinical outcomes while strengthening patient engagement and enabling data-driven care across routine visits and population health programs. Despite strong evidence of benefit, CGM remains underused in primary...
Posted in: Endocrinology, Diabetes, and Metabolism22
SMJ Article | Original Article
Perspectives of Academic VA Clinician Educators: A Qualitative Analysis from a Single Facility
Objective: As part of a quality improvement initiative focused on medical educator faculty development, we sought to explore the perspectives of clinician-educators based at a large urban Veterans Affairs Medical Center (VAMC) who navigate the workplace communities of both their VAMC and academic medical center (AMC). Methods: Informed by the...
SMJ Article | Original Article
Cultural Competency in Medical Education through the Arts and Humanities: An Innovative Immersive Community-Based Workshop
Objective: Teaching cultural competency is a critical but challenging task for clinician educators. Immersive experiential learning in the local community through the arts and humanities remains underexplored in medical education. To address this gap, a novel arts and humanities–based cultural competency workshop was developed. Methods: This half-day cultural competency workshop...
SMJ Article | Original Article
Gender-Affirming Care of Transgender Patients in Primary Care: An Asynchronous, Online Case-Based Curriculum for Internal Medicine Residents
Objectives: Transgender and gender-diverse (TGD) individuals represent a growing demographic in the United States. This population, however, faces many health inequities, in part attributable to a lack of education for physicians in training on transgender health care at both the graduate and undergraduate medical education levels. We developed a curriculum...
SMJ Article | Original Article
Mind the Gap: Rethinking Procedural Skill Assessment in Medical Residency
Objectives: The purpose of this study was to investigate the efficacy of various assessment tools in accurately evaluating resident proficiency in bedside procedures and to determine the potential value of incorporating self-assessment as a means to bridge the “competency gap” between perceived and actual procedural skill. Methods: This retrospective, observational...
SMJ Article | Original Article
Medicare Insurance Is Associated with Reduced Hip Arthroscopy Patient–Reported Outcome Measures
Objective: The purpose of this study was to evaluate the difference in patient-reported outcome measures (PROMs) after hip arthroscopy (HA) among patients with commercial insurance as compared with those with government-provided insurance, such as Medicare, Medicaid, and TRICARE or Veterans Affairs (VA). Methods: This retrospective cohort study queried an institutional...
Posted in: Rheumatology and Orthopedics30
SMJ Article | Original Article
Perceived Barriers and Needs Related to Chronic Disease Self-Management among Rural Appalachian Kentucky Residents
Objectives: In rural Appalachian Kentucky, managing chronic conditions presents a challenge due to limited healthcare access, inadequate health education, and poor dietary resources. This study explores factors contributing to healthcare barriers and examines how social support may help individuals better manage chronic illness.Methods: We interviewed residents of rural Appalachian Kentucky...
Posted in: Endocrinology, Diabetes, and Metabolism22
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 Orthopedics30
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 Orthopedics30
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...
