SMJ // September 2025, Volume 118 - Issue 9

Original Article

A Framework for Residency Application Support: The Impact of a Mandatory Career Advising and Professional Development Course

Objectives: The residency application process has become increasingly complex, with factors like holistic review, specialty signaling, and multiple application services posing new challenges for medical schools seeking to offer personalized support to students. In addition, fourth-year students often quickly dive into demanding externships, which make it challenging to access residency…

Original Article

Dissemination and Impact of a Multimodal Pain Regimen on Analgesia Prescribing at an Academic Hospital

Objectives: An opioid-sparing, multimodal pain (MMP) protocol was initiated at our institution in August 2016 in the Division of Trauma and Acute Care Surgery (TACS). During the next year, the practice was codified into a protocol. This study aims to evaluate the dissemination and impact of MMP. Methods: We conducted…

Original Article

Minimally Invasive Burch Colposuspension to Reduce De Novo Stress Incontinence: The MICRO Randomized Trial

Objective: The objective was to determine whether the addition of prophylactic retropubic colposuspension is superior to no anti-incontinence procedure during minimally invasive surgical sacrocolpopexy for stress-continent patients in decreasing rates of postoperative de novo stress urinary incontinence (SUI). Methods: In this randomized superiority trial, we recruited stress-continent prolapse patients undergoing…

Posted in: Obstetrics and Gynecology50

Original Article

Financial Literacy of Medical Trainees: A Major and Worrisome Educational Void to Fill

Objectives: The purpose of this study was to evaluate the financial literacy of medical trainees and assess knowledge gaps in loan repayment, credit management, investment strategies, and financial planning. Methods: A cross-sectional survey study was conducted at a single institution between July 25, 2023 and January 10, 2024. A 52-question…

Original Article

Evaluating Internal Medicine Intern Report Efficacy: Findings from a Cross-Sectional Survey

Objective: The case-based morning report (MR) is a widespread tradition in Internal Medicine training. Because MR content was originally geared toward second- and third-year residents, however, there are limited data regarding any specific learning considerations when having an intern-only MR. We aimed to elicit attitudes surrounding the intern report (IR)…

Perspectives

Beyond the Discharge Summary: 10 Critical Considerations for Primary Care Physicians Managing Postdischarge Care

The transition from inpatient to ambulatory care represents a critical period requiring seamless coordination between hospital teams and primary care physicians (PCPs). This handover is particularly crucial for older adult patients with multiple comorbidities, including cognitive and physical impairments, for whom careful management can prevent readmissions and ensure successful recovery….

Original Article

Risk of Nephrolithiasis in Cirrhosis: A Comparison between MASLD Cirrhosis and Cirrhosis Due to Other Etiologies

Objectives: Nephrolithiasis is a systemic condition influenced by metabolic disorders, with rising prevalence worldwide. Although several studies have investigated the relationship between metabolic-associated steatotic liver disease (MASLD) and nephrolithiasis, few have focused on cirrhosis-specific etiologies. As the epidemiology of cirrhosis shifts from viral and alcohol-related causes to metabolic dysfunction-related etiologies,…

Posted in: Liver Disease10

Original Article

Outcomes and Complications of Thoracentesis in Hospitalized Patients

Objectives: Despite the common performance of thoracentesis, predicting risk for adverse outcomes and abnormal postprocedural findings remains difficult. Although guidelines and experts have suggested that routine postprocedure imaging has low yield, compliance with these guidelines has not been well studied. In addition, previous studies have shown that pleural effusions are…

Posted in: Pulmonary Disease19

Original Article

Self-Administered Relaxation Techniques Improving Postconcussive Mood Symptoms in an Appalachian Population

Objectives: Concussions are one of the most frequent pediatric injuries, especially for high school athletes. Many of the psychological sequalae from concussions go unnoticed and undertreated particularly in the rural setting. There is limited research on optimizing recovery for these patients; however, newer studies are beginning to show the utilization…

Original Article

Analysis of Biopsy Modalities and Timeline for the Workup of Undiagnosed Lesions: Mayo Clinic Experience

Objective: Incidental lesions identified clinically or on imaging are diagnostically challenging. The workup for these lesions is not well established. We investigated diagnostic modalities used at our institutions for undiagnosed lesions and the timeline from intake to biopsy and resultant diagnoses. Methods: We retrospectively analyzed data from all 3 Mayo…

Review Article

Psychiatric Condition Management in Primary Care for Adults with Intellectual and Developmental Disabilities

Psychiatric conditions are prevalent among adults with intellectual and developmental disabilities (IDDs), with studies estimating that 33% of this population experiences psychiatric disorders such as mood, anxiety, and behavioral issues. These rates are significantly higher than the general population, underscoring the need for proper management within primary care settings. Although…

Original Article

Regional Differences in Hospitalizations among Patients Admitted with Chronic Obstructive Pulmonary Disease

Objective: Extreme temperatures negatively impact pulmonary function. This study explored whether the variability in ambient temperatures across disparate geographic regions in the United States was associated with differences in hospital outcomes for patients admitted with chronic obstructive pulmonary disease (COPD). Methods: Using the 2016–2019 National Inpatient Sample database, we compared…

Posted in: Pulmonary Disease19

Original Article

Comparing ACL Reconstruction Postoperative Outcomes in Medicaid versus Private Insurance Patients: Is There a Difference?

Objectives: There has been growing evidence that insurance status is a major indicator of postoperative outcomes, which has been extensively reported in orthopedic procedures such as shoulder and knee arthroplasty. Patients with Medicaid public insurance had increased complications, longer lengths of stay, and increased costs compared with patients who had…

Posted in: Rheumatology and Orthopedics21

Original Article

Utilizing Learning Communities to Implement a Wellness-in-Action Session in Undergraduate Medical Education

Objectives: Learning communities (LCs) are on the rise in medical education. Key features of LCs include fostering student learning, wellness, and engagement. The ways in which different programs are currently using LCs are still relatively new, however, and literature on this topic is scarce. We developed and incorporated a wellness-in-action…

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