Darren B. Taichman, MD, PhD
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From the Editors of Annals of Internal Medicine and Education Guest Editor, Gretchen Diemer, MD, FACP, Associate Dean of Graduate Medical Education and Affiliations, Thomas Jefferson University.
Listen to an audio recording, read by Dr. Michael LaCombe.
Ask your learners if they have decided on a career path. How did they reach their decisions? How certain are they? In what ways are they uncertain?
Should uncertainty about the training and career paths we're on concern us? How should we manage uncertainty?
How should your trainees assess the paths they're on? What questions should we ask ourselves?
Does a career in medicine provide the opportunity to switch directions?
Consider arranging a series of informal meetings (perhaps meals) with your learners and more senior individuals whose careers have taken diverse twists and turns. Ask them to share the lessons they learned about navigating and adjusting paths.
Start a teaching session with a multiple-choice question. We've provided one below!
Ask your learners how they approach colorectal cancer screening in their practices.
At what ages do they recommend screening begin? Is there an age after which they no longer recommend screening? Do they make that decision on their own, or do they discuss it with their patients?
How do we determine at what ages to start and stop screening? Use the accompanying editorial to help frame your discussion.
How do your learners explain the relative advantages and disadvantages of the available means to perform screening? Do they discuss the patient's preferences or just make a recommendation? For which patients do they recommend colonoscopy? What about stool-based tests?
Ask your learners whether they ask patients how much they pay for their prescriptions.
Should we ask? Why might it matter?
Teach at the bedside! Ask patients on rounds how much they pay for their prescriptions. Ask whether cost is ever a factor in how they use their drugs. Do they “shop around”? How much effort does that require?
Ask whether your patients purchase some of their prescriptions from one pharmacy and others from a different source. What medical problems might this cause?
Why is it difficult to know ahead of time how much a prescription you write will cost your patient? Can we rely on the conclusions of this article to advise patients? Use the accompanying editorial to help frame your discussion.
Ask your learners whether we should screen for T2D. In whom? How? Can it be prevented?
How is a diagnosis established? What initial evaluation is in order after diagnosis?
What nonpharmacologic interventions should be initiated?
What approach should your learners take to choosing pharmacologic therapy? What considerations should be discussed with patients? When should insulin be considered?
Should patients with newly diagnosed T2D see a specialist? How about patients with long-standing disease?
Use the multiple-choice questions to help introduce topics for discussion during a teaching session. And, be sure to log on and enter your responses to earn CME and MOC credit for yourself!
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Taichman DB. Annals for Educators - 5 November 2019. Ann Intern Med. 2019;171:ED9. doi: https://doi.org/10.7326/AWED201911050
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Published: Ann Intern Med. 2019;171(9):ED9.
Cancer Screening/Prevention, Cardiology, Colorectal Cancer, Coronary Risk Factors, Diabetes.
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