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March 2013

Feature: ACP IMpact Now Optimized for Mobile Viewing

IMpact can now be viewed on your smartphone! The new mobile formatting allows for easier reading on your mobile devices! All new issues, as well as all of the IMpact Archives can be read on your phone.

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Internal Medicine residency match results encouraging for adults needing primary care

The number of U.S. senior medical students choosing categorical internal medicine residencies increased for the fourth consecutive year. According to the 2013 National Resident Matching Program, 3,135 U.S. medical school seniors matched for residency training in internal medicine, a 6.6 percent increase compared to 2012, when 2,941 matched in internal medicine.

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Medical Student Perspectives: Developing Critical Thinking Skills for the Wards

When will I become capable of reaching a diagnosis without using an excessive number of diagnostic exams? When are students or residents expected to learn how to streamline? Will there be an enlightened moment when we realize we have developed enough clinical confidence to confirm a diagnosis while being efficient with hospital funding? There are so many questions for which I do not have answers.

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IMIG Update: Free Money! 2013-2014 ACP Internal Medicine Interest Group Sponsorship Program Application Now Available!

Internal Medicine Interest Groups (IMIG) in U.S. medical schools can apply for funding for 2013-2014 at www.acponline.org/imigapp.

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Advocacy Update: Leadership Day on Capitol Hill

The 21st annual Leadership Day on Capitol Hill will be held on May 21-22, 2013 at the Liaison Hotel in Washington, D.C. ACP Medical Student Members are encouraged to participate in this two day event where they will receive advocacy training, an update on the College's priority legislative issues; briefings from Members of Congress, Administration officials and key Capitol Hill staffers, and an opportunity to meet with their state's elected officials.

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Winning Abstracts from the 2012 Medical Student Abstract Competition: A Curious Case of Caffeine-Induced Hypokalemic Paralysis

Excessive caffeine intake, while an unusual cause of hypokalemia, may be sufficient in a patient with potassium deficiency to result in hypokalemic paralysis. Thorough history taking, including a dietary history, can be critical for accurate diagnosis.

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Subspecialty Careers: Critical Care Medicine

Critical care medicine encompasses the diagnosis and treatment of a wide variety of clinical problems representing the extreme of human disease. Critically ill patients require intensive care by a coordinated team. The critical care specialist (intensivist) may be the primary provider of care or a consultant. The intensivist needs to be competent not only in a broad range of conditions common among critically ill patients but also with the technological procedures and devices used in the intensive care setting. The care of critically ill patients raises many complicated ethical and social issues, and the intensivist must be competent in areas such as end-of-life decisions, advance directives, estimating prognosis, and counseling of patients and their families.

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In the Clinic: Transitions of Care

In the Clinic

"Transitions of care" refers to changes in the level, location, or providers of care as patients move within the health care system. One critical transition of care that has garnered great attention and is the focus of this review is the transition involving hospital discharge. Acute hospitalization represents a significant event in a patient's life, and health care providers in partnership with patients need to address myriad issues related to the hospitalization and subsequent posthospitalization care for a safe transition out of the hospital. The care of the hospitalized patient has evolved over time, such that patients are sicker; length of stay has decreased; medical technology and knowledge have advanced; and new models of hospital-based care have evolved, such as the advent of hospitalists as the principal hospital-based providers. All of these factors have contributed to the complexity of coordinating transitions of care.

In the Clinic is a monthly feature in Annals of Internal Medicine that focuses on practical management of patients with common clinical conditions. It offers evidence-based answers to frequently asked questions about screening, prevention, diagnosis, therapy, and patient education and provides physicians with tools to improve the quality of care. Many internal medicine clerkship directors recommend this series of articles for students on the internal medicine ambulatory rotation.

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What's the diagnosis?
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Highlights from ACP Internist® & ACP Hospitalist®


Anemia is fairly common, but its many etiologies complicate diagnosis. It affects more than one in five black and Hispanic people, one in 10 seniors and one in five of those over the age of 85. Learn how to fine-tune the diagnosis to best help patients.


A medical education piece by Robert Centor, MD, FACP, Chair of the board of regents


Learn what separates a highly functioning ward team from one that never seems to gel.


This month's column presents a fictional look at a very cartoonish hospital.

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