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Understanding your patient’s belief system regarding health and well being. ICEE: Impact, Concerns, Expectations, Explanatory Model of Disease. What is the Impact of the patient’s illness on their lives and work? What is it about their illness that Concerns them? What are the patient’s Expectations of their interaction with you and the rest of the health care team? What is the patient’s explanation for their symptoms? https://www.cafeloggia.com/new-page daily 0.75 2020-10-22 https://www.cafeloggia.com/new-page-1 daily 0.75 2020-10-22 https://images.squarespace-cdn.com/content/v1/5edff010fc073f2c570c5e7a/1603395615587-612JW3ETXPS5R5241UTH/unconscious-bias+header.jpg Cult Comp 1PC for PGY 3 - Written into our DNA and our neural circuitry is a way to make snap decisions without a great deal of data. This “System One” reasoning is how our ancestors managed to avoid being killed by predators. It is what people are using when they rely on their “instinct” or their “gut reaction”. While System One thinking is fast and effortless, it is also often wrong. It causes us to avoid danger but also limits our ability to trust. To overcome it we use rational thought or “System Two”. System Two requires more effort and it is slower. But it allows us to see the reality behind our fears and mistrust. Understanding how your system one thinking interferes with your development of a doctor-patient relationship and how your patient’s unconscious bias interferes with their trusting, opening up and taking your recommendations is the subject of the Cultural Competency One Page Curriculum for PGY 3s. In this 1PC you will go online and take one of the Intrinsic Bias Surveys from Harvard University. You will then read a condensed version of “Everyday Bias” from the Cook-Ross Foundation. Then you will answer questions about two cases which are meant to make you think about your own bias as well as how to overcome the bias of a patient who may be quite different from you. https://www.cafeloggia.com/pocusdx daily 0.75 2020-10-23 https://www.cafeloggia.com/peabody-club daily 0.75 2026-04-01 https://www.cafeloggia.com/medical-ethics daily 0.75 2020-10-25 https://images.squarespace-cdn.com/content/v1/5edff010fc073f2c570c5e7a/1603551821362-XJEG7Y9B7LGLKC6TA0JL/autonomy.jpg Medical Ethics Ethics One Page Curriculum - PGY 1 “Autonomy” Who directs the care of a patient? If you answer anything other than the patient them self then you are wrong. Patient autonomy happens when the physician gives the patient enough information for them to make up their own mind. https://images.squarespace-cdn.com/content/v1/5edff010fc073f2c570c5e7a/1603553234777-ZBMU5IE8KL9UP4PJH6KS/benificence.jpg Medical Ethics ethics one page curriculum - pgy 2 “BENEFICENCE/non-malificence” We all want to do good. Sometimes we must weigh doing good with potential harm. That judgement may be the most difficult one to make. It is also incredibly personal. A risk averse patient may need the benefit/harm ratio to be unreasonably high. This section will teach you a way to think about decision making https://images.squarespace-cdn.com/content/v1/5edff010fc073f2c570c5e7a/1603553024602-MM2ZDGY4Z7TH3P3H6XNL/justice.png Medical Ethics Ethics one page curriculum - pgy 3 “justice” As a doctor you are not only treating the patient sitting in front of you. You are responsible for all of your patients and other’s patients and society as a whole. We have built a highly technological medical entity and we must choose wisely in the way we use it. Sometimes that means saying “no” to a patient’s request. This section will help you to make that decision justly. https://www.cafeloggia.com/autonomy daily 0.75 2020-10-24 https://images.squarespace-cdn.com/content/v1/5edff010fc073f2c570c5e7a/1603554867808-ZKJ5F436A8RUXJO4JU0E/autonomy.jpg Autonomy - Why “informed” consent? Touching a patient without consent is assault. To give consent a patient must understand the context, the potential benefit, the potential risks, and alternatives and their risks and benefits. They must be able to have questions answered. You must be assured that they have understood you by employing teach back. Then, and only then, they can make the call. The reading and assignment below are designed to make you think about patient’s autonomy. https://www.cafeloggia.com/beneficence/non-malifecence daily 0.75 2020-10-24 https://images.squarespace-cdn.com/content/v1/5edff010fc073f2c570c5e7a/1603556367352-QUE1I1XLNGQ2RNZF0H77/risk-benefit.jpg Beneficence/Non-malifecence - Risks and benefits We all want the benefits of interventions. We all want to avoid the risks. Step in an elevator. You get to a high floor without having to climb stairs. Could the elevator cable break? Could you be riding with an infected COVID 19 victim? Might the doors get stuck? What if you accidentally drop your keys through the opening between the elevator floor and the shaft? It’s only when the risks are minimized or when the benefit is so great that it can’t be passed up that we take that risk. This section will help you make sense of making decisions. https://www.cafeloggia.com/justice daily 0.75 2020-10-25 https://www.cafeloggia.com/test-ideas daily 0.75 2020-12-03 https://images.squarespace-cdn.com/content/v1/5edff010fc073f2c570c5e7a/1605280846583-JWUO2EP4I8PR7N7G76QL/MRToxo.png Test Ideas https://images.squarespace-cdn.com/content/v1/5edff010fc073f2c570c5e7a/1607022807527-FN3QO4VXI8XWK7QCQTFG/Urinalysis.jpg Test Ideas https://www.cafeloggia.com/escape-the-room daily 0.75 2020-12-03 https://www.cafeloggia.com/photo-contest daily 0.75 2020-12-09 https://www.cafeloggia.com/steps daily 0.75 2020-11-11 https://images.squarespace-cdn.com/content/v1/5edff010fc073f2c570c5e7a/1605021950067-BCL43HH2K30HT547B1OS/unnamed.png Steps https://images.squarespace-cdn.com/content/v1/5edff010fc073f2c570c5e7a/1597174650917-4GMH0HAL7EUMJARVMBWF/dl-apple.png Steps https://images.squarespace-cdn.com/content/v1/5edff010fc073f2c570c5e7a/1597174732551-G9ISK9BGHANBNLM3GNAC/dl-googleplay.png Steps https://www.cafeloggia.com/about-old daily 0.75 2021-10-24 https://images.squarespace-cdn.com/content/v1/5edff010fc073f2c570c5e7a/1634915133515-7QDS6WHK8SU1IYG6O9RN/fried.jpg Meet Our Program https://images.squarespace-cdn.com/content/v1/5edff010fc073f2c570c5e7a/1634915154178-C7555ACAWCF1LVEBU5VX/ahmadi.jpg Meet Our Program https://images.squarespace-cdn.com/content/v1/5edff010fc073f2c570c5e7a/1634915199292-5QXUURAN7P651CGKUG15/im+picture.jpg Meet Our Program https://images.squarespace-cdn.com/content/v1/5edff010fc073f2c570c5e7a/1634915234047-NMO2IAEMRLZZMRJ2VXBO/shukla+picture.jpg Meet Our Program https://images.squarespace-cdn.com/content/v1/5edff010fc073f2c570c5e7a/1634915255412-DD6N6S2NQNRL51M4B8QN/bhagat.jpg Meet Our Program https://images.squarespace-cdn.com/content/v1/5edff010fc073f2c570c5e7a/1634915344263-T17N9LI67VAWUPNCUDYF/killian.png Meet Our Program https://images.squarespace-cdn.com/content/v1/5ec321c2af33de48734cc929/1589847833743-F4ZNTSBG6SV6QOKKH98U/image-asset.jpeg Meet Our Program - “Whatever it is, the way you tell your story online can make all the difference.” — Quote Source https://www.cafeloggia.com/section-1 daily 0.75 2020-11-18 https://www.cafeloggia.com/problem-representation daily 0.75 2021-03-25 https://images.squarespace-cdn.com/content/v1/5edff010fc073f2c570c5e7a/1615579382046-PEOPQ5J5DF4VPDRUCXZG/tripodding.jpg Step One: Problem Representation - Remember this guy? Let’s imagine what his Problem Representation is The patient is a 35 year old man appearing much older than his stated age. He has a ten pack year-year smoking history. He presents to the Emergency Department complaining of severe shortness of breath and exercise intolerance. The shortness of breath has been progressive over the last 2 years and he has noted an unplanned weight loss of 20 pounds over the last 8 months. https://www.cafeloggia.com/qip3 daily 0.75 2025-03-18 https://images.squarespace-cdn.com/content/v1/5edff010fc073f2c570c5e7a/6aa522b0-b3d2-4c61-b8f1-003834e41b16/Capture.PNG https://images.squarespace-cdn.com/content/v1/5edff010fc073f2c570c5e7a/3696e49f-2b59-41d8-ad2d-4bd25ed0bda9/we+want+your+feedback%21+Customer+satisfaction%2C+survey+template+design.png https://images.squarespace-cdn.com/content/v1/5edff010fc073f2c570c5e7a/9128040a-46ed-4944-a581-6c4a899a688b/QRCode+for+Quality+Improvement_Patient+Safety+Curriculum+-+Quarter+3+%284%29.png https://www.cafeloggia.com/gallery-2 daily 0.75 2020-12-09 https://images.squarespace-cdn.com/content/v1/5edff010fc073f2c570c5e7a/1607543089802-22GBSOYXVZQUE5ZAVC37/christabelnyange.jpeg Gallery 2 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https://images.squarespace-cdn.com/content/v1/5edff010fc073f2c570c5e7a/0c15c40a-47d9-448d-b5c8-f8c403f154f7/shewhart-control-chart.jpg https://images.squarespace-cdn.com/content/v1/5edff010fc073f2c570c5e7a/3696e49f-2b59-41d8-ad2d-4bd25ed0bda9/we+want+your+feedback%21+Customer+satisfaction%2C+survey+template+design.png https://images.squarespace-cdn.com/content/v1/5edff010fc073f2c570c5e7a/21e872c1-ac14-4d4c-8e74-c705a562834a/QRCode+for+Quality+Improvement_Patient+Safety+Curriculum+-+Quarter+4.png https://www.cafeloggia.com/clinical-reasoning daily 0.75 2021-02-12 https://images.squarespace-cdn.com/content/v1/5edff010fc073f2c570c5e7a/1613146303874-Y295Y7ETSJ4SF7BL2GZ0/LUCY.jpg Clinical Reasoning Front Page You may recognize “Lucy” the “first human”. Imagine Lucy scrounging for roots to eat in the Serengeti. Suddenly she hears rustling in the nearby trees. She has two choices: 1) assume that the rustling is from a saber toothed tiger about to leap on her or 2) think about the various things that could cause the trees to make a rustling sound like squirrels, the wind, tigers, or other hominids. If Lucy’s first response was to reason things out I’m sure you can see that she would not survive long enough for there to be offspring who would one day turn into us. On the other hand, if she makes a snap decision with a high potential to be wrong but also a high potential for saving her life that will be the preferred system of thinking. https://www.cafeloggia.com/system-1-and-2 daily 0.75 2021-02-12 https://images.squarespace-cdn.com/content/v1/5edff010fc073f2c570c5e7a/1613149375244-74MT262TE1XGJ7REMA08/tripodding.jpg System 1 and 2 pat croskerry, an author with whom you should get familiar, describes critical thinking in medicine as an iterative process consisting of two systems. System one is quick, easy and often wrong. System one is Lucy assuming that the rustling is a tiger. It’s also when you look at a patient who is in his sixties, has a pack of cigarettes in his shirt pocket and is “tripodding” and “pursed-lip breathing” in the emergency department and you immediately know he has an exacerbation of COPD. So what’s the problem? It turns out that System One thinking is often subject to COGNITIVE BIAS https://images.squarespace-cdn.com/content/v1/5edff010fc073f2c570c5e7a/1613160456358-H7CF7MWPJM6QC7XBFGTU/Alpha-1_Antitrypsin_Deficiency.png System 1 and 2 - System Two is more thoughtful, harder, and more accurate. After making your initial guess at a diagnosis you think of all the associations of that diagnosis checking them against your patient. Does everything fit? Wait. How old did he say he was? He looks like 60 but he’s only 35. I’ve never seen that before. What looks like advanced emphysema but occurs in a much younger patient? Could he have alpha 1 anti-trypsin deficiency? https://www.cafeloggia.com/critical-thinking-quiz daily 0.75 2021-02-12 https://www.cafeloggia.com/critical-thinking-answers daily 0.75 2021-03-25 https://images.squarespace-cdn.com/content/v1/5edff010fc073f2c570c5e7a/1613165871584-9W26482DFW9OUJE8JCSY/4th+and+July.jpg Critical Thinking Answers Is there a July the 4th in England? Certainly there is. It is not celebrated as Independence Day. https://images.squarespace-cdn.com/content/v1/5edff010fc073f2c570c5e7a/1613166590572-9P361O6E7VOQ7IX8XL0F/birthday+cake.jpg Critical Thinking Answers How many birthdays does the average man have? We all get only one birthday. We celebrate the anniversary of that day for many years afterward. https://images.squarespace-cdn.com/content/v1/5edff010fc073f2c570c5e7a/1613166964138-8ZYKLJ4Q6CNB0N0DSUUW/Calendar.jpg Critical Thinking Answers Some months have 31 days, how many have 28? They all have at least 28 days. Don’t they? https://images.squarespace-cdn.com/content/v1/5edff010fc073f2c570c5e7a/1613167215668-K81RDZX3VPYO6DWAZB7M/US+AND+CANADA.jpg Critical Thinking Answers Why can't a man living in the USA be buried in Canada? We try not to bury the people that are living. https://images.squarespace-cdn.com/content/v1/5edff010fc073f2c570c5e7a/1613167450274-TFBNXJO1YDMOJ3U7650O/BAseball.jpg Critical Thinking Answers How many outs are there in an inning? If both sides get to play, aren’t there six? https://images.squarespace-cdn.com/content/v1/5edff010fc073f2c570c5e7a/1613169397673-46WZT2FS3V7OFQ5P8PML/marraige.jpg Critical Thinking Answers Is it legal for a man in California to marry his widow's sister? With or without marriage equality, if she’s the widow than he’s the one who is dead. There is nowhere that one can marry a dead man. https://www.cafeloggia.com/bias-in-clinical-reasoning daily 0.75 2021-03-25 https://www.cafeloggia.com/step-2-hypothesis-generation daily 0.75 2021-03-25 https://images.squarespace-cdn.com/content/v1/5edff010fc073f2c570c5e7a/1616697967187-59MNWM0WHEPBMSCC59QP/infectious.png Step 2: Hypothesis generation Infectious https://images.squarespace-cdn.com/content/v1/5edff010fc073f2c570c5e7a/1616698899997-N6SAZIZVB8GP40A10YAK/neoplastic-colonic-polyp-7-728.jpg Step 2: Hypothesis generation Neoplastic https://images.squarespace-cdn.com/content/v1/5edff010fc073f2c570c5e7a/1616699168290-BPQ9GPC859CRB9VXM86N/organ+systems.jpg Step 2: Hypothesis generation https://images.squarespace-cdn.com/content/v1/5edff010fc073f2c570c5e7a/1616699395885-70O1E0BV5B49J60CNI04/RF+schema.jpg Step 2: Hypothesis generation https://images.squarespace-cdn.com/content/v1/5edff010fc073f2c570c5e7a/1616707113319-APRQHH83US3AF1B33BQI/tripoding.jfif Step 2: Hypothesis generation - Let’s develop a set of differential diagnoses for this patient Using our Mechanisms of Injury Model: We might say relatively young man with severe shortness of breath and involuntary weight loss Infectious: Advanced TB Neoplastic: Potential small cell lung cancer Inflammatory: Sjogren’s? Scleroderma? other connective tissue disease Metabolic: Emphysema secondary to Alpha 1 Antitrypsin deficiency Toxic/Traumatic: Emphysema secondary to smoking Delivery: Chronic pulmonary embolus or severe heart failure https://www.cafeloggia.com/hypothesis-testing daily 0.75 2021-03-25 https://images.squarespace-cdn.com/content/v1/5edff010fc073f2c570c5e7a/1616709409475-TASDOVSPR01NI4OHCTD5/Picture1.png Step 3 Hypothesis Testing What’s the best fit with our patient. His age is important as is his lack of a fever or joint abnormalities (which we checked for after creating our set of hypotheses). The best fit for this patient would be Alpha 1 Antitrypsin Deficiency. We could measure liver function as well as conduct a more detailed family history and measure A1AT action to confirm. https://www.cafeloggia.com/variety-show-submissions daily 0.75 2021-04-27 https://www.cafeloggia.com/fellowship-2024 daily 0.75 2024-02-27 https://images.squarespace-cdn.com/content/v1/5edff010fc073f2c570c5e7a/1622073108331-D03W7VISH4H940F99DVQ/medical+interns.jpg Fellowship https://images.squarespace-cdn.com/content/v1/5edff010fc073f2c570c5e7a/1622117871404-2Q13DIKF01FU9IYQJ4ZP/Scrubs.PNG Fellowship https://images.squarespace-cdn.com/content/v1/5edff010fc073f2c570c5e7a/1622117910729-RBJ1ZTWLVBJEGDA4NWQC/472563_538650002858887_1061174610_o.jpg Fellowship https://images.squarespace-cdn.com/content/v1/5edff010fc073f2c570c5e7a/1622068502873-N2M173ZCSL2A7N3VM79F/LOR+cartoon.jpg Fellowship - letters of recommendation Start thinking of who to ask for letters of recommendation (ask the letter writer 2-3 months before ERAS opens) For Dr. Fried, in addition to your CV/personal statement, please prepare a “hero” story, describing a patient scenario, where you are the hero! Be as descriptive as possible! https://images.squarespace-cdn.com/content/v1/5edff010fc073f2c570c5e7a/1622068459971-347FD5HB8JU1Z89BFHZX/Cartoon-employer-reviewing-a-resume.png Fellowship - organize your cV General tips: Emphasize strengths Be clear, concise, accurate, <2 pages Organized, start keeping track starting PGY-1 Heading, Education, Honors/Awards, Research/publications/presentations, Work, Extracurricular, Professional memberships, personal interests Give it to someone for feedback Revise!! https://images.squarespace-cdn.com/content/v1/5edff010fc073f2c570c5e7a/1622068191896-NKNZ7X9QYW7VQPUILFPS/image+for+personal+statement.png Fellowship - write your personal statement Start working on your personal statement, format is similar to residency personal statement. Why do you want to go into this field, what have you done in the field, highlight strengths (why will you be an excellent fellow). Be sure to have perfect grammar and spelling. Have people read it and have feedback. The personal statement is your opportunity to communicate you career goals and highlight your talents and experiences. https://www.cafeloggia.com/our-residents daily 0.75 2025-10-21 https://images.squarespace-cdn.com/content/v1/5edff010fc073f2c570c5e7a/b76a863c-23a7-4e75-bcf1-f4dab4191f7b/Slide1.jpg https://images.squarespace-cdn.com/content/v1/5edff010fc073f2c570c5e7a/ebef835c-5253-4749-8a73-63dcbfdf6bba/Slide2.jpg https://images.squarespace-cdn.com/content/v1/5edff010fc073f2c570c5e7a/507a9784-6128-4f06-a6ee-dea9d0bace6e/Slide3.jpg https://images.squarespace-cdn.com/content/v1/5edff010fc073f2c570c5e7a/cf1b2fdd-c8a8-49ce-b6b7-3f0aece1e0c6/Slide4.jpg https://www.cafeloggia.com/careers-in-medicine daily 0.75 2021-11-10 https://images.squarespace-cdn.com/content/v1/5edff010fc073f2c570c5e7a/1635446456529-IT5UKK7V899UTSLHNVIS/512px-Doctor_with_Patient_Cartoon.svg_.png Careers In Medicine - Make it stand out Whatever it is, the way you tell your story online can make all the difference. https://images.squarespace-cdn.com/content/v1/5edff010fc073f2c570c5e7a/1635446578909-BFO3MH4UGI0V0XF4ZU5D/hospital+room.jpg Careers In Medicine - Make it stand out Whatever it is, the way you tell your story online can make all the difference. https://images.squarespace-cdn.com/content/v1/5edff010fc073f2c570c5e7a/1635452236749-16ZNC4UREQQH244Y53UD/LocumTenens_LifestyleOpps-1200x671.jpg Careers In Medicine - Make it stand out Whatever it is, the way you tell your story online can make all the difference. https://images.squarespace-cdn.com/content/v1/5edff010fc073f2c570c5e7a/6d506ba5-3e19-4a5c-a8c1-df01725d3b40/resumee.png Careers In Medicine - Make it stand out Whatever it is, the way you tell your story online can make all the difference. https://www.cafeloggia.com/cafe-loggia daily 1.0 2025-10-21 https://images.squarespace-cdn.com/content/v1/5edff010fc073f2c570c5e7a/1603122162936-Y6QEZ5DNBK61DNJJGGPP/HospitalFront3.jpg Cafe Loggia https://www.cafeloggia.com/meet-our-program-copy daily 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