Articles related to Residency

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Delve into the changes in the updated Beers criteria and their implications for medication use in older patients. The American Geriatrics Society (AGS) has recently revised the Beers criteria. Significantly, these guidelines advise physicians to be cautious when prescribing medications like warfarin and sodium-glucose cotransporter-2 (SGLT2) inhibitors for patients over 65. Importantly, warfarin is now a drug to avoid in initial therapy for venous thromboembolism or nonvalvular atrial fibrillation unless alternatives are contraindicated or face significant usage barriers. The Beers criteria are organized into five distinct categories. These include potentially inappropriate medications, ones that might be inappropriate for patients with certain conditions, medications requiring careful usage, potential drug-drug interactions, and medications needing renal function-based dosage adjustments. An expert panel sifted through evidence from June 1, 2017, to May 31, 2022, to create these updates. These guidelines apply to patients aged 65 years and older in most care settings in the US, excluding hospice and end-of-life care situations. Among the notable changes since 2019 is the inclusion of warfarin. For older patients using warfarin long-term, continuation might be reasonable if they show well-controlled international normalized ratios and no adverse effects. Additional drugs introduced since 2019 include ticagrelor and SGLT2 inhibitors (use […]

Delve into the fascinating world of an integrated approach to brain medicine that amalgamates neurology and psychiatry, ushering a new era in patient care. Our understanding of the brain is constantly expanding. This unprecedented knowledge blurs the boundaries between neurology and psychiatry. However, an issue arises: current clinical training maintains a dichotomy stemming from 19th-century practices. This divergence is creating a shift. Neurologists, traditionally untrained in psychiatric management, find themselves treating more psychiatric patients. Likewise, new neuroscience-based precision treatments and diagnostic biomarkers demand skills beyond the psychiatric training purview. This status quo poses a significant challenge to training future doctors. We need to focus on establishing competence in whole-brain aspects and fostering subspecialized expertise. Additionally, implementing feasible and practical programs is paramount. In response, this article proposes a novel 4-year residency program. The first two years concentrate on common and urgent neurology and psychiatry aspects, followed by two years of elective subspecialty tracks. This concept mirrors internal medicine residencies and fellowships, without necessitating changes to existing departmental structures. The article further introduces ‘brain medicine’ as a fitting term for this unified practice. The name emphasizes a holistic focus on all brain aspects. Conventionally, the division between neurology and psychiatry relates […]