2nd year of fellowship has been good to me.
But excited to finish fellowship, move back to Ann Arbor and begin as a new ID attending
@umichmedicine
@UMIntMed
!!!
#OhSantaMySanta
@PrezOno
So grateful for an unending list of mentors at many stops for getting me here 😍
@TBrnaughtTB
Following the highest rule in all of medicine “literally every presentation ever can be explained by UTI in the setting of literally any abnormality on urinalysis” 😃
When your boss who is the best human/physician/mentor gets a well-deserved promotion and you can’t wait for the admin to update the faculty wall but you do know where they keep the crafting supplies 😍😍
@Stanford_ID
@Marisa_Holubar
Highly recommend IDWeek to trainees- great science, and fun/welcoming people. Of course we’ll try to recruit you, but we have objectively the best specialty so… 😁
DYK:
#IDWeek2023
had record breaking attendance, with over 12,000 attendees! And 2,000 of those attendees – another new record – were students, residents and fellows!
#FutureofID
I may start working again in 18 days and I may be on service for the first time as an attending in 52 days. But today, I’m chilling in a pub in Dublin with a Guinness and a raucous bunch Irish folks watching the footie game and that’s nice, I think.
(Not a pic of the pub but…)
@okwalding
A/P has also gone from
Early: according to Walding et al 2021… expected clinical course… 0.000002% better survival with… and thus in conclusion… P.S. P.P.S. P.P.P.S.
Late: continue cefepime or whatever, follow cultures. HIV screen. ask and document Monday’s dinner.
I don’t like to think of myself as “the mean fellow” but am 100% sure that (have needed to apologize to consulting teams before) I am at times. Huge shoutout to A) the interns that forgive me for being awful and B)
@VarunPhadke2
and
@JenniferSpicer4
for teaching us better.
I am truly among the most fortunate fellows alive to get to work with
@Marisa_Holubar
every single day! Matching to the ASP track
@Stanford_ID
has maybe been the best thing I have ever done 😍
#IDTwitter
@PriyaNori
@ASHE_Journal
is proud to publish a Women of ASHE Careers perspective- fully open access- Dr. Marisa Holubar on the “Mentorship Mindset” …promoting learning, building partnerships, and finding fulfillment
@jack_turban
Heyyyyy. I’m an ID fellow at Stanford moving back home to Michigan in a several months for my first real job.
Interested include stewardship, clinical reasoning, MDRO’s, TB, baking and lounging poolside with a good book.
Excited to welcome a bunch of new fellow to
@Stanford_ID
a little bit later this morning (what you EST people call “afternoon)! Big congratulations to everyone joining ID, what an amazing field and we are lucky to have you!
We are so excited to gain such an incredible new class of incoming fellows today! Congratulations to each of you on all you have already accomplished. We cannot wait for you to join our Stanford ID family in a few short months!
@okwalding
Me on interviews: “I only have one question, how do you shorten ‘vancomycin’ at your institution?”
Also really hate “Cef” or “cef-y”. Just say the drug name don’t make me guess which cephalosporin you mean. Will even take someone using “CTX” to mean ceftriaxone (😫) over those…
Good news: passed Boards! I’m a real-real doctor now- after paying $1500 and waited most of a day for their website to work. Bad news: ID was my worst subject 😅. Either I really need this fellowship or I need to transfer into endocrine and join
@lauraemitchell
!
It took 53 weeks, but I'm done with first year of fellowship
@Stanford_ID
!! Excited to take not one, but TWO full days off (get you a mentor like
@Marisa_Holubar
) before getting to spend my entire year 2 with the sensational
@StanfordASP
team, continuing to learn and grow in ID!
Tomorrow is my last scheduled day of service of fellowship. I am simultaneously verrrry ready and verrrry not ready 😳. Time to drown my elation and terror in peanut m&m’s!!
Will retweet this sentiment for as long as I live and also hopefully my ashes keep doing so.
“The ID pharmacist is the ID attending’s attending”-
@Darcy_ID_doc
.
Ever thankful for the harms pharmacists (all of them, not just ID) have prevented me from doing to patients!
Today, my attending
@Stanford_ID
:
1) Baked me a loaf of (delicious!!) banana bread
2) Is holding the pager for the last hour+ of the day so I get some extra time off
Get you a fellowship that isn't just not-malignant, but straight up benign 🤗
#BlessedByBlish
#BadAtHashtags
@jtrebach
One time at band camp (I know I know) I got stung by a bee that I swallowed on the inside of my lip. Had amazing band nurses that literally saved my life. I think about this 24/7.
Amazing time at
@IDWeekmtg
! Met with wonderful friends new and old and experienced more stupendous science than you can shake a stick at (most of it was
@G_ROD_11
's I think)!!
Now, if anyone has recs for a good caffeine taper... 😅
So happy for/jealous of everybody getting to find out they're getting to be a part of
@uvaimr
tomorrow!! Wish I could do it again (maybe without COVID this time?)...
Congrats to everyone finding out where they matched today, but most especially those who get to spend the next 3 years with
@uvaimr
🥰. Still the best possible choice I could have made.
Thankful for
@Stanford_ID
for showing thanks to the fellows working today with a GIANT spread and Buca Di Beppo for providing. If you gotta work on a holiday, may as well get fed for it!
#ThanksUpi
!
I decided I'm a professional now 🤷♂️ I think first tweet should go to my unbelievable residency mentors: Amy Mathers, Brian Uthlaut, Molly Hughes, Rachel Kon and so many more. Excited to develop similar at Stanford. And make more antibiotic jokes.
I'm so excited to start my first real job. But
@Stanford_ID
keeps getting harder and harder to leave every faculty has the same message- "You are ready for this, you know what you're doing. BUT, I'm also only ever a text away if you need anything, clinical or non" 🥹🥲
@TBrnaughtTB
Meropenem probably prevents infection💪💪. We should continue ad infinitum. It is also a fabbbbbulous anti-pseudomonal. They are sick. May die unknown if from meropenem or because they only got it for 96 days instead of 97.
We're feeling feverishly excited 🥵 about our incredible new class of antimicrobial aficionados! From our Staph to our fellows, we really have a great culture here! 🧫
Welcome to the
@Stanford_ID
family, Alvaro, David, Uttara, Naveera, Christina, Nathan, Wajeeha, & Jenna!
Tomorrow after a Hawai'ian Ho'ala ceremony I'm formally applying to jobs. So thankful for incredible mentors getting me to this point at both
@Stanford_ID
and
@uvaimr
-
@Marisa_Holubar
, Dr's. Mathers, Hughes, Uthlaut, Kon, Singh, Sahni, Blackburn, Sturt and so many more!
When the surgeons switch from my beautiful penicillin to vanc and pip-tazo for Group A Strep because the abscess they want to medically manage isn't medically managed
In fellowship hard to find a day where you can: exercise, get an oil change, get a haircut, go grocery shopping, cook and do laundry. But today was that day 💪💪
I lied.
@ArunaSubraman12
is as excited as I am!! And while she can’t make it to the show with me we belted our best “Don’t Cry for Me, Argentina” after seeing some of the patients in our transplant ID list 😍🎶🎵
@Stanford_ID
I was promoted to the (not really existent) role of “back-up chief” today, for the next like, 6 days, and excuse me while I am never sufferable ever again 💁♀️💅
Reason ♾️ it’s great to be a fellow
@Stanford_ID
: brilliant co-fellows giving amazing Grand Rounds on infectious issues surrounding breastfeeding. Something I knew shamefully little about and now know… still too little about, but worlds more than before. Amazing job, Eugenia!!
Answered the last question of my first ABIM Board exam a few hours ago! I'd love to say I'm done with Boards, but don't know if I'll feel that way until we get results. In November. For a computerized exam.
@Gabby_Brauner27
I recommend (non-urgently) emailing their PD the positive feedback about them as well- amazing to get positive feedback, but even better when somebody who has control of your future also gets it about you unsolicited. No "I'm just an intern" about it either, still SO meaningful!
‼️New in
@JAMANetworkOpen
w
@HMS_MI
: Risk of bacteremia in hospitalized adults with
#ASB
Key findings:
In patients with
#ASB
, bacteremia from a presumed urinary source was rare:
~1.4% overall
<1% in
#AMS
<1% in
#AMS
+
#dementia
~3% if signs of sepsis
📰:
Omg!!! Dr. Tran was my intern when I was in residency and she was so amazing and it was so obvious she was meant for amazing things!! And now look- leading the way in nephrology as the amazing physician she is!!!!!!
Everyone in my fellowship class is amazing and award winning or featured presenters at international conferences and such. And it would be so humbling… but I have the highest score of anyone in my class on
@IDFellowsCup
so 😏😏😏
#MultipleChoiceChampion
Updated update:
@okwalding
jumped my car and it worked and now it just has to work for tomorrow and then on Monday I can get to a place that does battery replacement things and maybe I will survive. This concludes your episode of 24 hours in the life of an ID fellow 😅
Busy consult day. Started with my car NOT starting. At noon with my 8th consult, phone broke. Finished rounds, went to fix phone before notes. Tech said when iPhone gets stressed it does this. Phone now works. My PHONE got so stressed from pages it broke. What happens to docs?
I finished my first block as a
@Stanford_ID
fellow today! Grateful to have been on elective and had a chance to continue my move (residency to fellowship NEEDS to systemically be a better transition and not a dice toss on havin the best residency PD ever
@UvaDOM
).
We're proud to share the full list of 2023 Teaching Awardees from
#StanDoM
!
Each year, these awards honor educators across the department's divisions for their outstanding dedication, commitment, & expertise in
#medicaleducation
:
Big congrats to my boss, PD, mentor and all around great person and great physician
@Marisa_Holubar
on earning FIDSA recognition!! So lucky to work with her 😍
Dean is amazing and we’re lucky to learn from him!!
@Stanford_ID
faculty just raking in recognitions!
He’s super talented and brilliant, so I guess we can share him with
@StanfordHospMed
;-)
Congrats Dr. Dean Winslow for being awarded the U.S. Public Health Service Outstanding Service Medal for his contributions towards advancing, protecting, and promoting our Nation’s key public health programs and initiatives!
@Neera_Ahuja
Such an honor to be included in Dr. Tompkins’ celebration! I know her as the kindest, most helpful soul with the most brilliant insights during clinical case conference. So much fun (and awesome in the literal sense) to hear about decades of her being all that and more 😍🥰
The entire department came out to honor the career of the illustrious Dr. Lucy Tompkins (who revolutionized the field of molecular epi!) as she transitions to retirement, but we know she’ll be sticking around the office 😉
@Stanford_Med_ID
@Stanford_ID
!
Fine, I will also shout-out to the co-rezzies for making residency bearable (they didn't have to do THAT much <3 UVAIMR). Happy to say the new co-fellows on-track to do the same. Hopeful to be able to say they didn't have to.
#FIsForFun
?
My favorite people at UVA!! The absolute best, kindest, encouraging people!!! Miss them and higher grounds more than anything else there 😭 (sorry
@BPeterson_MD
)
As an ID fellow, I try REALLY hard to avoid crit care. Luckily
@TaisonBell
is the opposite and he (+all
@UVAIMR
PCCM!) taught me enough to keep a peri-code patient alive my last moonlighting shift, until the real MICU fellow could arrive. Thanks! But I'm gonna stick with abx.
@okwalding
@mimimd83
Tho also data that if you don’t cover enterococcus at all in IAI even if grows outcomes are the same. so from that may be difficult to answer the erta question. Bacteremia may be a different story. I could list sources, but
@febrilepodcast
already did!
@okwalding
Just to be clear, this applies at 10pm as well. My co-fellow got a call last night and then the team had to talk to me again this morning anyway to answer all my nitty-gritty questions…
#ConsultStewardship
YESSSS!!!!!!!! Verrrrrrrryyy well earned honor for Alex and Frankie who keep our division running with their competence, great humor, friendliness and endless snack supplies. Nobody more deserving than these absolute stars 😍😍
Had a ton of fun and learned a ton (mostly about what how much I have to learn) with
@StanfordASP
@Marisa_Holubar
@DHpharmd
(and Lina and Emily and Will and Amy and Mary) Excited/terrified to start service on Monday!
I was so lucky to have Upi as my chief during fellowship!! She’s an amazing division chief, physician, scientist, mentor, cheerleader and happy-hour companion and will be a fabulous department chair! Most importantly, she’ll be closer now to my new gig 💁♀️💅
Upinder Singh, MD, has been named chair and department executive officer of the Department of Internal Medicine, effective Oct. 1. Dr. Singh is a professor and division chief of Infectious Diseases and Geographic Medicine at Stanford. Welcome, Dr. Singh!
Sorry, can't follow right now, too busy dealing with brucella, bartonella, TB, a mystery non-MALDIable fungemia, a true FUO and cocci. Always got some cocci!
Maybe if you were cornier I'd find the time 🤷♂️
Get ready, Twitter! Stanford ID is back 🦠 🎊
Follow along with us:
- to learn what makes Stanford ID awesome
- for high-quality med ed content
- for retweets from our dope faculty & fellows
- for shamelessly 🌽y ID puns
😎
@Stanford_Med_ID
#ID
#IDTwitter
#meded
Staffed my last patients today 🥺
Next time I see patients I’ll either be staffing with myself or being staffed WITH!!
And if that’s not just the wildest thing anyone has ever conceived of.
Yes I know I don’t tweet about medicine or infectious diseases very much. But I’m at a show about to see Adam Pascal live and that’s almost as cool as Acinetobacter so.
Talking to surgery
@TBrnaughtTB
: I don't really do this anymore, but he probably shouldn't have glucoses in the 400's. Increase lantus by X and lispro by Y. Actually I'll just put in the orders
For all those wondering, there probably is a good reason for this and there probably is no problem using levo - so, a 🧵 on quinolone resistance in Enterobacterales
So many nice things today: learned from not one but two luminary faculty on rounds, got a picture from my favorite niece making fun of her dad/my brother, chatting with a dear residency friend and of course Michigan football and volleyball wins!
#GoBlue
!
@gu_girl
Dear heavens. I’m literally quaking. Dr. Coffey is a Ph.D chemist, by the by. Maybe she still gets into the lab on occasion and is creating a few new classes. Maybe. 😭😭
@G_ROD_11
@MariamAssiMD
@IdVilchez
@wwrighID
@ErinMcCreary
Most likely a porin, doesn’t seem to have particularly broad beta lactamase production and erta sensitive to those. Could feel comfortable using CRO (or Mero or… but seems excessive) personally, IV=PO, levoflox plenty fine regardless ;-)
@UvaDOM
@gu_girl
@UVA_Endocrine
Very well deserved! I can’t think of a consultant I’ve learned more from as the primary team or one who was more willing to sit down and discuss recs and honestly anything endocrine with a curious resident. Dr. Kirby is absolutely one of the best!!
I know mom hugs mostly because i’m gay and even though my family are v supportive, they sometime aren’t physically present when I need a hug. Amazing, but classic mom, that they are also here for this. Wouldn’t it be nice if they didn’t have to be.
Women held up signs at Michigan State University that say: “Free mom hugs. Just tap my shoulder. I’ll hold tight until you let go, just like a mom would do if she were here.” Students have collapsed sobbing in their arms.
We don’t have to live like this.
Join Dr. Jacqueline Hodges from UVA for
#IDGrandRounds
. “Bridging the gap from knowledge to practice: leveraging implementation science methods to study mobile health interventions for personalized care of people with HIV and substance use." Monday, July 17 at 4:00pm
#IDTwitter
@TBrnaughtTB
I feel like our entire relationship is just this convo over and over and over again, but sometimes we swap who says what 🤷♂️. Probably because that’s all of ID fellowship 😂
At Michigan, there was this fountain. Matriculation we all walked thru it one way, graduation the other. Idk if Stanford (or life) has the same. But anyway, enjoy beginning Kindergarden and ending fellowship. Bye
@Stanford_ID
hello again
@UMich
cya tomorrow! 👋✌️
I started watching "Ted Lasso" for the first time ever just on Sunday. And my word, what a wonderful show! I feel like just watching it makes me a better person.
@Stanford_ID
@okwalding
I'm cheating on Stanford a little bit, but nice visual from
Lotsa TB! And Dr. Sahni is the greatest!!!
(Still waiting for 🌽 tho)
【Tuberculosis overview】Core curriculum
@TXMedCenter
A big thanks to our
@UT_Infectious
alumni, Dr. Lisa Armitage, co-director at Heartland National TB Center!
✍️Which Mycobacterium species are IGRA+?
✍️How to interpret intermediate T-Spot?
@BCMIDFellowship
@MDAndersonNews
When people experience gratitude from their manager, they're more productive. And when teams believe that their colleagues respect and appreciate them, they perform better.
@AlexZimmet
I can't remember if from residency Chief's or CE track, but I love the "trick" of zooming in/out the PR when you need to re-frame. Have also found it very useful that my resident's/student's PR may be different based on their lens of the case, but will trigger new ddx to explore!
This tweet is from my old (parent's) home in Michigan! Which is my home for the next week or so until I move into long-term housing in Michigan. To start my new job in/at Michigan. Which is in Michigan. Which is where I'm from. And the only word I really have still is "wild"!
I'm a bad back-up chief who did not take pictures :-(
But what an amazing
@Stanford_ID
journal club tonight, hosted by Julie Parsonnet and Dean Winslow and led by Melanie Kiener!!! Delicious food, great stories and much thoughtful discourse 🤗
Just since moving to CA for fellowship 7 months ago, both places I did my medical training at have had mass shopping’s. UVA was terrifying for all the close friends I still have there. MSU hit different. I rotated with those trauma surgeons. I could have been in those OR’s.
ID fellowship is all about learning. Yesterday it was aspergillus and metronidazole. Today I’m learning how great Ben Platt is in concert! HIGHLY recommend Frost Amphitheater as a venue if you’re ever in the area. Beautiful!