Michael S. Firstenberg

Stanislaw P. Stawicki

Thomas Papadimos

James P. Orlando

Graduate medical education (GME) continues its decades-long evolution. Evidence-based approaches are increasingly transforming the way we educate, evaluate, and promote GME trainees. Key to this transformation is our ability to recognize that “medical education” constitutes a true lifelong continuum, beginning with pre-medical education, then proceeding to medical school, residency (and potentially subsequent fellowship) training, and then finally the so-called maintenance of certification that continues throughout one’s entire professional career. This book explores a broad range of important topics, including the novel concept of “coping intelligence,” the important role of “work-life integration,” professional coaching and mentorship, professional development and career-long learning, patient-provider relationship, the impact of the COVID-19 pandemic on medical education, as well as the introduction of modern technologies to ameliorate the effects of social distancing. The book further discusses two important aspects of GME program management: the process of establishing new GME programs as well as the highly intricate process of merging residency programs. Different aspects and perspectives are incorporated, including those of residents, faculty, and program leadership. The book ends with chapters on diversity, equity and inclusion, and the importance of community-based medical education.

Volume 2

Contemporary Topics in Graduate Medical Education

Andrew Miller

Sagar C. Galwankar

Since the publication of the first volume of Contemporary Developments and Perspectives in International Health Security, a lot has happened in this rapidly evolving area. Perhaps the most dominant global event of the past eighteen months is the COVID-19 pandemic. Within this general context, the importance of the multiple and diverse international health security (IHS) subdomains is becoming evident, especially when one begins to appreciate the interconnectedness of the modern world and the interdependence of various existing societal systems. Moreover, this complexity presents our civilization with both dangers and opportunities, and among the most pronounced opportunities is our ability to effectively “work together and coordinate” as humanity. With a goal to summarize and synthesize our collective experiences from the COVID-19 pandemic, this second tome of Contemporary Developments and Perspectives in International Health Security is a repository of knowledge and a practical resource for those who seek to learn about the current pandemic as well as for those who may already be preparing for the “next pandemic” or as yet unforeseen IHS threats. In addition to the COVID-19 global response, topics discussed in this book include climate change, mental health, supply chain management, and clinical diagnostics, among others.

Contemporary Developments and Perspectives in International Health Security

Mamta Swaroop

Shock is a physiological state of war! From a healthcare provider perspective, the word “shock” is associated with a mixed array of feelings, including dread, well-founded fear, and deep respect. The physiological state of shock is well recognized for the associated destructive consequences, and its successful management requires prompt identification, immediate action, and sustained effort by all members of the healthcare team. This mindset of advanced preparation and constant readiness constitutes the foundation of the modern approach toward shock – early detection and prompt treatment for optimal outcomes. Despite the heterogeneity of “shock” as a clinico-pathological entity, there are some common threads that permeate all forms and manifestations of shock, with apparent increase in observed commonalities in the more advanced (and often irreversible) stages of the systemic syndrome. When faced with shock, the body and its systems do their best to compensate for the maldistribution of oxygen and nutrients. This is known as the so-called compensated shock. Beyond that, the body loses its ability to adjust any further, thus descending into “uncompensated shock,” with a refractory state characterized by vasoplegia and irreversible cardiovascular failure. As the reader journeys through the chapters of the book, he or she will read about various biomarkers and endpoints of resuscitation, explore different types of shock (e.g., septic, hemorrhagic, anaphylactic) and learn about some of the less often discussed topics such as neurogenic and spinal shock, as well as the amniotic fluid embolism. Our goals were to keep things clinically relevant and practically oriented, thus enabling the reader to apply the newly acquired knowledge in their everyday clinical routines. As the reader progresses through the book, we hope to help stimulate further discourse and innovative thinking about the topic. In this context, it is critical that basic, translational, and clinical research on shock continues to advance. Only through ongoing scientific progress can we help improve outcomes for patients with both rare and common forms of shock.

The Science and Art of Physiological Restoration

Clinical Management of Shock

It is clearly recognized that medical errors represent a significant source of preventable healthcare-related morbidity and mortality. Furthermore, evidence shows that such complications are often the result of a series of smaller errors, missed opportunities, poor communication, breakdowns in established guidelines or protocols, or system-based deficiencies. While such events often start with the misadventures of an individual, it is how such events are managed that can determine outcomes and hopefully prevent future adverse events. The goal of Vignettes in Patient Safety is to illustrate and discuss, in a clinically relevant format, examples in which evidence-based approaches to patient care, using established methodologies to develop highly functional multidisciplinary teams, can help foster an institutional culture of patient safety and high-quality care delivery.

Vignettes in Patient Safety

One of the most important advances in the delivery of healthcare has been recognition of the need for developing highly functioning multi-disciplinary teams. Such teams, when structured in a cohesive fashion, can function more effectively and efficiently than the sum of their parts. The benefits of teamwork extend from the delivery of care to a single patient to the overall structure and function of entire care delivery systems. Recognizing the value of collaborative approaches for improving all aspects of healthcare delivery and having champions, leaders, structure, function, goals, and accountability are paramount to success, regardless of how defined. Another important pillar of teamwork is excellent communication with clearly defined information flows and cross-verification mechanisms. This book outlines how to work together for shared goals in a complex, diverse, and constantly evolving health care system.

Stanislaw P. Stawicki

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