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Aditya Ganguly MBBS MD II Internist Profile picture
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Nov 23 • 7 tweets • 2 min read
1) The most important aspect of a medical residency and one that I always pay great heed to --> how well you are able to follow up your patients.

I cannot overstate how vital this is.
2) A lot of residents love talking about how they have seen this case and that --> but they have no case details and have no longitudinal data on the patient.

It means nothing.
3) You discharge your patient and they never come back to you.

How will you know whether the diagnosis you have made or the treatment that you have started has yielded benefit?

Longitudinal data is crucial.
4) Different colleges have different ways of ensuring follow up --> some do it better than others.

A very common way is to have a separate OPD room for follow up cases only.
5) In the end, one method is not necessarily better than the other.

How you ensure follow up within the framework of your existing residency is upto you.
6) What is incontestable is that you need this if your knowledge is to progress.

Hundreds of cases don't matter.

A few cases with diligent follow up +/- preservation of data for future analysis will be of MUCH MORE benefit.

#MedTwitter
#residency
#followup
In the meantime, if you are also wondering how you are going to preserve case details in some place that is MORE SECURE than your cellphone --> I have this thread for you.

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More from @AdiG1993

Aditya Ganguly MBBS MD II Internist Profile picture
Nov 23
I normally don't push brands on social media but @SkechersIndia has to be an exception.

I have suffered from plantar fasciitis for years and it has been gruelling.

I have tried every brand --> homegrown to foreign and most of those don't work. Image
I bought this pair of running shoes a few days back and put them through the paces.

They are amazing. No doubt about it.

Single best pair of shoes I have ever worn.
Hard surface or soft, uneven ground or metalled roads --> this has your back.

The heel support is great and it really feels like an extension of your feet.

This is a great buy as far as I am concerned.
Read 9 tweets
Aditya Ganguly MBBS MD II Internist Profile picture
Nov 22
1) This was an interesting case that I heard on a podcast yesterday.

A young patient with a diagnosis of Friedrich's ataxia EXCEPT it wasn't.
2) Dr Bertoni from @NeurologyUNMC who was a young neurologist at that time, goes against popular knowledge and makes a different diagnosis and starts treatment.

The patient improves drastically and manages to go home!
3) Here is the link

blog.unmc.edu/case-files-in-…
Read 6 tweets
Aditya Ganguly MBBS MD II Internist Profile picture
Nov 21
Its a beautiful Monday morning and its also time for a reality check.

The vast majority of all media that humans consume are focused on the small percentage of winners.

Nobody thinks about the ones who have lost.

This is called survivorship bias.
Its statistically unlikely that you will be a winner even if you work hard or make all the right moves.

Many situations in life are zero sum games
My job here is not to demotivate you.

I am only the devil's advocate here.

A lot of 'inspiration' on social media is a marketing ploy which must be balanced with reality --> this is true for every sphere of life.

You will not be a winner always --> make your peace with this.
Read 5 tweets
Aditya Ganguly MBBS MD II Internist Profile picture
Nov 20
Simple to understand, difficult to implement.

Lack of sleep is dangerous.

This is how much you should be getting across age groups.

#MedTwitter
#sleepmedicine
#sleep
#insomnia
Reference

thensf.org
The study of science must be wedded to knowledge of the great personalities that have advanced its cause.

Sleep medicine is incomplete without knowing its father --> Dr William C. Dement

Here is his obituary.

science.org/doi/10.1126/sc…
Read 5 tweets
Aditya Ganguly MBBS MD II Internist Profile picture
Nov 19
1) The clinical exam receives a lot of flak everyday but we forget one very simple thing.

Many investigations like the USG or echo are highly operator dependent.
2) Secondly, the cornerstone of all investigations is basically clinical correlation.

Imaging or lab findings by themselves are not to be taken too seriously --> without a clear clinical issue.

This is what we have been taught and it works!
3) This is important for all residents.

Don't order investigations blindly without understanding the reasoning and defining a clinical question that needs to be answered.

You need concordance btw all three --> hx, findings and labs!
Read 6 tweets
Aditya Ganguly MBBS MD II Internist Profile picture
Nov 18
This is an important clinical finding I picked up several years back.

What is it ?

PS. For gen med residents and below!

#MedTwitter
#NeuroTwitter
This is just a great example of patellar clonus as you have answered correctly.

Its a classic UMN finding.

I will provide the case details after a few days.
Apparently, this was likely a long segment myelitis and the patient had tried alternative medicine for nearly 6 months prior to coming to us.

Obviously, the cord is dead and the patient has very little chance of regaining any function.

I will try do dig up the MRIs.
Read 5 tweets

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