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you've been using Claude without knowing 40 of its commands.
Then read the guide below.
It’s strange that we ask trainees to read clinical trials but never really teach them how to read clinical trials.
I’d request all training program directors and mentors to please share this article to their trainees and fellows- https://t.co/HJhZlsAS4u
Grateful to @JCOOP_ASCO for making this free.
The Hook
Cardiology trials keep telling you "20% risk reduction."
But what if that same trial meant:
→ 1 in 50 patients helped (NNT 50)
→ 49 of 50 got zero benefit
Welcome to the greatest trick in clinical trials: Relative Risk vs. Absolute Risk. A thread 🧵👇
Most common med student presentation mistake I see:
The opening sentence when presenting a patient should give the patient’s age, gender and why they are being seen but NOTHING more. Leave the other stuff out until after you orient the listener to why the patient is there.
Good: “53yom here with chest pain” “82yof day 3 post op”
After this you can fill in details and the listener is oriented as you speak.
Bad: “60yom with h/o HTN, diabetes, prior hip fracture, BPH, ED, anxiety, family history of colon CA who now comes in because of chest pain.”
The listener has no idea which parts of that PMH matter most until you say why the patient is being seen.
@jasonryanmd I have been doing this so far and I keep telling my interns to do the same. This is the most effective way to present a patient or to do a consult in my opinion. You can give the on liner and then switch to the PMHx and other details.
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@MaryBowdenMD I live in Monroe and I know AMGs don’t rank the programs here. If foreign graduates are not hired, the health system would not function. FMGs are providing their services and they in return get training, win-win for both!
Not a tough hill to door on. Residency is a meritocracy, not a domestic entitlement. Per NRMP 2026, USMD match rates remain at 93.5%, but non-U.S. IMGs hit a 5-year low of 56.4%. The system isn't "replacing" Americans; it’s filtering top 1% global talent to maximize patient care
@MaryBowdenMD Rage-bait Mary doesn’t mention that the US students not matching are trying to get into ultra-competitive specialities while the foreign grads generally match into the least competitive specialties that wouldn’t fill otherwise.
@MaryBowdenMD This is a misleading post.
% of U.S. Citizens that matched - 93%
% of IMGs that matched - 56%
Out of 20k+, only 1367 did not match and its mainly a qualification issue.
meanwhile, 5k+ IMGs out of 11k+ did not match.
Should residents & fellows bill?
A single resident can provide >$300k/yr in uncompensated care due to outdated @CMSGov rules.
Our @NEJM paper proposes a competency-based framework to capture this revenue, improve trainee pay, and offset massive debt. #MedTwitter#MedEd#GME
This is why medicine will no longer attract the best and brightest. Come spend 17 years of your life to train, assume all the risk, take on enormous debt and get paid less than most trades these days. It’s hard to believe we allowed this. We are Medcine, Surgery, but somehow we turned our profession over to suits and allowed them to control us,get paid more than us and in many cases go work for them instead of ourself 🤷♂️
@UnmatchedMD Again, this isn’t even about the Match. The Visa is required for unfilled jobs. If the hospitals had the option to choose a candidate who did not require a Visa (be a US citizen or IMGs with greencard) they would always go for them.
The H1b is required to sustain healthcare!