Despite EBM’s role as an incredible advancement in the history of medical care and patient management, there remains many challenges that young clinicians must face when attempting to implement EBM into their respective practices.
A surgical resident writes: “Several recent studies suggest current general surgery residents are poorly trained and unprepared for independent practice at the completion of residency. In general, do you agree that current general surgery residents are poorly trained and unable to operate independently at the completion of residency?”
It’s 2 a.m., and the patient’s blood pressure is beginning to rapidly decrease. Every IV line is occupied by an antibiotic or IV fluids, and we are in need of a vasoactive medication. The nurse comes to my computer and sternly states, “We can no longer avoid it. I think the patient needs a central line.” I quickly say “okay,” but I don’t move. I am momentarily frozen by my unease with the bedside procedure ahead.