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Reposted by paul evan bunce, md

🎃nisillos @onisillos.bsky.social · 2d

A great and informative discussion of peer review. I have too many opinions to go into depth here.

My general solution is to better value, in all senses, both peer and editorial review. If peer review was formally counted as work by an academic that might encourage more engagement.

CMI Communications @cmicomms.bsky.social · 3d

🎙️ Just published: Communicable E37: 'Peer review is broken'

Hosted by @angelahuttner.bsky.social & @anniejoseph.bsky.social

w/ invited guests: Melinda Baldwin @mbaldwin.bsky.social & Serge Horbach

Listen on Communicable:

#IDSky #Clinmicro #MedSky #peerreview #AI

Communicable E37: 'Peer review is broken'

share.transistor.fm

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paul evan bunce, md @paulbuncemd.bsky.social · 2d

statin use in PLWHIV, a routine question in outpatient HIV care.

this brief review covers the key points (rationale + recommendations).

IMO, starting a statin in all PLWHIV should be a shared decision, not just for those at moderate CV risk.

www.cmaj.ca/content/197/...

#idsky @cmaj.ca

Statin use in people with HIV

Despite advancements in treatment and HIV viral suppression, people with HIV experience a risk of myocardial infarction that is 1.73 times higher than in people without HIV.[1][1] Believed to be in pa...

www.cmaj.ca

1

paul evan bunce, md @paulbuncemd.bsky.social · 3d

turns out what The Host Response really needed to make it great was... a new host (well, guest host).

brooke fraser joins the show as we dig into a few topics on the teaching and practice of ID.

pretty sure we’ll be making a habit of this type of episode.

FirstcallID @firstcallid.bsky.social · 3d

🎙️ New from The Host Response: The Bundle

This episode features a new format—part roundtable, part reflection—where we talk about what’s shaping ID thinking right now.

Featuring guest host, Dr. Brooke Fraser.

🔗 firstcallid.ca
#FirstCallID #MedEd #IDsky

Episode 12 - The Bundle

Podcast Episode · The Host Response: A FirstcallID Podcast · 10/05/2025 · 15m

podcasts.apple.com

4

paul evan bunce, md @paulbuncemd.bsky.social · 8d

of the many reasons patients with pneumonia fail to improve, the one i encounter most often is a complicated parapneumonic effusion.

easy to overlook but important to catch.

(and trust me, you need to look at the CT with your own eyes to appreciate them)

FirstcallID @firstcallid.bsky.social · 10d

New FirstcallID Teaching Video 🎥

Approach Non-Resolving Pneumonia 🫁

A practical framework for ID consultations; covering history, exposures, investigations, and when to consider further interventions.

Watch now(and share often)!

#InfectiousDiseases #MedEd #AntibioticStewardship #idsky

FirstcallID - How to do an Infectious Diseases Consultation: Non-Resolving Pneumonia

YouTube video by FirstcallID

youtu.be

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Reposted by paul evan bunce, md

FirstcallID @firstcallid.bsky.social · 10d

New FirstcallID Teaching Video 🎥

Approach Non-Resolving Pneumonia 🫁

A practical framework for ID consultations; covering history, exposures, investigations, and when to consider further interventions.

Watch now(and share often)!

#InfectiousDiseases #MedEd #AntibioticStewardship #idsky

FirstcallID - How to do an Infectious Diseases Consultation: Non-Resolving Pneumonia

YouTube video by FirstcallID

youtu.be

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paul evan bunce, md @paulbuncemd.bsky.social · 15d

i'll admit that i fall back on this strategy routinely.

the "mulligan", when thoughtfully deployed, is a helpful way to manage cases where you aren't sure where to turn next.

the art is knowing when best to take this approach, but the timing (and optics) need to be weighed carefully.

FirstcallID @firstcallid.bsky.social · 17d

⛳️ THR Episode 11 – The Mulligan

In golf, a mulligan is a do-over.

In ID, sometimes the best move is the same: stop, reset, and start fresh.

We discuss the value of this strategy and when use it (or shelve it).

#InfectiousDiseases #AntibioticStewardship #MedEd #idsky

🎧 Listen here:

Episode 11 - The Mulligan

Podcast Episode · The Host Response: A FirstcallID Podcast · 09/21/2025 · 5m

podcasts.apple.com

1

paul evan bunce, md @paulbuncemd.bsky.social · 19d

i really enjoyed this discussion with nick daneman and rob fowler on the #Communicable & #Breakpoints podcasts, where the lead investigators break down the journey of the BALANCE trial.

the story behind this epic study is almost as compelling as the results.

CMI Communications @cmicomms.bsky.social · 22d

The 2nd #Communicable & #Breakpoints collaboration drops on 19 Sept! Hosts @angelahuttner.bsky.social & @erinmccreary.bsky.social invite BALANCE trial leads Nick Daneman & Robert Fowler to discuss everything from the trial's humble start to its meteoric impact in clinical practice.
#IDSky #clinmicro

Screenshot of Communicable & Breakpoints hosts Erin McCreary & Angela Huttner with guests Rob Fowler and Nick Daneman.

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Reposted by paul evan bunce, md

FirstcallID @firstcallid.bsky.social · 24d

Gram-neg bacteremia is common, important, and often the reason ID is called.

It's not just about picking an antibiotic, but also asking why it happened, and what else to do?

This FCID session reviews an approach to the patient with GNB bacteremia.

#MedEd #InfectiousDiseases #FOAMed #idsky

FirstcallID - How to do an Infectious Diseases Consultation: Gram-negative Bacilli Bacteremia

YouTube video by FirstcallID

youtu.be

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paul evan bunce, md @paulbuncemd.bsky.social · 27d

as a hospital based internist, i find my physical exam skills are elite.

mind you, i’ve usually reviewed the blood work and imaging prior to seeing the patient.

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paul evan bunce, md @paulbuncemd.bsky.social · Sep 7

having been on both sides, i wanted to highlight this dynamic and ways to improve the sync between trainee and attending.

in hindsight, i think this one may speak more to staff than trainees…

FirstcallID @firstcallid.bsky.social · Sep 7

🎙️The Host Response: Out of Step

When your plan is careful, evidence-based… and your attending still says “No, do the opposite”?

This episode is about those moments of mismatch between trainee & attending, and how to find your footing when you feel out of sync.

#MedEd #InfectiousDiseases #idsky

Episode 10 - Out of Step

Podcast Episode · The Host Response: A FirstcallID Podcast · 09/07/2025 · 5m

podcasts.apple.com

2

paul evan bunce, md @paulbuncemd.bsky.social · Aug 30

interesting. i was halfway through it but lost track with other life stuff.
i will pick it up again.

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paul evan bunce, md @paulbuncemd.bsky.social · Aug 19

job posting: clinician scientist in infectious diseases at UofT (UHN/Sinai Health), with a focus on TB research.

it’s a great academic environment, full of supportive colleagues, engaged learners, and all the energy of toronto.

spread the word!

#idsky #clinicianscientist #tuberculosis

Assistant Professor - Academic Infectious Diseases Physician

jobs.utoronto.ca

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paul evan bunce, md @paulbuncemd.bsky.social · Aug 7

as a longtime proponent of calculating or noting the anion gap, this case was fascinating.

it also puts my personal record for “lowest AG” to shame.

if of interest, this case of Li toxicity includes summary of causes of a negative AG.

www.cmaj.ca/content/176/...

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paul evan bunce, md @paulbuncemd.bsky.social · Aug 5

ICYMI - FirstCallID is a growing collection of free, focused ID teaching videos made for rounds, clinics, and learners at all levels.

🌐 Website: www.firstcallid.ca
📺 YouTube: www.youtube.com/@FirstcallID
🎧 The Host Response podcast also available via Apple/Spotify

Use it, share it, teach with it.

FirstCallID – ID Teaching Videos & Podcast for Trainees

Case-based ID teaching videos and a short-format podcast for trainees. Created by Dr. Paul Bunce to support real-world clinical thinking.

www.firstcallid.ca

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paul evan bunce, md @paulbuncemd.bsky.social · Jul 25

call it PCP - you might come across as a relic

call it PJP - you may seem cleverish

either way, don't call it PCP-pneumonia or PJP-pneumonia - you will come across as redundant redundant

this @idiots-pod.bsky.social is a great review of the clinical aspects of pneumocystis infections.

#idsky

115. The Yeasts: PCP/Pneumocytis jirovecii - ID:IOTS - Infectious Disease Insight Of Two Specialists

Listen to this Pretty Comprehensive Pod on PCP. Alyssa and Callum cover:EpidemiologyTaxonomy (PCP vs PJP?)Diagnosis TreatmentNote this pod episode also includes some Positively Jolly Puns on...

idiotspodcasting.buzzsprout.com

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paul evan bunce, md @paulbuncemd.bsky.social · Jul 24

i am thinking of “the lives of others”(2006).

“people who tell the truth can re-formulate things, and they do. a liar has prepared sentences, which he falls back on when under pressure.”

“the truth is in the details. a liar’s story is too consistent.”

paul evan bunce, md @paulbuncemd.bsky.social · Jul 14

congrats to drs. hugh huang and manreet dhaliwal, coauthors on this brief cmaj review.

the result of much thought, effort, and fine-tuning.

we hope it's helpful to clinicians.

#idsky

CMAJ @cmaj.ca · Jul 14

Indeterminate HIV test:
An indeterminate HIV test could represent either a false-positive or false-negative result.
➡️ www.cmaj.ca/lookup/doi/10.1503/cmaj.241576

A 43-year-old man with an indeterminate HIV test

A 43-year-old man presents requesting screening for sexually transmitted infections (STIs). His medical history is remarkable for systemic lupus erythematosus (SLE), and he is currently receiving no a...

www.cmaj.ca

2

paul evan bunce, md @paulbuncemd.bsky.social · Jul 11

this is so good! i'd like to staple this article (and graphic) to the wall in every ID trainees' room.

these tips for ID case presentations are useful, easy to enact, and high value.

nice work @takamatsuo-id.bsky.social et al.

#meded #idsky

academic.oup.com/ofid/advance...

Ten Practical Tips for A Successful Presentation at Infectious Diseases Clinical Case Conference

Abstract. This mini review provides ten practical tips for Infectious Disease (ID) trainees presenting at ID Clinical Case Conferences. These tips, grounde

academic.oup.com

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paul evan bunce, md @paulbuncemd.bsky.social · Jul 4

a classic ID consult: unexplained eosinophilia.

i fall back on my usual diagnostic framework:
- infectious
- inflammatory
- malignant
... 🤔

(in this case drugs, primary heme, endocrine, etc.)

Great review + infographic via The Intern at Work:
🔗 www.theinternatwork.com/infographics...

Eosinophilia — The Intern at Work

Written by: Dr. Shreyash Dalmia (Hematology Fellow) Reviewed by: Dr. Siraj Mithoowani (Hematology & Thrombosis) & Dr. John Neary (General Internal Medicine) Infographic by: Lily Yu (Medical...

www.theinternatwork.com

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paul evan bunce, md @paulbuncemd.bsky.social · Jul 2

for incoming internal medicine trainees, i would suggest this @idiots-pod.bsky.social episode on meningitis:

idiotspodcasting.buzzsprout.com/1782416/epis...

it is comprehensive, clear, evidence-based, and palatable.

98. Meningitis Masterclass - ID:IOTS - Infectious Disease Insight Of Two Specialists

Jame and Callum are joined by Dr Fiona McGill, lead author of the 2016 Joint Specialist Societies Meningitis Guidelines.Listen to hear an overview of the epidemiology, presentation, diagnosis and mana...

idiotspodcasting.buzzsprout.com

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paul evan bunce, md @paulbuncemd.bsky.social · Jul 2

i have respect for clinicians who sit with “box 2” — getting better, diagnosis unknown — without rushing to claim credit. it takes humility to accept improvement you can’t fully explain.

“despite our efforts, the patient recovered…”

Paul Sax @paulsaxmd.bsky.social · Jul 2

Currently attending on a general medical service. Remarkable how often cases fall into one of these 4 categories.

(Hint: You want to be in Box #1.)

The Four States of Clinical Medicine, and a Movie Review (Sort Of) blogs.jwatch.org/hiv-id-obser...

The Four States of Clinical Medicine, and a Movie Review (Sort Of)

I finally saw The Big Sick. And hooray, it’s excellent. 9/10. Based loosely on the real-life courtship between comedian Kumail Nanjiani and writer Emily V. Gordon, the movie has great word of mouth, i...

blogs.jwatch.org

2

paul evan bunce, md @paulbuncemd.bsky.social · Jun 25

got my first recombinant shingles vax—partly for the benefits (less shingles, maybe less dementia), partly to experience what i recommend

12h: sore arm, subjective fever
24h: back to baseline

boldly following the footsteps of marshall, kean, carrion…

is there a nobel prize coming my way?

#idsky

5

paul evan bunce, md @paulbuncemd.bsky.social · Jun 24

Protect the Macrolide!™

this @febrilepodcast.com episode is an excellent overview of commonly faced dilemmas in NTM treatment—concise, practical, and clinically relevant. excellent discussants as well.

player.captivate.fm/episode/ad81...

#idsky #NTM #meded #pulmsky

122: StAR: Protect the Macrolide! NTM Pulmonary Disease

Quickly and easily listen to Febrile for free!

player.captivate.fm

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paul evan bunce, md @paulbuncemd.bsky.social · Jun 23

having just recorded/released a teaching video on HIV that highlighted these OI guidelines as an invaluable resource - i was saddened to see this shared by dr. sax. the potential loss of this living, practical, evidence-based tool is a huge step backward
grateful to those who built and maintained it

Paul Sax @paulsaxmd.bsky.social · Jun 20

The federal HIV guidelines face a shutdown.
A trusted, living resource -- used by clinicians, programs, and public health agencies for decades -- may disappear due to “budget decreases and revised priorities.”
Big mistake. #IDSky blogs.jwatch.org/hiv-id-obser...

Federal HIV Guidelines Face a Shutdown — A Critical Loss for Clinicians and Patients

Each week, our HIV clinical group gathers to review active patients, share updates, and celebrate good news. On our whiteboard, we list four columns: Inpatients, Outpatients, Issues, and Celebrations....

blogs.jwatch.org

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paul evan bunce, md @paulbuncemd.bsky.social · Jun 9

an unfortunate issue that we can expect to see more frequently - measles during pregnancy.

this is a great summary of the condition and patient management.

@cmaj

#idsky

Measles in pregnancy

www.cmaj.ca

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