Resident supervision, nerve agents, and clinical conferences

This issue delves into dilemmas of training and terrorism, among other topics.

We're midway through the academic year, a point when even first-year residents should have gotten the hang of the hospital. But how much independence should they be granted, asks this month's main story? Do you stay with them at all times, use digital tools to remotely see what they're doing, or simply ask them to keep you informed? Much like parents, hospitalists debate this question. Considerations include not only what's best for patient care and trainee learning, but also how academic supervision can be incorporated most efficiently into hospital practice.

Letting residents off the leash isn't even the scariest concept in this issue. That would be the article in this issue about nerve agent exposures, and how hospitalists should respond if one were to occur nearby. It was inspired by the Novichok poisonings in England last summer, but the experts' tips also apply to more common chemicals that could be used in an attack, including chlorine, hydrogen sulfide, and cyanide.

On a happier note, we attended multiple conferences in recent months and have brought back coverage of various clinical topics for you. From the American College of Gastroenterology, there's advice on diagnosing and treating inpatient constipation. (This month's Test Yourself has related questions from MKSAP 18.) Our first-ever coverage of the Southern Hospital Medicine Conference features acute-on-chronic liver failure, psychosis, and a bonus online-only article on syncope.

This month's Q&A and Success Story focus on lung health, describing efforts to avoid respiratory compromise and hospital-acquired pneumonia, respectively. Always feel free to give us a shout at

Stacey Butterfield