Time for change: Dyslipidemia management by internal medicine residents

We evaluate the need for monitoring and reinforcement of inpatient dyslipidemia management throughout Internal Medicine residency training. We reviewed 150 randomly selected chest pain admissions by different levels of Internal Medicine trainees at a tertiary care center and classified their risk factors, lipid panels, and treatment measures according to the National Cholesterol Education Program guidelines. Our sample included 99 patients (66%) with dyslipidemia and mismanagement occurred in 63 cases (42%). Interns handled 94 cases, whereas 56 cases were handled by senior residents. The error rate was 38/94 (40%) among interns and 25/56 (45%) among senior residents. A two-sample comparison of binomial proportions resulted in a P-value of 0.614, indicating statistically similar error rates. In conclusion, inpatient lipid management must be promoted at the beginning of postgraduate training, with re-emphasis and monitoring throughout training to ensure coronary heart disease risk reduction and optimal patient care.