paul evan bunce, md
@paulbuncemd.bsky.social
internist, infectious diseases md, educator. he/him.
toronto
creator of firstcallid.ca and “the host response”
https://podcasts.apple.com/ca/podcast/the-host-response-a-firstcallid-podcast/id1813669140
toronto
creator of firstcallid.ca and “the host response”
https://podcasts.apple.com/ca/podcast/the-host-response-a-firstcallid-podcast/id1813669140
Reposted by paul evan bunce, md
while this teaching video isn't focused on the acute evaluation and management of UTI, it outlines an approach to a very common (and often frustrating) condition.
people's quality of life can be greatly impacted by recurrent UTI, and we (ID) can often play a big role in improving their situation.
people's quality of life can be greatly impacted by recurrent UTI, and we (ID) can often play a big role in improving their situation.
Just released 🎥
FirstCallID: Approach to Recurrent UTI.
A very common problem that still refuses to be simple.
#idsky #meded #uti
FirstCallID: Approach to Recurrent UTI.
A very common problem that still refuses to be simple.
#idsky #meded #uti
FirstCallID - How to do an Infectious Diseases Consult: Recurrent Urinary Tract Infections
YouTube video by FirstcallID
youtu.be
November 24, 2025 at 4:14 PM
while this teaching video isn't focused on the acute evaluation and management of UTI, it outlines an approach to a very common (and often frustrating) condition.
people's quality of life can be greatly impacted by recurrent UTI, and we (ID) can often play a big role in improving their situation.
people's quality of life can be greatly impacted by recurrent UTI, and we (ID) can often play a big role in improving their situation.
does anyone else get excited during the window when “GPC in chains” is reported from blood cultures, but speciation is pending?
November 23, 2025 at 12:07 AM
does anyone else get excited during the window when “GPC in chains” is reported from blood cultures, but speciation is pending?
after 15 years in practice and reviewing the evidence, here’s what i’ve learned about durations of abx for pneumonia:
• outpatient: 3d
• inpatient: 5d
• aspiration: 3–7d
• VAP: 7d
• and if you ask respirology: 14d
#idsky
• outpatient: 3d
• inpatient: 5d
• aspiration: 3–7d
• VAP: 7d
• and if you ask respirology: 14d
#idsky
November 22, 2025 at 11:28 PM
after 15 years in practice and reviewing the evidence, here’s what i’ve learned about durations of abx for pneumonia:
• outpatient: 3d
• inpatient: 5d
• aspiration: 3–7d
• VAP: 7d
• and if you ask respirology: 14d
#idsky
• outpatient: 3d
• inpatient: 5d
• aspiration: 3–7d
• VAP: 7d
• and if you ask respirology: 14d
#idsky
this felt like an 8 Mile moment, leading with the part of my game you would probably call out anyway.
that said, i have great respect for Dermatologists and recognize that mastering key dermatologic syndromes is essential for effective ID practice.
that said, i have great respect for Dermatologists and recognize that mastering key dermatologic syndromes is essential for effective ID practice.
🎙️ The Host Response - Don’t Be Rash
A walkthrough of dermatologic presentations with implications for infectious diseases, systemic illness, and acute care decision-making.
Focused, clinically oriented, and applicable to everyday ID practice.
#InfectiousDiseases #meded #idsky #idderm
A walkthrough of dermatologic presentations with implications for infectious diseases, systemic illness, and acute care decision-making.
Focused, clinically oriented, and applicable to everyday ID practice.
#InfectiousDiseases #meded #idsky #idderm
Episode 15 - Don’t Be Rash
Podcast Episode · The Host Response: A FirstcallID Podcast · 11/16/2025 · 14m
podcasts.apple.com
November 19, 2025 at 1:02 AM
this felt like an 8 Mile moment, leading with the part of my game you would probably call out anyway.
that said, i have great respect for Dermatologists and recognize that mastering key dermatologic syndromes is essential for effective ID practice.
that said, i have great respect for Dermatologists and recognize that mastering key dermatologic syndromes is essential for effective ID practice.
this is an excellent podcast, covering a series of important clinical issues faced when managing PLWHIV.
credit to the hosts for their practical, evidence-based, and compassionate discussions.
credit to the hosts for their practical, evidence-based, and compassionate discussions.
November 13, 2025 at 4:39 AM
this is an excellent podcast, covering a series of important clinical issues faced when managing PLWHIV.
credit to the hosts for their practical, evidence-based, and compassionate discussions.
credit to the hosts for their practical, evidence-based, and compassionate discussions.
Reposted by paul evan bunce, md
New teaching video from FCID: Approach to CNS infections (meningitis, encephalitis, abscess).
This session focuses on framing the history, contextual clues, and early evaluation. Also the importance of considering non-infectious mimics when the pieces do not fit.
#meded #idsky #CNSinfections
This session focuses on framing the history, contextual clues, and early evaluation. Also the importance of considering non-infectious mimics when the pieces do not fit.
#meded #idsky #CNSinfections
FirstcallID - How to do an Infectious Diseases Consultation: Central Nervous System Infections
YouTube video by FirstcallID
youtu.be
November 9, 2025 at 8:16 PM
New teaching video from FCID: Approach to CNS infections (meningitis, encephalitis, abscess).
This session focuses on framing the history, contextual clues, and early evaluation. Also the importance of considering non-infectious mimics when the pieces do not fit.
#meded #idsky #CNSinfections
This session focuses on framing the history, contextual clues, and early evaluation. Also the importance of considering non-infectious mimics when the pieces do not fit.
#meded #idsky #CNSinfections
Reposted by paul evan bunce, md
A paper doesn’t have to be widely read/cited to matter.
If you wrote it with a trainee, at least you know that one person learned something.
🎧 The Host Response: Publication for the Non-Publicationist
#idsky #meded
If you wrote it with a trainee, at least you know that one person learned something.
🎧 The Host Response: Publication for the Non-Publicationist
#idsky #meded
On being quietly pleased with small academic wins.
On learning to say no.
On the psychic who told my mother that I’d be published.
It’s a reflection on writing, and on protecting your bandwidth.
🎧 The Host Response: Publication for the Non-Publicationist
#idsky #meded #academicmedicine
On learning to say no.
On the psychic who told my mother that I’d be published.
It’s a reflection on writing, and on protecting your bandwidth.
🎧 The Host Response: Publication for the Non-Publicationist
#idsky #meded #academicmedicine
Episode 14 - Publication for the Non-Publicationist
Podcast Episode · The Host Response: A FirstcallID Podcast · 11/02/2025 · 5m
podcasts.apple.com
November 7, 2025 at 2:13 AM
Useful paper on native joint septic arthritis and surgical timing.
Delays seem less common now, but this is welcome support when advocating for urgent washouts.
Retrospective, yes, but still a helpful reference.
@takamatsuo-id.bsky.social
Delays seem less common now, but this is welcome support when advocating for urgent washouts.
Retrospective, yes, but still a helpful reference.
@takamatsuo-id.bsky.social
Consequences of Delaying Surgical Intervention in Patients with Native Joint Septic Arthritis
✅ Just Accepted
#IDSky
✅ Just Accepted
#IDSky
Consequences of Delaying Surgical Intervention in Patients with Native Joint Septic Arthritis
AbstractBackground. Although recent guidance recommends early surgical debridement for native joint septic arthritis (NJSA), supporting data, particularly
bit.ly
November 4, 2025 at 5:37 PM
Useful paper on native joint septic arthritis and surgical timing.
Delays seem less common now, but this is welcome support when advocating for urgent washouts.
Retrospective, yes, but still a helpful reference.
@takamatsuo-id.bsky.social
Delays seem less common now, but this is welcome support when advocating for urgent washouts.
Retrospective, yes, but still a helpful reference.
@takamatsuo-id.bsky.social
despite countless excellent reviews on FUO, my approach remains guided by the teaching of my former mentor, dr. vellend.
i hope this episode reflects his wisdom clearly.
i hope this episode reflects his wisdom clearly.
New FCID teaching video - How to do an Infectious Diseases Consultation: Fever of Unknown Origin.
The consult that humbles everyone, eventually.
A structured approach to FUO...and when to stray off the path and “go for the money.”
youtu.be/afKxBzwz-d4
#idsky #meded #fuo
The consult that humbles everyone, eventually.
A structured approach to FUO...and when to stray off the path and “go for the money.”
youtu.be/afKxBzwz-d4
#idsky #meded #fuo
FirstCall ID - How to do an Infectious Diseases Consultation: Fever of Unknown Origin
YouTube video by FirstcallID
youtu.be
October 27, 2025 at 12:12 AM
despite countless excellent reviews on FUO, my approach remains guided by the teaching of my former mentor, dr. vellend.
i hope this episode reflects his wisdom clearly.
i hope this episode reflects his wisdom clearly.
this is wonderful.
anyone who practices (or is interested in) ID would gain from
signing up for this.
good luck with the newsletter, paul.
(and wish me luck navigating substack for the first time)
anyone who practices (or is interested in) ID would gain from
signing up for this.
good luck with the newsletter, paul.
(and wish me luck navigating substack for the first time)
Inspired by many others, I've started a newsletter to stretch my writing a bit. Hope you'll subscribe! #IDSky paulsaxmd.substack.com/about
October 25, 2025 at 7:11 PM
this is wonderful.
anyone who practices (or is interested in) ID would gain from
signing up for this.
good luck with the newsletter, paul.
(and wish me luck navigating substack for the first time)
anyone who practices (or is interested in) ID would gain from
signing up for this.
good luck with the newsletter, paul.
(and wish me luck navigating substack for the first time)
one of my favourite topics covered on "the host response" to date.
credit to my colleague in training, dr. sumon chakrabarti for coining the term.
credit to my colleague in training, dr. sumon chakrabarti for coining the term.
Finally, someone’s given a name to the performative act of expounding wisdom just recently learned… VDRAK!
Now you can spot it when you see it, chuckle when it appears, and (hopefully) catch it in yourself before falling into the same trap.
#vulgardisplayofrecentlyacquiredknowledge
Now you can spot it when you see it, chuckle when it appears, and (hopefully) catch it in yourself before falling into the same trap.
#vulgardisplayofrecentlyacquiredknowledge
🎙️ New Episode of The Host Response:
“The Vulgar Display of Recently Acquired Knowledge”
We’ve all seen it: the colleague who drops a shiny new fact like it’s ancient wisdom.
Let’s talk about performative expertise and why it stings (and seduces) us all.
#idsky #TheHostResponse #FirstCallID #MedEd
“The Vulgar Display of Recently Acquired Knowledge”
We’ve all seen it: the colleague who drops a shiny new fact like it’s ancient wisdom.
Let’s talk about performative expertise and why it stings (and seduces) us all.
#idsky #TheHostResponse #FirstCallID #MedEd
October 24, 2025 at 12:16 PM
one of my favourite topics covered on "the host response" to date.
credit to my colleague in training, dr. sumon chakrabarti for coining the term.
credit to my colleague in training, dr. sumon chakrabarti for coining the term.
Reposted by paul evan bunce, md
October 24, 2025 at 12:46 AM
Reposted by paul evan bunce, md
🎙️ New Episode of The Host Response:
“The Vulgar Display of Recently Acquired Knowledge”
We’ve all seen it: the colleague who drops a shiny new fact like it’s ancient wisdom.
Let’s talk about performative expertise and why it stings (and seduces) us all.
#idsky #TheHostResponse #FirstCallID #MedEd
“The Vulgar Display of Recently Acquired Knowledge”
We’ve all seen it: the colleague who drops a shiny new fact like it’s ancient wisdom.
Let’s talk about performative expertise and why it stings (and seduces) us all.
#idsky #TheHostResponse #FirstCallID #MedEd
Episode 13 - The Vulgar Display of Recently Acquired Knowledge (VDRAK)
Podcast Episode · The Host Response: A FirstcallID Podcast · 10/19/2025 · 6m
podcasts.apple.com
October 19, 2025 at 2:01 PM
🎙️ New Episode of The Host Response:
“The Vulgar Display of Recently Acquired Knowledge”
We’ve all seen it: the colleague who drops a shiny new fact like it’s ancient wisdom.
Let’s talk about performative expertise and why it stings (and seduces) us all.
#idsky #TheHostResponse #FirstCallID #MedEd
“The Vulgar Display of Recently Acquired Knowledge”
We’ve all seen it: the colleague who drops a shiny new fact like it’s ancient wisdom.
Let’s talk about performative expertise and why it stings (and seduces) us all.
#idsky #TheHostResponse #FirstCallID #MedEd
i once went to trop rounds on “entomology.” i was so excited, i love this topic!
five slides in i asked why they kept showing pictures of bugs.
i thought it was going to be about the meaning of words.
(true story)
five slides in i asked why they kept showing pictures of bugs.
i thought it was going to be about the meaning of words.
(true story)
October 17, 2025 at 2:09 AM
i once went to trop rounds on “entomology.” i was so excited, i love this topic!
five slides in i asked why they kept showing pictures of bugs.
i thought it was going to be about the meaning of words.
(true story)
five slides in i asked why they kept showing pictures of bugs.
i thought it was going to be about the meaning of words.
(true story)
Reposted by paul evan bunce, md
New FirstCallID session: Chemotherapy-Induced Febrile Neutropenia.
A structured approach to history, exam, investigations, and empiric therapy.
🎥 youtu.be/oPhsYsWTj74
#InfectiousDiseases #MedEd #idsky
A structured approach to history, exam, investigations, and empiric therapy.
🎥 youtu.be/oPhsYsWTj74
#InfectiousDiseases #MedEd #idsky
FirstcallID - How to do an ID Consultation: Chemotherapy-Induced Febrile Neutropenia
YouTube video by FirstcallID
youtu.be
October 12, 2025 at 3:50 AM
New FirstCallID session: Chemotherapy-Induced Febrile Neutropenia.
A structured approach to history, exam, investigations, and empiric therapy.
🎥 youtu.be/oPhsYsWTj74
#InfectiousDiseases #MedEd #idsky
A structured approach to history, exam, investigations, and empiric therapy.
🎥 youtu.be/oPhsYsWTj74
#InfectiousDiseases #MedEd #idsky
Reposted by paul evan bunce, md
I've really enjoyed listening to this podcast by old GIM/ID colleague from Toronto @paulbuncemd.bsky.social - Paul, why is this podcast making me weirdly nostalgic about our 7 am reviews of my admissions to your GIM team in my PGY-1 and PGY-2 year? #idsky
podcasts.apple.com/it/podcast/t...
podcasts.apple.com/it/podcast/t...
The Host Response: A FirstcallID Podcast
Medicina · Ogni 2 settimane · The Host Response is a clinically focused, practical podcast exploring Infectious Diseases and critical topics in medical practice. Designed for learners at all stages—fr...
podcasts.apple.com
October 9, 2025 at 2:23 AM
I've really enjoyed listening to this podcast by old GIM/ID colleague from Toronto @paulbuncemd.bsky.social - Paul, why is this podcast making me weirdly nostalgic about our 7 am reviews of my admissions to your GIM team in my PGY-1 and PGY-2 year? #idsky
podcasts.apple.com/it/podcast/t...
podcasts.apple.com/it/podcast/t...
Reposted by paul evan bunce, md
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.
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.
🎙️ 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
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'
Contrary to popular belief, peer review has only recently become an...
share.transistor.fm
October 6, 2025 at 5:28 PM
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.
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.
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
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
October 6, 2025 at 12:33 PM
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
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
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.
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.
🎙️ 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
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
October 5, 2025 at 1:04 PM
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.
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.
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)
easy to overlook but important to catch.
(and trust me, you need to look at the CT with your own eyes to appreciate them)
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
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
October 1, 2025 at 2:24 AM
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)
easy to overlook but important to catch.
(and trust me, you need to look at the CT with your own eyes to appreciate them)
Reposted by paul evan bunce, md
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
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
September 28, 2025 at 12:52 PM
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
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
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.
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.
⛳️ 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:
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
September 23, 2025 at 11:31 AM
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.
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.
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.
the story behind this epic study is almost as compelling as the results.
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
#IDSky #clinmicro
September 19, 2025 at 8:58 PM
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.
the story behind this epic study is almost as compelling as the results.