The Host Response: A FirstcallID Podcast

In this episode of The Host Response, infectious diseases physician Paul Bunce reflects on how clinical judgment, priorities, and perspective evolve over time in practice.Drawing on advice he shared early in his career (and revisiting it a decade later) this episode contrasts three tips for new ID doctors then with three updated lessons now, highlighting what has changed and what has stayed the same.Topics include:Early career reputation and professional identityAntibiotic overuse and unintended patient harmClinical pacing, sustainability, and burnout preventionCollegial support, trusted second opinions, and work “buddies”Why some truths in infectious diseases never really changeThis episode is not a checklist or a how-to guide. It’s a reflection on approaching competence, ongoing learning, and the realities of long-term practice in infectious diseases and internal medicine.Relevant for infectious diseases physicians, fellows, residents, internists, hospitalists, and trainees thinking about early career development, clinical reasoning, and sustainable practice.

In this episode of The Host Response, Infectious Diseases specialist Paul Bunce flips the usual conversation about “favourite ID consults” on its head.Instead of rare pathogens and diagnostic fireworks, this episode focuses on the consults many ID clinicians quietly dread and why they may be some of the most meaningful work we do.Topics include:Recurrent urinary tract infections and lower urinary tract symptomsRecurrent Staphylococcus aureus skin and soft tissue infectionsPersistent symptoms after treated Lyme diseasePost–IV antibiotic follow-up and PICC line visitsRefractory Helicobacter pylori infectionThese are the consults that test patience, communication skills, and clinical judgment, often with no dramatic “save.” But they’re also opportunities to reduce harm, restore perspective, teach trainees, and meaningfully improve quality of life.This episode is about reframing so-called “nuisance consults,” resisting the urge to defer or dismiss them, and recognizing where Infectious Diseases expertise adds value even when we aren’t prescribing antibiotics.Ideal for:Infectious Diseases physicians, Fellows, Residents, Internists, Hospitalists, and trainees interested in the real work of ID consultation.More ID teaching resources and short-form educational videos are available at FirstCallID.ca.

The Bundle 2.0 is here. In this episode of The Host Response, Dr. Paul Bunce and returning guest Dr. Brooke Fraser take another rapid-fire tour through what’s catching their attention across infectious diseases and adjacent domains: teaching tools worth knowing, papers that may shift practice, ideas from outside ID that still matter, and the small-but-important clinical pearls that surface in everyday work.We cover:ID teaching tools worth your time, including Open Evidence and the Breakpoints podcast.www.openevidence.comhttps://breakpoints-sidp.org/episodes/Literature we’re thinking about, from cardiac complications of Mycoplasma pneumoniae to whether immunosuppression really needs to be held during infection.https://academic.oup.com/cid/advance-article/doi/10.1093/cid/ciaf453/8244960 https://academic.oup.com/cid/advance-article-abstract/doi/10.1093/cid/ciaf442/8232734?redirectedFrom=fulltext&login=false#google_vignetteReflections from beyond medicine, including writing on polarization in healthcare and why “giving” may actually be a strategic advantage.https://macleans.ca/society/health/a-doctors-plea-for-civil-discourse/Safe-space learning, featuring fluoroquinolone-associated tendinopathy and a practical look at divalent-cation interactions with dolutegravir and common antibiotics.https://www.mdpi.com/1424-8247/18/2/184https://accp1.onlinelibrary.wiley.com/doi/10.1002/jcph.439If you’re an ID clinician, general internist, resident, or simply ID-adjacent and curious, this one is packed with things you can actually use.

This episode explores the infectious diseases approach to rashes, skin lesions, and cutaneous manifestations of systemic illness. We review key diagnostic clues, high-yield dermatologic findings in infectious diseases, and life-threatening rash presentations clinicians must recognize early. Topics include erythema nodosum, Sweet syndrome, nodular lymphangitis, pyoderma gangrenosum, disseminated viral exanthems, necrotizing fasciitis, purpura fulminans, and ecthyma gangrenosum. Practical guidance is provided on describing skin lesions, identifying dermatologic signs of immunosuppression or acute infection, and differentiating benign from high-risk presentations in adult patients.

In this episode of The Host Response, Dr. Paul Bunce (Infectious Diseases specialist and clinical teacher) reflects on his complicated relationship with academic writing. From a fellowship project that refused to die to his mother’s psychic prediction that he’d one day be “published,” this episode explores what makes a medical paper worth writing.He shares his personal criteria for taking on a writing project: lessons about mentorship, practicality, curiosity, and the occasional clever title that never made it past peer review.Whether you’re a trainee, educator, or reluctant author, this episode offers a candid, funny, and ultimately hopeful take on publication in medicine, and how writing can still matter, even if it’s not your main metric of success.

In this episode of The Host Response: A FirstCallID Podcast, Dr. Paul Bunce explores a familiar phenomenon in medicine...when someone wields a freshly learned fact like long-held expertise. We unpack why “the vulgar display of recently acquired knowledge” happens, how it affects team dynamics and learning culture, and what it says about our relationship with uncertainty and expertise. With humor and honesty, this episode offers practical ways to recognize the behavior, respond gracefully, and avoid falling into the same trap.

This episode kicks off a new recurring series we’re calling Bundles — a grab bag of ID-adjacent topics we’re reading, noticing, and trying to make sense of. And for the first time, I’m not hosting alone. Joining me is Dr. Brooke Fraser, a general internist and newly minted infectious diseases physician.Together we tackle four prompts:Educational tool: How ChatGPT can help organize and synthesize infectious disease knowledge and Indiana University ID Fellowship Bluesky account (https://bsky.app/profile/iuidfellowship.bsky.social)Recent literature: Rocky Mountain Spotted Fever in Ontario/Quebec and RSV’s link to cardiovascular events Non-ID perspective: Books that shaped our thinking: Everything is Tuberculosis by John Green and How to Talk to a Science Denier by Lee McIntyreSomething new we learned: Rabies risk from North American wildlife and TMP-SMX-induced thrombocytopeniaThis episode ranges wide, but circles back to what matters in practice and education.

Sometimes the best next step in infectious diseases isn’t to add more antibiotics — it’s to stop, reset, and start fresh. In this episode, Dr. Paul Bunce reflects on the value of a “mulligan,” borrowed from golf but applied to patient care: the strategic do-over.Through real-world cases, we explore when pressing reset can clarify confusing clinical stories, improve stewardship, and spare patients unnecessary risk — and when holding back is the safer choice.

🎙️ The Host Response — Episode 10: Out of StepEver had your careful, evidence-based plan shot down by your attending with little more than a shrug and a “let’s do the opposite”? You’re not alone.In this episode, Dr. Paul Bunce unpacks the uneasy moments when trainees and attendings seem just a little out of sync — not wrong, just misaligned. He reflects on the subtle signals that shape trust, the risk of defaulting to “what the attending wants,” and the importance of sharing not just your plan, but your reasoning.Whether you’re a resident trying to find your footing or an attending navigating the balance between correction and collaboration, this conversation explores how mismatched frames can quietly undermine learning — and how to get back in step.

The Host Response — Episode 9: Blame It on the Drugs 💊Every drug has side effects—but which ones actually matter at the bedside? In this episode, Paul Bunce (infectious diseases and internal medicine specialist) shares his teaching framework for approaching medications:Anything can cause anything (clinical humility matters).The most common side effect (what your patient will ask about).The most dangerous side effect (for safety and informed consent).A curveball or trivia fact (the kind your attending might quiz you on).From amoxicillin-clavulanate to vancomycin, TMP-SMX to fluoroquinolones, we walk through antibiotics with this four-part lens—highlighting what’s essential for both patient care and clinical teaching.Whether you’re a trainee, a seasoned clinician, or just someone who’s ever wondered why metronidazole is…Flagyl, this episode will sharpen how you think about prescribing.🎙️ Listen now, and check out more teaching resources at firstcallid.ca.

In this short bonus episode, Paul Bunce, an Infectious Diseases and Internal Medicine specialist, reflects on bias and transparency in medical education. Where do our perspectives come from? How do personal values, training, and outside influences shape the way we practice and teach medicine?Paul shares his own lenses — from minimalism in practice and antimicrobial stewardship to distancing from industry — along with financial disclosures and the background of the FirstCallID project. This episode is about honesty, trust, and making medical education just a little more transparent.

🎙️ The Host Response — Episode: This Email Could Have Been an Alphanumeric PageWelcome to The Host Response, the FirstCallID podcast hosted by Dr. Paul Bunce, adult Infectious Diseases specialist and Internal Medicine physician.In this episode, we dive into a surprisingly powerful but often overlooked tool in infectious diseases consultations: the humble email. Whether you’re advocating for your patient, collaborating across specialties, or course-correcting clinical decisions, effective email communication can make or break your consult experience.Learn why well-crafted emails matter in ID practice — from clarifying complex clinical recommendations asynchronously to managing tensions before they escalate. Get practical tips on tone, structure, audience awareness, and common pitfalls to avoid, so your messages land with clarity and professionalism.If you want to sharpen your communication skills as an ID consultant, trainee, or any healthcare provider involved in infectious diseases care, this episode is for you.Tune in and master the art of consulting by email — a tool that’s low-tech but high-impact.🔗 Check out firstcallid.ca for more podcasts and educational videos on ID consultation strategies.Subscribe on Apple Podcasts or Spotify and help spread the word!

In this episode of The Host Response, Dr. Paul Bunce dives into the art and science of writing infectious diseases consult notes that get read, understood, and acted upon. Learn how to craft clear, concise recommendations that not only answer the clinical question but also reveal your clinical reasoning — all while fostering collaboration with the care team.Whether you’re an ID trainee or a seasoned consultant, discover practical tips to:Focus your recommendations on the consult questionBe explicit and precise with your suggested ordersOrganize your notes for maximal clarityTime your suggestions thoughtfully in complex casesUse your consult notse as a teaching tool and legacy for future careVisit firstcallid.ca for more podcasts and educational videos. If you find this helpful, please follow and share!

Why do some decisions in ID haunt us months later? In this episode of The Host Response, Infectious Diseases and Internal Medicine specialist Dr. Paul Bunce explores the role of anticipated regret in Infectious Diseases consultations. From empiric TB therapy to culture-negative PJIs, learn how to navigate uncertainty, avoid common traps, and make decisions your future self won't curse you for.Perfect for ID consultants, medical trainees, and clinicians interested in the art of medical decision-making.

Infectious diseases is a specialty built on inference, nuance, and—not infrequently—doubt. In this episode, Paul Bunce reflects on the uncertainty baked into ID practice, from ambiguous diagnoses to the risks of overconfidence.Why are we rarely sure, even after years of training?How do we keep moving forward without pretending we’re certain?The practice of Infectious Diseases isn’t always about finding “the answer”—it’s about learning to work in the fog, and still make decisions that matter.

Antibiotics might be the headliners in ID—but there’s a whole supporting cast of medications quietly influencing outcomes. In this episode, Dr. Paul Bunce explores the non-antibiotic drugs that affect infection risk, immune response, and antibiotic safety. From warfarin and DOACs to steroids, biologics, QT-prolongers, and methadone, it’s a tour through the meds that should catch your eye on a medication list.If you’ve ever glossed over a transplant patient’s meds or wondered how serious that QTc really is—this one’s for you.

Before you can treat an infection, you need to define the syndrome. In this episode, Paul Bunce unpacks the foundational ID skill of naming the clinical syndrome — the key that unlocks investigations, management, and meaningful recommendations.

Welcome to The Host Response, a FirstCallID podcast for clinicians navigating the uncertainties of infectious diseases. In this opening episode, Dr. Paul Bunce introduces the mission behind FirstCallID — to help clinicians feel more grounded, confident, and less overwhelmed when facing ID questions. Unlike the structured teaching tools on the website, this podcast offers space for reflection, clinical insight, and honest conversations about the messiness of real-life decision-making. Whether you're early in training or decades in, you're not alone in the grey zone.