Bracamonte, Jesse D.

Introduction: Financial literacy is an often-overlooked aspect of medical education. Prior research indicates that trainees frequently lack knowledge in areas such as loan repayment, retirement planning, and investing, despite reporting strong interest in financial education. Insufficient financial literacy may contribute to financial stress, burnout, and suboptimal long-term planning, highlighting the need for targeted curricula. Methods: We sent a cross-sectional survey to 446 medical students across all Mayo Clinic Alix School of Medicine campuses. One hundred thirteen recipients responded (25% response rate). Participants completed the abbreviated five-item Consumer Financial Protection Bureau (CFPB) financial well-being scale, five previously published “Big 5” objective financial literacy questions, five investigator-developed medical training-specific knowledge questions, and seven investigator-developed self-assessed financial literacy items. We used descriptive statistics to summarize responses. We used analysis of variance, t tests, and regression analyses to assess differences across demographic groups. Results: Despite moderate literacy in all three measured domains, we identified gaps of knowledge regarding loan repayment and retirement planning. Students scored higher on “Big 5” items (3.91/5) than medical training-specific items (3.48/5; P = 0.001). No significant differences emerged across age, campus, or training year for financial well-being or objective literacy. Perceived and objective literacy were moderately correlated (r = 0.52, P<0.001). Interest in additional financial education was high (81%). Conclusion: Despite moderate financial literacy on basic concepts, medical students exhibit notable gaps in knowledge regarding loan repayment and retirement planning. These findings persist across all years of training, highlighting the need for structured, early financial education to better prepare students for long-term financial security.

We describe a patient who had failed renal transplant after 13 years, eventually requiring a graft nephrectomy and discontinuation of immunosuppressive therapy, including antithymocyte globulin, tacrolimus and mycophenolate while on steroid avoidance protocol. Within a few months of complete discontinuation of the immunosuppressive medications, she developed lower back pain associated with numbness in her right anterolateral thigh. The radiological imaging demonstrated multiple bony lesions throughout her axial and appendicular skeleton with normal pulmonary findings. A computerised tomography-guided bone biopsy from the left iliac crest revealed fragments of bone with granulomatous inflammation, thus making the diagnosis of extrapulmonary sarcoidosis. Initiating treatment with prednisone resulted in near-complete resolution of symptoms. Long-term immunosuppressive therapy is administered to all renal transplant recipients to help prevent acute rejection and loss of renal allograft. This case highlights that immunosuppressants can conceal the presence of underlying conditions in transplant patients.

Desmoid fibromatosis is a rare connective tissue malignancy. It can occur in a variety of locations, including the abdominal wall, extremities and abdominal cavity. There has been an association with development in a prior surgical scar. Common symptoms can vary depending on the location and can include being painless to having pain at the site, functional impairment and bowel obstruction from intra-abdominal masses. In the following report, we discuss a case in which a patient’s abdominal pain was attributed to a postoperative haematoma based on CT radiographic features; however, further work-up and biopsy yielded desmoid fibromatosis, a rare locally aggressive malignancy.