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paul evan bunce, md

@paulbuncemd.bsky.social
1.3K followers 66 following 208 posts

internist, infectious diseases md, educator. he/him. toronto creator of firstcallid.ca and “the host response” podcasts.apple.com/ca/podcast/the-h… youtube.com/@firstcallid?si=vcip2Et…

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paul evan bunce, md @paulbuncemd.bsky.social · 22/09/2026
have we spent so much time teaching people not to "treat the culture" that we've started ignoring information that might actually be useful? a culture, on its own, doesn't make a diagnosis. but it can sometimes provide a clue. listen here for my confession (and feel free to disagree).
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paul evan bunce, md @paulbuncemd.bsky.social · 15/09/2026
i could not agree more with this. not only does the shingles vaccine do an amazing job preventing shingles, the additional benefits may be even more significant for those who receive it. it may also be the best thing to look forward to when someone is turning 50. www.cmaj.ca/content/198/...
cmaj.ca
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paul evan bunce, md @paulbuncemd.bsky.social · 11/09/2026
love this paper in @cmaj.ca regarding the benefits of the recombinant zoster vaccine. it's the additional benefits beyond preventing shingles that really stand out with this vaccine. www.cmaj.ca/content/198/...
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paul evan bunce, md @paulbuncemd.bsky.social · 10/09/2026
sometimes the act of taking a sexual history carries more value than the answers you get. #meded #STIsky
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paul evan bunce, md @paulbuncemd.bsky.social · 24/08/2026
there are patients/cases/situations where you just know every moment matters. not because they are critically ill, but because any misstep can mean missing their chance. there’s an art to anticipating these, knowing what’s around the bend, and finding a way to change the course. #meded #idsky
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paul evan bunce, md @paulbuncemd.bsky.social · 11/08/2026
if i could sum up this episode of the host response in one image… #idsky
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paul evan bunce, md @paulbuncemd.bsky.social · 10/08/2026
another solid episode of the Communicalbe podcast - a quarterly catch-up. podcasts.apple.com/ca/podcast/c... for some reason i felt they were speaking to me directly.
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paul evan bunce, md @paulbuncemd.bsky.social · 06/08/2026
viremic is a great educational podcast - basically a mini-curriculum covering the care of HIV-positive individuals. highly recommended.
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Reposted by paul evan bunce, md
Isaac Bogoch @isaacbogoch.bsky.social · 05/08/2026
New World screwworm has returned to the U.S. after more than 40 years, threatening livestock & wildlife (including potentially billions in economic losses). This is a solvable "one health" issue. Link: tinyurl.com/y3k8hc7p, with Jason Andrews and J. Scott Weese.
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paul evan bunce, md @paulbuncemd.bsky.social · 27/07/2026
a few pearls about fever that i find myself repeating to trainees (and patients): - fevers often resolve on their own, and it can be hard to know if any intervention changed the course - fevers tend to come at night. "afebrile so far today" is not always reassuring - fever ≠ infection #idsky
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paul evan bunce, md @paulbuncemd.bsky.social · 20/07/2026
i have had the privilege of caring for people who lived through the darkest years of the HIV epidemic. listening to their stories has changed me. this episode is an invitation to reflect on those stories and, perhaps, your own. #HIV #IDsky
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paul evan bunce, md @paulbuncemd.bsky.social · 30/06/2026
this one took a bit longer to write, and i'm not sure i got it exactly right. i've met people who can captivate a room, and i've met others who quietly make everyone around them better (and a select few who do both). this episode is really just my attempt to recognize both kinds of excellence.
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paul evan bunce, md @paulbuncemd.bsky.social · 15/06/2026
we offer you a 30 minute glimpse into the mind of brooke fraser in the latest episode of the bundle. particular thanks to our co-host, who prepared and recorded this episode while navigating several major life events (all positive). listen, share, follow, and enjoy.
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paul evan bunce, md @paulbuncemd.bsky.social · 01/06/2026
ever since recording this episode, i've noticed "translocation" showing up everywhere. maybe it's availability bias. maybe it's confirmation bias. or maybe translocation has quietly become the leading cause of infection in modern medicine.
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paul evan bunce, md @paulbuncemd.bsky.social · 19/05/2026
this episode was prompted by a colleague who reminded me, during an inpt consult, that she might be the one left sorting through unresolved issues after d/c. sometimes i inherit the loose ends. and, being honest, sometimes i create them. my aim here was more reflection than criticism.
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FirstcallID @firstcallid.bsky.social · 17/05/2026
New episode of The Host Response 🎙️ D/C summaries often contain phrases like: “repeat imaging” “drain to be R/A” and several new medications with no stop date. 🤞 Episode 28 explores what happens when no one is assigned ownership, but someone ends up holding the bag. 👜 #MedEd #IDsky #PrimaryCare
podcasts.apple.com
Episode 28 - Holding the Bag: Discharge, Follow-Up, and Lost Ownership in Medicine
Podcast Episode · The Host Response: A FirstcallID Podcast · May 17 · 6m
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FirstcallID @firstcallid.bsky.social · 07/05/2026
Also highlighted in the latest Bundle 4.0: "Towers of Silence," from 99percentinvisible. 99percentinvisible.org/episode/579-... A haunting story of Mumbai’s Towers of Silence, where the disappearance of vultures puts an ancient funerary tradition on the brink of collapse.
99percentinvisible.org
Towers of Silence - 99% Invisible
Situated right near downtown Mumbai, India is an area of about 55 acres of dense, overgrown forest. In one of the most populous cities in the world, this is a place where peacocks roam freely — a spac...
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FirstcallID @firstcallid.bsky.social · 05/05/2026
We covered a lot of material in Bundles 4.0 of The Host Response. Here is the link to the Gorgas Course "Case of the Week" - a great resource for those wanting to brush up on their tropical medicine knowledge. #idsky #tropmed
uab.edu
Case of the Week | Gorgas Course
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paul evan bunce, md @paulbuncemd.bsky.social · 04/05/2026
don't miss our latest episode of bundles (feat. brooke fraser). perfect for listening on your commute, as you relax before sleep, or during your workout. i was so excited to have brooke back that i had to re-record my opening line to dial back the intensity. link below:
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paul evan bunce, md @paulbuncemd.bsky.social · 26/04/2026
inspiring to see another potential HIV “cure”; this time led by local colleagues and mentors, sharon walmsley and mario ostrowski. #hiv #idsky #cahr
thestar.com
In a Canadian first, a Toronto man's HIV is in sustained remission. Here's what's giving scientists hope
Cancer patient’s bone marrow was replaced with donor cells that have a rare natural resistance to HIV.
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paul evan bunce, md @paulbuncemd.bsky.social · 20/04/2026
the latest episode of the host response is out: liars who lie. this is probably the best episode we've done yet...but you should make sure for yourself, rather than taking my word for it. #idsky #meded #goodshow
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Reposted by paul evan bunce, md
Bug Pharmacist // Tim Gauthier @idstewardship.bsky.social · 18/04/2026
😶‍🌫️🫥🫣 Imposter!!! Who me? #ImposterSybdrome is extremely common and something to recognize and work on if you experience it. Take it from me, I’ve totally felt this way more times than I can count!! 😆 … #ESCMIDglobal2026 … 7/n #meded #pharmed #pharmacist @escmid.bsky.social @sidpharm.bsky.social
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paul evan bunce, md @paulbuncemd.bsky.social · 18/04/2026
i enjoyed this discussion, including the antibiotic that everyone loves to hate (and hates to say the full name of).
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paul evan bunce, md @paulbuncemd.bsky.social · 17/04/2026
as a regular consumer of ID-related podcasts, i was surprised (and saddened) when i recently tried to share a podcast series with a trainee, who asked me to find the show because they had never used a podcast app before. how exactly are current trainees accessing digital learning resources? #meded
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paul evan bunce, md @paulbuncemd.bsky.social · 15/04/2026
a good piece from CBC-the current on how the r-word is creeping back into use (and why it matters)
cbc.ca
The R-word was taboo as a slur for people with disabilities. Now it's being normalized again | CBC Radio
The R-word has been considered taboo for several years, as a slur against people with intellectual and developmental disabilities. Now, the word appears to be undergoing a resurgence and normalization...
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paul evan bunce, md @paulbuncemd.bsky.social · 13/04/2026
Excellent review on diabetes-related foot infections. Reassuring that not everything in our 2013 @cmaj.ca paper has aged terribly...and the updates here are well laid out. @yasmoayedi.bsky.social www.cmaj.ca/content/198/...
cmaj.ca
A 67-year-old man with diabetes presenting with a foot ulcer
A 67-year-old man with a history of type 2 diabetes, diabetic peripheral neuropathy, and hypertension presents to the emergency department with a skin ulceration on the bottom of his great toe ([Figur...
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paul evan bunce, md @paulbuncemd.bsky.social · 09/04/2026
it's one thing to be told that you are right. but when Open Evidence comes back with: “You're absolutely correct, and I apologize for the error.” it lands a different kind of satisfaction.
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paul evan bunce, md @paulbuncemd.bsky.social · 09/04/2026
JOB OPPORTUNITY! adult immunocompromised id clinician position at uhn / university of toronto. amazing clinical work, wonderful colleagues...and (if they turn things around) a world series contenting baseball team. share widely. jobs.utoronto.ca/job/Toronto-... #idsky
jobs.utoronto.ca
Assistant or Associate Professor - Academic Infectious Diseases (Oncology ID)
Assistant or Associate Professor - Academic Infectious Diseases (Oncology ID)
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paul evan bunce, md @paulbuncemd.bsky.social · 07/04/2026
as a med student on a NSx elective, a hair fell from the fellow’s head onto the OR field. as they irrigated the area i contemplated my career options. after ~30s i said aloud “i’m not sure if he’s more upset about contaminating the field…or that he’s losing his hair.” i am now an internist.
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paul evan bunce, md @paulbuncemd.bsky.social · 06/04/2026
sometimes there are 10 possibilities: ddx, tests, treatments you don’t need to say them all at once. good consulting can be as much about timing as it is about knowledge. listen here to the latest episode of The Host Response. #idsky
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IDHub @id-hub.bsky.social · 03/04/2026
Hi everyone! this is IDHub. #IDsky #idmeded #meded #infectiousDiseases A space for Infectious Diseases learning through: • cases • teaching essays • clinical tools to make clinical reasoning FUN! If you're a student, resident, or clinician, I hope this is useful! infectiousdiseasehub.com
infectiousdiseasehub.com
IDHub | Infectious Diseases Education, Cases & Clinical Tools
Free interactive clinical cases, diagnostic reasoning tools, and ID teaching essays.
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paul evan bunce, md @paulbuncemd.bsky.social · 31/03/2026
saddened to hear of the passing of Stephen Lewis. i was fortunate to have met him, and like so many, my wife and i were inspired by his words, conviction, and work. he leaves a remarkable legacy.
cbc.ca
Stephen Lewis, Canadian politician, diplomat and journalist, dead at 88 | CBC News
Former politician, diplomat and activist Stephen Lewis has died at age 88.
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paul evan bunce, md @paulbuncemd.bsky.social · 23/03/2026
another consideration i neglected to include: the salt load associated with various IV antibiotics. you can't cure heart failure associated edema with IV antibiotics (but you sure can make it worse).
academic.oup.com
Sodium Content of Intravenous Antibiotic Preparations
To the Editor—We read with great appreciation the recent publication by Frisbee et al [1], which examines a common and perhaps underappreciated phenomenon
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paul evan bunce, md @paulbuncemd.bsky.social · 23/03/2026
I tried to illustrate the balancing act behind choosing destination antibiotics… this is my best attempt. the point is that the decision (ideally) takes a variety of factors into account.
a multi-armed balance
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paul evan bunce, md @paulbuncemd.bsky.social · 20/03/2026
A very cool application of smartwatch data, used here to identify patients at risk of heart failure decompensation before clinical deterioration. (admission: my wife is one of the authors...but it's still fascinating) @yasmoayedi.bsky.social
thestar.com
Can your smartwatch predict heart failure before it happens? Toronto scientists say it can
Scientists from Toronto’s University Health Network developed an AI algorithm capable of accurately predicting heart failure based on smartwatch data.
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paul evan bunce, md @paulbuncemd.bsky.social · 17/03/2026
look what came in the mail today! if only they were available as audiobooks….
stack of mark crislip’s “puswhisperer” books
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paul evan bunce, md @paulbuncemd.bsky.social · 17/03/2026
is there a better day to decide to learn the irish language? here is a cbc story on those who have decided to take up the challenge.
cbc.ca
An bhfuil Gaeilge agat? Why the Irish language is ‘having a moment’ | CBC Radio
Do you speak Irish? A growing number of people are picking up Ireland’s native language, both inside the country and here in Canada.
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FirstcallID @firstcallid.bsky.social · 13/03/2026
Reminder: If you haven’t listened yet, check out The Host Response podcast for insights, tips, and perspectives on Infectious Diseases consultation. Perfect for anyone curious about, learning, or already practicing ID. #IDsky #meded #IDpodcast
podcasts.apple.com
The Host Response: A FirstcallID Podcast
Medicine Podcast · Updated Biweekly · The Host Response is a clinically focused, practical podcast exploring Infectious Diseases and critical topics in medical practice. Designed for learners at all s...
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paul evan bunce, md @paulbuncemd.bsky.social · 14/03/2026
well. this is exciting. u of toronto job posting for id physician with ipac role. great city. amazing colleagues. top notch hospitals, world series contending mlb team ⚾️. apply if interested. share broadly. #idsky
jobs.utoronto.ca
Assistant / Associate Professor - Academic Infection Prevention and Control Physician
Assistant / Associate Professor - Academic Infection Prevention and Control Physician
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paul evan bunce, md @paulbuncemd.bsky.social · 08/03/2026
some of my favourite pearls from mark crislip include: “piperacillin–tazobactam is the decerebrate antibiotic of choice” “the plural of anecdote is anecdotes, not data” mark’s impact was felt by many within and beyond the field of ID. here is a small glimpse of part of that legacy.
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CMAJ @cmaj.ca · 04/03/2026
I know you’ll understand: A transgender woman physician reflects on her encounters with female patients ➡️ www.cmaj.ca/lookup/doi/10.1503/cmaj.251220
cmaj.ca
I know you’ll understand
“Oh, when I saw that I was getting a colonoscopy, I just assumed you’d be a man. I’m so glad to see a woman is going to be doing my procedure today. I just feel more comfortable around female doctors....
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Joseph Marcus @josephmarcusid.medsky.social · 26/02/2026
Important review of stewardship in ECMO #IDSky 🔑 points: -ID should be part of multi-disciplinary team -More interventions not associated with 👍 outcomes -Lots of gaps in 📚 Thanks to @mirandapharmdmph.bsky.social and team for writing! www.clinicalmicrobiologyandinfection.org/article/S119...
clinicalmicrobiologyandinfection.org
Antimicrobial stewardship during extracorporeal membrane oxygenation: challenges and new perspectives
Extracorporeal membrane oxygenation (ECMO) has emerged as a crucial modality in managing severe cardiac and respiratory failure; however, nosocomial infections and complex antimicrobial prescribing ch...
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paul evan bunce, md @paulbuncemd.bsky.social · 23/02/2026
i've found that it's often the smartest clinicians who tend to ask for input on tough cases i try to do the same (in my head or directly), thinking who to ask and how they’d approach the case. WWJD? episode 22 of the host response is up. #idsky #meded #medsky
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paul evan bunce, md @paulbuncemd.bsky.social · 17/02/2026
should doxy+levo be the default for culture-negative PJI (if no contraindications)? i’ve been leaning this way for a while (ever since Manreet presented the prelim data at city-wide rounds in 2024). great to see this work published. #IDSky #PJI
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paul evan bunce, md @paulbuncemd.bsky.social · 10/02/2026
this recent Viremic podcast on the management of pregnant people living with hiv was outstanding. the discussion was full of important pearls and concepts, and was shared with such humanity and empathy. credit to the show host and guest, dr. jean anderson. #idksy
podcasts.apple.com
Case 14. “AIDS Is Not My Worst Problem”: Caring for Women with HIV
Podcast Episode · Viremic – Cases in HIV · 01/20/2026 · 39m
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paul evan bunce, md @paulbuncemd.bsky.social · 09/02/2026
i'll tell you a secret... when i review cases remotely, i often look at the imaging before i go to the micro. 🤐
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Joseph Marcus @josephmarcusid.medsky.social · 01/02/2026
I highly recommend @patrickching.bsky.social latest commentary in @ashejournal.bsky.social describing: -the history of contact precautions -the need for balance ⚖️ between the benefits of gowns/gloves with their cost/environmental impact www.cambridge.org/core/journal... #IDSky
cambridge.org
The rise and fall of contact precautions: how does personal protective equipment fit into sustainable healthcare? | Antimicrobial Stewardship & Healthcare Epidemiology | Cambridge Core
The rise and fall of contact precautions: how does personal protective equipment fit into sustainable healthcare? - Volume 5 Issue 1
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paul evan bunce, md @paulbuncemd.bsky.social · 31/01/2026
hypothetical: drained MSSA limb pyomyositis, not bacteremic cefazolin is the easy choice, but if cure above all else is the priority, would anyone use another agent or strategy? #idsky
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CMI Communications @cmicomms.bsky.social · 25/01/2026
🎙️ Just published Communicable E45: Top infectious diseases papers in 2025 Hosted by Josh Davis & Emily McDonald w/ invited guest Steven Tong Listen on #Communicable: share.transistor.fm/s/9e626f2a #IDSky #clinmicro
share.transistor.fm
Communicable | Communicable Episode 45: Top infectious diseases papers in 2025
In this episode of Communicable, Josh Davis (Newcastle, Australia) and Emily McDonald (Montreal, Canada), plus invited guest, Steven Tong (Melbourne, Australia)—all practicing physicians and clinical trialists— assemble to discuss some of their ‘top infectious diseases papers published in 2025’....
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paul evan bunce, md @paulbuncemd.bsky.social · 25/01/2026
check out our biggest bundle yet, same low price! highlights include: • sunnybrook hospital’s ASP website (excellent!) • tstin3d (so helpful!) • another “communicable” pearl - @cmicomms.bsky.social • updated cUTI guidelines - adding clarity to the murkiness plus, 2 non-id reads worth your time.
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