Background: With a recognized increase in the incidence of venous thromboembolism (VTE) in children, especially in those with complex, chronic conditions, it is important for patient safety and risk management to identify subgroups that would benefit from prophylactic treatment. The aim of our study was to assess whether scoliosis surgery in children was associated with an increased incidence of VTE, including deep venous thrombosis (DVT) and pulmonary embolism, and if chemoprophylaxis is warranted. Methods: We reviewed our institution’s Pediatric Orthopaedic Spine Database (1992-2019) to identify patients who had a symptomatic VTE postoperatively. Results: There were 1471 patients (1035 female, 436 male) with a mean age at surgery of 12.1±3.2 years (range, 1 to 18 y) underwent posterior spinal fusion and instrumentation (2131 procedures). No patients were given pharmacological VTE prophylaxis, and no routine screening for VTE was performed. Two patients had a lower extremity DVT (0.13%) within 6 months following surgery, (range, 55 to 161 d). Neither patient had a subsequent pulmonary embolism. They were 9 and 17 years of age with a diagnosis of neuromuscular scoliosis (1 each postpolio and myelodysplasia). One affected patient had a central venous line inserted perioperatively, a known risk factor for thromboembolism. All DVTs were treated with appropriately dosed anticoagulants. None had a family history of hypercoagulation. Conclusions: The risk of symptomatic VTE is extraordinarily low after pediatric spinal deformity surgery. Mechanical prophylaxis is sufficient in most cases. Further multi-center studies may help identify patient specific risk factors.

4-part noon lecture series through Spring 2021 that was available to all IM residents. The curriculum culminated in a daylong symposium in April 2021including a keynote address, workshops, and race-based caucusing-for which all residents on outpatient rotations were granted protected time to participate. For the symposium, residents designed 6 original interactive workshops, facilitated by University of California, San Francisco faculty, that deconstructed race in the core areas of practice: clinical medicine, medical education, and research. Participants were guided through seminal literature and case studies and tasked with identifying personal and structural areas for antiracist intervention in their practice as physicians. The day concluded with race-based caucusing for residents identifying as people of color and those identifying as White.The symposium was well received. Formal evaluation is underway with the intention of broader dissemination, as few published curricula on structural racism exist. 2 The IM department has adopted a curricular footprint with longitudinal antiracist education for all residents and will continue to sponsor the antiracist working group to address other areas of systemic racism in medicine.The time is now for medical schools and health systems to embrace antiracist change. Resident physicians can be catalysts for reform. Our work should be amplified with programmatic support by way of faculty partnerships, funding, and dedicated curricular time.