Internal Medicine Residency News: November 4, 2013

Monday, November 4, 2013

From the Director


Doctoberfest/comes sadly to a close/hello, recruitment! ….or perhaps another haiku to get us started on the recruiting season  daylight savings time/longest call night of the year/turkey bowl is soon! 

We welcomed the preliminary intern applicants on Friday, with our first recruiting day, and Monday marks the first categorical recruiting day! We are looking forward to meeting our future Duke residents, and appreciate the efforts of everyone to make them feel welcome and to show off our fantastic residency program.  Coach K's grand rounds certainly gave us some "street cred" to get the season started.  Please remember to sign up with Erin for the recruitment dinners, as well as take time to talk with the applicants at lunch and throughout the day.

Kudos this week to Jenn Rymer and Christine Bestvina – Jen presented the GME incentive program at the National AAMC meeting this weekend and Christine presented at the ASCO Quality Care Symposium.  Over the weekend, I received emails from our DIO Dr. Cathy Kuhn regarding Jenn's superb presentation, and from Duke Med Res alum and current oncology fellow Tian Zhang about Christine's outstanding talk as well.  Other kudos to Schell Bressler on her gold star for outstanding patient care,  Amera Rahmatullah for winning the final Doctoberfest question (what are ghost cells?), and to Noah Kalman and Landon Meekins for helping with prelim interview day.

To conclude our "Building Our Community" Doctoberfest, WE DID IT!!! We raised over $1200 to purchase the mobile wheelchair ramp for the North Street Community.  I am so proud of everyone for their efforts to help others and to make a difference in the lives of the residents of North Street.  Thank you so much for your thoughtfulness and generosity.  In addition, we took time to recognize the nurses who work with us everyday in the hospital and in the clinics.  And, as a result of all this, the chiefs and I have to sumo wrestle (honestly, it seemed like a good idea at the time).  Details to follow.

We are continuing to work to make our program even better.  Last week, we had our first Clinical Competency meeting.  This is an RRC requirement for all programs, and allows the advisors, chiefs and I to summarize each residents clinical performance, year to date.  Please take time to meet with your advisor and me to discuss the process and to set further learning goals for the year.  This week, we will be having our "Noon Conference" summit, where representatives of the residency council will work with the APDs, chiefs and I to analyze the information from the Noon Conference survey and plan how to improve noon conference. Thanks to Steve Bergin for organizing and leading this effort.

This weeks Pubmed from the Program goes to Josh Briscoe for his presentation at the Association for Medicine and Psychiatry national meeting in Chicago.  His presentation  "Bridge Over Troubled Water: Philosophy in Medicine and Psychiatry"  sparked great discussion among attendees.

Have a great week and HAPPY RECRUITING!


QI Corner

QI Noon Conference

Please join me in thanking Dr. Joanna Kipnes and her discussion of "Health Insurance" as part of our High Value Cost Conscious Care Lecture series.

Stay tuned for our next HVCC lecture, 11/20/2013 with Dr. Daniella Zipkin discussing "High Value Biostatistical Concepts"


Flu Vaccine & QI Champs

Congratulations to Susanna Naggie and Martin Society for being the first recipients of our Flu Vaccine Compliance Trophy by being the first Stead Society to reach 100%.  They were also award the honor of QI Champs for the month of September.

We also want to acknowledge Jennifer Averitt as a QI Champ for her efforts helping to coordinate the flu vaccine campaign.  Special thanks to all residents and Stead Leaders who once again helped us protect our patients by getting vaccinated - 100% 3 years running!

2013 stead flu trophy presentationstead flu trophy














Burnout and Resiliency Survey

Don't forget to complete you burnout surveys as part of a resiliency study lead by Dr. Hany Elmariah. Our goal is >50% completion and we are currently around 30%.

 GME Incentive Program Update

Here is our current HH performance through Mid-October


Observations YTD Compliance YTD Non Compliance YTD Hand Hygiene Rate YTD
Unit 9300





Unit 9100





Unit 8300





Unit 8100





Unit 7800





Unit 7300





Unit 7100













What Did I Read This Week

Submitted by Lynn Bowlby, MD

What Would You do if it Were Your Kid?  NEJM October 3, 2013 369 (14) ;1291-1293, Author:  David N. Korones, M.D.


What would you do if it were your kid?

I hope that many of you have had an opportunity to attend the Schwartz Center Rounds, the monthly Rounds I lead with Lynn O'Neill where caregivers share their feelings and responses to a particular case, with the goal of improving our compassionate responses to patients and their families.

The next Rounds are in 2002 Noon Nov 13.

We can add you to the list serve to send you the monthly announcements, many are the 3rd Tues of the month during noon conference. Just email me to be added!

One of the many benefits to Rounds is the working across Departments and Divisions. The ED has presented several cases. David Gordon sent me the following article as a topic idea for the Rounds.

Have you ever been asked what you would do by a patient if they were your parent or spouse?

All of us know the very ill and complex patients we take care of and often the very difficult decisions that have to be made.

When we make medical decisions for our own family, we use our emotions just as much as our cognition. What we want for our family may be very different than what another family wants.

So how do we answer that question? Can we share with them what our instincts tell us? They ask for guidance, can we be a bit human with them and tell them?

Some families may be asking for our permission to do something different than what we might do..can we help give them permission to do what they feel is right?  Some words to use...explain how our decision is both emotional and rational, and we don't know exactly what we would do...but here is what I think I would do...

Think about those time when it has been your family member with hard medical decisions....and you will feel some of what our patients and families feel in trying to make these tough decisions.











From the Chief Residents

SAR Talks, Noon Conference, 11/5/13

12:00-12:30: "Blood Transfusions – From Monsters and Murderers to Modern Day Marvel" - Dr. Carter Davis

12:30-1:00: "TAVR – Past, Present, Future" - Dr. Wassim Shatila

Grand Rounds

Lord Ajay Kakkar

Noon Conference

Date Topic Lecturer Time Vendor Room
11/5 SAR talks: Blood Transfusions - From Monsters and Murder to Modern Day Marvel / TAVR - Past, Present, Future Carter Davis, Wassim Shatila 12:00 Bullock's BBQ 2002
11/6 Ambulatory Town Hall  Clinic Directors 12:00 Chick Fil-A 2002 (8262 Pickett, 2003 PRIME)
11/7 Speed Bumps in the Head and Neck Ray Esclamado 12:00 Sushi 2001



From the Residency Office

DOCTOBERFEST was a Huge Success!




Your contributions are SO appreciated and will more than pay for the new portable wheelchair ramp that is so needed! – We will be sharing information about a presentation of the donation soon!

In case you haven’t heard it recently, the Duke Internal Medicine Residency Program family ROCKS!!!


Opioid Safety
Have you been reading about opioid safety? Aware of the epidemic of accidental opioid overdose deaths? More people now die from accidental overdose then from motor vehicle accidents. We've seen a tripling in our state over the last 10 years or so. I currently serve as co-chair of the Opioid Safety Task Force and we are trying to take steps to protect our patients. Here something simple you can do- sign up for the North Carolina Controlled Substance Reporting System. This would allow you access via a website to all of the controlled substances prescriptions that your patients have filled. This allows us to identify drugs that might interact with an opioid such as benzodiazepines but also allows us to know who is prescribing to our patients and what prescriptions they are filling. Sign-up is easy though it does require renewal each year while you are in training. After your training is over, you don't need to re-register.  Your application must be notarized and include a photocopy of your drivers license. At the medical residents' office, find Lauren Dincher and at Duke Outpatient Clinic, look for Gloria Manley to notarize your application.   The website is reasonably easy to use and is quite current. Attached is a copy of the application form and a brief list of do's and don'ts that you might review. Please take a minute and do this, you could save a life.

Do and Dont NCCSRS


Larry Greenblatt, MD

DOC Stead C Chief

Medical Director, NPCC, and affiliate of CCNC (Medicaid Care Management)


The time has come to plan the 14th Annual Duke Charity Auction!

For those new to the Duke family, the Charity Auction is one of the most fun events of the year -  with heavy hors d'oeuvres, drinks, and best of all - a silent and live auction, with all proceeds going to Senior PharmAssist, a program that helps low income seniors afford their medications, and the DOC patient fund. Last year, we raised over $16,000!

It's a chance to bid on and win awesome auction prizes-- such as Dr. Zaas-coverage on the rotation of your choice, Dr. Zipkin- coverage of your clinic at the DOC, Duke Basketball tickets, or gift certificates to your favorite restaurants and bars around Durham.  BUT we need your help in planning, and would LOVE to have you join us on Monday, Nov 4th at 5:45pm at the Med Res library. Interns are especially welcome! This is a great opportunity to get involved in something fun that is also for a great cause!

So, to recap:

WHAT: Charity Auction Planning Meeting

WHEN: Monday, Nov 4th at 5:45pm

WHERE: Med Res library


Thanks everyone!

Laura Caputo, Jen Chung, Meredith Clement, Marianna Papademetriou, Carling Ursem


NC ACP Meeting

The meeting this year is Friday and Saturday, February 28 - March 1, 2014, at the Grandover Resort in Greensboro, NC. They are accepting poster/abstracts until December 15th. There is an on line submission on the ACP web site

The prize is trip to the National ACP meeting to present the poster.  Flight, room board, and registration fees are included. The 2014 the meeting is in Orlando, Florida

Sharon Rubin, MD, FACP

Assistant Professor, Duke University Medical Center

Residency Director at Pickett Road

Internal Medicine

The annual enrollment period for medical, dental, vision and reimbursement account benefits for 2014 is now open. You have until 6 p.m. on Friday, Nov. 8 to review and make benefit selections to ensure appropriate coverage.

Please, remember that your participation in the Health Care and/or Dependent Care Reimbursement Accounts does not automatically continue from year to year. If you wish to use a reimbursement account in 2014, you must enroll to participate. However, your current selections for medical, dental and vision insurance will automatically continue for 2014 unless you make changes.

There are two ways to enroll or make changes to your benefits selections:

If you need assistance or have questions, contact the Duke Open Enrollment Service Center at 919-684-5600. Representatives are available weekdays from 8 a.m.- 6 p.m. from Oct. 28 - Nov. 8 and from 8 a.m.- 5 p.m. on Saturday, Nov. 2.


PIM 2013 pdf

Aspirus Internal Medicine-IM Residency Programs 10.22.13

Recruting Flyer Hospitalist


Upcoming Dates and Events

  • November 13:  Networking Event at Dr. Klotman’s! (An opportunity for JAR’s, fellowship directors, and division chiefs to connect!)
  • November 28:  Annual "Turkey Bowl"
  • December 4:  "Voices in Medicine"

Useful links