Internal Medicine Residency News, Oct. 28, 2019

Monday, October 28, 2019

From the Director

Busy weekend with Stead Tread and ResCo Halloween Party! Gearing up for the start of RECRUITMENT 2019-20 with the ZaasHouse Party on Friday night – looking forward to seeing you there.  Kids/significant others welcome!

Please don't forget to sign up for tours, My Takes, as well as sending your photos to Kayla for the recruitment season. Thanks to everyone for your help!

Many thanks for the birthday wishes – lots of bitmoji’s sent my way, which was MUCH appreciated!

Kudos
We have a lot of kudos to catch up on – first off to the amazing Stead Tread Team under the fearless leadership of Dr. Juliessa Pavon! They raised nearly $9,000 with more than 175 runners! Thanks so much to the planning committee of (Chairs) Jordan Gales and Aubry Vonck, and  Stead Tread team (Jessica Regan, Margaret DeOliveira, Alissa Stavig, Sarah Norton, Haley Cunningham, Katie Pollard, Erin Song, Kyle Geurink, and Peggy Sahu).

More kudos to Cindy Pabon from Talal Dahhan for amazing DRH DF handoffs, to Isaac Bleicher for contributing to a GOOD CATCH (with Kathryn Taylor) and receiving a Duke Patient Safety Good Catch Award, to Anthony Horton from JD Ike for pitching in to help out on a Sunday, to Qasim Hussaini for getting a “gold star” from a VA PRIME patient, to Alex Grubb, Michael Burt, Maggie Salinger, Kathryn Hutchins and Peter McCann from Dr. Yasmin Marcantonio for excellent work at DRH, to  Lena Eder and Alex Grubb for outstanding Chair’s Conferences, to Sebastian Estrada from Cindy Pabon for excellent antibiotic stewardship on Gen Med, to Carlos Rivera from Hayley Cunningham for being an outstanding VA GM JAR, and to the 9100 interns Peggy Sahu, Hannah Florian, AD Khatri, Matt Abbott - for doing incredible work for a busy, sick service from Matt Labriola!

PubMed from the Program
This week’s pubmed from the program goes to 

This week’s pubmed from the program goes to Nicholas Koutlas for his poster at ACG as well as Nicole Helmke for winning  the Martin Fenton Award for outstanding resident in a combined program (nationwide).

Nicole Helmke won third place in the vignette prize (out of 27+ submitted vignettes and 8 selected for platform presentation).

Cameron Strong (PGY2) presented a poster (selected for presentation in a very competitive process).

Alissa Stavig (PGY3) presented a poster (selected for presentation in a very competitive process).

Have a great week!
Aimee

Isaac Bleicher receives a gold star award

Nicholas Koutlas

Clinic Corner: Ambulatory

Contributed by Daniella Zipkin

Continuity Clinic Survey
You will receive your survey in MedHub in the beginning of November. Thank you for sharing your feedback regarding your continuity clinic site. We appreciate every bit of it and use your comments to make improvements at the sites. Thank you!

Advocacy in Clinical Leadership Track
Founded in 2012, the ACLT is an elective track for second and third year residents which focuses on advocacy, leadership, and education. Residents come together during twelve weeks per year during ambulatory clinical time, with weekly academic seminars on Friday afternoons. The curriculum includes:

  • Advocacy and health policy seminars given by faculty in government relations and health policy throughout the year, with an advocacy trip in the spring to either Washington DC or Raleigh, NC, alternating years. Residents create a platform based on issues they wish to address as a group and meet directly with lawmakers at the state and national level to present their views.
  • Seminars in leadership and career planning
  • Curricula in teaching and opportunities for small group teaching as a senior resident, with direct observation and feedback
  • Each block also includes General Internal Medicine Journal Club, presented by residents with support from EBM teaching faculty.

Current ACLT residents are:

SARs – Keva Garg, Alie Mara, Katie Pollard, Tamara Saint-Surin, Anmol Singh, Alex Sullivan, Nancy Yang

Med Psych –Nicole Helmke, Johnny Komisar, Colin Smith, Alyssa Stavig

JARs – Marius Chukwurah, John Davy, Nathaniel Harris, Cassie Lautredou, Soo Lim, Ahmad Mourad, Cindy Pabon, Bhavik Patel, Maggie Salinger

Applications will be distributed in November, and due at the beginning of January. Please email Dani Zipkin with any questions!

Ambulatory Lab Routing Changes – Reminder!
The health system made systematic changes to lab and order routing for all trainees at Duke. This has ramifications for workflow in clinic, particularly at DOC. For those who haven’t heard yet:

  1. Upon signing in to your workstation in the beginning, DO NOT select an attending, leave it blank
  2. Within each encounter, PEND all orders until you know who you are signing out with. This is critical. In the past, the name you put in that field didn’t matter, since results routed to a default attending designated at the front desk on check in. No longer!! The attending you put in AT THE TIME OF SIGNING ORDERS will be the attending copied on the results.
  3. This is true for POC orders, and all orders (because the attending designation prompt only appears ONCE per encounter) . Luckily, at the DOC, nurses are now doing POC glucose and POC A1c without our order, per protocol. But other POC orders will need to wait until you sign out. You can sign these selectively, first, as soon as you start signing out, to get things moving! (Selective sign is tiny, locate in the lowest right hand arrow, to the right of signing orders… try it!!)

Clinic Corner: PRIME

Contributed by Leigh Wynkoop and Sonal Patel

Last week was Pharmacy Week at the VA! If you have a chance, remember to thank our awesome clinical pharmacist, Alicia Watkins, for all she does to help you and our Veterans! 

Flu shots: patients will be offered flu shots on LPN intake. If the patient declines, the reminder will stay active so you will remember to discuss again with the patient and try to persuade them – at that time, please complete the reminder to reflect the outcome of your discussion.

Mammo and Pap results: instead of using the PRIME-Patient Letter note, please use the reminders: Mammo-Review Results and Pap-Review Results, which generate a letter remotely automatically and allow you to set the return interval. You can do an addendum on your last visit note to access these reminders.

PHASER genomics trial: Patients were secure messaged about getting a genetic analysis done for genes which may affect drug metabolism. If your patient asks about this, the attendings will have more information, and we’ll put some info in the precepting room.

Don’t forget that Todd Marquez, PT is here on Wednesday and Friday PMs to provide support with musculoskeletal issues – seeing patients with acute complaints, reviewing exams with you, discussing treatment options, etc. He is here to assist you as well as our patients!

We will get some sympathy cards to have on hand for you to send to families of patients who pass away, for you to express your sympathy for their loss and that it was an honor to care for the Veteran. The Chaplain’s Office has memorial services quarterly (with families of Veterans invited) and we’ll try to keep you apprised of those dates of those as well. 

Please let the attendings know when you’re done seeing all your patients for the clinic session.  Thanks for working so well with each other and for being in PRIME.

From the Chief Residents

 
 
Morning Report and MGR: Oct. 29-Nov. 1, 2019
Date Topic Lecturer Time Location
10/29/19 Readmissions Dr. Gallagher 7:15 a.m.

DUH 8253

10/30/19

Jeopardy

-- 7:15 a.m.

DUH 8253

10/31/19

Polypharmacy

Dr. Riordan 7:15 a.m. DUH 8253
11/1/19

Medicine Grand Rounds: Joseph C. Greenfield Lecture: Learning From Cases in Practice & Practice with Cases for Learning

Gurpreet Dhaliwal, MD 8 a.m. DUH 2002

 

Academic Half Day: Nov. 1, 2019
 
Thread Topic Lecturer Time Location
Rheum/Renal/Endo

SpA & Non-inflammatory back pain

ESRD

Brian Andonian

David Ortiz-Melo

9:15 a.m.

10:30 a.m.

VA NG032
ID/GI/GIM

ID 101

Micah McClain

9:15 a.m.

VA PRIME Conference Room
Card/Heme/Pulm/Onc

Asthma

New cancer diagnosis workup and patterns of metastatic spread

Loretta Que

Tian Zhang

9:30 a.m.

10:30 a.m.

VA C8016

 

Noon Conference: Oct. 28-Nov. 1, 2019
Date Topic Lecturer Time Location Lunch
10/28/19

CNS Tumors for General Internists

Maggie Johnson

12:10 p.m.

DUH 2002

Domino's

10/29/19 SAR Talk: Hypertensive Urgency/Emergency

Kyle Geurink

12:10 p.m.

DUH 2002

Popeye's

10/30/19 Meningitis and CNS Interpretation Nick Turner

12:10 p.m.

DUH 2002

Sazon
10/31/19 No Conference (Prelim Interview Day/We Care Week Celebration) --

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Panera
11/1/19

Chair's Conference

Alex Reddy

12:05 p.m.

DUH 2002

Cosmic Cantina
 
 
Duke Gen Med Conference Schedule: Oct. 28-31, 2019
Date Topic Lecturer Time
10/28/19

SAR Report - Orientation

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1:15 p.m.

10/29/19

SAR Report - DUH 8262

Intern Report 

Daphne Xiao to Joe Govert

Jeff Kwock to Stephen Bergin

1:15 p.m.

3 p.m.

10/30/19

SAR Report

Dennis Narcisse to Aimee Zaas

1:15 p.m.

10/31/19

None - Recruitment

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From the Residency Office

Feeling down? Need to talk to someone? Opportunities for Wellness
All trainees at Duke have FREE access to Personal Assistance Services (PAS), which is the faculty/employee assistance program of Duke University. The staff of licensed professionals offer confidential assessment, short-term counseling, and referrals to help resolve a range of personal, work, and family problems. PAS services are available free of charge to Duke faculty and staff, and their immediate family members. An appointment to meet with a PAS counselor may be arranged by calling the PAS office at 919-416-1PAS (919-416-1727), Monday through Friday between 8:00 A.M. and 5:00 P.M. For assistance after hours, residents and fellows can call the Blood and Body Fluid Hotline (115 inside DUH, 919-684-1115 outside) for referral to behavioral health resources. Another resource is Duke Outpatient Psychiatry Referrals at (919) 684-0100 or 1-888-ASK-DUKE. https://www.hr.duke.edu/pas/

Upcoming Dates and Events 

  • Nov. 1 - Recruitment Kick Off Party