Internal Medicine Residency News, Oct. 9, 2017

Monday, October 9, 2017

From the Director

Hi Everyone!

Doctoberfest continues! This week, we have the networking night for JARs and interns at Dr. Rogers’ home, as well as the party at our home on Friday, AND to keep you all active, the Martin Society Kickball Game (open to all!).  All in all, lots to do this week as we enjoy some amazing fall weather. 

Recruiting for the Duke IM Class of 2044 was quite active this past week!  Welcome to the Duke Family to Parker Anderson (proud parents Ryan and Jen), to Elizabeth Grace Moulton (proud parents Nate and Erin), as well as two alumni babies (Annie Ray, proud parents are Emily and Will Ray, and Nolan Horr, proud parents are Tara and Sam Horr).  We even got a chance to meet Parker as he made his first trip to the Med Res office! Congratulations to you all!

Kudos

Kudos this week to Landon Brown for an outstanding SAR talk, to Steph Garbarino for her outstanding Chair’s Conference (with thanks to alums Sanja Galeb and Olinda Pineda for their expert discussions!), to Lauren Donnangelo from Akash Goyal for her awesome work in the CCU, to Nancy Yang from Matt Labriola for VA Gen Med “beast mode,” to Adam Brock from Matt Labriola for his great job as a cards consult at the VA, to Shaki Salvador, Tara Holder and Mike Murn from Nate Moulton for covering so he could meet Erin in L and D! And to Claudia Leung from Suchita Shah Sata for great post-discharge communication with patients, and kudos to Nick Kamp, Madhu Eluri, Anish Badjatiya, and Peter McCann for doing a fantastic job on 9100 this week from Hannah Dzimitrowicz.

PubMed from the Program

This week’s pubmed from the program goes to Sarah Norton for her poster presented at ID Week! "Community Health Workers can Strengthen Isoniazid Preventive Therapy Implementation in Rural KwaZulu-Natal, South Africa," as well as to alum Pascale Khairallah who had the feature article on the AJKD webpage (https://ajkdblog.org/2017/09/11/in-ckd-the-more-acid-you-eat-the-more-ph...) for her work here at Duke with Dr. Julia Scialla.

Don't forget: SARs, board registration opens Dec 1. Lynsey will be sending out the information, so mark your calendars to register on time (i.e. before the price goes up).

Have a great week!

Aimee

Clinic Corner: DOC

Contributed by Lynn Bowlby

Hi all!

So much info, changes, projects at the DOC, how do we communicate to everyone?

DOC by the numbers..25 staff, 70 residents, 15 faculty, 5,000 patients…

We have a monthly newsletter for all, organized by Alex Cho, DOC Dispatch—recent example below on Opioids—for staff, edited by our very own Jan and written by me. And a Faculty update.

And lots of programs—HOMEBase, HIDoc, Suboxone, and on site PT, Endo, Card, Pulm, GI (Hep C), and of course 3 Behavioral health professionals—Jan, Joy and Ashley. The latter will sadly likely be changing due to funding changes. Always change at the DOC!

Congratulate Holly when you see her…she gets married next Sat the 14th!! So always feel free to talk with me about challenges, changes, etcRefer any Palliative Care pts to me, I will see them at Duke South on Mon PMs with Palliative Care attendings..

Thanks for all you do for our complex patients! Town Hall next month.

Lynn and Co.

Narcotics

or the official name ... Opioids … one of the most challenging aspects of clinical medicine, and at the DOC!

What are narcotics?

  • Narcotics are the most powerful medicines we have for pain…but there are many challenges!

How the world has changed in regards to narcotic use?

  • Until the early 1990s, narcotics were used primarily for cancer pain or acute pain.
  • As chronic (on-going) non–cancer pain increased, doctors began to use narcotics for this type of pain.

Why?

  • This change was encouraged partly by "Pharma" (the companies that make the drugs), and also by some studies that seemed to show little risk of addiction or diversion.
  • So prescribing narcotics for chronic non-cancer pain grew enormously. Some patients were prescribed these medications for years!
  • But, there are many risks, and not all of those risks were fully understood when narcotics began to be used for non-cancer pain.
  • As we now know, the risk for addiction or diversion is actually high!
  • All narcotics, such as oxycodone, morphine, Vicodin, MS contin, and even tramadol are the issue.

You mentioned challenges...

  • Pain is complicated with no test or way to prove someone is or is not in pain. And different people perceive pain differently. 
  • After years of little discussion about these risks, now we are hearing a lot about the rate of death from narcotics.  
  • In North Carolina, deaths from narcotics increased 73% from 2005 to 2015.
  • In Durham County, narcotic-related deaths nearly tripled during that same time period.   
  • Also, heroin (street opiate) deaths in North Carolina increased 884%.
  • Other countries have not used narcotics like we have in the US and don’t have the issues we now have.

Stay tuned:
So how do we handle chronic non-cancer pain?

From the Chief Residents

 
 
Morning Report and MGR: Oct. 9-13, 2017
Date Topic Lecturer Time Location
10/9/17

Menopause/HRT

Ann Phelps

7:15 a.m. DUH 8252
10/10/17

Travel Medicine at Pickett Road

Jason Stout

7:30 a.m.

Pickett Road

10/11/17

Adrenal Disorders

Diana McNeill

7:15 a.m. DUH 8252
10/12/17

Case Presentation

Hannah Dzimitrowicz to John Roberts

7:15 a.m. DUH 8252
10/13/17

Medicine Grand Rounds: William H. Kane Lecture in Hematology

David Ginsburg, MD

8:00 a.m. DN 2002

 

Noon Conference: Oct. 9-13, 2017
Date Topic Lecturer Time Location Lunch
10/9/17

MKSAP GIM/EPIC Update OR Debrief

Paul Riordan and Dinushika Mohottige/Dr. Galanos and Vicki Leff

12 p.m.

DUH 2002/ MedRes Domino's
10/10/17

SAR Lecture: DVT/PE/Thrombophilia

Sarah Nouri

12:15 p.m. DUH 2002

Cosmic Cantina

10/11/17

Dermatology Review

Janet Tcheung

12 p.m.

DUH 2002

Chick-fil-A
10/12/17

Opioids

Larry Greenblatt and Lynn Bowlby

12:15 p.m. 

DUH 2001

China King
10/13/17

Chair's Conference

Maryann Osayande

12:15 p.m.

DUH 2002

Mediterra
 
 
Duke Gen Med Conference Schedule: Oct. 9-12, 2017
 
Date Topic Lecturer Time
10/9/17

Resident Report

Signout 

Diana McNeill

Joseph Rogers

1:15 p.m.

6:30 p.m.

10/10/17

Resident Report

Joe Govert

1:15 p.m.

10/11/17

Resident Report

Intern Report

Aimee Zaas

Joseph Rogers

1:15 p.m.

3 p.m.

10/12/17

Resident Report: Hospital Bundles

Intern Report

George Cheely

Dana Clifton

1:15 p.m.

3 p.m.

From the Residency Office

 
 
Faculty-Resident Research Grant

The applications are due on April 8, 2018 for a funding start date on July 1, 2018.

For JARs, the funding end date is June 30, 2019. For Interns, the funding end date is June 30, 2020.

Attached please find the application forms, instructions, and sample NIH format biosketch (the old NIH Bioskecth format forms are acceptable for your CV)

Please submit your application as a single word or pdf file that includes your mentor’s NIH Biosketch (the new versus old NIH Biosketch format is optional for your mentor).

Please email a pdf file of the signed mentor's support letter with your application by April 9, either as part of the entire application or separately.

Each proposal must have a Human subjects section that describes the protections of the patients and patient data, describe the consent procedure if applicable, status of IRB protocol (to be submitted, already submitted or already approved, as appropriate) etc. This section is required whether to not your project is a retrospective or prospective study, whether patient identifiers are exposed (or not) during data collection/analysis, whether consent is to be obtained or there is a waiver for consent. Please see attached example language that you can adapt to your own specific protocol after discussing with your research mentor.

The next opportunity to apply for a research grant will be in September 2018. Please also find attached scholarship opportunity calendar for this academic year 2017-2018

For any questions, or to discuss mentorship and research project opportunities please contact murat.arcasoy@duke.edu

 
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

  • Oct. 1-31 - Doctoberfest!

  • Oct. 10 - Intern and JAR Cocktails and Networking with the Division Chiefs - Hosted by Katina and Joseph Rogers

  • Oct. 13 - Recruitment Kickoff

  • Oct. 27 - Halloween Bash

  • Nov. 23 - Turkey Bowl!

  • Dec. 9 - Department of Medicine Holiday Party

Doctoberfest!
  • Oct. 3 - Kickoff Doctoberfest with doughnuts!
  • Oct. 11 - A fall treat with lunch
  • Oct. 13 - Recruitment Kickoff Party
  • Oct. 15 - Join the Martin Stead Society for kickball and cider
  • Oct. 18 - Home cooked meal in the MedRes for the night crew
  • Oct. 23-26 - "We Care Week" 
  • Oct. 26 - Pure Barre Class with Kerri Shore
  • Oct. 30 - Doctoberfiesta lunch
  • Oct. 31 - Halloween Tricks and Treats
  • Nov. 1 - Res-teering opportunity with Durham Habitat for Humanity