Internal Medicine Residency News, July 29, 2019

From the Program

Thanks to everyone who came out to the Durham Bulls game last week! Thank you to Joel Boggan and the Kerby Society for hosting!

Kudos
Kudos this week go to Hannah Florian for doing an amazing job on VA Gen Med from Alex Reddy, and to Nicole Helmke for stepping in to care for some very sick patients at DOC from Lynn Bowlby. Kudos to the excellent VA Gen med team for the month of July: The JARs (Cameron Oswalt, David Elliot, Tanmay Gokhale, Alex Reddy, Caitlin Driscoll, Cameron Strong, Nick Koutlas, Stacy Bagrova) were absolutely amazing and created a very positive learning environment; they had fun, helped each other out and took care of some really sick patients from Anish Badjatiya. Kudos to the VA Gen Med interns (Lara, Shawn, Saad, Hannah, Peggy, Melanie, Mike, and Matt) for diving deep into residency, handling VA call with grace and enthusiasm, and being the most humble, compassionate and eager group that I have seen also from Anish Badjatiya. Kudos to Ceshae Harding for fantastic work in GI clinic from Rey Quevedo, to Tammy Hsu, Aarti Thakkar (subintern) and Surya Ravichandran (MS2) for working hard and keeping up a great attitude on Gen Med from Qasim Hussaini, to Anish Badjatiya for a fantastic SAR Talk, and to the ResCo Chairs for leading our first town hall!

Have a great week!

Clinic Corner: Ambulatory

Contributed by Daniella Zipkin

Ambulatory Lab Routing Changes
This is primarily for DOC residents (it’s happening at Pickett too, but simpler there with one attending per session):

Starting on 8/6/19, Maestro leadership is changing lab routing for all GME trainees to copy the attendings. Up until now, attendings have not been copied on your lab results. We do receive imaging and procedure reports. At the DOC, this creates some very important workflow changes:

  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!
  4. Thank you in advance for your patience with this. This is a major DUHS system-wide change to address patient safety issues.

Observed Encounters
The greatest opportunity for feedback and insights about your patient communication skills comes through direct observation. While a bit awkward, direct observation is a rich opportunity for learning!

We are planning to do Observed Encounters for every resident in clinic (these were formerly called CEX). Please note that you can see your Observed Encounter evaluations completed in MedHub to keep track. The goal is TWO for every Intern, ONE for every JAR and SAR, during the year. Please help us get these done by being proactive during clinic – asking us for observation before you see a patient. You may see the signs up in your clinic, designating days when the attending ratio is more favorable to do these. It’s best if we can observe the history and physical – we will generally scoot out and reconvene at sign out. Thanks in advance for helping with this!

From the Chief Residents

Morning Report and MGR: July 30-Aug. 2, 2019
Date Topic Lecturer Time Location

7/30/19

Hypertension

 Daniella Zipkin

7:15 a.m.

DUH 8253

7/31/19

Cancer Screening

David Edelman

7:15 a.m.

DUH 8253

8/1/19

Immunizations

Larry Greenblatt

7:15 a.m.

DUH 8253

8/2/19

Medicine Grand Rounds: PCI in High Bleeding Risk Patients: A World of Change 2019

Mitchell W. Krucoff MD, FACC, FAHA, FSCAI

 8 a.m.

DUH 2002
 
Academic Half Day: Aug. 2, 2019
Thread Topic Lecturer Time Location

Rheum/Renal/Endo

Continuity Clinic Orientation

 

9:15 a.m. & 10:30 a.m.

 

ID/GI/GIM

 Continuity Clinic Orientation  

9:15 a.m. & 10:30 a.m.

  

Card/Heme/Pulm/Onc

Long Term Care

Long Term Care

--

Anne Phelps

9:15 a.m.

10:30 a.m.

DUH 8253
 
Noon Conference: July 29-Aug. 2, 2019
Date Topic Lecturer Time Location Lunch

7/29/19

Radiology for the Internist

Linnan Trang

12:10 p.m.

DUH 2002

Domino's

7/30/19

SAR Lecture: HIV

Tamara Saint-Surin

12:10 p.m.

DUH 2002

Sazo'n

7/31/19

 Pulmonary Emergencies

Stephen Bergin

12:10 p.m.

DUH 2002

 Chick-fil-A

8/1/19

 How to get out of the hospital faster: Maestro Tips

Alex Sullivan and Kyle Geurink

12:10 p.m.

DUH 2001

 Subway

8/2/19

Chair's Conference

John Davy

12:05 p.m.

DUH 2002

 Popeye's
 
Duke Gen Med Conference Schedule: July 22-25, 2019
Date Topic Lecturer Time

7/29/19

SAR Report 

Cake Pops with Cooney - Canceled

Juliette Logan to Bill Hargett

--

1:15 p.m.

--

7/30/19

SAR Report - 8262

Intern Report 

Adrian Clark-Randall to Myles Wolf

Nate Goodwin to Dr. Sadun

1:15 p.m.

3 p.m.

7/31/19

SAR Report 

Kyle Geurink to Thom Ortel

1:15 p.m.

8/1/19

No Prep Journal Club

Hospitalist Series: Hyponatremia

--

Adam Tosh

1:15 p.m.

3 p.m.

From the Residency Office

PWIM Welcome Event
The Program for Women in Internal Medicine invites ALL residents and fellows from the Department of Medicine to a casual meet-up with food, drinks, and networking on Aug. 28. See email invitation for RSVP.

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

  • Aug. 15 - Intern Retreat
  • Aug. 23 - Chair's Welcome Party
  • Aug. 28 - PWIM Welcome Party 
  • Oct. 26 - Stead Tread 5K

Opportunities

Useful links

 

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