Internal Medicine Residency News, November 10, 2014

By residency1

From the Director

DUKE.RESEARCH.NIGHT.03 (1)Interview season is in full swing..thank you to everyone for your enthusiasm and ongoing efforts to meet and talk with applicants.  Thanks this week to our resident share participants Andrea Sitlinger, Ben Lloyd, Sneha Vakamudi, Angela Lowenstern, Joy Bhosai, Zach Wegermann, Kara Johnson, Jenny Van Kirk, and Brian Sullivan.   Kudos also to Nina Beri for doing our first applicant afternoon report and to Rajiv Agarwal for an amazing chair’s conference!  And a big thank you to Manesh Patel, Mary Klotman, Tony Galanos, Dave Zaas and Harvey Cohen for donating Duke Basketball tickets to the residents this week.  Hope all that went had a great time! Thank you to Lauren Dincher for delivering our “BIG CHECKS” to the Durham Rescue Mission and the Lincoln Clinic, based on our donations from DOCTOBERFEST WE CARE WEDNESDAYS! Other kudos go to Titus Ng’eno from Svati Shah for great work in clinic, to Adam Banks for doing leadership rounds in the CCU, to Katie Broderick-Forsgren from the CCU nursing staff for being organized and a great problem solver and to Matt Hitchcock for an excellent SAR talk on antibiotic management. Important things to know….Agile MD is offering a free download of the UCSF Hospitalist Manual.  It’s usually $19.99, so take advantage and keep using your Duke Survival Guide APP as well. We are kicking off our ANNUAL THANKSGIVING FOOD DRIVE! Steve Crowley and the Warren Society are our official “Stead Backers”.  We are making it REALLY easy for you to contribute, via a paypal account.  See upcoming email and other announcements for details.   We have a few short weeks to provide food for patients in need from the DOC and PRIME clinics!  As we enjoy our thanksgiving meal after Turkey bowl and another meal with our friends and families, let’s do our best to make thanksgiving for others who are less fortunate. SARs…..if you are applying for fellowship, NOV 12 is the last day to enter your match list and certify it.  Right after you do that, get ready to sign up for the ABIM exam.  Details are posted in this week’s med res news and also on the ABIM website. Pubmed from the program goes to our awesome chief resident Bonike Oloruntoba for her presentation at the AASLD meeting! Have a great week Aimee   DRM-Duke-Residency-Donation [divider] [box]

What Did I Read This Week?

bowlby

Submitted by: Lynn Bowlby, MD

New Eng Journal of Medicine 2014, 371:1324-1331 October 2, 2014

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Review Article : Microcytic Anemia One of the first and most basic issues in medicine I remember learning about as a medical student was the evaluation and treatment of anemia. At the DOC so many of our patients have so many other chronic diseases that capture our attention that anemia can be lost. I was very happy therefore to find this comprehensive review article on one aspect of anemia. I was glad to see that some things have stayed the same since I was a student---RBCs in microcytic anemia is the size of a lymphoctyic nucleus--as well as new information to learn. Causes: Microcytic due to lack of hemoglobin Lack of globin-thalassemia Restricted Iron delivery-Inflammation Lack of Iron delivery-iron-def anemia Defects in synthesis of heme--sideroblastic
  1. Thalassemia-
alpha thal-African, SE Asian and Mediterranean Heritage Hgb H/ Bart--more severe, SE Asian and Medicterranean B thal-major, minor and intermediate Hgb E-- lysine substituted for glutammine
  1. Inflammation-
renal production of erythropoetin supressed by cytokines and lack of iron availability due to hepcidan
  1. Iron Def-most common anemia,   iron found in many key proteins of the cell, hence leading to the new concept of nonanemic iron deficiency leading to fatigue.
Women, athletes and post bariatric surgery at risk of iron def anemia. Diagnosis: MCV < 70 rare in inflammation Anemia of inflammation is one of exclusion. Iron deficiency--ferritin is the most efficient and cost effective test (as my Heme/Onc husband Neal Ready taught me years ago!) Determining the cause of iron def anemia is key, blood loss must be assumed. Treatment: In medicine Iron def anemia is the most easily treated--on a practical level (and what I have done) Ferrous sulfate 325 mg qd with meat/Vit C, AVOID tea, and likely coffee (interferes with absorption) change to Ferrous gluconate if can't tolerate sulfate. Retic count should go up in one week, HgB up at the end of 2 weeks. IV iron if po not successful- infusion reaction is the issue. Thallassemia- since a genetic disease, gene therapy will likely be an option in the future. So read, and learn about anemia!

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Clinic Corner

zipkin

Hello Team DOC! Thanks for reading the Clinic Corner! I’m keeping it short and sweet this month:
  • See Dr. Bowlby's slides attached from the recent Town Hall meeting last week. And keep your eyes peeled for the next one in the spring – the more of you that can make it, the happier we are!
  • See the DOC Newsletter 2014 November, with some resources that may be new to you, updates on what the Steads are doing, and our October and November Employees of the Month, Robin Claud-Everett and Gina Green!!!
Take care, Dani p.s. a big prize will go to the person who emails me remembering (or looking up) how I referred to the DOC last month :)  

QI Corner

[caption id="attachment_16361" align="aligncenter" width="119"]Aaron Mitchell, MD Aaron Mitchell, MD[/caption] Just as a reminder – this week on Wednesday afternoon we are having a meeting of the patient safety and quality group. This will be a chance to work on (or join!) one of the ongoing Choosing Wisely projects. We will spend at least some time talking about Maestro Care workbench reports, which is a great tool to generate data for chart reviews and QI projects. As always, if you have any project ideas or safety concerns, come and share! We just got fresh data on how we are progressing towards our GME incentive program targets. We crushed ED consult time last month – go 1010! Great job to the night float residents! We hit our target of <30min for the first time, so let’s keep it up. QI1 And, just in case you wanted to compare, to see how much we are dominating all the other departments: QI2   Our SRS reporting has also picked up. We submitted 72 safety reports in October, from only in the 40s the last few month.  

From the Chief Residents

Grand Rounds

Fri., Nov. 14: Geriatrics, Dr. Mitchell Heflin

Noon Conference

Date Topic Lecturer Time Vendor
11/10/14  Interview Day  Lunch w/ applicants 12:00/MedRes  Panera
11/11/14  SAR Emergency Series - Acute Stroke  Joe Brogan 12:00/2002  Chick-Fil-A
11/12/14  MED PEDS INTERVIEW  Lunch w/ applicants 12:00/MedRes  Saladelia
11/13/14  SAR Emergency Series - Topic TBA  Veronica Jarido  12:00/Room 2001  Mediterra
 11/14/14  Interview Day  Lunch w/ applicants  12:00/MedRes  Jason's Deli
         

From the Residency Office

Recruitment 2014!

Reminder to All Residents: Please email your recruitment buddies! This has such a large impact on their visit and is greatly appreciated! 

ABIM Summer 2015 Examination Dates

Please see the attached flyer for information on dates and registration!

Pin Station Re-located

The pin station is the MedRes library has been re-configured so that images can be projected on the large screen for report.  If you need an individual pin station for work, please feel free to use the one in the front cubicle of the MedRes office, suite 8254.  

Duke AHEAD Announcement

Duke Ahead

Registration for “Celebrating the Education of Health Care Professionals” is now open at dukeahead.duke.edu.   The event begins on 11/13/14 in collaboration with the Duke Office of Graduate Medical Education and Duke University School of Nursing Institute for Educational Excellence.  Keynote Speaker, Dr. Lee Shulman, immediate past-president of the Carnegie Foundation will present “Interprofessional Collaboration: Value and Vision.”  Attached is the full itinerary. While you’re at the website, please take a moment to check out the Duke AHEAD video, recently completed. Thank you for your continued support of Duke AHEAD! Kristin Dickerson Duke AHEAD

Chronic Hepatitis C Infection: Making the Decision to Treat

Join Andrew Muir, MD and Susanna Naggie, MD, MHS for a free live workshop for clinicians and patients

ACP Abstracts Due!

Please find attached the information to submit abstracts by December 12, 2014 of your scholarly activites (case reports, research, QI projects) American College of Physicians NC Chapter Meeting Date: Feb 13,14 2015 Where: Sheraton RTP Submissions for abstracts due 12/12/14 http://www.acponline.org/about_acp/chapters/nc/abstract_comp.htm Wishing you all success with your projects ! Murat and Aimee  

Partners In Health and BWH Hospitalist Program

PIH is currently seeking excellent physicians in Internal Medicine (or Internal Medicine/Pediatrics) to join our teams in Rwanda, Haiti, and Malawi for the 2015-2016 academic year .  This full-time position provides an opportunity to serve as both a clinician educator at a PIH field site and as an academic hospitalist at Brigham & Women’s Hospital in Boston.  Candidates interested in this exciting opportunity should submit an application at http://www.pih.org/pages/employment before December 1, 2014, or can contact Dr. Neil Gupta at ngupta@pih.org. Partners In Health and BWH Hospitalist Program Background: Partners In Health (PIH) is a health and social justice organization with a mission to build high quality, comprehensive public health systems around the world.  PIH has partnered with local communities and governments over the past 25 years to provide high-quality health care to the poorest of the poor and train the next generation of physicians, nurses and public health professionals in countries around the world. General Description: We are currently seeking excellent physicians in Internal Medicine (or Internal Medicine/Pediatrics) with strong interest in global health and medical education to join our teams in Rwanda, Haiti, and Malawi.  This full-time position provides an opportunity to serve as both a clinician educator at a PIH field site and as an academic hospitalist at Brigham & Women’s Hospital in Boston. Specific Responsibilities: Internists at PIH field sites serve as clinician educators, working with local medical staff and trainees on inpatient medical wards and outpatient clinics in rural districts hospitals and health centers as well as academic teaching centers.  These clinician educators are faced with a vast diversity of diseases, including but not limited to, HIV, tuberculosis, malaria, non-communicable diseases, oncology, and other tropical infectious diseases. They also supervise international trainees and students rotating from Brigham & Women’s Hospital and other international institutions, engage in quality improvement and research activities, and help to develop and implement innovative programs to strengthen health delivery. Financial Support: The Brigham and Women’s/Faulkner hospitalist program provides hospitalist salary support and full benefits package, including malpractice insurance and health insurance. PIH provides international airfare as well as full accommodations while at PIH sites. Successful candidates will also have the opportunity for academic appointment at Brigham and Women’s Hospital and a diversity of professional development opportunities. Qualifications:
  • ABIM board-certification or board-eligibility in internal medicine or internal medicine / pediatrics; candidates with sub-specialty interests are welcome to apply
  • Board-eligible graduating senior medical residents are eligible to apply
  • A desire to gain experience with health care delivery in sub-Saharan Africa
  • A talent for teaching and an interest in medical education and quality improvement
  • Flexibility, humility, creativity and enthusiasm
  • A two-year commitment is encouraged but not required
Application and Contact Information: If you are interested in pursuing this opportunity, please submit your application at http://www.pih.org/pages/employment.  If questions, please contact Dr. Neil Gupta at ngupta@pih.org.

Information/Opportunities

Sign up to receive a complimentary e-subscription to The American Journal of Medicine in 2015! All you have to do is to complete the online form by December 8, 2014.  The subscription starts in January. MD Fellowship Flyer V5 Financial Planning Webinar for New Physicians - CST Des Moines IM Opportunities STL_NocturnistFlyer STL__GenInternalMedicineFlyer Internal Medicine opportunities    

Upcoming Dates and Events

November 27, 2014 - Turkey Bowl

December 13, 2014 - DoM Holiday Party

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