Internal Medicine Residency News: November 18, 2013

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From the Director

DUKE.RESEARCH.NIGHT.03 (1)Hi everyone! How 'bout those Blue Devils!! Glad they are getting us ready for the real upcoming football game!Looking forward to the final weeks of trash talk.Recruiting continues to go well...thanks for all your enthusiasm and support! And thanks to Dr Klotman for hosting a fantastic networking event for JARs, fellowship directors and division chiefs. As it gets close to resident research grant submission time, happy to see all the career connections being made. We also had a great turnout for the CIMIgro internal medicine interest group event on Thursday...lots of students making the best career choice!Kudos this week to Marcus Ruopp from the endocrine team, to Emily Ray, Nick Rohrhoff, Kevin Shah, Chris Hostler, Aparna Swaminathan and Gena Foster for doing the end of recruitment day resident share and to Adrienne Belasco for chairs conference. Greg Brown was our Duke basketball ticket winner for best chairs conference participation.Don't forget to donate to our "Thanksgiving Food Drive" to benefit the kids of Hope Valley Elementary.PubMed:  Congratulations to Liz Gilbert, MedPsych PGY1 for winning the 1st prize poster award at the Academy of Psychosomatic Medicine! Liz presented a poster based on worked carried out while she was a student at Brown with Dr. Colin Harrington entitled  "Unintentional Injuries in Patients with Dementia:  Hospital Course and Outcomes" Have a great week! Aimee  

QI Corner, Submitted by Joel Boggan, MD

QI Conference:  Join us this Wednesday, 11/20, at noon for a presentation on High-Value Biostatistical Concepts by Dr. Dani Zipkin  for the next in the HVCC lecture series. QI Abstracts and Meetings:  If you have something you'd like to submit for either the Duke Patient Safety and Quality Conference or the NC ACP meeting in March, the abstract submission dates are coming up in early December.  Contact Jon or I for more details . . . We Follow-Up:  Be on the lookout for data about our lab follow-up rates in your clinic over the next 1-2 months.  If you're willing to help Jon and I brainstorm ways to present these data at either the DOC or Pickett sites, please let Jon or I know. PSQC Updates:  At our meeting last week, we celebrated our improvements in hand hygiene compliance.  Last month was our first month of meeting the collective goal, so keep up the good work!   And, just to remind you of how important hand hygiene is, take a look at this photo shot of just a few of the "dirty hands" at our last noon conference - SCARY !!Hands [box]What Did I Read This Week, Submitted by Jonathan Bae, MD

Yanovski, J, et al. “A Prospective Study of Holiday Weight Gain.” NEJM, 2000; 342: 861-7.

[/box] With Halloween now two weeks past, and the holiday season briskly approaching, I wanted to read something more festive for this week’s installment of “What I Read This Week”. With a pumpkin bucket half filled with the ghosts of ingested candy, I began to muse on any preventative steps for an expanding waistline I would need to take with Thanksgiving just around the corner. A quick pubmed search led 072709_jonathan_bae_prdme to the article of interest in which the authors attempted to explore long held assertions that Americans gain weight (5 lbs. or more) during the holiday period from Thanksgiving to New Years Day. It is a plausible hypothesis in that there is data cited by the authors suggesting that people are more likely to gain weight during different periods of the life cycle including adolescence, pregnancy and midlife. Apparently this includes “the period after marriage in men” as well although I neglected to pull the citation directly despite its very compelling title (Sobal J, et al. “Marital status, fatness, and obesity.” Soc Sci Med, 1992; 35: 915-23.). In order to answer this critical question of Yuletide weight gain, the authors recruited a convenience sample of 195 adults and recorded weights at 4 periods:Pre-holiday (late September/early October to mid-November), holiday (mid-November to early/mid-January), post-holiday (early/mid-January to late February/early March) and September/October the following year. The authors also recorded vital signs and self reported health measures and attempted to mask the intent of the study to the participants. After all was said and done, there was found to be a statistically significant weight gain during the holiday period although much less then the prior anecdotal evidence from my Uncle Billy would have suggested: only 0.37 kg (or 0.81 lbs) on average was gained. My initial presumption was that this increase was simply due to the number of festive sweaters worn during the holiday period. But as it turns out, the authors adjusted for this by weighing all participants in the same drab, un-festive hospital gowns which most certainly lacked any reindeers, snowmen, or unnaturally generous bearded elders in red suits. Of note, this study was completed in 2000 so it does not account for new food industry standards such as chocolate covered Slim Jims, Locos Doritos Tacos, Chicken ‘n Waffle potato chips, and Double Chocolate Blasted Krispy Crème Taco Burgers (I only made up one of these items). Interestingly, weight that was gained during the holiday period often was maintained the following year suggesting that weight gain during the holiday period is certainly a factor in the incremental increase in body weight noted during adulthood. Over a lifetime of holiday seasons and deep-fried turkeys, one can reasonably conclude that holiday dietary habits do put us at risk for weight gain (and the subsequent health risks) although much more insidiously. Is there anything that can be done to combat this? Perhaps. The authors found that weight gain was inversely related to how active you were during the holiday season (Figure 4A), which should come as a shock to no one. As an aside, the authors also found a direct relationship between weight gain and participant hunger levels leading to a graph that made me laugh out loud (attached below). What did I take away from all of this? Holiday weight gain is real, increased activity levels may blunt the effects, and Double Chocolate Blasted Krispy Crème Taco Burgers on Christmas morning may be a bad idea. Happy Holidays!

 WDIRTW Pic

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From the Chief Residents

 SAR Talks, Noon Conference, 11/21/13 Dr Kevin Shah and Dr Carling Ursem 

Grand Rounds

M&M Conference - 2002 DN 

Noon Conference

Date Topic Lecturer Time Vendor Room
11/18 INTERVIEW
11/19 MED PEDS INTERVIEW Med Res Lib
11/20 QI Patient Safety Noon Conference Dr. Zipkin 12:00 Pita Pit 2002
11/21 SAR   talks Kevin Shah / Carling Ursem 12:00 Rudino's 2001
11/22 INTERVIEW
 

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From the Residency Office

Choosing a Career as a Clinician Educator

(sponsored by the Martin 210_McNeillDiana2010Society)

 

Presented by Diana McNeill, MD

Monday, November 18th

7:00 PM Medical Residents Library

   

USMLE Step 3

JAR's:  For those of you who have not already done so, please be sure that you register to take the USMLE Step 3 exam.  We HIGHLY recommend that you plan to take it no later than February 2014 to ensure that test scores will be available prior to 6/30/14.  You will not be allowed to begin your PGY3 year until you have taken and passed the USMLE Step 3 exam. Please be should to let the Chiefs know as soon as you have a scheduled test date so that they can approve it and make any scheduling changes necessary.  Once you have taken the test and received your official scores back, you will need to provide a PDF copy to our office, which we will forward to GME.  If you have any questions about the process, please feel free to contact Jen Averitt.  As a reminder, Lauren Dincher is a notary for the residency program! For those of you who have let us know your dates for testing and/or submitted your scores, THANK YOU!  

Thanksgiving Food Drive - Off to a Great Start

This week marked the beginning of our Annual Thanksgiving Food Drive! In the past, we have attempted to help the local food kitchens that serve the homeless and poor in our local area of Durham and we have been quite successful. This year we have decided to help one of our local schools, Hope Valley Elementary. Hope Valley Elementary is a Title I school that has a student population of 648 students. Out of those, 58% participate in the free and reduced lunch program. Furthermore, many of the students live in low income apartment complexes that are in our attendance district. One of these apartment communities partners with the Cascade Drug and Alcohol Rehabilitation Program, in which several of our single mothers participate. These families are among the poorest in Durham. Several Hope Valley Elementary families are currently homeless and there are children that are dependent on the school to meet their nutritional needs. There are children who on EACH Friday of EVERY week have their backpacks lined up in a row by the social worker and have food placed in them to take home because they do not eat enough on the weekend. This year our hope is for the house-staff to help these families. We have established a pay-pal link in order to raise funds: https://www.paypal.com/cgi-bin/webscr?cmd=_s-xclick&hosted_button_id=UNV67MVQQQH3N. These funds will help the social worker continue to provide food to the families that cannot feed their own children especially on Thanksgiving. Even the smallest amount can help. The drive deadline is November 21. Thank You! Armando Bedoya & Jeremy Halbe  

Wanted: Future leaders in ambulatory care.

Interested in careers in ambulatory medicine – i.e., primary care and/or an outpatient subspecialty like Endo or Rheum?  Interested in Choleadership?  The Ambulatory Care Leadership Track (ACLT) is an opportunity for upper-level residents to gain additional clinical experiences and training that will help them function as leaders in the ambulatory environment.  Four JAR spots and two SAR spots will be open for the 2014-15 academic year.  If interested or if you have questions please contact Alex Cho, Stephen Bergin, or Daniella Zipkin.  A brief, one-page application will be due Monday, December 30.  You can also go to http://residency.medicine.duke.edu/duke-program/training-pathways/ambulatory-care-leadership-track for more information. ACLT application form   Respiratory Fit Testing Schedule for November 2013 Fit Testing is available at Duke North Room 4000C.  (4th Floor beside service elevator) or at Duke South EOHW. Walk-ins allowed. We are still experiencing a shortage in the TB testing solution- TB testing is still suspended unless your group has been notified differently. We are adding more TB Testing groups back at this time, managers are being notified this week. Others groups will be added as we continue to evaluate the situation. Also available:
  • Color Vision
  •  (T-Dap) vaccine (Diphtheria, Tetanus, Pertussis) Required for all employees working with Children 18 months of age or younger.
  • Flu Shots
Fit Testing Schedule is attached below and is also available on the HR website--- http://www.hr.duke.edu/about/departments/eohw/ November 2013 Resp Fit Testing-T-Dap-TB Skin Testing Flyer  

Information/Opportunities

  

Upcoming Dates and Events

  • November 28:  Annual "Turkey Bowl"
  • December 14:  DoM Holiday Party
  • January 15th:  "Voices in Medicine"
 

Useful links

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