Internal Medicine Residency News, Oct. 29, 2018

Clinic Corner: Ambulatory

Contributed by Daniella Zipkin

Ambulatory Threads Updates
We have received a TREMENDOUS amount of feedback from interns and JARs regarding the ambulatory threads model, and we thank you so much for sharing it. We have also been meeting with groups of faculty to hear their thoughts and share info. Overall, we’ve been very pleased to see the threads going well! Here is a summary of the positive and some negative we need to work on:

• Having contact with subspecialty attendings on a more longitudinal basis has been great, and allows for better learning. Attendings are also really loving the continuity with you all!
• Matching up the didactic Academic Half Day talks with the clinical thread and working with cases has been good, when it works.
• People are reporting an overall improved sense of cohesion and commitment to teaching in the ambulatory setting.
• Residents greatly prefer actively seeing patients rather than shadowing, and this feedback is being communicated to all attendings.
• The continuity has not been smooth everywhere. We are aware of certain sub-specialties where shifts in schedules interfered with the experience and we are working to fix those.
• Geography has been challenging, with many people experiencing long transitions from one clinic to the next. Several sub-specialties added South Durham locations after the threads were built. Winn is working hard to incorporate locations into the next iteration of the threads, starting in January.
• There have been gaps and errors in the Academic Half day schedule in some threads. We are working on this learning curve of having a shared schedule among many people!
• Some sub-specialty clinics feel too specialized for the resident to feel useful. We are working with the division to re-assess the clinical balance.
• Attendings are always working on balancing teaching and clinical care, and we work to support them and will offer faculty development opportunities on these skills.

All in all, for our first quarter of rolling out a huge curricular change, not too shabby! We ALWAYS want to hear from you, so please keep the comments coming. The best ideas always come from all of you.

Advocacy Clinical Leadership Track
Interns: Stay tuned for the brief application for the ACLT coming to you this week.

From the Chief Residents

Duke Gen Med Conference Schedule: Oct. 29-Nov. 1, 2018

From the Residency Office

PWIM "Before They Were Stars"
Join us for an evening with Dr. Kathy Cooney. This event is a casual Q&A format about career and personal paths and successes. It is open to all residents and fellows in the Department of Medicine. It will be Tues., Nov. 13 from 6-8:30 p.m. in the Med Res library (Duke North 8253).

Narrative Medicine
The next narrative medicine session will be held on Fri., Nov. 16 at 6:30 p.m. in Med Res! We are incredibly lucky to have Dr. G (or Dr. Anthony Galanos, to be formal about it) to precept our next meeting! Our prompt this session will be "Uncertainty." By choosing this theme, we hope to inspire you to think about the often morally grey, emotionally confusing, and intellectual no-man's land that we have to navigate, and we hope the broad nature of this theme allows you to be as creative as you would like. Of note, we are planning on collaborating with the Voices of Medicine group to potentially publish pieces based on this theme in their upcoming Spring publication, which may even lead to a multidisciplinary collaboration in the future! If you are interested in joining us, please send Irena Tan an email so we know how many to expect and can plan out how many narratives can be discussed. Dinner/drinks will be provided. To ensure a safe and intimate space, we are limited to ~12 participants so make sure to grab a spot!

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 - Doctoberfest

• Oct. 30 - Preliminary Recruitment Day
• Oct. 31 - We Care Celebration in the Quad!
• Nov. 1 - Movember Kickoff 
• Nov. 2 - Recruitment Kickoff 
• Nov. 13 - PWIM "Before They Were Stars" with Kathy Cooney
• Nov. 16 - Narrative Medicine

Opportunities

• ​https://www.phs.wakehealth.edu/public/edu.cfm
• http://www.careermd.com/employers/latestbulletins.aspx
• Fellowship Hall physician opportunity
• Duke Health Hospital Medicine Program
• Doctors Making House Calls
• FirstHealth Physician Group
• CompHealth
• ​Stanford University Clinical Excellence Research Center Design Fellowship

Useful links

• GME Mistreatment Reporting Site
• Duke Health Influenza Policy
• http://duke.exitcareoncall.com/
• Main Internal Medicine Residency website
• Main Curriculum website
• Department of Medicine
• Confidential Comment Line Note (All submissions are strictly confidential unless you chose to complete the optional section requesting a response.)
• Updates from the Division of Hematology
• The Scope