From the Director
Hard to believe it is almost NOVEMBER! Congratulations interns on completing 1/3 of internship! We had a really fun and busy week last week, and are gearing up for another very fun and very busy week this week. By all accounts, PAINTBALL was a huge success, apologies for not giving you the opportunity to shoot at me. I hope to join you all next year! Thanks to Chris Hostler and Marc Samsky for organizing and to the many residents and faculty who participated. Other fun was going out with Peter Hu, Rachel Hu, Winn Seay, Lauren Collins and Ryan Orgel to the rooftop at the Durham Hotel for our monthly JAR dinner, and also “TACO Thursday” in the courtyard. Thank you to Jen, Tia, Lynsey and Madi for your hard work to make the ‘fun lunch’ and all Doctoberfest goodness happen.
This week, SARs should start paying attention to ABIM registration (yikes!) -dates are announced and posted in the Med Res office. Fellowship lists are due Nov 11, so please make sure to stop in if you need to talk about life next year. Also, pay attention to the BLS blitz dates so you can stay on top of your training in BLS and in ACLS as needed. Recruitment officially starts Friday with “Prelim Day” and our first categorical day on Monday 11/2. Madi will be sending out lists of applicants so you can check for your friends and people who went to your med school. Dinner signups as well as tour signups are out as well. We are looking forward to showing the Future Duke Residents how amazing you guys are.
Super excited to have you all over for the Recruitment Kickoff on Friday! A couple of notes … the party at my house is not a costume party (although feel free if you are so inclined), and is casual and kid friendly. The Residency Council party on Saturday night is a costume party. See AJ Blood and the interns on the residency council for details (great name for the planner of a Halloween party, no?) for details.
Kudos this week to Annie Reihman from Jon O’Donnell for being a huge help, to Sky Vanderburg and Leah Machen from the cardiology nurses for being really great to work with on CAD and to Sam Lindner for an awesome chair’s conference. Kudos also from Jessie Seidelman to Tanya Aylward, Kevin Smith, Nicole Helmke, and Sarah Cohen for all of their hard work and amazing attitudes with a very busy, sick Gen Med service. Keep sending me your kudos and congrats about your fellow residents!
This week’s pubmed from the program goes to 1st place poster winner Joanne Wyrembak who presented Chorea-Hemiballism in Hyperosmolar Hyperglycemic State at the Southern Hospital Medicine Conference.
Have a great week and see you Friday!
Aimee
What did I read this week?
Submitted by: Dr. Murat Arcasoy
Potential Mechanisms for Cancer Resistance in Elephants and Comparative Cellular Response to DNA Damage in Humans. Abegglen et al- JAMA October 8, 2015
Why did I read this article?
I am currently reading a wonderful book entitled “Sapiens: a brief history of humankind” by Yuval Noah Harari, so I found the article title involving comparison of elephants and humans as it pertains to cancer risk very intriguing.
What did the authors do?
Cancer mortality across 36 mammalian species was calculated in large and long-lived organisms surveying necropsy data. Then, the authors analyzed elephant genomes for potential mechanisms of apparent cancer resistance, focusing on DNA repair and apoptosis in elephant versus human peripheral blood lymphocytes. As controls for DNA damage response, they examined specimens from patients with Li-Fraumeni syndrome (LFS) who lack 1 functional allele of the TP53 gene - a key tumor suppressor- predisposing these patients to 90% lifetime risk of cancer. TP53 protein plays a critical role in determining whether DNA will be repaired or the damaged cell will undergo apoptosis.
What did the authors find?
1)- Cancer mortality did not increase with body size and/or maximum life span of mammals
2)- Elephants are cancer resistant, with estimated cancer mortality 4.81% compared to humans 11%-25%, potentially related to multiple copies of TP53 in elephants
3)-In contrast to humans who have 1 copy (two alleles) of TP53 gene, elephants have at least 20 copies (40 alleles)
4)- In response to ionizing radiation-induced DNA damage, elephant lymphocytes underwent TP53-mediated apoptosis at significantly higher rates (14.6%) compared to LFS (2.7%) and normal human controls (7%). Similar results were observed in response to doxorubicin-induced damage – apoptosis in elephant cells 24.7% versus human controls 8%.
Why is this study important?
These findings support the concept of an evolutionary based approach for understanding mechanisms related to cancer suppression. Furthermore, the mechanism of cancer resistance appears to involve DNA repair pathways, a current topic of great interest. As you know, the Nobel Prize in Chemistry 2015 was just recently awarded jointly to Professors Paul Modrich (Duke!!), Aziz Sancar (UNC-Chapel Hill) and Tomas Lindahl (United Kingdom) for their lifetime work in mechanistic studies of DNA repair.
QI CORNER
High value care proposals are due TODAY! Get them in by email to alicia.clark@duke.edu. We can't wait to see your great proposals!
CLINIC CORNER
Ambulatory Care Leadership Track (ACLT): Attention interns! The ACLT is perfect for those planning an outpatient-based career in general medicine or subspecialties with a focus on education, research, administration, or health policy. Please see the residency newsletter from September 28th for details. Application forms will be sent out in early November, and due at year’s end, December 31. The ACLT group meets for three blocks per year, so, over two years, there are roughly 24 weeks. We ask that not more than 4 weeks be in any one subspecialty, and that at least 4 weeks be in general medicine ambulatory, to promote a diversity of clinical experiences. You will rank ambulatory clinical preferences prior to each block.
Mark your calendars for an ACLT social event the evening of January 5th, to hang out and get to know more about the track with current ACLT residents! Thanks to Sharon Rubin for organizing!
Continuity Clinic Experience Evaluation results are in, thank you for filling them out! Clinic directors are reviewing feedback and working on improvements when needed.
Ambulatory Town Hall took place last week during noon conference, thank you to those who were able to attend. We want you to feel like your clinic is family – please don’t hesitate to share questions and suggestions with me and with your clinic leads.
DOC shout out – Stead B is focusing on improving the paperwork flow and durable medical equipment process in clinic. All are welcome to join us for our planning meeting on November 10th, 6:30 pm, location TBA – email Dani if you’d like to be added to the group, and I’ll let you know the location (when I figure it out)!
Thanks as always for being the reason the continuity clinics exist!!
Dani
From the Chief Residents
Grand Rounds
Friday, October 30 - Neurology, Patrick Hickey
Noon Conference
| Date | Topic | Lecturer | Time | Vendor |
| 10/26/15 |
Wellness |
Jim Lefler and Jake Feigal |
12:00 | Dominos |
| 10/27/15 | Financial Planning |
Marc Flur |
12:00 | Chick-Fil-A |
| 10/28/15 | QI Patient Safety Noon Conference: HVCC & EBM |
Dani Zipkin |
12:00 | We Care Wed - No lunch |
| 10/29/15 | SAR Emergency Series: Sickle Cell Crisis |
Eric Fountain |
12:00 | Nosh |
| 10/30/15 |
Chair's Conference- Research Seminar Series |
Research | 12:00 | Research Conf-Panera |
From the Residency Office
Duke Medicine Jackets -Order Today!
This year the Duke Internal Medicine Residency Program will be ordering Patagonia ¼ Zip Better Sweater Pullovers in Grey!! They will be $90.00 each. This price will include the Duke Medicine logo. Samples will be available to try on in the Med Res Office during regular business hours: 8am-4:30pm!
To order your 2015 Duke Medicine Pullover, Please complete this survey by Monday, October 26th!! Orders will be placed the following morning (10/27AM) and if you have not ordered and/or paid by the deadline, we will not be able to include you in the order.
Any questions/comments/concerns please contact Lynsey Michnowicz
Subway coming to Duke Hospital Cafeteria!
RE: Construction of New Subway Store in Duke North Atrium Dining Room
DATE: 22 October 2015
In an effort to enhance our food services to the Duke family, we are excited to announce that we will be constructing a new Subway Store in the Duke North Atrium dining room. Construction begins on October 26 in our existing dining room seating space, located at the back wall of the Starbucks store in Duke North. As this project gets under way, construction barricades and walls will displace some of the current seating area. Please remember that additional seating is available outside the cafeteria in the long concourse leading to the Duke Medicine Pavilion.
It is anticipated that the project will be completed by the end of January 2016. When completed, the new Subway Store will be open 24 hours-per-day, seven days-per-week and offer a variety of hot and cold foods.
We understand that the Duke community may be inconvenienced throughout the duration of this project and we truly appreciate your patience as we continue to improve food services for our patients, their loved ones and each other.
Get Your Flu Shot!!
A schedule of vaccination clinics will be posted on the employee intranet in early September. This list will be updated throughout the vaccination season. Vaccination is also available at Employee Occupational Health and Wellness (EOHW) during business hours.
If you have questions about the flu vaccine or its availability, please visit the DUHS Influenza Resource Guide or duke.edu/flu, ask your manager or contact EOHW.
Together, we can stop the flu. Thank you for your commitment to keeping our patients, and our community, safe and healthy.
Get this done ASAP.
If you have medical exemption, be sure it shows up on your personal OESO Page—contact EOHW for any questions.
If the flu vaccine is received at any site (including the VA) besides DUH, DRH, or DUKE RALEIGH, you should take a picture of your documentation form (legible name, date, location and lot #) and email it to eohwflu@dm.duke.edu.
Please direct any questions to kathryn.andolsek@duke.edu
BLS Blitz - November 2015
Just a reminder that the bi-annual BLS Blitz is coming up in November. The flier posted at the end of this blog has the dates. REMEMBER - Duke only holds BLS classes during the November and March blitz each yer, so if your BLS is expiring before March, PLEASE sign up for one of the dates in November!!
2015 Carolinas COPD Symposium
When: November 20th, 2015
Location: Cone Center, UNC Charlotte; Charlotte, NC
Registration Link: https://continuingeducation.dcri.duke.edu/2015-carolinas-chronic-obstructive-pulmonary-disease-copd-symposium
Cost: $50 for Healthcare Providers; $25 for Public Health Practitioners
Event Contacts: For registration questions, please contact dcri.cme@dm.duke.edu or 919‐401‐1200. For program questions,
please contact Roy Pleasants at roy.pleasants@duke.edu
Annual Call for New Ideas
The Journal of Graduate Medical Education is seeking brief articles on novel ideas in curricula, teaching, assessment, quality and safety, program evaluation, or other topics relevant to graduate medical education. Selected papers will be published in the July 2016 issue.
Criteria
New Ideas must describe an intervention that is novel.
The intervention must have been implemented at least once; longer implementation is preferable. While outcomes data may be preliminary; feasibility (effort, costs) and acceptability (to subjects) must be discussed.
Preliminary evidence should suggest the intervention is successful.
The intervention can be replicated in other specialties.
New Ideas manuscripts must
Follow required manuscript format
No more than 650 words
Organized into 3 parts:
Setting and Problem
Intervention (the “New Idea”)
Outcomes to Date
May include 1 figure or table
Descriptions should not include a literature review or references
Be submitted via the online editorial management system by 8:00 am CT, Monday, November 16, 2015.
Acceptance decisions will be communicated by January 31, 2016.
NOTES:
Due to the brevity of these submissions, manuscripts that are not accepted will not receive editor comments.
Manuscripts not following the required submission format and/or submission deadline will not be considered.
If you have additional questions, please contact the Journal office.
Opportunities for Wellness
Feeling down? Need to talk to someone?
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
October 30 - Recruitment Kick-off!
November 26 - Turkey Bowl
December 12 - DOM Holiday Party
Useful links
https://intranet.dm.duke.edu/influenza/SitePages/Home.aspx
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
Opportunities
www.bidmc.org/CentersandDepartments/Departments/BIDHC
http://www.careermd.com/employers/latestbulletins.aspx