From the Director
Hi Everyone!
Hope many of you got to enjoy some of this beautiful weekend outside! Or in the beautiful halls of Duke, DVAMC or DRH! We have a busy week coming up, with the FLU BLITZ on Wednesday…I hope you got a chance to see the flu posters made by the Stead Leaders, The QI Council and the chiefs and I. Thanks Jon Bae for bringing out the dormant photoshop skills. We have Dan Ariely at noon conference on Wed and you will have the opportunity to hear an amazing lecture from a best selling author and economist AND get a flu shot. And lunch. What a deal.
Kudos this week go to Alex Fanaroff for at "cat"-tastic chairs (and to Angela Lowenstern for getting the diagnosis in 3.7 seconds, leaving us to discuss many unlikely but interesting other neuro disorders) and especially for Alex getting the functional pagers to VA Gen Med. We hope to improve patient safety and resident well being through functional pagers! Other kudos go to Brian Sullivan — we received an email from an outside rehab stating that he had written the best DC summary they had ever seen! I was also stopped by Chet Patel to say how wonderful Matt Atkins and Stephanie Giattino are doing on his CAD service and by the 9300 fellow for compliments to Yi Qin and Jonathan Buggey. Other high fives go to those who continue to help cover colleagues for interview season.
Looking forward to JAR dinner this week, as well as the official ERAS download! Interns — there is a new wave of eager 4th year med students coming. Hard to believe it's been a year since that was you. We have our recruitment kickoff coming up and we had a great time hosting the 4th year students who are applying in med and prelim med last week. Great turnout from students, ACRs, chiefs and faculty!
This week's pubmed from the program goes to Howard Lee! Individualized Therapy for Hepatitis C Infection: Focus on the Interleukin-28B Polymorphism in Directing Therapy. Lee TH, Tillmann HL, Patel K, Mol Diagn Ther. 2013 Sep 11. [Epub ahead of print] PMID:
QI Corner
It's HERE - the annual FLU BLITZ will be held on September 18 and 19, and it looks like the Stead Leaders are all planning to be first in line. Flu vaccinations will be available before and after noon conference on the 18th - so PLEASE make a point to be there - and come early.
What Did I Read This Week
Submitted by Aimee Zaas, MD
Seasonal Influenza Vaccination Coverage Among Adult Populations in the United States, 2005-2011.
Lu PJ, Singleton JA, Euler GL, Williams WW, Bridges CB.
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Why Did I Read This? It is FLU (VACCINE) SEASON! We have our flu blitz this week (Wednesday!) What better time is there to read about flu vaccines? IN addition, flu is expensive and vaccines are generally effective. One national study estimated the annual economic burden of seasonal influenza in the United States to be $87.1 billion, including $10.4 billion in direct medical costs. Influenza vaccination has been shown to be a cost-effective tool for reducing morbidity and mortality associated with influenza among adults. What DId the Authors Do? The authors were doing a large epidemiological study using the NHIS database, and wanted to ask the question of how many members of the US population received influenza vaccination during each of the 6 seasons studied. They also wanted to evaluate rate of vaccination by age, gender and ethnicity. What is the NHIS? it is a CDC run face to face weekly survey of a probability sample of US households where a variety of data is collected. How did these authors use the NHIS? In this data-dredge, the authors were looking at influenza vaccination status as well as health literacy. They sliced the samples so that they captured the flu season each year as well, as a better sampling of vaccination status. They were then able to calculate point estimates for vaccination status by each group they studied, and also use a t test to see if trends were apparent in vaccination status over the years of the study. For example, the CDC did not recommend universal vaccination in those 18-49 until 2010-11. How are we doing as a country on flu vaccination? Pretty good overall. Influenza vaccination coverage among adults aged ≥18 years, 18–64 years, 18–49 years, and 50–64 years increased significantly from 27.4%, 20.0%, 15.2%, and 32.5%, respectively, during the 2005–2006 season to 38.1%, 31.5%, 26.1%, and 43.7%, respectively, during the 2010–2011 season, with annual average increases of 2.2%, 2.3%, 2.2%, and 2.3%, respectively (P-trend < 0.05). Health care workers hover around the 60% rate; and the elderly (65%) and chronically ill (45%) are not close to the target of 90% vaccination rate. Disparities by race exist, with non Hispanic whites having the highest rates of vaccination. Why is this study important? We are doing better overall with flu vaccination, but not good enough. Authors give varied means to improve vaccination, especially in high risk groups (like health care workers). They even mention having vaccine be free at work and offered convenient to the actual site where you work (like at noon conference) is one way to increase vaccination of HCWs like ourselves. The obvious limit of this study is self report, with the bias towards over reporting your vaccine status to an NHIS interviewer rather than underreporting. SO>>>get your shot unless you are medically exempt! [divider]From the Chief Residents
Grand Rounds
Date: September 20, 2013 Presenter: Ken Lyles, MDNoon Conference
| Date | Topic | Lecturer | Vendor | Room |
| 9/16 | Managing the sickle cell crises | Laura De Castro | Saladelia Salads | 2002 |
| 9/17 | MED-PEDS Combined: Sexually transmitted infections OR Difficult Death Debrief | Richard Chung / Tony Galanos | Saladelia Sandwiches | 2002 OR DN9242 |
| 9/18 | QI Patient Safety Noon Conference | Dan Ariely | Moe's Quesadillas | 2002 |
| 9/19 | Unstable SVTs - Acute management | Al Sun | Domino's | MEDRES |
| 9/20 | Chair's Conference | Chiefs | Chick-fil-A |
MEDRES |
Holiday Schedule Posted
We have completed the holiday schedule and your individual assignments are listed on Amion and will be posted to your MedHub Schedule (not a file). We did everything we could to give you your preference and ~90% of all residents got their first choice holiday off! For those who did not, we are sorry! There were more requests for Christmas off than possible and so for the continuity of patient care we needed to place you elsewhere. A couple of quick reminders:- Christmas Block is from 12/22 to 12/27 (or morning of 12/28 if on night shift or on overnight call on 12/27).
- New Year's Block is from 12/28 to 1/2 (or morning of 1/3 if on night shift or on overnight call on 1/2).
- There are NO days off during the holiday block! Please keep the above dates in mind when making travel plans, you are required to be present for 100% of that time!!
- Given the complexity of the schedule making, we cannot accept any schedule change requests or trades. If there is an EXCEPTIONALLY IMPORTANT CONFLICT or we have overlooked an important request please let us know by the end of the weekend. Please do NOT send any requests/issues to Lauren, Jen, or Randy.
G-Briefing Session (with Dr. Galanos)
This month we will start our G-Briefing sessions on Tuesday, September 17th! Dr. G would like to help create space and time for Internal Medicine house staff to meet to allow you to debrief around the issue of deaths that you’ve witnessed or feel strongly about as part of your work here. This WILL NOT be in place of noon conference but you have the OPTION of grabbing a lunch from the second floor and joining this session in conference room 9242 instead of noon conference. Conversation will start at 12:10! Please note- these will continue to be every 3RD Tuesday from 12:10 to 1:00 each month. Both Dr. Galanos and your programs leaders hope that this is of great value and significance to you! Mark your calendars!VA Gen Med Pagers - NEWS FLASH!
(submitted by Vaishali Patel)
Have you ever been paged at home about a VA inpatient that you took care of a week ago? Did you have to call back and tell them you were not the doctor on Red 3 any longer? Well, fret no more about those 4-digit callback numbers!!
VA GEN MED TEAMS NOW ALL HAVE FUNCTIONAL PAGERS!! We have rolled out the functional pagers at the VA this week. This will undoubtedly improve communication between nurses and residents, and will be better for patient safety. A BIG thanks goes to the current VA ACR, Alex Fanaroff, who made this happen!
Cardiology Grand Rounds
We are delighted to kick off the 2013 Duke Cardiology Grand Rounds series next Tuesday at 5pm in DN2002. With mixed emotions, we will have Dr. Richard Becker present before accepting a new position at his alma mater, the University of Cincinnati College of Medicine. As you know, he will serve as the Mable Stonehill Endowed Chair for the Division of Cardiovascular Health and Disease; director of the Heart, Lung, and Vascular Institute; director of the Cardiovascular Center of Excellence in Research; and chief of Cardiovascular Services at West Chester Hospital. The title of his talk is: " Where is Osler?" Afterwards, there will be a reception for Dr. Becker outside of DN2002 with food and drink. Please make every effort to attend. If you missed our last Grand Rounds, visiting professor Dr. Les Miller spoke on stem cell and gene therapy for cardiovascular disease. You can see it here. Zubin Eapen, MD, MHS Assistant Professor of Medicine Medical Director, Duke Heart Failure Same Day Access Director of Education IT Innovations, Department of Medicine [divider]From the Residency Office
Conference Recordings/Presentations
Thanks to everyone who logged in and provided feedback as to the use of conference recordings that we upload to MedHub. We'll leave the survey open one more week, but so far we are seeing two categories of responses:- Those who did not know they were available or how to find them
- Those who see a lot of value in having them on line
Duke Internal Medicine Residency Program Fleece – Time To Place Your Order
Reminder that the opportunity to place orders for a fleece this year closes on Sunday, September 22, 2013. Sample jackets are available to check out/try on in our office. Contact lynsey.michnowicz@duke.edu if you have any questions, and just in case you missed the first email - we are sending out the link agian on Mondauy to residents and senior program leadership.
Developing the next generation of globally educated, socially responsible healthcare professionals dedicated to improving the health of disadvantaged populations.
Global Health Elective Rotations, Application Deadline is this week!
The Hubert-Yeargan Center for Global Health (HYC) is accepting applications for Global Health Elective Rotations for July 2014 and March 2015. Application is open to residents from Departments of Medicine: Internal Medicine (PGY 2); Med-Peds (PGY 3) and Med-Psych (PGY 4). Access the application form and FAQ at http://dukeglobalhealth.org/education-and-training/global-health-elective-rotation.
(Application addendum is available by request – tara.pemble@duke.edu)
How are residents selected to participate in a Global Health Rotation?
Faculty-Resident Research Grant Request for Applications 2014
REQUEST FOR APPLICATIONS
Purpose:
To provide funding for Internal Medicine Residents to develop their skills in clinical or laboratory-based research, to carry out research projects, to present their research findings at scientific meetings and to publish their work
Application Instructions
Eligibility:
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Interns and residents in the Department of Medicine, Med-Peds, Med-Psych are eligible
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Clinical or Basic Science research proposals are acceptable
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Research project must be performed at Duke under the direction of a Duke faculty member
Funding Mechanism:
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Grants will be funded up to $2,000
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The term of the award must NOT extend beyond the residency training period at Duke. The beginning date for funding is July 1, 2014 and end date is June 30th 2015. Interns who are awarded may apply for extension to use the funds for use during their SAR year.
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An itemized budget must be included with the application (use attached forms)
Application Process:
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Application deadline is April 11, 2014 by email to murat.arcasoy@dm.duke.edu
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Late or incomplete applications will not be accepted. Please submit on time!
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A faculty committee will review applications for scientific merit
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Letter of support from faculty mentor is requested and must accompany grant please, Letter addressed to “Award Review Committee, Faculty Resident Research Grant”
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Use application forms online and follow instructions please. Scientific proposal – strict 3 page limit with tables and figures (excluding references, budget page, and human subjects sections) http://residency.medicine.duke.edu/duke-program/resident-research/research-funding
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Itemized budget may include but is not limited to research supplies, reagents, temporary personnel time for data collection, data analysis costs and statistician time, poster preparation, travel expenses to present abstract at scientific meeting, publication costs of research project
Annual Healthcare Conference (submitted by Tarika Mansukhan)
I'm reaching out because the Healthcare Club here is hosting it's annual Healthcare Conference. We're looking forward to bringing students from neighboring schools, both MBA and other, as well as several healthcare focused businesses to Fuqua for the event on November 16th. The conference centers on The Evolving Healthcare Landscape this year. Attached you can find details regarding the keynotes, agenda and panel, and below is the registration link for the conference: https://fuqua.campusgroups.com/Health/rsvp?id=175385 HC Conference Flyers| Tarika Mansukhani Candidate for MBA, Class of 2014 Duke University, The Fuqua School of Business Tel +1.740.281.9395 Tarika.Mansukhani@fuqua.duke.edu |
BLS Challenge Course
A BLS Challenge Course wil be held at Duke on November 5. For more information please call 919-684-4293.Information/Opportunities
Louisiana Internal Medicine CentralUpcoming Dates and Events
- September 17: Application deadline for Global Health Electives
- September 18/19: Flu Shot Blitz
- October 1: Duke’s Global Health-Internal Medicine Residency deadline to submitt applications
- October 18: SoM Clinical Science Day
- October 28: Annual Recruitment Kickoff
- November 28: Annual "Turkey Bowl"
- December 4: "Voices in Medicine"
Useful links
- https://intranet.dm.duke.edu/influenza/SitePages/Home.aspx
- August 2013 Resp Fit Testing-T-Dap-TB Skin Testing Flyer
- http://duke.exitcareoncall.com/.
- Main Internal Medicine Residency website
- Main Curriculum website
- Ambulatory curriculum wiki
- Department of Medicine
- Confidential Comment Line Note: ALL submissions are strictly confidential unless you chose to complete the optional section requesting a response.