Weekly Updates - April 23, 2012

By heffe004@dhe.duke.edu

From the Director

Hi everyone Thanks to everyone for being so professional and understanding with any schedule requests after the block schedule went out! The chiefs are breathing a huge sigh of relief to have that monkey (almost) off their backs…..now on to making sure the interns don't have back to back to back gen med months. This week, SAR Ryan Schulties knocked it out of the park (ha!) with a Moneyball themed look at Markov modeling in his SAR talk, intern Kevin Shah intrigued us with a case of thyrotoxic periodic paralysis at DRH morning report and JAR Lisa Vann brought out a zoo full of zebras with a case of Cogan's syndrome at Chair's.  Nice job, everyone.  Got some great compliments on patient care by our residents as well…shout out to intern Bobby Aertker from Loretta Que for his care of patients and enthusiasm on the pulmonary service, and to MedPsych JAR Anne Mathews for changing the course of care for a patient who she saw as a psychiatric consultant.  Very appreciative of the way many are covering for others during family emergencies as well. The biggest mention of the week goes to Matt Crowley and his stead society for an incredible inaugural STEAD TREAD 5K! Over 100 people signed up, and many of us even showed up despite the rain…actually almost everyone who signed up, showed up including great representation from the interns (including house staff fastest male Aaron Mitchell (20 min!) and fastest house staff female Meredith Edwards (somewhere not far behind Aaron).  Duke Chief Eileen Maziarz was fastest overall female, and Joanne Piscitelli and Mike Kelley were fastest faculty.  I almost got run over by Brian Schneider and his jogging stroller! The VA and the DCRI represented well, including new DCRI director Eric Peterson.  Super impressed with this effort…big thanks to SAR Leon Cannizzaro, JAR Leah Rosenberg and interns Meredith Edwards and Marianna Papademetriou for taking the extra effort with Matt to make this happen.  I am not sure the total raised for Lincoln Clinic, but it should be impressive! Keep filling out your ACGME survey….we are at 33% on our way to our goal of at least 80%.  Next week we'll get to see completion rates by Stead Society. I'm headed to Atlanta this week for the program directors meeting…sure to learn a lot . Pubmed from the program goes to Intern Brian Miller and med student Christina Behrend for their prize winning presentations at the national ACP meeting in New Orleans! Way to go! Aimee

What Did I Read This Week (by Lynn Bowlby, MD )

[box]    Annals of Internal Medicine  February 21, 2012  156 (4), 253-262.   [/box] Every week at the DOC (Duke Outpatient Clinic) , like all practices, we see new patients.  Part of the initial visit includes asking about Family History.  As Sarah Piper presented a new patient to me this week, I wondered, what do we really ask?  How effective is our evaluation of family history?  In the era of personalized medicine could we do better?  The evidence that our collection of family history information has value is limited.  I found this interesting article in the Annals. This was a clustered randomized trial at 24 practices in the UK, looking at  the CV risk of 748 patients.  The control group had Framingham CV risk calculated thru usual means, primarily chart review.  The intervention group completed a validated questionaire, and 98% completed it!! The outcome measured was the number of pts identified as high risk, CV risk >20%.  Those pts were offered a MD visit in 2 weeks.  The difference? 0.3 % high risk in the control group,  4.8% high risk in the intervention group, a significant difference.  Not known of course is if seeing the MD to discuss this will change outcomes, but this is a great start. Locally personalized medicine is being looked at in many ways....       google   Guilford Genomic Medicine    or   My Family Health History   familyhistory.hhs.gov Comments regarding this article, by Aimee Zaas, MD "I was really happy to see this article and discussion in WIRTW.  A few weeks ago I had the opportunity to participate in an all day personalized medicine symposium at the IGSP (with Dr. Phelps and Dr. Sabina Lee in the audience).  My role was to discuss the need for education in the concepts of personalized medicine in residency training.  A survey we did last year shows that NO IM programs across the country have a curriculum related to personalized medicine.  We are exploring the opportunity to lead the way in this area, with a survey course in personalized medicine that residents may be able to participate in, as well as a collaboration with genetic counselors in the ambulatory clinic.  Additionally, Our incoming APD for Ambulatory (Alex Cho) helped design the Guilford County study mentioned by Lynn.  Stay tuned…and thanks Lynn and Sarah for providing an outlet for a shameless plug for personalized medicine.  --Aimee"

Quality and Patient Safety (by Jon Bae, MD)

Hand Hygiene Compliance report from April 9 to April 15th.    We have had 100% MD compliance on 7800, 8100, 8200, & 8300 for the last 2 weeks. KUDOS !!!  to all the team members.    Hand Washing - Report by Unit [hr] [divider]

From the Chief Residents

Grand Rounds

4/27 - Stan Branch, Gastroenterology

Noon Conference

Day Date Topic Lecturer Time Vendor
Monday 4/23 resident M&M conference Anne Marie Navar-Boggan 12:00 Saladelia
Tuesday 4/24 SAR TALK Tiffany Randolph/Jason Lappe 12:00 Domino's
Wednesday 4/25 Colorectal Screening Yousuf Zafar 12:00 Chick-fil-A
Thursday 4/26 PWIM Carla Brady 12:00 Bullock's BBQ

Cardiology Grand Rounds  ( from Drs. Matt Wolf and Tracy Wang)

Please join us for Cardiology Grand Rounds at 5:00 on Tuesday in the 2002 conference room.  We will have visiting professor, Jay Cohn, lecturing on “Structural Remodeling of the Heart and Vasculature: a Key to Progression of Heart Failure”.  Pizza and soft drinks will be served.

SAR Fellowship Advice Session #2:

Session #2 of the Residency Council's SAR driven fellowship advice sessions will be subspecialty specific advice and opinions regarding the application process and various programs.  These will be led by SARs who have matched in the respective field.  There will be 4 sessions to reflect the 4 subspecialties that are expected to be most applied to by the current class.  Dates and times are as listed below.  If you have any questions, please don't hesitate to email Leon.C@duke.edu. All sessions will be in the medres library. Heme/Onc:     Wed, April 25th 5:30-6:30PM Cardiology:     Thur, April 26th 5:30-6:30PM Pulmonology:  Wed, May 2nd 6:00-7:00PM GI:     Thur, May 3rd 5:30-6:30PM

Pictures from the Wedding!

The newlyweds are back!  Juliessa and Tony sent us the following to prove that the wedding did in fact happen last week.   Enjoy!! [gallery link="file" columns="2"] [divider]

From the Residency Office

 

Dates to Add to Your Calendars /Contact Information

April 25 - Cardiology Symposium, Searle Lecture Hall 8:00am to 5:00pm. April 26 - Ronald McDonald House  dinner, hosted by Stead E (michael.shafique@duke.edu) April 27 - DoM Annual Resident Photo  Shoot, after Grand Rounds (rain date - May 18) April 27  Nephrology Fellowship Discussion (contact Dr. Steve Smith (stephen.smith@duke.edu)) May 1 - Annual Duke Residents vs Faculty Basketball Game (6:00 @ Cameron Indoor Stadium) May 4 - Humanism in Medicine May 19 - Annual Resident Picnic (Dr Burton's Farm) June 2 - Annual SAR Dinner (invitations only) June 13 –Resident Research Event, 5-7pm

Opportunities

TSMA (work done inside Duke for extra compensation)

The program fully supports Duke's policies regarding moonlighting as delineated in the Trainee Manual and Benefit Guide found on the GME website. At no time may the hours allocated for TSMA activities negatively impact training or violate duty hour policies. Residents who would like to be considered for Temporary Special Medical Activity (TSMA) on the Oncology or Student Health must meet the following: 1.     Program level - either JAR or SAR 2.     Successful completion of rotations on MICU and Gen Med 3.     Be in good standing and without any active corrective action 4.     Provide written support from their advisor supporting the trainee's request.  The advisor may send an email to the attention of the Program Director, copy to the Program Coordinator, confirming their approval (to be completed prior to initiating the online TSMA form). 5.     Initiate the online TSMA form found on MedHub. On notification of approval by GME, the trainee may contact the service Director and request approval to participate in the TSMA service.

Please Note:  TSMA is approved only for each academic year.  If you are currently participating in TSMA and plan to continue after July 1, you will need to resubmit the required forms for approval.

Useful links

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