Weekly Updates - August 27, 2012

By admin3

From the Director

Hi everyone! Can't believe another block has been completed by the interns (one more week for SARs and JARs)!  In a couple of weeks, ERAS opens up and the intern recruiting season officially starts. This is the first year the fellowship interviews are going to happen right before residency interviews...again, thanks to the SARs and chiefs (and Laura who keeps up with all the changes) for working out a way to get everyone to their interviews and for covering each other to help out. It's always a bit interesting to be the first in a new process, but I really appreciate how everyone is working together to make this happen. We had a really nice impromptu discussion at intern report this week (thanks Amit Bhaskar!), and Duke Chief Jeff Clarke led a session on how to use the 9100 scope to view blood films, including the film from Amit's patient and another from Erin Boehm's patient. It was a good reminder of why we try to look at the original data ourselves, even better with an expert to guide us.  I also heard from ID attending Barb Alexander that med peds JAR2 Ben Mouser was an amazing ID resident last weekend! And thanks to JAR Carter Davis for a great chairs conference - take home points include the workup and DDX of acute renal failure, how to manage the oncologic emergency of tumor lysis, what causes splenomegaly, and what all those categories of myeloproliferative disorders are. We have an opportunity to help the community - Don't forget to sign up to help teach CPR at the Duke football game on Sept 1.  Details in the med res office. This week, the APDs, hospital medicine attendings and I will be holding a retreat in the med res library to work on preparing for the "next accreditation system", which is the new way that the RRC is going to require unto evaluate residents. Once this phase of background work is complete, we will be asking for your opinion also on what characteristics and behaviors best define when a trainee is ready for more responsibility, and, eventually, independent practice. We are looking forward to getting your opinion! I have been asked by a number of interns what they should be reading...there are so many available resources, a ton of clinical questions, and a fair amount of pressure to make the most of limited time. If you haven't done so, I would recommend the Part 2 of Harrison's "cardinal manifestations and presentations of disease". Each chapter is short, relevant and gives a framework for approaching a patient based on presentation.  And it's free online through the duke library, under the "e-books" section. This weeks pubmed from the program goes to SAR Newton Wiggins for his article published with Chris Granger and John Alexander,   Cardiovasc Drugs Ther. 2012 Jun;26(3):265-71.  Novel oral anticoagulants after acute coronary syndromes.   Wiggins NB, Granger CB, Alexander JH. And, on a final note as a we face the traditional end of summer - this week is the last SEERSUCKER TUESDAY until after memorial day! Bring out your stripes!! Have a great week, Aimee

What Did I Read This Week (Aimee Zaas, MD)

[box]     "Burnout and Satisfaction with Work Life Balance Among US Physicians Relative to the General Population" by Shanafelt, et al published online in the Archives of a Internal Medicine     [/box]

I found the article because one of my med school friends posted a reference to it in Pauline Chen's NYT blog.  It's timely because burnout among residents and faculty (and myself, for that matter), is of particular concern to me as a program director.  I wanted to be updated on the latest literature, and consider what we can do to improve rates of burnout among ourselves and our colleagues. The authors surveyed a sample of 27000 physicians across all specialties, over sampling in smaller specialties with the Maslach Burnout Inventory, a well validated 22 question survey.  Eligible participants got an email, and about 28% answered (n = 7288).  They also sampled a random sample of about 3000 non physicians for comparison, using the two best questions from the MBI (emotional exhaustion and depersonalization), which have a PPV for burnout of about 90%. The skinny - 45% of physicians have symptoms of burnout on at least one domain. Compared to US adults, we are far more likely (38% vs 28%) to have emotional exhaustion or symptoms of depersonalization ("who cares?, not my problem"), but no real difference in depression or SI.  Emergency Medicine, family medicine and internal medicine are the most burnt out. Now that we know this (and probably aren't surprised), what do we do about it? For now, some small suggestions....and also Stay tuned for a major program intervention to help combat burnout (thanks, Jon Bae). This week, try a few things ... Take a moment to go grab a coffee or snack with your team on a busy day.  Check in with each other.  Walk outside from the parking garage instead of in the tunnel and grab a little fresh air. I am starting to read the book "drive" to learn more about job satisfaction and what makes people enjoy their work.  I hope to incorporate more meaningful feedback for you guys on a consistent basis, as that is part of true job satisfaction. Any suggestions you all have are welcome also. Finally, GET YOUR RUNNING SHOES OUT.  I just signed up for the 2nd annual Rambling Rose/Duke Med Women's Half Marathon. It is on Oct 21 and benefits the DCI.  It's a really fun race, and it even has a relay option if 13.1 miles isn't your thing.  Guys can run too.  Let's have some major Duke IM (and Med Peds and Med Psych) participation.  Former chief Eileen Maziarz is running, and last year I spotted our now recent grads Blair Irwin and Rebecca Burke. See the website for more info..http://www.endurancemag.com/durham-home [hr]

From the Chief Residents

Grand Rounds

Date Division Speaker
31-Aug-12 Cellular Therapy Dr. Sandeep Dave

Noon Conference

Day Date Topic Lecturer Time Vendor Room
Monday 8/27 ABG interpretation Craig Rackley 12:00 Saladelia 2002
Tuesday 8/28 QI/Patient Safety Conference Aubrey Jolly-Graham/Jon Bae 12:00 Domino's 2002
Wednesday 8/29 Alcohol withdrawal Sarah Rivelli 12:00 Moe's 2002
Thursday 8/30 Stead Society Noon Conference 2002, 8253, 8262, 4275, 1700B Stead Societies 12:00 Papa John's 2002
Friday 8/31 Chair's Conference Chiefs 12:00 Meelos 2002

[divider]

From the Residency Office

Attendings, Fellows, and Residents - Smart Phone/Tablet Survey (University of California)

"I am asking your input regarding the use of smart phones and tablet computers in the medical setting. Please consider voluntarily completing a 3-minute survey that can be found HERE.  All data is anonymous and results will be publicly available.   This study has been IRB approved by the University of California, San Diego  (UCSD Project #110845XX).  The survey below links to a Google Form, which is used to compile the data.  All data are collected anonymously." Thank you for your help, Orrin Franko, MD Resident Physician, Post-Graduate Year 4 University of California, San Diego SURVEY LINK HERE

Volunteer Opportunity - CPR @ Wallace Wade Stadium ( from Leatice Short)

On September the 1st, we will offer a CPR education tent at the football game at Wallace Wade Stadium.  We would welcome medical residents to assist as volunteers during shift 3.  Also, if others would like to volunteer during  shifts 1 and 2, that’s fine as well! Sign up sheets have been posted in the Residency Office.  

HEALTH POLICY: JUST IN TIME LECTURE SERIES  (Supported in part by the Chancellors GME Innovation Fund)

OPEN TO ALL DUKE GME TRAINEES & PROGRAM DIRECTORS

Registration Link:  https://www.surveymonkey.com/s/HealthPolicy2012_2013

The Fuqua School of Business and the Duke University Hospital Office of Graduate Medical Education have joined together for the 4th year to offer a Health Policy lecture series for Duke GME programs. Program Directors, residents and fellows are invited to participate. Future physicians will benefit from an understanding of health care delivery systems, payment structures, incentives, and policy.  Increasingly, the role of the physician will be less of a clinical technician and more of a team-leader as our health care system evolves, using a more multidisciplinary & team-based model.  To this end, we are offering a program which covers topics that will allow residents and fellows to acquire a baseline understanding of our health care system. Participation addresses the ACGME competency of Systems Based Practice and provides critical knowledge to graduate physician leaders.

HEALTH POLICY LECTURE SERIES OBJECTIVES:

Objective 1:    Provide health policy content for residents and fellows, to better prepare them for practice following GME training.

Objective 2:     Offer content using a hybrid approach with live lectures and online material, to attempt to meet individual schedule needs and learning styles.

Objective 3:     Enhance GME training with topics that address the ACGME Core Competencies, specifically, systems-based practice.

Objective 4:     Enhance interaction and collaboration across Duke GME departments and programs by enrolling together GME Program Directors, resident and fellows from a variety of programs.

Objective 5:     Evaluate the usefulness of content and delivery method using confidential written evaluations as well as qualitative verbal feedback.

TOPICS INCLUDE:

  • Overview of Affordable Care Act (September 2012)
  • Law & Medicine (October 2012)
  • Presidential Candidates Political Views Discussion (November 2012)
  • Employment Law/Contracts (December 2012)
  • Quality & Performance (January 2013)
  • Conflicts of Interest (February 2013)
  • Healthcare Reform (February 2013)
  • MedPac Annual Report Overview - Medicare/Medicaid (March 2013)
  • Comparative Health Systems (April 2013)
  • TBD (May 2013)

PROGRAM FORMAT:  Sessions will be held the second Thursday of each month (6:00pm-7:30pm) in the Medical Center Board Room from September 2012 to May 2013.

PARTICIPATION OPTIONS:

  1. Residents/fellows can earn a Health Policy Series Certificate of Completion (with letter presented to their Program Director) by completing these requirements:
  • Attend all sessions
  • Complete a self-assessment at the beginning and end of the series
  • Evaluate all sessions and provide feedback on the program overall (via on-line surveys)
  • Please use the link below to register
  1. Residents/fellows (and their Program Directors) are welcome to attend as few or many sessions as they would like and their schedules will permit. Register for individual sessions via the link below.

Registration Link:

https://www.surveymonkey.com/s/HealthPolicy2012_2013

Dates to Add to Your Calendars /Contact Information/Opportunities

Sept 19-20          Flu Shot BLITZ Oct 25                   Recruiting Kick Off Event  

Useful links

Share