The Internal Medicine Residency newsletter is posted each week to share important news, announcements and updates about the residency program. Please contact Randy Heffelfinger or Emily Strollo with corrections, contributions and suggestions.
The interns have made it through Block 2 and will start new rotations on Monday! I am taking somewhat of a risk writing this BEFORE all the “weather” arrives this weekend, but we are all hoping for the health and safety of those in the path of Irene.
Many of our trainees and faculty deserve shout outs for their hard work this week….some notables are our “Proceduralists of the Week” Lindsay Boole (PGY1) with 8 blood draws in 30 minutes on Duke Gen med and Carrie Horney (PGY2) doing 4 thoracenteses in one afternoon in Dr. Momen Wahidi’s clinic! That’s lots of med hub procedures to sign off, Momen! As has been aptly mentioned by Ashleigh Owen (PGY-3), we are turning burning and learning on Duke Gen Med, evidenced by her fantastic presentation of a fever in the returned traveler to Drs. Joe Govert and Mary Klotman at afternoon report. The wards are at record census levels, but that doesn’t stop Paul Lantos from pausing to correctly identify the lonestar tick nymph brought in by Kathleen Kiernan (PGY2). Insects abound in the program, as our new chair’s conference mascot “The Cricket” was introduced. During the conference, Zach Healy (PGY2) did a fantastic presentation of a case of acute HBV infection, with great discussion by the crowd (notably Kaley Tash (PGY1), Hassan Dakik (PGY2), Tara Spector (PGY3) and Vaishali Patel (PGY3) to name a few). The MS2’s are looking like pros on the wards and new medicine Sub-I’s are off to a great start as well. Everyone is keeping busy at the VA, DRH and the clinics.
The DOM fellows are also deserving of mention….way to go Heme-Onc fellow (and future Duke Chief) Jeff Clarke on receipt of a Strength, Hope and Caring Award with Dr. Gow Arepally and Dr. Laura DeCastro, and also to Lance Okeke (ID) for spending his day running specimens back and forth from the OR to the lab to help care for a patient.
NEW EVENTS! NEW EVENTS! NEW EVENTS! NEW EVENTS!
Mark your calendars for two new mentorship events in the program…
For ALL med students, residents and interested faculty…”Leader’s Board” will begin on Tuesday Sept 27 at 5:30 PM in the Faculty Lounge. Designed to introduce trainees to faculty that they may not encounter in their routine work, Leader’s Board will have wine, cheese and career discussions with key Duke faculty. We are very pleased to have Dr. Victor Dzau as our first Leader’s Board featured speaker.
For SARS, SAR-significant others and interested faculty, “Evening Rounds” will begin on Tuesday October 11 at 7 pm at the Zaas home (no, not putting my address in weekly updates…). Evening Rounds are a chance for senior residents to relax and talk with interesting and intelligent individuals from Duke and the community. Our featured guest for the first Evening Rounds is Ann Lore, the Assistant VP for Health System Innovation Planning at Duke. She has also served in the role of the CEO for WellPath Community Health Plans and as the state government relations representative for Duke. We are looking forward to a great conversation about the future of health care in the US.
We hope to see you there!
The first Pubmed award from the program this week goes to Duke alum Jodi Nienaber for her article published in the Journal of Infectious Diseases (mentor Dr. Vance Fowler).
Methicillin-Susceptible Staphylococcus aureus Endocarditis Isolates Are Associated With Clonal Complex 30 Genotype and a Distinct Repertoire of Enterotoxins and Adhesins.Nienaber JJ, Sharma Kuinkel BK, Clarke-Pearson M, Lamlertthon S, Park L, Rude TH, Barriere S, Woods CW, Chu VH, Marín M, Bukovski S, Garcia P, Corey GR, Korman T, Doco-Lecompte T, Murdoch DR, Reller LB, Fowler VG Jr; for the International Collaboration on Endocarditis-Microbiology Investigators.J Infect Dis. 2011 Sep;204(5):704-713.
Aaron Mitchell is our 2nd Pubmed awardee of the week for the following paper accepted for publication in Case Reports in Oncology:
A Case of Highly Aggressive Extraskeletal Myxoid Chondrosarcoma; Mitchell, A.P.; Poiesz, M.; Leung, A.
We would also like to congratulation the PGY-1 representatives who were recently elected to the residency council: Armando Bedoya, Laura Caputo, Chris Hostler and Jeremy Halbe! We are sure you will do a fantastic job representing your class.
It’s hard to believe, but interview season is fast approaching, with the opening of the ERAS application process on Sept 1st! Dr. David Butterly, APD-Recruiting, and I will be sending more information your way soon about how to sign up for times to interview applicants, and also updated “FAQs” about our program. We look forward to strong participation in the recruitment process from all divisions….Duke residents are our future faculty, so please be involved in the recruitment process.
Aimee
Residents who participate in GH rotations should be flexible and willing to step in where needed. Due to limited resources at the sites, much of the responsibility for coordinating daily activities is the resident’s responsibility. In this case, the age old adage rings true: You will get out of the experience what you put into it. A Global Health Rotation is a wonderful opportunity to understand clinical presentation and management of common diseases in a resource-poor environment as well as understand alternative health systems and cultural settings.
Application deadline is September 23, 2011. Interviews will be held from September 26 to October 7. For more information, contact Tara Pemble, Program Coordinator at tara.pemble@duke.edu or 668-8352.
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From the Director
The interns have made it through Block 2 and will start new rotations on Monday! I am taking somewhat of a risk writing this BEFORE all the “weather” arrives this weekend, but we are all hoping for the health and safety of those in the path of Irene.
Many of our trainees and faculty deserve shout outs for their hard work this week….some notables are our “Proceduralists of the Week” Lindsay Boole (PGY1) with 8 blood draws in 30 minutes on Duke Gen med and Carrie Horney (PGY2) doing 4 thoracenteses in one afternoon in Dr. Momen Wahidi’s clinic! That’s lots of med hub procedures to sign off, Momen! As has been aptly mentioned by Ashleigh Owen (PGY-3), we are turning burning and learning on Duke Gen Med, evidenced by her fantastic presentation of a fever in the returned traveler to Drs. Joe Govert and Mary Klotman at afternoon report. The wards are at record census levels, but that doesn’t stop Paul Lantos from pausing to correctly identify the lonestar tick nymph brought in by Kathleen Kiernan (PGY2). Insects abound in the program, as our new chair’s conference mascot “The Cricket” was introduced. During the conference, Zach Healy (PGY2) did a fantastic presentation of a case of acute HBV infection, with great discussion by the crowd (notably Kaley Tash (PGY1), Hassan Dakik (PGY2), Tara Spector (PGY3) and Vaishali Patel (PGY3) to name a few). The MS2’s are looking like pros on the wards and new medicine Sub-I’s are off to a great start as well. Everyone is keeping busy at the VA, DRH and the clinics.
The DOM fellows are also deserving of mention….way to go Heme-Onc fellow (and future Duke Chief) Jeff Clarke on receipt of a Strength, Hope and Caring Award with Dr. Gow Arepally and Dr. Laura DeCastro, and also to Lance Okeke (ID) for spending his day running specimens back and forth from the OR to the lab to help care for a patient.
NEW EVENTS! NEW EVENTS! NEW EVENTS! NEW EVENTS!
Mark your calendars for two new mentorship events in the program…
For ALL med students, residents and interested faculty…”Leader’s Board” will begin on Tuesday Sept 27 at 5:30 PM in the Faculty Lounge. Designed to introduce trainees to faculty that they may not encounter in their routine work, Leader’s Board will have wine, cheese and career discussions with key Duke faculty. We are very pleased to have Dr. Victor Dzau as our first Leader’s Board featured speaker.
For SARS, SAR-significant others and interested faculty, “Evening Rounds” will begin on Tuesday October 11 at 7 pm at the Zaas home (no, not putting my address in weekly updates…). Evening Rounds are a chance for senior residents to relax and talk with interesting and intelligent individuals from Duke and the community. Our featured guest for the first Evening Rounds is Ann Lore, the Assistant VP for Health System Innovation Planning at Duke. She has also served in the role of the CEO for WellPath Community Health Plans and as the state government relations representative for Duke. We are looking forward to a great conversation about the future of health care in the US.
We hope to see you there!
The first Pubmed award from the program this week goes to Duke alum Jodi Nienaber for her article published in the Journal of Infectious Diseases (mentor Dr. Vance Fowler).
Methicillin-Susceptible Staphylococcus aureus Endocarditis Isolates Are Associated With Clonal Complex 30 Genotype and a Distinct Repertoire of Enterotoxins and Adhesins.Nienaber JJ, Sharma Kuinkel BK, Clarke-Pearson M, Lamlertthon S, Park L, Rude TH, Barriere S, Woods CW, Chu VH, Marín M, Bukovski S, Garcia P, Corey GR, Korman T, Doco-Lecompte T, Murdoch DR, Reller LB, Fowler VG Jr; for the International Collaboration on Endocarditis-Microbiology Investigators.J Infect Dis. 2011 Sep;204(5):704-713.
Aaron Mitchell is our 2nd Pubmed awardee of the week for the following paper accepted for publication in Case Reports in Oncology:
A Case of Highly Aggressive Extraskeletal Myxoid Chondrosarcoma; Mitchell, A.P.; Poiesz, M.; Leung, A.
We would also like to congratulation the PGY-1 representatives who were recently elected to the residency council: Armando Bedoya, Laura Caputo, Chris Hostler and Jeremy Halbe! We are sure you will do a fantastic job representing your class.
It’s hard to believe, but interview season is fast approaching, with the opening of the ERAS application process on Sept 1st! Dr. David Butterly, APD-Recruiting, and I will be sending more information your way soon about how to sign up for times to interview applicants, and also updated “FAQs” about our program. We look forward to strong participation in the recruitment process from all divisions….Duke residents are our future faculty, so please be involved in the recruitment process.
Aimee
What I Read This Week “WIRTW” (by Daniella Zipkin 8-26-11)
[box]Overheard in the DOC sign out room: “Should we be giving daily prophylactic Azithromycin to our patients with COPD?” Hmmm. Interesting question! Azithromycin for Prevention of Exacerbations of COPD. N Engl J Med 2011;365:689-98 – published August 25, 2011[/box] P [population] – 1142 pts over 40 with COPD, on O2 or with steroids in past year, Hx of ER or admit I [intervention] – Azithromycin 250 mg daily C [control] – matching placebo O [outcome] – time to first exacerbation of COPD T [type of study] – Randomized controlled trial – validity was solid, blinded, groups treated equally, analysis by intention to treat (analyzed in groups to which they were randomized). RESULTS: Rate of acute COPD exacerbation 1.83 per patient year in placebo, 1.48 per patient year in Azithro. Time to first exacerbation 174 days in placebo, 266 days in Azithro. Microbial resistance wasn’t seen in the one year study (probably takes longer). [They calculate a number needed to treat, but considering that nearly all patients in both groups ultimately had exacerbations, and the time delay was the main result, it’s not clear if the number is accurate. EBM consult in progress.] BOTTOM LINE: Daily Azithro has a statistically significant, but not very clinically significant, impact on COPD flares in sicker patients with COPD. Harms haven’t been fully assessed. DO NOT CHANGE PRACTICE!! (At least, not yet, not based on this paper)
Global Health Residency:
Developing the next generation of globally educated, socially responsible healthcare professionals dedicated to improving the health of disadvantaged populations.
Now Accepting Applications for Global Health Elective Rotations
The Hubert-Yeargan Center for Global Health (HYC) is now accepting applications for Global Health Elective Rotations for July 2012 and March 2013. 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-electi….
Residents who participate in GH rotations should be flexible and willing to step in where needed. Due to limited resources at the sites, much of the responsibility for coordinating daily activities is the resident’s responsibility. In this case, the age old adage rings true: You will get out of the experience what you put into it. A Global Health Rotation is a wonderful opportunity to understand clinical presentation and management of common diseases in a resource-poor environment as well as understand alternative health systems and cultural settings.
Application deadline is September 23, 2011. Interviews will be held from September 26 to October 7. For more information, contact Tara Pemble, Program Coordinator at tara.pemble@duke.edu or 668-8352.
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From the Chief Residents
Grand Rounds
| Date of Lecture: | September 2, 2011 | Learning Objectives: |
| Title of Lecture: |
"The Challenge of Sudden Death in Hemodialysis Patients" |
Following this activity series, learners should be able to: 1. Understand the epidemiologic impact of sudden death on chronic kidney disease patients. 2. Describe known risk factors for sudden death in hemodialysis patients 3. Describe possible pathophysiologic mechanisms of sudden death in hemodialysis patients. 4. Understand the current status of interventions aimed at reducing sudden cardiac death among dialysis patients. |
| Speaker(s): |
Patrick H. Pun, MD, MHS |
Noon Conference
|
Day |
Date |
Topic |
Lecturer |
Time |
Vendor |
| Monday |
8/29 |
Pneumonia | Peter Kussin |
12:00 |
Jersey Mike's |
| Tuesday |
8/30 |
Common HIV/ID issues | Charles Hicks |
12:00 |
Dominos |
| Wednesday |
8/31 |
ETOH withdrawal | Sarah Rivelli |
12:00 |
Moe's |
| Thursday |
9/1 |
Worst Practices in Hospital Medicine | Daniel Kaplan |
12:00 |
Bullock's BBQ |
From the Residency Office
Dates to Add to Your Calendars
Looking ahead, here are just a few of the dates to keep in mind: Sept 21 – CPC @ 604 W Morgan (RSVP to follow) Dec 10 – DOM Holiday Party Feb 24 – Charity Auction (Contact Tian or Ann Marie to participate) June 13 –Resident Research Event, 5-7pmEmergency Preparedness & Planning
The approach of Hurricane Irene offers us the perfect opportunit to review the various sources of information and resoures that are available in case of an emergency. The following is a summary for reference: 1. North Carolina Government - Hurricane Information: This Web site has valuable information and checklists for families preparing for hurricanes. It will also have updates during storms. http://nc.gov/1764,1764,NC_Hurricane_Information,NC_Hurricane_Information.html 2. Duke Severe Weather Policy: http://www.hr.duke.edu/weather 3. Duke Hospital Severe Weather Childcare: http://www.hr.duke.edu/benefits/family/care/severe_weather (Available only on weekdays to Essential Staff who have pre-registered and who call the reservation line at 681-RSVP) 4. Duke Severe Weather Notice Posting Site: http://www.duke.edu/today/ 5. Duke Severe Weather hotlines: Duke University & Medical Center 684-INFO (4636) Duke Hospital 681-SNOW (7669) Durham Regional Hospital 470-SNOW (7669)Useful links
- Main Internal Medicine Residency website
- Main Curriculum website
- Ambulatory curriculum wiki
- Confidential Comment Line Note: ALL submissions are strictly confidential unless you chose to complete the optional section requesting a response.
- Department of Medicine website