The Internal Medicine Residency newsletter is posted each week to share important news, announcements and updates about the residency program. Please contact Randy Heffelfinger with corrections, contributions and suggestions.
From the Director
Residency Family,
As this week played out, I had an opportunity to be impressed and humbled, but not at all surprised, at the strength and cohesiveness of our team. This has been an incredibly difficult week for many, and the support of colleagues and friends in times of crisis came so easily to all of you – thank you so much.
With Thanksgiving just passed, and the holiday season coming at us quickly, it is a good time to take a moment to check in on each other and recognize that we are all able to help one another in different ways, and that we can all use a shoulder now and then.
Best
Aimee
[box]PubMed from the program this week is from SAR
John Stanifer for the following citation: Stanifer, John,
Rheema Metha, N. Mettu, Jeff Sanders, and Nippon Setji. “Muehrcke's Lines as a Diagnostic Clue to Increased Catabolism and a Severe Systemic Disease State.”
Am J Med Sci. 342(4):331, Oct 2011.[/box]
What Did I Read This Week (by Aimee Zaas, MD)
[box]Morbidity and Mortality Weekly Report – Vital Signs:HIV Prevention Through Care and Treatment – United States; Dec 2, 2011; 60(47)1618-23[/box]
Why Did I Read This?: In honor of World AIDS Day
What Did Investigators Do?: Using 3 surveillance datasets and published information, CDC assessed the estimated number of persons with HIV infection and the numbers and percentages of persons who were 1) aware of their infection, 2) linked to care, 3) retained in care, 4) prescribed ART, and 5) virally suppressed. From these analyses, CDC developed a national estimate of the percentage of all HIV-infected persons with viral suppression.
What are the findings?: Among the estimated 1.2 million persons living with HIV in the US, 77% were linked with care within 4 months of diagnosis, and 51% were retained in care. The investigators then looked at how well those persons with HIV who were receiving care were doing with regards to viral suppression. Of those receiving care, 89% had been prescribed ART. Of these, 77% had a suppressed viral load at their most recent test. Again, however, this represents a modest proportion of all individuals living with HIV in the US.
The investigators synthesized these findings to determine the number of persons in selected categories of the continuum of HIV care (diagnosed, in treatment, and virally suppressed). They estimated that 328,475 (35%) of 941,950 persons diagnosed with HIV (or 28% of all 1,178,350 persons with HIV) in the United States are virally suppressed.
What are the limitations of these findings?: Not all states report the same way, so data may not represent the country equally. Any viral load test may not be representative of a patient’s overall trajectory, and persons not receiving care were assumed to NOT have a suppressed viral load.
What can be done in response to these findings?: While we are doing better at testing for HIV, we need to do better than having only 28% of individuals with HIV having a suppressed viral load. Thus, better systems for diagnosis, referral, treatment and retention in care are needed.
Of note, the CDC's comprehensive HIV testing strategy includes 1) routine HIV screening in health-care settings with prevalence of undiagnosed infection ≥0.1%, 2) targeted testing of persons with risk factors associated with increased HIV prevalence, and 3) retesting at least annually for HIV-negative persons at increased risk for HIV. If a person is diagnosed with HIV, efforts need to be made to engage and maintain them in care.
Update on Flu Vaccination
We have seen tremendous gains in our rates of immunization over the past week, with hats off to Heather Whiston and her Stead team on reaching 100% compliance. For those who have not yet received their vaccination we are attaching the schedule as to when they are available in Duke North. At this point,
there are only 13! residents who have not received their flu shot or completed exemption. There is a also a strange rumor that we will be seeing
Unusually Virulent Strains" this year, so PLEASE, let's all make sure we all hit 100% and stay healthy!
Resp Fit Testing-T-Dap-TB Skin Testing Flyer Dec 2011
QI Corner (by Jon Bae)
SAQ Survey: For those of you out there who have not completed the Safety Assessment Questionnaire, please do so ASAP. Our rates have steadily improved but we have been eclipsed by pediatrics. Thank you to the 116 residents who have already responded. The more responses we have, the more accurate the results. We will be reviewing the results of the survey with you at noon conference on 3/28/2012 with Judy Milne, Patient Safety Officer for Duke Hospital. The survey was emailed to you from "PASCAL METRICS" and closes
Dec 16, 2011. Do it today!
QI Modules: Lastly, our QI Module completion rates have been lagging. These modules give a great introduction to concepts in quality improvement. We will be giving all of you dedicated time to complete them.
Interns will be assigned time while on geriatrics.
JARS/SARS: please be on the look out for QI time while on ambulatory.
To complete, please go to
https://courses.duke.edu and log-on using your NetID and password. You should see "Fundamentals of Health Care Improvement" course assigned to you . The course has 8 modules (each roughly 15 min) followed by individual module tests.
Interns will be assigned time while on geriatrics.
JARS/SARS: please be on the look out for QI time while on ambulatory.
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From the Chief Residents
Grand Rounds
| Date |
Speaker |
Division |
Topic |
| 12/9/11 |
Ziad F Gellad |
Systems Engineering |
Quality of Care |
Noon Conference
| Day |
Date |
Topic |
Lecturer |
Time |
Vendor |
| Monday |
12/5 |
Medicine Interview Day |
|
12:00 |
Panera |
| Tuesday |
12/6 |
Med Peds Interview Day |
|
12:00 |
Saladelia |
| Wednesday |
12/7 |
Gallops |
ACRs/Chiefs |
12:00 |
Bullock's BBQ |
| Thursday |
12/8 |
SAR TALK |
Dave Karol/Sarah Piper |
12:00 |
Papa John's |
| Friday |
12/9 |
Chair's Conference |
Chiefs |
11:00 |
Pipers |
Additions to the "Residency Family"
For those who may have missed the announcement, the parents of "Cameron Sassan Hodavance" proudly announce his arrival on his due date on 11/25.
Hodavance Picture
[divider]
From the Residency Office
Opportunity in Rwanda
Duke will be recruiting physicians post residency for yearlong assignments as clinical mentors/educators at the National University of Rwanda beginning in July, 2012. Please review the attached flyer for additional information regarding this unique opportunity.
RwandaAdvert
ACP Meeting - February, 2012 (by Murat Arcasoy, MD)
The annual ACP meeting will be held in February, 2012, in Greensboro, NC, which will offer residents the opportunity to present scholarly achievements during the poster session, including
research, clinical cases, and quality improvement projects. Previously presented work is also welcome at this meeting.
The deadline is soon,
December 15 but it is easy to submit. Please check out the following link and let us know if we can help you.
Please use the following link for abstract submission:
http://www.acponline.org/about_acp/chapters/nc/abstract_12.htm
Also, please use the following link to indicate to us that your will be participating:
https://www.surveymonkey.com/s/ACP_Poster_Abstract_2012
Request for Applications- Resident Research Grants
The annual Faculty Resident Research Grant applications are due on March 2, 2012. Please see attached the Request for Applications, instructions, a sample NIH style biosketch, and application forms. Please do not exceed the 3 page limit for the Research Plan, and please note that you do not need preliminary data to apply.
Our "Resident Research" website will be launched in the coming weeks. These forms will also be posted on the website along with a list of previously funded projects and sample grant applications.
To discuss any issues regarding your research interests, for guidance to identify a research project and mentor, for questions related to the application process or once you decide to submit an application, please e-mail me at
arcas001@mc.duke.edu.
Please email me as well to
declare your intention to apply, your research mentor's name, the title of your Grant Application or any questions.
Faculty Resident Research Grant Instructions 2011-2012
Faculty Resident Research Grant Application Forms 2011-2012
Biosketchsample_2011
Other Opportunities
The Jersey City Medical Center is recruiting for an energetic, clinically strong, PGY 3 who would like to be become a Chief Resident in the Internal Medicine Residency Program at the Jersey City Medical Center, starting on July 1, 2012. Please send CV and personal statement to Marisa Sugalski at
msugalski@libertyhcs.org.
Dates to Add to Your Calendars
Dec 10 – DOM Holiday Party
March 9 - Charity Auction
June 13 –Resident Research Event, 5-7pm
Useful links
