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
Another busy week! Even with recruiting “officially” over, we have a number of applicants returning for second looks. Thanks to everyone for continuing to show them the many reasons why Duke is an outstanding place to work! SARs
Richard Wu, Kyle Hornsby and Leon Cannizzaro gave outstanding SAR talks, and Med Psych SAR1
Anne Mathews (almost) stumped
Dr. Joel Morgenlander with a case of limbic encephalitis due to thymoma at Chair’s Conference. At report, we heard about unusual causes of metabolic acidosis from Intern
Lauren Prats, the elusive diagnosis of relapsing polychondritis from JAR
Krishn Sharma and a great discussion of why we should respect Staph bacteremia led by SAR
Rebecca Burke. Nice job! Thanks to
Dale Okorodudu for serving as the resident MRRC representative for recruiting!
Congratulations to the 2013-14 Chief Residents (Krish Patel, MD – Duke; Vaishali Patel, MD – DVAMC; Stephen Bergin, MD – DRH/Amb).
Additional congratulations to our 2012-13 Assistant Chief Residents (ACRs). Assistant Chief Residents are selected from the current JARs and serve a teaching, administrative and leadership role throughout the year. The ACRs are
Hassan Dakik, Megan Diehl, Sam Horr, Nilesh Patel, Lisa Vann, Newton Wiggins, (Duke); Coral Day, Matt Chung, Ann-Marie Navvar, Ryan Nipp, Bonike Olorontoba, and Nicki Storms (DVAMC); Blake Cameron, Carrie Horney, Kathleen Kiernan, Charlie McCormick, Scott Westphal, and Tara Weiselberg (DRH).
We also had a very successful Stead Society Honorary Faculty Draft on Thursday. While
Matt Crowley’s Stead Society was not successful at trading one first round draft picks for a third and fourth round draft pick plus a player to be named later, the rest of the draft was flawless. A big congratulations to our selected faculty members….the commissioner is checking eligibility on all selected and a final list will be published soon! A great effort by all, thanks to our Stead Society Leaders (
Matt Crowley, Steve Crowley, Susanna Naggie, Ben Powers and Heather Whitson).
We are hoping to get everyone together to watch the Duke-UNC game, so keep a lookout for an announcement.
Pubmed from the program this week goes to JAR
Callie Coombs for her submission of original research (with mentor
Mark Lanasa) to Blood. Looking forward to seeing the manuscript make it through review.
And in the QI corner…look what’s going on at the DOC! MLPR SAR
Adia Ross and colleagues have designed a Kaizen Event to get everyone ready for MaestroCare, and to improve communication in the clinic. See below for details!
DOC Rooming and Ready Project Description:
In March 2012, the Duke Outpatient Clinic (DOC) will be having a Rapid Cycle Improvement Event (Kaizen Event) focused on MD-nursing communication during patient office visits. Currently there is a process for communication between physicians and nurses but it is labor intensive and inefficient. In addition, there is a lack of standardization of the clinical workflow for common procedures at the DOC including: point-of-care hemoglobin A1C testing/blood glucose monitoring, and Pap smears/pelvic exams. In the wake of the Maestro Care Ambulatory deployment in the summer of 2012, the DOC must develop a standardized communication strategy prior to its implementation. As a result, a one day rapid cycle improvement event will be scheduled to determine the barriers to effective, efficient communication for common procedures and to generate innovative, low cost and rapidly implementable solutions. The rapid cycle improvement team will be composed of residents, management engineers, office staff, Maestro Care Ambulatory content experts, attending physicians, nurses and CMAs. In preparation for the event, the project team will begin a week long period of pre-event data collection beginning February 23rd, 2012. We will be asking providers and nurses during this period to aide in providing feedback about physician and nursing communication. More information regarding the data collection tool will be provided in the next few weeks. In addition, we will be conducting pre event information sessions about Lean/Six Sigma methodologies for both team members and the DOC staff. The project leaders include Adia Ross, Kristian Knutsen (management engineer), Emmanuel Brown (management engineer), Kevin Cooper (management engineer) and Alex Cho. The project sponsors are Lynn Bowlby and Jessica Colquhoun.
Have a great week…and Go Duke
Aimee
What Did I Read This Week (by Juliessa Pavon, MD)
[box]
Addressing Requests by Patients for Nonbeneficial Interventions, Allan S. Brett, Laurence B. McCullough, JAMA. 2012;307(2):149-150. [/box]
Summary of Article:
Top reasons for granting patient requests:
- -Physicians do not want to harm the patient-physician relationship
-
-Explaining why a treatment is not helpful takes time
-
-Appealing to external sources of authority, such as guidelines, as to depersonalize the potential conflict with the patient.
Why are patients challenging our authority: misinterpretation of...
-
-Media publicity
-
-Intern sources
-
-Consumer advertising
Patient autonomy vs. Professional Integrity
Using "patient autonomy" to justify patient requests is felt to violate professional standards of intellectual and moral excellence. Physicians should submit to clinical judgment and evidenced based reasoning when making clinical decisions.
Utilization of Health Care Resources
Conclusion:
-
-Actively challenging patients’ requests for nonbeneficial interventions does not subvert properly understood respect for patient autonomy and is consistent with the professional obligation to practice high-quality, cost-effective medicine.
-
-Successful adherence to this involves physician commitment to evidence based medicine and lifelong learning
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From the Chief Residents
Special Schedule Requests
The end of the year is a very complicated time for scheduling. This year, we have to add in a day of MaestroCare (EPIC) training for all interns and JARs to the already packed schedule. Any scheduling requests related to blocks 11 and 12 should be made to the chiefs NO LATER than Friday February 10
th. We are currently finalizing the orientation and end of year schedule and will give you this information ASAP.
Grand Rounds
| Date |
Topic |
Lecturer |
| 2/10/12 |
TRIVIA BOWL !! |
The "Chiefs" |
Noon Conference
| Day |
Date |
Topic |
Lecturer |
Time |
Vendor |
| Monday |
2/6 |
SAR TALK |
Jen McCarty |
12:00 |
Saladelia |
| Tuesday |
2/7 |
SAR TALK |
Ed Coverstone |
12:00 |
Dominos |
| Wednesday |
2/8 |
IBD |
Jane Onken |
12:00 |
Chick-fil-A |
| Thursday |
2/9 |
Pharmacy Smoking Cessation |
Roy Pleasants |
12:00 |
Jersey Mike's |
| Friday |
2/10 |
Chair's Conference |
Chiefs |
11:00 |
Bullock's BBQ |
City of Medicine Academy Mentor Project
If you are interested in signing up to be a mentor to motivated high school juniors or seniors at the City of Medicine Academy, please use the survey monkey link below. We definitely need current JARS and Interns to get involved so we can continue next academic year in addition to this year. I can try to answer any questions you may have, just email
john.roberts@duke.edu
Signup link:
http://www.surveymonkey.com/s/YGW3ZQ8
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From the Residency Office
Procedures
The following table summarized the number and type of procedures residents are required to complete.
| Procedure(s): |
Requirement(s): |
| Abdominal Paracentesis |
5 Total |
| ABG, Draw and Interpret |
5 Total |
| Arterial line placement |
5 Total |
| Arthrocentesis |
5 Total |
| Central Venous line placement |
5 Total |
| Drawing Venous Blood |
5 Total |
| Electrocardiogram |
5 Total |
| Incision & Drainage of an Absces |
5 Total |
| Lumbar Puncture/Spinal Tap |
5 Total |
| Nasogastric Intubation |
5 Total |
| Pelvic/Pap Smear |
5 Total |
| Placing a peripheral venous line |
5 Total |
| Thoracentesis |
5 Total |
We would recommend that all residents review their procedure reports in MedHub on a regular basis to help insure that they remain on track.
Faculty Resident Research Grants - 2012-2013 (deadline is March 2, 2012)
biosketch FORMS_2012 Faculty Resident Research Grant Instructions 2012-2013
Faculty Resident Research Grant Application Forms 2012-2013
February - Month to Celebrate GME
Please join Duke GME Leadership and staff in celebrating our GME community and the contributions made towards making this a terrific year of GME. The month of February has many events scheduled. We encourage you to take advantage of some of these opportunities during the month. GME Month 2012 - Calendar of Events<
https://gme.duke.edu/sites/medicine.duke.edumedicine.duke.edudefault/files/files/GME%20Month%20Calendar%20of%20Events%201-18-12_0.pdf
Dates to Add to Your Calendars
March 23 - Charity Auction
June 2 - Annual SAR Dinner
June 13 –Resident Research Event, 5-7pm
Opportunities
Univ of Chicago
Useful links
