From the Director
Well, it's official! The 2012-13 interns are on the wards (and, as of Monday, in the clinics)! Orientation week went smoothly, and even esig is working. Thanks to GME, Randy Heffelfinger, Jen Averitt, Lauren Dincher, Erin Payne, Laura Kujawski, and Shawna Alkon for all the hard work "behind the scenes". Also thanks to JARs
Jim Gentry, Kevin Shah, Laura Caputo, Marianna Papademitriou, Nancy Lentz, Carling Ursem and Bobby Aertker for planning and running a fantastic intern practicum.
Notable happenings this week include a "page the intern" cake on June 30th from our new SARs to the new JARs...love it, an "enastaende" (thanks Google translate) intern report by now JAR
Jim Gentry, and a hilarious Tom Holland lecture by SAR
Jon Menachem. Word is, based on Jon's salary, we won't see him on 9300 this year.
Also thanks to SARs
Phil Lehman, Scott Westphal, and Jon Menachem for covering on June 29th, as well as
Blake Cameron and Eric Chu for covering a friend who had an important family event (happy first birthday, Tony O!). Finally, congrats to newly graduated SAR
Carly Kelley and her husband
John (honorary resident) on the
birth of Cameron! Click on the following link to see the BIG smile on Carly's face !
Kelley - picture
Pub Med for the week goes to:
Kevin R. Riggs, Zachary J. Reitman, Thelma J. Mielenz, Philip C. Goodman, (
2012) Relationship Between Time of First Publication and Subsequent Publication Success Among Non-PhD Physician-Scientists.
Journal of Graduate Medical Education: June 2012, Vol. 4, No. 2, pp. 196-201.
Happy 4th of July. Stay cool, make the new interns feel at home and have a great week
Aimee
What Did I Read This Week (Anne Phelps, MD)
[box] USPSTF published new guidelines on Pap smear screening [/box]
In March of 2012, the USPSTF published new guidelines on Pap smear screening. Every week in clinic I get asked do I have to do a pap smear given the new guidelines. I have attached the new guidelines. Here are two cases we had in clinic.
Case #1: We had a new 67 year old female establishing care with multiple problems including chronic pain. We had no previous records for her. She has no history of cervical cancer. Does she still need a pap smear? The new guidelines stop screening at age 65.
To stop screening at age 65, the following criteria must be met:
- You must be able to document 3 consecutive negative cytology results.
- You must be able to document 2 consecutive negative HPV results in the last 10 years. The most recent test has to be within 5 years.
- You must be 20 years after regression of a high grade lesion.
Patients who need to be screened after age 65 include:
- Patients who do not have any previous documentation. Especially patients from underdeveloped countries where they would not have been screened.
- Patients who have had previous cervical cancer that has been treated or previous high risk lesions.
- DES exposure
- HIV patients or immunocompromised patients
You do not need to restart screening a patient who is over age 65 if they have a new sexual partner.
Answer: Yes she needs a pap or you need her records. A pap is easier than getting her records.
Current Recommendations from the USPSTF:
Release Date: March 2012
These recommendations apply to women who have a cervix, regardless of sexual history. These recommendations do not apply to women who have received a diagnosis of a high-grade precancerous cervical lesion or cervical cancer, women with in utero exposure to diethylstilbestrol, or women who are immunocompromised (such as those who are HIV positive).
- The USPSTF recommends screening for cervical cancer in women ages 21 to 65 years with cytology (Pap smear) every 3 years.
- For women ages 30 to 65 years who want to lengthen the screening interval, screening with a combination of cytology and human papillomavirus (HPV) testing every 5 years..
- The USPSTF recommends against screening for cervical cancer in women younger than age 21 years.
Grade: D Recommendation.
- The USPSTF recommends against screening for cervical cancer in women older than age 65 years who have had adequate prior screening and are not otherwise at high risk for cervical cancer.
- The USPSTF recommends against screening for cervical cancer in women who have had a hysterectomy with removal of the cervix and who do not have a history of a high-grade precancerous lesion (i.e., cervical intraepithelial neoplasia [CIN] grade 2 or 3) or cervical cancer.
Grade: D Recommendation.
- The USPSTF recommends against screening for cervical cancer with HPV testing, alone or in combination with cytology, in women younger than age 30 years.
Grade: D Recommendation.
[hr]
From the Chief Residents
Grand Rounds
We will not hold Grand Rounds this week
Noon Conference
| Day |
Date |
Topic |
Lecturer |
Time |
Room |
| Monday |
7/2 |
Chest Pain Emergencies |
Kristen Newby |
12:00 |
2002 |
| Tuesday |
7/3 |
GI Bleed |
Dan Wild |
12:00 |
2002 |
| Wednesday |
7/4 |
NO NOON CONFERENCE |
|
12:00 |
2002 |
| Thursday |
7/5 |
CNS infections |
Aimee Zaas |
12:00 |
2002 |
| Friday |
7/6 |
Chair's Conference |
Chiefs |
12:00 |
2002 |
Thank You!
Thank you to all of the interns for a smooth weekend transition at Duke Hospital and terrific start to the new year! We want to recognize the outstanding work by the SARs on gen med who helped make this possible as well. Keep up the good work!
Also, we have already received many requests for schedule or pull list changes. We greatly appreciate your help in continuing to trade weeks or find coverage with each other. Please continue to keep us updated on and involved in any changes, so that these can be approved.
Looking forward to a great 1st full week of the year! -Jeff Clarke
divider]
From the Residency Office
Maestro Countdown! 17 days to go live!! July 18 (from Drs Bowlby and Phelps!!)
Tips--
1. There is the Maestro Playground--thru start button on PINs, training, Maestro, Maestro playground and your usual password will work with the Maestro icon on PINs, the real system--only do data abstraction into Maestro with the real system
2. Practice, Practice, Practice...you need to be ready on your first clinic day on the 18th to go! We are working on setting up the computer lab in Duke South for you to practice
3. Keep cleaning up your problem list and meds in the current Browser system! will help a lot as we abstract data from Browser to Maestro!
Dates to Add to Your Calendars /Contact Information
Useful links
