Weekly Updates - March 12, 2012

From the Director

Well, if you were lamenting having an extra day with leap year added into your schedule, at least some of you got to shave an hour off your call night with daylight savings time.  I’m glad to lose an hour because Friday cannot come fast enough! I am very much looking forward to Match Day on Friday! But before that, lots of kudos to pass along….Kevin Harrison stopped in my office to tell me how great a job intern Mandar Aras did on the DHP service.  We heard from four SARs this week with great SAR talks…Priyesh Patel, Ashleigh Owen, David Lofthus (quite possibly the best use of humor in a talk to date!) and Andrea Archibald, and a great chair’s conference by SAR Krish Patel.   Also, cardiology faculty Sunil Rao put his mark in the sand for best grand rounds of the year with a discussion of a comprehensive approach to increasing the use of radial artery approaches for cardiac catheterization.  Why do I mention this here? Because if you listened closely, you realized that Dr. Rao began his extremely impressive career with a clinical question that arose during his fellowship.  Now, he’s an international expert.  As Chief Resident Juliessa Pavon liked to say in her recruiting speech..”That is DUKE MEDICINE!” Congrats to JAR Carrie Horney for being selected as the Duke representative to the Southeastern Center of Excellence in Geriatrics Meeting? Please stop by this week to the office and give a big THANKS to Emily Strollo, our amazing recruitment coordinator.  As many of you know, Emily got engaged earlier this year, and is going to be moving to Chicago in a few weeks.  We’re very happy for her but quite sad to have her leave….she’s a fantastic member of our team with big shoes for us to fill. This weeks Pubmed from the Program goes to SAR (and future Duke ID fellow) Kristen Dicks:  "What the eyes don't see, the heart doesn't grieve over" - Epidemiology and Risk Factors for Bloodstream Infections following Cardiac Catheterization, Infection Control and Hospital Epidemiology; Kristen V. Dicks, MD; Russell Staheli, MPH; Deverick J. Anderson, MD, MPH; Becky A. Miller, MD; W. Schuyler Jones, MD; J. Kevin Harrison, MD; Daniel J. Sexton, MD, FIDSA; Rebekah W. Moehring, MD; Luke F. Chen, MBBS, MPH, CIC, FRACP  Also big time congratulations to (SAR) Emily and Jim Ruden on the birth of Hunter Ruden.  He’s impossibly cute..see the pictures below.  Have a great week Aimee  

      Future Duke Resident

 

 

 

 

 

 

 

What Did I Read This Week (by Bill Hargett, MD )

Decisions regarding life-sustaining treatments for critically ill patients are complex and extremely challenging for medical professionals and surrogate decision makers.  Communication between surrogates and care providers has been demonstrated to affect both patient and family outcomes, as well as health-care resource utilization, but our overall understanding of these issues remain limited.  The following study was performed to better understand how surrogates interpret prognostic information: [box]  Zier LS, Sottile PD, Hong SY, Weissfield LA, White DB. Surrogate decision makers' interpretation of prognostic information: a mixed-methods study. Ann Intern Med. 2012 Mar 6;156(5):360-6. PubMed PMID: 22393131.   [/box] In brief, 80 surrogate decision makers for critically ill patients answered a questionnaire requiring them to interpret both qualitative and quantitative prognostic statements by estimating a patient's chance of survival along a probability scale.  Surrogates were generally accurate in affirming statements with a high probability of a good outcome but were overly optimistic when interpreting statements describing a high risk of death.  In 15 surrogates with inaccurate interpretations, researchers conducted semi-structured interviews and identified "register optimism" and belief that positive patient attributes outperform physicians' grim prognostications as themes for the discrepancy in interpretations. This article adds several things to the current literature, the most important being additional evidence that inaccurate interpretation of doctors' prognostications may arise not only from surrogate misunderstanding or unclear physician disclosure but also from identifiable cognitive and psychological biases.  The study has a number of weaknesses, the most obvious being the hypothetical scenarios outside of actual clinician-surrogate encounters and the limitations in an individual's or researcher's ability to explain and capture, respectively, complex behaviors.  That being said, the authors' findings will likely come as no surprise to those familiar with caring for critically ill patients and families and highlight the ongoing need for further study in this area.  [hr] [divider]

From the Chief Residents

Grand Rounds

M & M Conference

Noon Conference

Day	Date	Topic	Lecturer	Time	Vendor
Monday	3/12	Board Review, Nephrology	ACR	12:00	The Picnic Basket
Tuesday	3/13	Business of Medicine		12:00	Domino's
Wednesday	3/14	MedPeds Conference - Proteinuria	Uptal Patel	12:00	Moe's
Thursday	3/15	Clin Pharm	Richard Drew and Dev Anderson	12:00	Meelos
Friday	3/16	Chair's Conference	Chiefs	12:00	Rudinos

Reminders

Charity Auction - 12th annual Charity Auction save the date Friday March 23rd at 7pm, at the Durham Arts Council Building.  Tickets are available from multiple sources, including the Med Res office on the 8th floor and outside Grand Rounds on Friday morning.   Questions or donations can be directed to Tian Zhang tian.zhang2@duke.edu.           Humanism in Medicine May 4, 2012 -  I hope everyone used pencil when writing down the date of the upcoming Humanism in Medicine night, because we have to change the date.  Naturally, we will do so in haiku form:   Wait, wait, change the date - Humanism, now MAY 4th For realsies this time, and hope to see you there!"     Christopher J. Hostler, MD MPH

Stead Society Activities

Stead "E" Society  (Steve Crowley's group) We will host / prepare a dinner for the residents at Ronald McDonald house Durham (2 blocks from Duke campus) on Thursday, April 26.  Some of us will begin cooking / arranging at about 4pm with a plan to serve the food at 6pm.  Everyone is welcome to join in.  Contact Steve Crowley or Michael Shafique for more information or to sign up.   steven.d.crowley@dm.duke.edu     michael.shafique@duke.edu

Fellowship Interest Discussion Opportunities 

Hematology Oncology: You are  invited to attend one of the following meetings if you are interested in continuing your career in the Hematology/Oncology subspecialty.  Dr.  Carlos deCastro, the Program Director, as well as Dr. Richard Riedel, the Associate Program Director would like to answer any questions you may have about the Hem/Onc Program as well as to share why you should consider the Hem/Onc Program at Duke.  Please contact Sarah Overaker if you are planning to attend.  sarah.overaker@dm.duke.edu Tuesday, March 13, 2012, 4:30 p.m. – 5:30 p.m., IM Residents Conference Room on 8^th floor Tuesday, April 10, 2012,  1:00 p.m. – 2:00 p.m. 405 Seeley G. Mudd Building Conference Room  

Applying for Fellowship Q & A

 Residents and interns interested in learning more about applying for medicine subspecialty fellowships are invited to attend our annual "Applying for Fellowship Q & A" information session.  Typical FAQs will be covered (e.g. application process and timeline) but the session is primarily an informal Q & A focused on how to "shine" as an applicant before, during, and after your interview.  To accommodate for potential schedule conflicts and trainee availability, there will be two sessions with identical planned content (though there may be differences in based on interactive Q & A).  Title:  Applying for Fellowship Q & A Date/Time:  Tuesday March 20  OR  March 27, from 5 – 6 pm Location:  Medical Resident Library Moderator:  Bill Hargett [divider]

From the Residency Office

RESIDENT RESEARCH NIGHT, June 13, 2012, SEARLE CENTER 5 - 7 PM   and presentation of the 2012

THE CALIFF MEDICINE RESIDENT RESEARCH AWARDS

We are now receiving submissions for the annual Califf Medicine Resident Research Awards.  All medicine residents and interns are eligible to submit an abstract of their work, including those already presented at national and regional meetings

Abstracts will be judged by a faculty committee, and the top 3 will be presented as research talks (15 minutes each) during Resident Research Night on June 13, 2012 (5-7 pm) 

All Resident Research Night participants will present their abstracts as a poster during the poster sessions. The best poster will be selected between 5 – 6 pm.

Poster viewing will commence at 5 pm and continue after the research talks until 7pm

Poster templates are available to facilitate preparation. For further assistance with printing posters, please contact Shawna Alkon in the residency office.        

Califf Award RFA_ 2012     Califf Award-INSTRUCTIONS-2012

TSMA (Moonlighting) 

We would recommend that everyone who was approved for TSMA activity (moonlighting) log into their MedHub account and confirm services and the end dates.  Please confirm that you are NOT signed up to cover a service after the end date.  If you are, you need to reapply for approval, and can are not authorized to work until this step is completed.  Please note that TSMA approval can only be granted for the current  academic year.  Also be on the lookout for reminders in Weekly Updates when it is time to complete TSMA request for the next academic year.

ACLS/BLS and Other Resources

Links to these and other compliance modules are provided in the resource document section of MedHub.  Please take advantage of this resource information.

End of Life Resuscitation and End of Life Decision Making: 

The following are the "official titles" of the modules for reference: 

	End-of-Life Decision-making Update
	End-of-Life Resuscitation Update

If these modules do not show up on your home page on OESO, click on "Courses Available On-line" in the paragraph below your name on their OESO home page.  Modules are listed in alphabetical order

Dates to Add to Your Calendars

March 23 - Charity Auction May 4 - Humanism in Medicine June 2 - Annual SAR Dinner (invitations only) June 13 –Resident Research Event, 5-7pm

Other Dates

Medical Education Grand Rounds Session

Upcoming Medical Education Grand Rounds Sessions:  April 3rd - "Legal Issues & Remediation" with Jamie Padmore and Kerry Richard, MedStar Cardiovascular Symposium, Wednesday April 25 in Searle Lecture Hall 8:00am to 5:00pm.    This free event is available to everyone and provides 6.50  AMA PRA Category 1 Credit(s)^TM (all in one day!!).   Please register at http://cmetracker.net/DUKE/Courses.html

Opportunities

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