Weekly Updates - October 1, 2012

From the Director

Hi Everyone! Get ready, it's now officially the first annual "Doctoberfest" not to be confused with "Movember" (I know that Brian, Kevin, Halbe and Armando are already gearing up for this..), Doctoberfest is a month of celebrating some of the great things that we do here, building community and perhaps even infusing some learning.  Thanks very much to Randy, Jen, Laura, Lauren and Shawna for helping us kick off Doctoberfest and, I'm sure, maintain enthusiasm throughout the month. On OCTOBER 1st, be sure to clear your calendars and join us for an important Noon Conference….we are kicking off a major program initiative, so be there! We have already recognized our best noon conference attenders for the first quarter (congrats to Intern Erin Boehm, JAR Ashley Lane and SAR Jason Watts), so now is a good time to get yourself into the running for quarter 2.   Other key upcoming events for DOCTOBERFEST include:   ---- the "Wall of Fame", posted in the Med Res office.  Stop in and recognize good work by your colleagues or email Lauren and she will post your comments on the wall.    ---- input on the upcoming "Milestones" for residency education….look for an email from Bill Hargett and I, where you will get a chance to consider what parameters we should be evaluating residents (I.e. YOU) on as you round on Gen Med.  Most programs aren't asking the residents their opinion, so be sure to give us your thoughts and be counted!  ---- Stead Society recognition and social events…stay tuned ----Volunteering at the Project Homeless Connect at the DBAP on October 11th.  Join Nicole, Jeff, Jason, Larry G, and I as we assist in providing health consultation to the homeless in Durham County.  This is sponsored by Lincoln Community Health Center's Healthcare for the Homeless Clinic (where SAR Shereen Katrak, among others, volunteers with Dr. Greenblatt). Please contact Nicole if you are interested and available to help.   ----Wine tasting and mingling with the division chiefs at Dr. Klotman's on Oct 19th.  Check your emails for the evite!  ---Recruitment Kickoff on Oct 25th!  Bill H, Dave B and I are in the midst of reviewing over 3000 applications to our program.  There are some great people who are looking to become Duke Residents!  Come celebrate the beginning of a fun and productive recruitment season…plus a special screening of the Duke Med Res movie! (Thanks Anton and Erin!) And more!   There will be some daily medical questions for various prizes……today's question: In your patient with new onset atrial fibrillation, you are excited to try one of the new oral anticoagulants.  Prior to e-prescribing, you notice that her creatinine clearance is 47.  Which oral anticoagulant is contraindicated in patients with renal dysfunction?  Bonus:  What level of creatinine clearance indicates that you should avoid all novel oral anticoagulants and prescribe warfarin?   Send me an email with your answer!  Kudos for today go to Global Health Residency SAR Paul Park for winning the best oral abstract award at the CFAR Symposium this week.   I also had the opportunity to do my first podcast! Thank you to SAR Dale Okorodudu for asking me to talk for DiverseMedicine (www.diversemedicine.org), the mentoring website that he founded. I am honored to have been asked to discuss the commitment of the program to promoting diversity and extremely proud if Dale for his incredible efforts. Get your vote on! No matter what your political persuasion, please exercise your right to vote! Intern Ravi Vakani has taken the initiative to help people register if they need to. He asks that you contact him if you need to register and he can help direct you through the process. Today's Pubmed from the Program goes to SAR Sam Horr:  Pseudohypoxemia in a Patient With Chronic Lymphocytic Leukemia.  Horr S, Roberson R, Hollingsworth JW. Respir Care. 2012 Jul 10. [Epub ahead of print]  Have a great week and Happy Doctoberfest!  Aimee  

QI Corner (by Jon Bae, MD)

Quality Improvement and Patient Safety Noon Conference -Thank you to Bill Burton, Director of Duke Performance Services, for his discussion of the operations of performance services and the balanced scorecard at QIPS Noon Conference on 9/19.  Save the date for our next conference Wednesday, 10/24/2012, when Tiffany Christensen from Duke Patient Advocacy will be discussing "Patient-Centered Care" GME Performance Incentive Program Update -Check out hospital performance for the GME Performance Incentive Program for July 2012 (posted below).  We are meeting target for 3 of 4 measures as detailed in Metrics, so hopefully we can maintain that level of excellence.  If you are interested in getting involved, we have several related projects ongoing on gen med.  Ask George Cheely, Ryan Schulteis, or Jon Bae for details! THREE GOOD THINGS IS COMING! Starting Monday, October 1, the Medicine Residency Program will embark on a journey to improve its resilience through a program wide roll-out of 3 Good Things.  This is an exciting opportunity to interact with each other and leaders of the program and hopefully have fun.  For all the details about how to get started, please be sure to attend NOON CONFERENCE, MONDAY, OCTOBER 1st with DR. BRYAN SEXTON.

What Did I Read This Week (by Anne Phelps, MD)

[box]   Source:  CDC - Seasonal Influenza (Flu) - Q & A: Fluzone High-Dose Seasonal Influenza Vaccine  http://www.cdc.gov/flu/protect/vaccine/qa_fluzone.htm     [/box]

This year we have both the regular flu shots and the high dose Fluzone for our patients above age 65.  I thought I would review the difference between the two.  Fluzone High Dose is a flu vaccine designed for patient 65 and older.  It has 4 times the amount of antigens compared to the regular flu shot.   Fluzone has shown that patients develop higher antibody titers.  It has not been shown yet whether this will be clinically relevant though.  The results of this ongoing trial are due in 2014-2015.  What are the side effects?  The most common adverse events experienced during clinical studies were mild and temporary.  There were injection site reactions which included pain, redness and swelling at the injection site.  Also patients have reported headache, muscle aches, fever and malaise. Most people had minimal or no adverse events after receiving the Fluzone High-Dose vaccine.  [hr]

From the Chief Residents

Grand Rounds

Date	Division	Speaker
5-Oct-12	PWIM-Visiting Professor	Dr. Nancy Brown

Please Note:  A special M&M conference that will involve Medicine, General Surgery, and Orthopedics discussing a recent case of necrotizing fasciitis will be held on 10/3/12 from 7-8am in 103 Bryan Research Building. Anybody interested should plan to attend, and senior residents on Duke General Medicine are strongly encouraged to attend.     DRH AM report will be cancelled in lieu of this conference so that amb people can go to this conference. Thanks –Jeff, Nicole, Jason

Noon Conference

Day	Date	Topic	Lecturer	Time
Monday	10/1	3 Good Things	Brian Sexton	12:00
Tuesday	10/2	Shock	Dan Gilstrap	12:00
Wednesday	10/3	Global Health Gallops	Cecelia Pezdek	12:00
Thursday	10/4	Rash in the febrile patient	Sarah Wolfe	12:00
Friday	10/5	Chair's Conference	Chiefs	12:00

 

DOC Facebook Page for Maestro et al.

There has been a fair bit of discussion among folks at the DOC about how best to communicate with residents about Maestro on an ongoing basis, and Blake Cameron suggested a facebook page – being something that (most) folks were already using.  So he set up a page and we began posting tips to it a couple of weeks ago, accumulating nearly 400 views to date.  We definitely want this to evolve into folks spontaneously sharing their own tips, questions, and Epic triumphs/fails.  We are also beginning to post other DOC news and notes as well.  Not everyone is on it yet, so please friend Blake Cameron, Jen Rymer, or myself and we can sign you up.  We are also looking for a few good interns: We need 1-2 interns to become admins as well; please let Blake, Jen or myself know if you are interested!

The Influenza Vaccine Blitz Is Still On!! 

Our goal is 100% participation!   The following graph gives you a quick view of vaccination rates by class  after just the first 10 days of the drive.  We have had a great start - with 68% overall and the interns leading the charge by a handy margin. 

Flu Vaccine Reporting, Exemption, or Declination

Global Health Gallops: Clinical Case Presentations

Location: Duke Hospital North, Room 2003 From: October 3, 2012 at 12:00pm to: 1:00pm Join the Department of Medicine and the Hubert-Yeargan Center for Global Health for a Global Health Gallops on Wednesday, October 3rd to highlight recent global health clinical rotations. A mix of residents and faculty from Internal Medicine, Psychiatry, the Combined Med-Psych and Med-Peds Programs, and the Global Health Residency Pathway will present clinical cases from their recent trips to Kenya, Sri Lanka, and Tanzania.   Interested residents should note that the Hubert-Yeargan Center is now accepting applications for 2013-2014 Global Health Elective Rotations.  Application deadline is October 5, 2012.  These rotations provide valuable and unique experiences for Duke residents dedicated to improving the health of disadvantaged populations.  Visit the Hubert-Yeargan Center website for more

Join us for a virtual open house!

On Thursday, October 4^th, from 12:00-1:00pm, please join faculty and staff from the Duke Global Health Institute for a virtual open house featuring the Master of Science in Global Health program.  The hour-long presentation will cover the academic program, field research opportunities, and overall resources available at Duke University.    The presentation will be available in real-time using AdobeConnect and requires a connection to the internet. To join, please go to: http://tiny.cc/mscgh     Additional details on the attached flyer:  MScGH Open House_Oct4  [divider]

From the Residency Office

Duke Medicine Fleece -  Last Chance! 

If you are planning to order a fleece(s), this is the last chance for the year.   We stop collecting requests as of Wednesday, October 3.  If you did place an order, a reminder as well to bring your payment to the Med Res office.  Here is the link to the order form:    https://www.surveymonkey.com/s/MED_RES_FLEECE_2012   Doctober Fest is Here: The Wall of Fame:  During ‘Doctoberfest” stop by the MedRes office to honor one of your fellow residents!  Put an anonymous post-it note on our Wall of Fame to recognize a “job well done” by one of your peers.  If you can’t stop by the office, email your “note” to Lauren lauren.dincher@duke.edu and she will post it for you.  At the end of the month, we will choose one of the notes randomly and the person who was honored will receive a prize. Name the Gnome:  The gnome has joined the team and he needs a name!  Come by or email your suggestion! Food - Lauren thought it would be great to start off the month with traditional German fair.  So, make sure you are at noon conference tomorrow to see what she has selected.  Residency Program Wall of Recognition - to be posted in the Med Res Office - more details in next week's issue

Stead Groups - What You May Not Know:

Each Monday during the month of Doctober we will be featuring one of the Stead Groups.  First up is Kerby Society, led by Heather Whitson, MD. The Kerby Society is named for Dr. Grace Kerby, the Department of Medicine’s first female chief resident (1948) who went on to become the first female Professor of Medicine and first female Division Chief (Rheumatology).  Dr. Kerby began her career as a microbiologist at Johns Hopkins, where she served as head of the Clinical Bacteriology Lab before entering medical school at Duke at age 31, ultimately graduating first in her class.  As a faculty member, Dr. Kerby was best-known for overseeing the residency program and its schedules (in the days before Program Director was an official title) and for generally serving as Eugene Stead’s “stalwart right-hand” in the 1950s.  Dr. Kerby also ran the Fluorescent Antinuclear Antibody Lab, co-founded the Arthritis Clinic, and pioneered trial collaborations between Duke and evolving industries in the Research Triangle Park.  In the Duke Archives, Dr. Kerby is described by those who knew her as “a very good doctor,” “an incredibly organized multi-tasker,” a “worker-bee,” and a woman known for quiet, unassuming competence.  In the Kerby Society, we strive to emulate Dr. Kerby’s courage as a trail-blazer, her dedication to medical education and practice, her spirit of service to her colleagues and department, and her brilliance as a clinician and scientist. The Kerby Society has had a great first year!  We were thrilled to take first-prize in two program-wide competitions (first society to achieve 100% flu vaccination rate & first-prize in the Holiday gift drive).  We drafted five top-notch senior faculty members: Tony Galanos, Ralph Corey, Richard Riedel, Terry Fortin, and Joseph Govert.  We’ve enjoyed dinner at my house, a post-workday dinner and happy-hour in the Medical Residents’ Library, and Lunch with the Greek (aka Dr. Galanos).  As a society, we lent support to last year’s highly successful Housestaff Charity Auction, which was chaired by our very own Ann Marie Navar-Boggan.  We were proud to see many of our individual members receive awards and honors within the program (to name a few: Stephen Bergin named as rising Chief Resident; Daniel Fox received the Haskill-Schiff Award; Hassan Dakik, Ann Marie Navar-Boggan, Omobonike Oloruntoba, and Kathleen Kiernan were selected as ACRs; Armando Bedoya and Shereen Katrak were elected to the Residency Council). We are very thankful to Drs. Corey and Riedel who helped our SARs prepare for the fellowship interview trail by grilling them during “mock interviews” this summer.  We were excited to welcome 11 new interns in July – and special thanks to Shereen Katrak, who has organized our big sib/little sib program.  We look forward to the coming year and are planning several social events and community service ventures together – the first will be a big sib/little sib get-together in October.  And as always, I enjoy getting to know our members one-on-one (over coffee, whenever possible!) to discuss life, career, or anything else.

Now Accepting Applications for Global Health Elective Rotations

Developing the next generation of globally educated, socially responsible healthcare professionals dedicated to improving the health of disadvantaged populations.

The Hubert-Yeargan Center for Global Health (HYC) is now accepting applications for Global Health Elective Rotations for July 2013 and March 2014. 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-elective-rotation. What factors should I consider when deciding which sites are my top choices? You should think about what you are hoping to get out of the experience. Many sites offer excellent hands on clinical experience. Other sites offer opportunities for research, teaching, or learning about other health care systems. Application deadline is October 5, 2012. Interviews will be held between October 8 and November 7. We encourage you to speak with past participants to get a better idea of what daily life is like on the wards of your top sites. For more information, contact Tara Pemble, Program Coordinator at tara.pemble@duke.edu or 668-8352. Application deadline is October 5, 2012. Interviews will be held between October 8 and November 7. We encourage you to speak with past participants to get a better idea of what daily life is like on the wards of your top sites. For more information, contact Tara Pemble, Program Coordinator at tara.pemble@duke.edu or 668-8352.

Developing Academic Leaders in Global Health

The Global Health Residency Pathway offers Duke internal medicine residents the opportunity to broaden their training to address health disparities in a resource-poor setting.  We are currently soliciting applications from Internal Medicine Residents for enrollment in July 2013.  Application deadline is November 1, 2012.    Please see attached flyer for eligibility and application process.  You can also visit us on the Global Health Residency Pathway website. 2012 Global Health Medicine flyer FYI: Current Global Health Pathway Resident, John Stanifer, will be presenting a case from Tanzania at next week’s Global Health Gallops, October 3^rd, 12:00pm, 2003 DN.  Please contact me at cecelia.pezdek@duke.edu or 919-668-5976 if you have any questions. 

Project Homeless Connect  (from Julia Gamble, NP)

Project Homeless Connect is a one day, one-stop event that brings together services (among other things housing, benefits, healthcare, and haircuts) and people who are in need. It takes place at the Durham Bulls ballpark from 10-4 pm on October 11.   Last year the Lincoln Community Health Center Healthcare for the Homeless Clinic and Duke's Internal Medicine Department provided health consultations to 25 people in need.  A sign up sheet will be posted in the Med Res Office for those who are able to help provide coverage.  

An Important Note About Coverage During ITE

As you are all aware, the ITE schedule starts on Friday, October 5.  The latest schedule with revisions is posted in the ITE folder on MedHub and each individual schedule on Amion and MedHub.  Several interns and residents are taking the ITE while on inpatient teams in all three hospitals.  To ensure that coverage is maintained, residents on Pre-Call will need to stay on duty until the resident taking the exam returns to be On Call.

Dates to Add to Your Calendars /Contact Information/Opportunities

October 19       "Doctoberfest" Wine tasting with the Klotmans Oct 25                 Recruiting Kick Off Event (Tylers) December 1       DoM Holiday Party

Opportunities

 South Texas Internal Medicine.pdf Fellowship in Global Health--Hospital Medicine   We are excited to announce that the Division of Hospital Medicine at UCSF is now recruiting for the one-year Fellowship in Global Health--Hospital Medicine. Intended for recent graduates or senior residents in Internal Medicine or Med-Peds, the fellowship aims to train global health leaders who plan on pursuing a career in academic hospital medicine.  Fellows will participate in a longitudinal global health curriculum, attend on the teaching wards at UCSF, and spend up to 7 months in the field at one of our partner sites (Haiti or Liberia) working alongside local colleagues to improve service delivery.    We are now accepting applications (deadline October 31, 2012) and will interview in November/December, 2012. Fellows will start on July 1, 2013.    For more information and application materials please visit our website at: http://hospitalmedicine.ucsf.edu/fellowship/globalhealth.html Phuoc V. Le, MD, MPH, DTM&H    ple@medicine.ucsf.edu

Useful links

• http://duke.exitcareoncall.com/.
• 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