Weekly Updates - October 17, 2011 - Week 17

By rf21@dhe.duke.edu
The Internal Medicine Residency newsletter is posted each week to share important news, announcements and updates about the residency program. Please contact Rhea Fortune with corrections, contributions and suggestions.

From the Director

Hello! I am writing a little early this week, so I can’t officially announce the results of the NLCS bet I have going with Brewer’s fan JAR Phil Lehman. Suffice it to say, I am hoping Phil owes me a six pack of a Budweiser product, rather than me having to buy him a six pack of Milwaukee’s Best. I have intern Jim Gentry and David Butterly on my side as well – Go Cards! Word on the street is that any kind of beer tastes good with the Harry Potter jellybeans that have become a staple foodgroup for the night JARs.

I am glad that some of you have been emailing me to recognize your colleagues for outstanding work – we always say that it is the residents that make this place great, but it is especially true when you take the time to let us know about how someone went above and beyond.  Special recognition this week (including the Diagnostician Award) goes to JAR Scott Westphal for strong team leadership at the VA , I was told that “Not only has he spun urine and looked at multiple patients' blood smears with me and our Sub-I Jen Schaeffer, he has also gone above and beyond what is expected for teaching while pre-rounding, and made a not easy diagnosis of RMSF very early in the patient's presentation”.  Also, JAR Newton Wiggins helped a critically ill patient and also his colleagues by doing a procedure overnight that greatly facilitated care.

Gold stars are being awarded from the hospital to SAR Tara Spector, Intern Jodel Giraud and MSII Kelly Hathorn for care provided on Duke Gen Med last month….gold stars are given when a patient takes the time to specifically complement someone on the care they provided.

SAR Dave Karol (MedPsych) and JAR Shereen Katrak helped organize a group of us to work at the Durham Project Homeless Connect on Thursday at the DBAC.  Through the work of Dave, Shereen, as well as Larry Greenblatt and Julia Gamble (Lincoln Clinic), Interns Meredith Edwards and Jennifer Chung, and SAR Jon Roberts and I were able to help staff the Lincoln Health Center “booth”.  I certainly learned a lot about resources in our community, and want to be sure to recognize the great work that Dave, Shereen, and Larry do at the Lincoln Clinic for the Homeless throughout the year, under the leadership of Julia.

Thanks to the SARs, significant others and Lynn Bowlby and Neal Ready who came over to hear Anna Lore at my house on Tuesday.  Despite the rain, we had a great discussion on the direction of US healthcare.  Hope to see you all again at our next Evening Rounds, date TBA!

By the time you read this, some of us (including me, and SARs Rebecca Burke and Blair Irwin) will be recovering from the Duke Ramblin’ Rose Women’s Half Marathon. Congrats, Rebecca and Blair! The run is fundraiser for the Duke Cancer Center, so see Blair or Rebecca if you are interested in making a donation.

Have a great week,  Aimee

WIRTW (Dr. Aimee Zaas)

[box] Stout JE, Gadkowski LB, Rath S, Alspaugh JA, Miller MB, and Cox GM.  Pedicure associated rapidly growing mycobacterial infection: an endemic disease.  Clinical Infectious Diseases 2011; 53 (8) 787-92.[/box] Why did I read this?  As a pedicure aficionado, I have been following my colleague Jason’s research in this area very closely trying to minimize my likelihood of contracting this emerging infectious disease. What did the study show?  Jason and his team (including former Duke resident and ID fellow Beth Gadkowski) investigated a series of cases of cutaneous mycobacterial disease associated with pedicures.  Samples were taken from a subset of implicated salons (n=13) and control salons (=11) in Wake and Durham counties.  They found that an equal proportion of case and control salons had RGM growth either from footbath water or from biofilm cultured from the drainage systems, and that exposure to RGM in the pedicure setting is quite common.  While case numbers were too small to draw definitive conclusions about host factors or peri-pedicure behaviors (shaving, etc) contributing to infection, the association between pedicures and cutaneous RGM disease is evident.  Improving education and cleaning practices at salons is a reasonable step to try to decrease disease incidence. How will this change my practice?  Not sure, unless Jason tells me where NOT to go for a pedicure. [ilink url="http://news.medicine.duke.edu/wp-content/uploads/2011/10/pedicure-RGM.p…" style="download"]Pedicure RGM[/ilink]

Recruiting Season (Dr. Dave Butterly)

It is hard to believe, but recruiting season is fast approaching.  We have 3200 applications in thus far and continue to receive 15-20 new applications daily.  We are about 98% done with our initial review and have 340 invites extended and over 320 already scheduled for interview dates.  We will again be hosting applicants Mondays and Fridays with corresponding dinners Sunday and Thursday evenings.  There will be a total of 18 days in all.  As with previous years, we will also be hosting our applicants interested in Global Health and Clinical Investigator Pathway on special Thursday-Friday recruiting days each month as well.  We again have an outstanding pool of applicants.  Many will be from your home institutions so please make every effort to meet them during their visit.  Please look for emails from Emily regarding recruiting and also from Laura Caputo who will help coordinate email contacts for applicants from your schools of Medicine.  The important dates and  restaurants are listed below: Recruitment Kickoff Event – Tuesday November 1,  7-9pm at G2B (on Shannon Rd, in Wachovia Bldg.) November Dinner Signups went up this week in the med res office.  Stop by to sign up! Restaurant List:
604 West Morgan Piazza Italia Six Plates
G2B Parizade Tobacco Road
Revolution Piedmont Pop's
The first day of Recruitment is Friday, November 4 Please contact Carly Kelley with photos for the slideshow.  Laura Caputo will be pairing Residents with Applicants (based on Med School, Undergrad) for “Recruitment Buddies!”  Look for her emails! Email Emily Strollo if you can give tours Fridays at 10:00, 1:00 or 2:00 and Mondays 10:00, 11:00 or 2:00, or if you are able to “host” the slideshow Mondays and Fridays from 3-345 Recruitment Days are:
  • November: Fri 11/4,  Mon 11/7,  Fri11/11,  Mon 11/14,  Fri 11/18,  Mon 11/21
  • December: Fri 12/2, Mon 12/5, Fri 12/9, Mon 12/12, Fri 12/16, Mon 12/19
  • January: Fri 1/6, Mon 1/9, Fri 1/13, Fri 1/20, Mon 1/23, Fri 1/27

QI Corner (from Dr. Jon Bae)

Remember to Save-the-Date for the next in our noon conference lecture series on Patient Safety and Quality Improvement.  The lecture will be during noon conference,  Wednesday Oct 26th.  Our featured speaker is Judy Milne, Patient Safety Officer for DUHS discussing the "culture of safety." Don't miss out! Also, be on the lookout for the Duke University Health System Safety Attitudes Questionnaire (AKA the SAQ) which will open on October 24th.  The SAQ is a survey tool to assess the safety culture here at DUHS and all GME programs will be asked to take part.  It helps to inform the health system about how to improve the culture of safety and to identify areas where we can do better.  Your participation is a must!  More information will be distributed as it becomes available. Don't forget to complete your new and improved QI modules.  All interns will be given dedicated time to complete these during geriatrics rotations.  SARs/JARs will be given a dedicated half day during ambulatory blocks to complete as well.  However, you are free to complete these modules at any time and instructions are included below. Lastly, thanks to all the residents who have been coming up with quality improvement ideas.  My advice: keep'em coming.  If you have a project idea, talk to Aimee Zaas or Jon Bae. Clinical Quality Improvement Modules Instructions: Some of you may notice that you have a half day of Quality Improvement while on ambulatory or geriatrics.  During this time, you are required to complete a clinical quality improvement course.  This course will help improve your skills in ACGME core competencies, Practice-Based learning and improvement and Systems-Based practice. Please go to https://courses.duke.edu and log on using your net id and password. You should see “Fundamentals of Health Care Improvement" course assigned to you. The course has pretests, 8 modules (each roughly 15-20 minutes in length) followed by individual module tests and post tests. We suggest logging in and not waiting until last minute to check and see if you are able to get to the modules without any difficulty.  All residents are expected to complete this course at least once.  If assigned, these modules must be completed by the end of the current ambulatory block; we suggest you utilize your dedicated half day to do so.  If there are any questions, please contact Jon Bae or Juliessa Pavon. [hr]

From the Chief Residents...

Lincoln Medical Center at Project Homeless Connect (by Dave Karol)

[caption id="attachment_3499" align="alignright" width="346" caption="Pictured, clockwise, starting from far left: SAR Dave Karol, SAR John Roberts, intern Meredith Edwards, JAR Shereen Katrak, and our fearless preceptor, Dr. Larry Greenblatt."][/caption] On Thursday, October 13, Duke internal medicine residents and faculty volunteered as health providers for the Lincoln Medical Center at Project Homeless Connect. The all-day event was held at the Durham Bulls Athletic Ballpark and was a one-stop fair for the homeless, uninsured, and/or at-risk of Durham. Services included information booths on housing, nutrition, education, employment, and medical and mental health resources. We operated a "mini-clinic" in a box on the upper level (on the first base side). Despite limited space and resources -- we even had separate "rooms" in different sections of the seats -- we were able to help between 25 and 30 patients. Participating faculty were Drs. Aimee Zaas and Larry Greenblatt. Resident participants included interns Jen Chung and Meredith Edwards, JAR Shereen Katrak, and SARs John Roberts and Dave Karol. Everyone had a good time and helped the at-risk of Durham get set up with much needed services; highlights of the day included Jen recruiting a patient to join her DOC panel and John setting up an urgent colonoscopy at DRH for a patient! The fun does not end here, however! The opportunity to continue to serve the homeless of Durham is possible for all internal medicine residents and faculty who wish to volunteer at the Urban Ministries Shelter Clinic (affiliated with Lincoln Medical Clinic) in downtown Durham. Available times are currently on the third Wednesday of the month from 5:30-7:30, when Dr. Greenblatt will serve as preceptor. More dates will also be available in the near future. Residents interested in volunteering, or faculty wishing to precept, should contact Dave Karol or Shereen Katrak for more information.

Halloween Party (from Residency Council)

To all Duke Resident Devils: our Halloween Party is coming up!

“Double, double, toil and trouble, your attending hates your one week stubble Fevers burn, and the nurses holler the attending knows you ‘ain’t no scholar Calling all witches, goblins and ghosts The Tavern will be your host… Stop on by for a trick or treat Eyeballs, brains, and interns… always plenty to eat The fun begins at the stroke of nine Wear your costume and be on time!”

(courtesy of  Residency Council Intern Rep Armando Bedoya)

[box]Where: The Tavern (Upper Level), 1900 W. Markham Ave., Durham, 919-286-7665 When:Sat. Oct. 29, 2011 at 9 P.M. Feel Free To Bring Your Spouses & Significant Other! There will be a Costume Contest held by the Tavern so wear your best costume![/box]

Final Week of ITE's.......

All ITE’s begin promptly at 7:30 a.m. All examinees should arrive by 7:15 to allow for check in and the distribution of materials.  Each day consists of two 4-hour sessions with a short lunch break in between. The total testing time is 8 hours.  Lunch will be provided for you.  Pencils will also be available for your use. The testing rooms are historically kept cold, so please dress appropriately and/or bring a sweatshirt or sweater. There is no dress code for test days, however, please wear your id badge.  The day will end no earlier than 4 p.m. [ilink url="http://news.medicine.duke.edu/wp-content/uploads/2011/10/ITE-Schedule.p…" style="download"]ITE schedule[/ilink] Please note that this weeks exams are NOT in Duke North
  • Mon., Oct. 17  - Room DS M224 (DS M224 is in Duke South, Green Zone. Take the elevator on left just before you walk out into the Quad (near Dr. Dzau’s Office). Exit onto the 2nd Floor, turn R, room is on your left.)
  • Tues., Oct. 18 - Room Hanes House 131 (Corner of Erwin and Trent (map attached). Testing room is on first floor

Grand Rounds

M & M;  2002 Conference Room, Oct 21st 8:00 AM

Noon Conference

Duke North Conf Room 2002, 12:00 p.m.
Day Date Topic Presenter Vendor
Monday 10/17 CAD/atherosclerosis Chris Granger Meelos
Tuesday 10/18 MedPeds Conference: Transitions of care for patients with congenital heart disease Ward/Rhodes Domino's
Wednesday 10/19 Medical Decision Making (GME sponsored) Dan Ariely Chick-fil-A
Thursday 10/20 Clinical Pharmacology - Pain Management Harry Goforth Jersey Mike's
Friday 10/21 Chair's Conference Ralph Corey & former Chiefs Moe's
 

Turkey Bowl Practice

Turkeybowl Practice - Sundays at 3:30pm - Forest Hills Park

  [hr]

From the Residency Office

Taxi Service Information:

The Duke Office of GME has identified transportation options for residents post call who are too fatigued to drive home safely. This includes a taxi service. Laminated cards that contain information for the taxi service are in the Med Res Office.  If you have not yet picked one up, please stop and pick up a card to attach to your id badge.

Open Enrollment / GME Newsletter (from Rhea)

Open enrollment will take place from October 24 to November 5, 2011. Your coverage term for benefits through Duke HR is one year. Changes in plan coverage can only be made for life changing events. You will be receiving an open enrollment packet for Health, Dental and Reimbursement accounts at your home before open enrollment begins. If you have questions about open enrollment, please contact Jill Watkins at 684-2897. This and other important GME related topics can be found in the GME newsletter.  I highly recommend taking a moment to  review the newsletter each month.  It has topics tagged which enable you to go directly to only  those items relevant to you or your interest.  It will be a good investment of your time.  GME October 2011 Newsletter

Duke Medical Alumni sponsored Lecture

Duke Medical Alumni has funded Joan M. Roediger, JD, LLM to provide a presentation titled "How to find the perfect job & negotiate your (ideal) employee agreement." Refreshments will be provided.
  • October 20th from 6 – 8pm, Duke North Lecture Hall (Room 2001)
  • October 21st from 7 – 9am, Duke North Lecture Hall (Room 2001)

Required Procedures for Program Completion:(repeated from last week, from Rhea)

The med res office has  received questions regarding which  procedures must be logged and the number for completion of your training in Internal Medicine.  I hope you find the information provided below answers these questions.  If you need further information, you may contact Rhea or Dr. Zaas.  Please don’t forget that all procedures must be logged into medhub and must be approved by an attending physician (fellows and senior housestaff are NOT permitted to sign off on intern/resident procedures).  Also note that you are encouraged to continue to log procedures even after you have met the threshold.  Many facilities require you to provide a log of procedures performed when you are credentialed  for employment. As stated by ABIM…. ABIM procedure requirements ". ….to assure adequate knowledge and understanding of the common procedures in internal medicine, each resident should be an active participant for each procedure five or more times." Required procedures include:
Abdominal paracentesis Incision and drainage of an abscess
ACLS  (continued certification) Lumbar puncture
Arterial line placement Nasogastric intubation
Arthrocentesis Pap smear and endocervical culture
Central venous line placement Placing a peripheral venous line
Drawing venous blood Pulmonary artery catheter placement
Drawing arterial blood Thoracentesis
Electrocardiogram   

Dates to Add to Your Calendars

  • Oct 17-18  -  Inservice Training Exams
  • Oct 18 - Fuqua Health Policy Lecture 5:30-8:30 pm
  • Oct 20 - Duke Med Alumni sponsored Lecture
  • Oct 21- Duke Med Alumni sponsored Lecture
  • Oct 22 - Greenfield Celebration
  • Oct 26 - Duke Internal Medicine Book club, 6:30 pm, Med Res Library
  • Oct 28 - Medicine Research Conference, 12 noon in DN2002
  • Oct 29- Resident Halloween Party, The Tavern, details TBA
  • Nov 1 - Recruitment Kickoff, G2B Gastropub 7-9
  • Nov 14-17 - BLS Blitz
  • Dec 10 – DOM Holiday Party
  • Dec 15 - Duke Patient Safety and Quality Conference
  • Feb 24 – Charity Auction (Contact Tian or Ann Marie to participate)
  • June 13 –Resident Research Event, 5-7pm

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