The 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
Block 3 has come to an end! Amazing – ¼ of the year is now behind us. I am continually impressed and happy with the outstanding work by the teams, both in the inpatient and outpatient arenas.
SAR
Talal Dahhan presented a fantastic CPC, with great discussion by Rich Reidel, Momen Wahidi, Bill Hargett, and Rajesh Dash (Pathology). Absolutely knocked it out of the park, and on his birthday no less.
We started off the week with an awesome ID Jeopardy in noon conference, prepared by Duke Chief Eileen Maziarz (no I am not biased regarding the content). It was a tough contest, but the Interns/JARs edged the Med Studs/SARs by a couple hundred bucks. Hats off to
Kaley Tash (PGY1),
Bronwyn Garner (PGY1) and
Callie Coombs(PGY2) for some great answers (including HLA-B*5701 testing for abacavir hypersensitivity syndrome), as well as the med studs for (somewhat) carrying the SARs with answers like chloramphenicol being the preferred treatment for RMSF in pregnant women (way to go
Kevin Huang), as well as the correct answer for Mollaret’s meningitis.
Of course, jeopardy is not complete without another question…..prizes to the first person to email me with the answer to this question….Weil’s disease is credited with (potentially) assisting in what important event in American history? Additional bonus for telling me what causes Weil’s disease and how you might treat it.
Most notable of this week was our “Global Health Gallops” noon conference where we welcomed back our SAR world travelers and heard a series of cases from around the world –
Jason Webb (Toxo encephalitis; Eldoret, Kenya);
Christy Kaiser (HSP – note that is 3 cases thus far this year – Leon, Nicaragua),
Megan Brooks (Tb pericarditis, Port-au-prince, Haiti),
David Karol (envenomation, Shiprock, NM),
Steven Sumner (rickettsia africae in a Wisconsin-native, acquired on safari). Our apologies to
Sarah Piper (Adelaide, Australia) as we ran out of time. Our “Diagnostician of the Week” award goes to presenter
Kristin Dicks (Bomet, Kenya) for traumatic neck pain/paralysis. If you didn’t see the xray, definitely ask her more about it.
Thanks to our Stead Attendings
Ben Powers, Manesh Patel and James Kelly!
Another notable is Chair’s conference presenter SAR
Jared Chiarchiaro who fielded tough comments and taught us all with a case of cerebral amyloid angiopathy.
Ed Coverstone even got to make fun of me in the Turkey Bowl photoshopping extravaganza – well deserved, I suppose!
Thanks to the CimiGRO internal medicine interest group for a great evening on Thursday – turnout was strong, and we had a great discussion of a complicated case of Staph aureus bacteremia. Thanks to
Greg Sprung and Rachel-Rose Cohen for organizing.
Many of you were able to attend the feedback from the program noon conference on Thursday…slides are on MedHub, and I encourage you to talk with me, the chiefs, the residency council or the ACRs about ways to get involved in “educational QI” in our program.
Chief Resident in Quality and Patient Safety (CRQS)
I am very excited to announce that we were awarded the position of
VA QI Chief Resident, one of few programs who received funding for this position through a competitive application! Much thanks to Dr. David Simel for taking the lead on our application. Per Dr. Simel,
[box]“The Department of Veterans Affairs has awarded the Durham VAMC one of eight Chief Resident in Quality and Patient Safety (CRQS) positions.The CRQS will be a postgraduate from the Department of Medicine, appointed as a staff physician at the Durham VAMC for 1 year. The first CRQS will intersperse didactic training in quality metrics with their clinical rotations from Jan 1, 2012-June 30, 2012 in preparation for the initial CRQS that begins July 1, 2012. The VA has optional continuation tracks that include Advanced Fellowships in Patient Safety (1-year) or the VA Quality Scholars program (2-3 years) for those who want extended work in this area after the CRQS year. We will select our CRQS through an application process. We encourage SARs to apply for this position.”
If interested in hearing more, join us on Tuesday at 1 pm in Room 2002 or Friday at 9 am in the MedRes library.[/box]
Looking forward to a fun week, with Leader’s Board on Tuesday in the Faculty Lounge. Congratulations go to JAR
Adam Garber and family on the birth of their son Davis Gene Garber! Also to SAR
Krish Patel on his engagement.
Pubmed from the program this week goes to the following residents:
SAR
Jared Chiarchiaro for his upcoming award-winning presentation at ACCP (in Hawaii, no less) -- ICU impact on trajectories of well-being in patients with advanced chronic illness , conducted with mentor James Tulsky.
Severe airway damage due to aspiration of an Alendronate pill,
Bryan D. Kraft, Daniel L. Gilstrap, Wael Al-Jishi, Sahar Koubar, Kamran Mahmood, Scott L. Shofer and Momen M. Wahidi, to be published in Chest, Oct 2011.
Have a great week, Aimee
Flu Vaccination
Reminder - the Flu Vaccination "BLITZ" is this week - September 27. The goal is to get 100% of all health care workers vaccinated in 24 hour period. Residents/fellows can receive at Duke Hospital, DRH and Duke South clinics (as they're working in clinical areas) Residents, at VA can come to cafeteria or Employee Occupational Health and Wellness Duke South Clinics.
From the Chief Residents
Grand Rounds
Morbidity and Mortality Conference; 2002 Conference Room, 8:00 AM
Noon Conference
| Day |
Date |
Topic |
Lecturer |
Time |
Vendor |
| Monday |
9/26 |
Antithrombotic Therapy and Atrial Fibrillation |
Chris Granger |
12:00 |
Rudinos |
| Tuesday |
9/27 |
Town Hall Meeting |
Chiefs |
12:00 |
Dominos |
| Wednesday |
9/28 |
QI/Patient Safety Conference |
Jon Bae |
12:00 |
Saladelia |
| Thursday |
9/29 |
EKG interpretation |
Al Sun |
12:00 |
Papa John's |
Quality is Coming (from Jon Bae)
We are all about to enter a new era of quality improvement in the practice of medicine. Join us this Wednesday at noon conference as we kick off our new quality improvement curriculum with the first in a series of lectures in Quality Improvement and Patient Safety. Jonathan Bae and Aimee Zaas will unveil new changes and opportunities in Quality Improvement around our program. Our invited speaker, Dr. Paul Lee, will then provide an introduction to "what is quality and how do we measure it". And all residents will receive their "QI Power Rings". Don't miss it!
What: Quality Improvement and Patient Safety Lecture Series
When: Wednesday, 9/28 at NOON CONFERENCE
Recruiting Season Kickoff
Make note on your calendar for the kickoff of our next major event - the kickoff to "RECRUITING" season!
November 1, at G2B Gastropub from 7 - 9.
Who's playing? The best team of residents and faculty in the country. Don't miss it!
Turkey Bowl Practice
Turkeybowl Practice - Sundays at 3:30pm - Forest Hills Park
DOC News Letter
Take a look at the September issue of the
DOC newsletter 9-11 . And, for those who like to try both their knowledge and luck, use the following link to answer the "Question of the Month".
https://www.surveymonkey.com/s/DOC_Question_of_the_Month
Trainee Time Out (from Tian Zhang)
It’s that time of year again!! Join housestaff from across the hospital at our annual Duke Football tailgating tent - Trainee Time Out! In what's become a housestaff ritual, over a hundred residents and fellows spent Saturday afternoons last year restoring their Vitamin D levels before every Duke home game. There are 7 home games this year, so ditch your white coat, dust off your (royal) blue face paint, and enjoy some quality outside-the-hospital time with your colleagues as the Duke Football team battles on Saturdays this fall!
If you are interested in hosting and/or tickets, please e-mail Leslie Johnson @
leslie.johnson@duke.edu The next home game is September 24th vs Tulane
Duke Internal Medicine Book Club
When was the last time you reflected on how a patient’s illness and death affected you?
If you would like to explore this and other related questions, please consider joining your fellow housestaff on October 26 at 6:30 in the MedRes library to review "Final Exam: A Surgeon's Reflections on Mortality" by Pauline Chen. Dr. Chen is a transplant surgeon who trained across the country, and you may have seen her column for the New York Times. In “Final Exam,” she looks at modern medicine and how medical training/the medical community deals with death and dying.
The book will be reviewed and discussed as a group over approximately one hour, with specific topics to touch on coping and self-care. There will also be a format to survey housestaff interest in future topics.
October 26 at 6:30pm Med Res Library
All are invited to share in this great discussion!
Look for more book club/self care events throughout the year!
Please contact: Ashlei Lowery, M.D. or Juliessa Pavon, MD for details
More Additions to the "Duke Internal Medicine Family" (from Adam Garber, MD)
My wife and I welcomed our son, Davis Gene Garber, with love yesterday, 9/22/11, weighing a big 8lbs 2oz. Mommy and son are doing well and his big sister is very excited as well" Adam M. Garber, M.D.
Click on the following link to see "big sister" making sure Davis is OK
Garber Siblings
Updates From Our ICGME Rep(from Kathleen Lee Kiernan, MD, PGY-2)
*The Duke Medicine-wide influenza vaccination effort begins this week! Make sure to get your flu shot.
*The Health Policy Lecture Series begins in October!! The lectures will be on a weekday evening 5:30-8:30pm and more information will be forthcoming. Law and Medicine / Employment Law (October 2011), Accountable Care Organizations (December 2011), Healthcare Reform and the Uninsured (February 2012), Quality and Performance (March 2012), and Negotiation (May 2012).
*Please keep the Duke Police number in your cell phone (919-684-2444)! Call for any questions or concerns involving your safety with patients, families, or on campus
From the Residency Office
Where’s my Schedule?
Have you ever been scheduled to start CAD on Monday, and have NO idea if you’re starting on PAC or DHP….
Please remember that the schedule assignments for many of our services are posted on MedHub’s home page under “Resource Documents”. The posted services include:
| Duke Gen Med |
DRH MICU |
| DRH Gen Med |
CCU Duke |
| VA Gen Med Call and Clinics |
CCU VA |
| Duke Night Float SS |
VA MICU |
| CAD |
Duke MICU |
| Pulm |
9100 Intern |
| Neuro |
|
Our target is to post detail schedules no less than 1 week before the start of each block.
North Carolina Controlled Substance Reporting System
Many of you have applied to use the NCCSRS. Thank you! If you haven't, keep reading. We are trying to get
all the residents to sign up and use this valuable resource routinely. Please note that the VA may have rules about using this resource. Please check with your faculty there before using for your veteran patients.
This website will allow you to see your patients' prescriptions of controlled substances that were filled in North Carolina. Information provided includes the medication, number dispensed, pharmacy, and prescriber. This information can be very useful in preventing unintended medication overdose as well as abuse and diversion of controlled substances. The application is attached below and is brief and straightforward. Your password needs to be renewed every 12 months form the time you first signed up. You'll need to have your application notarized. Locations of notaries include:
-Duke Outpatient Clinic, Gloria Manley
-Medical Residents Office, Rhea Fortune
-VA Federal Credit Union, First Floor. You will be charged a small fee.
Note that the VA requires physicians to obtain written, informed consent before accessing a veteran's data on this site.
We have arranged to have submitted to the state all resident DEA numbers and verification that you are in training at Duke. Your password on the website is good for one year from application and will need to be renewed annually.
Instructions for using the website are available after you have registered. It is easy to use. Please take a moment and read the Do's and Don'ts file about using this important resource.
North Carolina Controlled Substance Reporting System
csrs-applicationform
Do's & Don'ts for Prescribers Using NC Reporting System
Larry Greenblatt, MD ; Associate Program Director for Ambulatory
The Learners' Perceptions Survey is Open
The VA Learners' Perceptions Survey is a valuable tool that is used to help improve training opportunities. Please take the time this week to log in and provide your feedback using the following link:
http://www.va.gov/oaa/surveys/
Your responses will be kept confidential. If you have trouble logging in, call 1- 888-877-9869
or e-mail OAA Help Desk.
Cardiology Interest Group
The Cardiology program would like to offer the opportunity to meet with representatives to learn more about the fellowship program and address any questions that you may have. The meeting will be held on Wednesday, October 5, from 5-6 in the Med Res Library.
https://www.surveymonkey.com/s/Cardiology_Interest_Group
Noon Conference - Grand Rounds Recordings
Reminder noon conference and grand rounds are being recorded each day. If you missed conference and would like to "catch up", simply open MedHub, go to your personal calendar, click on the conference you would like to view, and then click on the link provided. Let us know how this is working and whether you find this option helpful.
ILP - Directions
Dr. Woods recently sent out a reminder to eveyone regarding
Individual Learning Plans. Attached please find a copy of the information distributed for future reference.
Dates to Add to Your Calendars
Sept 27 - Duke Mass Vaccination Exercise
Sept 27 - Leader Board @ 5:30 PM in the Faculty Lounge
Oct 5 - Cardiology Interest Group
Oct 7-18 - Inservice Training Exams
Oct 11 - Evening Rounds at the Zaas'
Oct 22 - Greenfield Celebration
Oct 26 - Duke Internal Medicine Bookclub
Nov 1 - Recruitment Kickoff, G2B Gastropub 7-9
Dec 10 – DOM Holiday Party
Feb 24 – Charity Auction (Contact Tian or Ann Marie to participate)
June 13 –Resident Research Event, 5-7pm
Career Opportunities:
Medical Career Path Opportunities
Useful links
Block 3 has come to an end! Amazing – ¼ of the year is now behind us. I am continually impressed and happy with the outstanding work by the teams, both in the inpatient and outpatient arenas.
SAR Talal Dahhan presented a fantastic CPC, with great discussion by Rich Reidel, Momen Wahidi, Bill Hargett, and Rajesh Dash (Pathology). Absolutely knocked it out of the park, and on his birthday no less.
We started off the week with an awesome ID Jeopardy in noon conference, prepared by Duke Chief Eileen Maziarz (no I am not biased regarding the content). It was a tough contest, but the Interns/JARs edged the Med Studs/SARs by a couple hundred bucks. Hats off to Kaley Tash (PGY1), Bronwyn Garner (PGY1) and Callie Coombs(PGY2) for some great answers (including HLA-B*5701 testing for abacavir hypersensitivity syndrome), as well as the med studs for (somewhat) carrying the SARs with answers like chloramphenicol being the preferred treatment for RMSF in pregnant women (way to go Kevin Huang), as well as the correct answer for Mollaret’s meningitis.
Of course, jeopardy is not complete without another question…..prizes to the first person to email me with the answer to this question….Weil’s disease is credited with (potentially) assisting in what important event in American history? Additional bonus for telling me what causes Weil’s disease and how you might treat it.
Most notable of this week was our “Global Health Gallops” noon conference where we welcomed back our SAR world travelers and heard a series of cases from around the world – Jason Webb (Toxo encephalitis; Eldoret, Kenya); Christy Kaiser (HSP – note that is 3 cases thus far this year – Leon, Nicaragua), Megan Brooks (Tb pericarditis, Port-au-prince, Haiti), David Karol (envenomation, Shiprock, NM), Steven Sumner (rickettsia africae in a Wisconsin-native, acquired on safari). Our apologies to Sarah Piper (Adelaide, Australia) as we ran out of time. Our “Diagnostician of the Week” award goes to presenter Kristin Dicks (Bomet, Kenya) for traumatic neck pain/paralysis. If you didn’t see the xray, definitely ask her more about it.
Thanks to our Stead Attendings Ben Powers, Manesh Patel and James Kelly!
Another notable is Chair’s conference presenter SAR Jared Chiarchiaro who fielded tough comments and taught us all with a case of cerebral amyloid angiopathy. Ed Coverstone even got to make fun of me in the Turkey Bowl photoshopping extravaganza – well deserved, I suppose!
Thanks to the CimiGRO internal medicine interest group for a great evening on Thursday – turnout was strong, and we had a great discussion of a complicated case of Staph aureus bacteremia. Thanks to Greg Sprung and Rachel-Rose Cohen for organizing.
Many of you were able to attend the feedback from the program noon conference on Thursday…slides are on MedHub, and I encourage you to talk with me, the chiefs, the residency council or the ACRs about ways to get involved in “educational QI” in our program.
My wife and I welcomed our son, Davis Gene Garber, with love yesterday, 9/22/11, weighing a big 8lbs 2oz. Mommy and son are doing well and his big sister is very excited as well" Adam M. Garber, M.D.
Click on the following link to see "big sister" making sure Davis is OK Garber Siblings