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The Robert J. Lefkowitz Society provides unique opportunity for physician-investigator trainees

At Medicine Grand Rounds this morning, Mary Klotman, MD, chair of the Department of Medicine, announced the formation of The Robert J. Lefkowitz Society, which provides a home for MD and MD/PhD post-graduate trainees who are in the Duke University Department of Medicine Internal Medicine Residency and Fellowship programs and are pursuing careers with a primary focus on basic and translational research as physician-investigators.

Through formal and informal mentoring relationships, the Lefkowitz Society provides promising post-graduate trainees with a greater understanding of how to develop successful academic careers. The Society provides members with opportunities to develop successful research projects and helps them find appropriate research mentors and investigative teams as early as possible in order to enhance their future research success and productivity. Members will benefit from direct interactions with senior physician-investigators at Duke through a series of dinner programs and other activities.

The Lefkowitz Society is named for Robert J. Lefkowitz, MD, professor of medicine in the Division of Cardiology and recipient of the Nobel Prize for Chemistry 2012. In his 40 years as a Duke researcher, Dr. Lefkowitz has mentored more than 200 trainees who have come through his lab. He has embraced the opportunity to serve as a role model and informal mentor for members of the eponymous Lefkowitz Society.

Learn more about The Robert J. Lefkowitz Society at medicine.duke.edu/education-and-training/lefkowitz-society. For more information, please contact Gerard Blobe, MD, PhD, professor of medicine and Lefkowitz Society program director.

by · Posted on October 18, 2013 in Fellowship programs, Internal Medicine Residency, Medical Education, Research · Read full story · Comments { 0 }

Internal Medicine Residency News: October 14, 2013

From the Director

DUKE.RESEARCH.NIGHT.03 (1)Doctoberfest continues! We are so excited to report that we reached 100% flu vaccination for the program on Oct 10th!!!! Tremendous job,and thanks to our Stead leaders for encouraging everyone in this important patient safety effort.

Congrats to our residents with best noon conference attendanceBrittany Dixon, Christine Bestvina and Jim Gentry  as well as best Grand Rounds attendanceDeanna baker, Marc Samsky and Tyler Black! We have (root) beer and pretzels this week so be sure to be there!

Other kudos go to Stephanie Giattino and Ashley Bock for excellent work from their VA gen Med JARs Michael Woodworth and Kedar Kirtane, to Mike Shafique from Matt Sparks for his leadership as VA day float, to Howard Lee for his appearance on Animal Planet (the liver fluke!) and to Amanda Verma from Neil Friedman for her work on cards consults! Our nurses have recognized great patient care and teamwork from Myles Nickolich, Matt Atkins and Alan Erdmann! Please remember to send in the names of nurses who are doing a great job helping you care for patients.

We will have the opportunity to use Paypal for our community service project – raising money to buy a portable wheelchair ramp for the North Street Community. You can find the link below next to the picture of sumo wrestlers (which I hear is what you might get to see).  If we all donate $10, we can meet our goal.

Our “safe discharge” milestones study has begun on gen med. we are part of a 14 center study looking at milestones needed to allow residents to do all the steps of a patient discharge independently. Unlike other milestone studies, we involved nurses and patients in choosing the milestones. Our site PIs are David Ming and Mitch Black. Please remember to fill out the pre study survey, and, interns on gen med should have attendings observe them doing the components of patient discharge.

This weeks pubmed from the program goes to Tyler Black for his article with Dr Rebecca Burbridge.  Black TP, Guy CD, Burbridge RA, “Retroperitoneal Cystic Lymphangioma Diagnosed by Endoscopic Ultrasound Guided Fine Needle Aspiration,” Clinical Endoscopy 2013; 46 (5): 595-597.Isa - black and white

Also congratulations to duke residency alum and renal fellow Blake Cameron on the birth of Elizabeth Ann, to Tim and Sarah Mercer on the birth of Isaaya (“Isa”) Jilani Mercer ( Isa – born October 11. – wearing the cap) and to the Trulock family Turlockon the birth of Eliza Renee Trulock, pictured here with her big sis Hattie!

Have a great week!   Aimee

 

 

What Did I Read This Week

Submitted by  Saumil Chudgar, MD

Strausburg MB, Djuricich AL, Carlos WG, Bosslet GT.  “The Influence of the Residency Application Process on the Online Social Networking Behavior of Medical Students: A Single Institution Study.”  Acad Med.  Epub ahead of Print, 25 Sep 2013

Why did I read this?

It is that time of year again – recruitment season!  Drs. Zaas, Butterly, and Hargett are reviewing thousands of residency applications, Erin Payne is scheduling hundreds of interviews, and Dr. Hargett and I recently finished advising the ~60 Duke med students applying for Categorical or Prelim Residencies.  A couple students had sought my advice regarding social media during the application process. This article piqued my interest as I was skimming the email from Academic Medicine with recent articles.133410_saumil_chudgar_prd

What I learned from reading this?

A survey study from Indiana University showed that of the 3rd and 4th year medical students who answered their survey, 99% used an online social networking site. Over half (60%) either changed/plan to change the profile somehow in preparation for applying to residency.  Of the people who changed their profiles, 50% deleted pictures/posts, 13% deleted their profile completely, 28% changed privacy settings, and 10% changed their names.  Reasons for change include inappropriate for PD to view their site (30%) and not believing they should be judged professionally by their personal site (60%).

Of those who did not change their profiles, the primary reasons were that they felt the content of their site was appropriate (42%) and due to privacy settings they had in place (36%).

70% of students believed program directors would use social media accounts to screen applicants, and most about half felt it was ethically acceptable to do so.

Thoughts about the article

I found the social media article very interesting in that medical students recognize that their online profiles may be accessible to program directors, and 70% of them believe PDs screen their social networking sites.  Admittedly this article is from a single institution and has a modest response rate for a survey study (30%).  It would be interesting to see if this behavior holds across other institutions.

A similar survey of program directors looking to see if they actually do so would be interesting—my guess is most of them don’t have time for that!  The implication for our own residents as they apply for fellowships should also be considered.  Finally, in the context of the new Duke social media policy, are our patients and colleagues also looking at our social media profiles, and how should that change our behavior?

From the Chief Residents

Grand Rounds

Alumni/Stead Dr. Lefkowitz

 

Noon Conference

Date Topic Lecturer Time Vendor Room
10/14 Acute Leukemias   Overview Louis Diehl 12:00 Picnic Basket 2002
10/15 MED   PEDS SAR TALK (Awerbach/Tolan) OR Difficult Death Debrief SARS/Galanos 12:00 Saladelia   Salads 2002   OR DN9242
10/16 Inpatient   Pain and Opiate Management Chris   Jones 12:00 Pita   Pit 2002
10/17 Intraosseous   Line Lab Chiefs/EZ-IO   Group 12:00 Domino’s 2001
10/18 Chair’s   Conference Chiefs 12:00 Chick-Fil-A MEDRES

From the Residency Office

DOCTOBERFEST IS HERE !

“Building Our Community”  October 1-31, 2013

Thank you to everyone who has donated so far to our Doctoberfest Fundraiser for the Northstreet Community project.  We have raised $135 to date!  The option to have our Chief Residents and Dr. Zaas sumo wrestle is by far the most popular option.  If you would like to see Summothat happen, (and really, who wouldn’t?) we must reach at least 50% of our goal of $1240, the amount needed to purchase a new portable wheelchair ramp for the community.  Please donate using the link below and help us reach $620 by October 31, 2013 – every penny counts!

https://www.paypal.com/cgi-bin/webscr?cmd=_s-xclick&hosted_button_id=4UF7XQFW9EGWS

Also, don’t forget to acknowledge a nurse for their outstanding work:

https://www.surveymonkey.com/s/doctoberfest2013_greatnurses

October 16 Join us at noon conference for a traditional “beer” garden treat!

October 31 Halloween Tricks and Treats! Join us at Noon Conference for some Halloween goodies and for the announcement of our fundraiser’s “winning” Chief!

We look forward to celebrating with and honoring our incredible Duke Medicine community all month

 

Evaluations – How do They Get Assigned?

Some of the evaluations that residents are assigned happen automatically – like rotation evaluations, which are generated directly from MedHub at the end of each rotation.  However, the vast majority of evaluation assignments start with you – the resident – beginning with the Resident Identify Supervisor (RIS) request.  You are asked to select the faculty you worked with on the rotation, and on some rotations you are asked to assign no less than an minimum number of faculty.  Please do not wait to make the assignments – complete the RIS selections when you receive the request – hopefully on the same day.  Why?  Faculty want to give you accurate feedback, and the only way to do that is if you give them the chance to do so BEFORE they move on to work with other residents.  Waiting weeks to make RIS selections does not help you – or the faculty you work with.  Delays generate the largest # of complaints that we receive from faculty when it comes to completing evaluations of trainees.

 

“Help me, I’m burned out…..”

Judy Milne, RN MSN CPHQ CPPS  

Patient Safety Officer, Duke University Hospital

You may be looking for resources for your team related to resilience.  The following information is offered by Bryan Sexton, PhD, Director of the Duke Patient Safety Center:

1) Consider the 3 day Resilience Retreat (every May and November) coming up November 4-6 2013, at the University Tower, 17th Floor.  Click the link to register.
- Registration Information; November 4 – 6, 2013
- Course Description

2) A shorter alternative, newly created is the 1 day Resilience Essentials Course (January 28 2014 will be awesome)
- Registration Information; January 28, 2014
- Registration Information; April 22, 2014
- Registration Information; September 30, 2014
- Course Description

3) And something you can do individually or with your group is to sign up for “Three Good Things”:

November/December 2013

For other course options, please check out the website:
www.dukepatientsafetycenter.com

There is much more to come from the Patient Safety Center, as it is expanding the line of tools for patient safety and resilience significantly in 2014.  In terms of numbers, the center has trained over 2,600 in our Resilience and Patient Safety Officer Certification courses!  Wow.  Keep them coming, the center can handle the numbers. In fact, the favorite evaluation item is “I would recommend this course to a friend,”  which has had nothing but “agree” for 2 years now, and 95% of that is “agree strongly”!  You will certainly enjoy any of these options you select!

 

GME Research Training Series

This is a reminder of the GME Research Training Series for residents beginning this month. Registration for the October sessions will close this week.

Please note two updates in this announcement:

  • Learning Objectives for the Sessions are attached
  • Given program feedback, we have added a new day/time option of two Saturdays (and deleted the April/May session times)

Additional Information on the Blitz sessions will be shared shortly.

These sessions will help meet ACGME requirements, enhance resident QI and research experiences, and help ensure residents follow sound research principles and practices now and upon graduation.

GME Research Training Series Announcement

GME Research Training Series Learning Objectives

Registration Link:

 https://www.surveymonkey.com/s/GME_Research_Training

 

Information/Opportunities

CareerMD Career Fair

“I am writing to let you know that the physicians in your program are invited to attend the CareerMD Career Fair for residents and fellows in Winston-Salem on the evening of Monday, December 02, 2013. Could you please advise the residents or fellows in your program of the upcoming event, at which they will be able to learn about postgraduate career opportunities and network with prospective employers?

Representatives from leading hospitals, practices, and healthcare organizations from around the country will be at the Winston-Salem CareerMD Career Fair to meet residents and fellows in all specialties and in all years of training.

Residents and fellows who would like to attend are asked to RSVP online at www.CareerMD.com/Winston-Salem or by emailing me directly at charles.howell@CareerMD.com. The event is free of charge to residents, fellows and their guests.

Location: The   Hawthorne Inn & Conference Center, 420 High Street, Winston-Salem, NC
Date   & Time: Monday,   December 02, 2013; arrive any time between 5:00 PM and 8:00 PM
Details: Casual   attire, complimentary light refreshments, spouses and significant others   welcome

Please feel free to contact me with questions about this event. Additional information is available at www.CareerMD.com/Winston-Salem.

Charles Howell
CareerMD
41 East 11th Street
New York, NY 10003
charles.howell@CareerMD.com
(800) 355-2626

 

Upcoming Dates and Events

  • October 18:  SoM Clinical Science Day
  • October 28:  Annual Recruitment Kickoff
  • November 13:  Networking Event at Dr. Klotman’s! (An opportunity for JAR’s, fellowship directors, and division chiefs to connect!)
  • November 28:  Annual “Turkey Bowl”
  • December 4:  “Voices in Medicine”

Useful links

by · Posted on October 13, 2013 in Chief Residents, Internal Medicine Residency, Medical Education, Uncategorized, Weekly Update · Read full story · Comments { 0 }

Internal Medicine Residency News: October 7, 2013

From the Director

DUKE.RESEARCH.NIGHT.03 (1)Doctoberfest continues! Remember, our theme is “Building Our Community and we are working to recognize the fantastic nursing staff that partner with us to take care of patients in the hospital and in the clinics.  Donuts and cider were delivered to the nursing stations on Monday, as well as the clinics.  Send us a note about a nurse (or nurses) who have been particularly outstanding, and we will recognize them on our Wall of Fame in the Med Res office.  Look for more Doctoberfest trivia, as well as the opportunity to see the chiefs and I do something ridiculous (sumo wrestling?!?!)   You can make that happen by donating to our community cause…we are trying to raise money to buy a portable wheelchair ramp for the North Street Community.  Collection buckets are in the med res office, and will also show up at noon conference.

We are FLU SHOT SUPERSTARS! When I left town on Wednesday night, we were at 96% overall for the house staff, with Martin Society edging out the win (Warren had 100% “in country” members get a flu shot first) and Orgain coming in 3rd.  It’s possible we are at 100% by now! Either way — what a tremendous effort and thanks to our Stead Leaders, to Jen Averitt for tracking and reporting (and reminding!) and to all of you for keeping our patients safe.  If we are not at 100%, and you are part of the few holdouts, GO GET YOUR SHOT!

Kudos this week go to SAR Lindsay Boole for helping out a colleague, to Jessie Seidelman for a great intern report (strong participation by the entire audience!), and to Fola Babatunde (from Murat Arcasoy) for presenting an amazing diagnosis that she made at the DOC during DRH morning report! More kudos to APD Bill Hargett for the milestones video! Bill, Murat and I presented a seminar on faculty development at the program directors meeting in New Orleans this weekend, and one of our participants said that watching the video was “worth the price of admission to the whole meeting!”.  It’s on medhub, so watch it if you haven’t seen it yet! Also at the meeting were Jane Gagliardi, Saumil Chudgar, Diana McNeill and Mary Klotman!  

Turkey Bowl preparation continues, and we are very excited that the recruitment season is about to begin. Look for recruitment dinner sign ups, and also for Erin to be asking you to help out with tours, talking to the applicants and for any other ideas you have to make our recruitment season successful!

This week’s Pubmed from the Program goes to Marc Samsky! Note the Duke Med Res alums Jake Jentzer and Ashleigh Owen as co-authors!  Ten Year Experience with Extended Criteria Cardiac Transplantation, Marc Samsky, Chetan B. Patel, Ashleigh Owen, Phillip J. Schulte, Jacob Jentzer,  Paul B. Rosenberg, G. Michael Felker, Carmelo A. Milano, Adrian F. Hernandez, and Joseph G. Rogers,  Circ Heart Fail.  Originally published October 2, 2013. doi: 10.1161/CIRCHEARTFAILURE.113.000296

http://circheartfailure.ahajournals.org/content/early/2013/10/02/CIRCHEARTFAILURE.113.000296.abstract.html

Have a great week!  Aimee

QI Corner

Patient Safety and Quality Council
Our next meeting will be this Wednesday at 5:30 pm in the Med Res Library – come and bring some nifty recipes for quality . . .

Flu Vaccination Campaign

Thanks to everyone who has been vaccinated – Martin Society was the first to hit 100% and that we’re only THREE residents short of 100% compliance!  Strong work everyone!

Our Thanks
If the Baldrige site visitors came and spoke to you this week, many thanks for your participation – we’ll let you know when we hear more.
We will be sending you the September handwashing information in the next week or two – keep foaming!

Follow Us on Twitter

– @DukeMarines – Duke Chief Resident Updates – @JonBae01 – QI and Patient Safety (general news and program updates) – @DukeDOMQuality – Duke DOM Quality Updates – @bcg4duke – Maestrocare and health informatics

 

What Did I Read This Week

Submitted by  David Butterly, MD

Efficacy of Remission-Induction Regimens for ANCA-Associated Vasculitis

NEJM-GPA2013

I read this article after seeing a patient this past month in clinic with John Roberts.

The patient is a 63 yo woman referred for a second opinion on treatment for ANCA associated vasculitis.  She reports a 2-3 year history of microscopic hematuria noted on routine yearly physicals.  Urology evaluation including CT and cysto were normal.  This spring she developed constitutional symptoms with weight loss, low grade fever and polyarthralgias.  Lab exam showed continued microscopic hematuria along with low grade proteinuria and creatinine now elevated at 1.8.  Serologies done were notable for P-ANCA positive at 1:640 and kidney biopsy revealed a pauci immune necrtotizing GN consistent with GPA vs MPA.  She was started on 60 mg of Prednisone and referred in for a second opinion regarding further therapy.

This study appeared in the NEJM  8/1/2013 and details longer term follow up from the RAVE trial evaluating the efficacy of Rituximab in patients with ANCA-associated128907_butterly005 vasculitis.  Earlier results from this trial were published in the NEJM in 2010.  Of note, Bill St. Clair and Nancy Allen of our Rheumatology Division at Duke are co-authors in this study.

Granulomatosis with polyangitits (formerly termed Wegener’s Granulomatosis) along with Micrscopic polyangitis are both ANCA-accociated vasculitidies because they are frequently associated with antibodies against PR3 or MPO.  For nearly 40 years now standard therapy for induction has been corticosteroids and Cytoxan.  In the early results of the RAVE trial published in 2010, a 4 week course of Rituximab was shown to be equally efficacious to Cytoxan followed by Azathioprine.  The current study reports on longer term results in this same patient group.

This study is a multicenter, randomized, double blind, placebo controlled study comparing 4 weeks of Rituximab (375 mg per square meter) with Cytoxan/Azathioprine given for 12-15 months.  Patients enrolled had severe ANCA associated vasculitis (AAV) with antibodies positive for PR3 or MPO along with Birmingham Vasculitis Activity scores for Wegener’s (BVAS/WG) of 3 or more.  Patients were randomized 1:1.  Prednisone was tapered in both groups over 5.5 months.  Ritux was given weekly for 4 weeks.  Patients in the Cytoxan group received CTX at 2 mg/kg for 3-6 months followed by Azathiopine (2mg/kg) for remaining 18 months.

A total of 197 patients were randomized.  99 received Rituximab and 98 were treated with CTX/AZA.    Figure 1 gives details on randomization and follow-up.  Complete remission was defined as a BVAS/WG score of 0.  64 % of patients in the Rituxan group had complete remission at 6 months with 48% and 39% retaining the remission at 12 and 18 months.  This compared to 53% , 39%, and 33% in the CTX-AZA group.  Rituximab thus met criteria for non-inferiorority, but not criterion for superiority.

As shown in Figure 2, relapse was common in both groups (2A).  As has been demonstrated previously, PR3 ANCA along with history of relapsing disease were strong predictors of relapse.  However increases in ANCA titer did not predict relapse in either treatment group.  There was no difference demonstrated between treatment groups in PR3 vs MPO ANCA patients (2C).  There was also no difference in adverse events between the groups with the exception of increased risk of leukopenia and pneumonia in the group receiving CTX-AZA.

So in conclusion, Riuximab given weekly for 4 weeks was found to be equally efficacious to 18 months of continued immune suppression with CTX-AZA.  Relapses were not uncommon in both groups, particularly in the group with PR3 antibodies.

Based on these results we elected to treat our patient with Rituximab.  She is now 3 weeks into her treatment course.  She has tolerated it well thus far with no problems with the infusions and a creatinine which has improved form 1.8 to 1.4.

Thanks for reading.

From the Chief Residents

Grand Rounds

Each year, as part of Duke Medical Alumni Weekend, the Department of Medicine hosts the Eugene A. Stead Jr., MD Lecture at Medicine Grand Rounds.

Please plan to join us at 8 a.m. on Fri., Oct. 18 in the Great Hall of the Trent Semans Center.

This year, the Stead Lecture will be presented by Ralph Snyderman, MD, James B. Duke Professor of Medicine and Chancellor Emeritus, to honor Robert Lefkowitz, MD, professor of medicine (Cardiology), and Nobel Laureate.

Dr. Snyderman’s talk, “From the Bronx to Stockholm via Duke: Bob Lefkowitz’s Journey,” will honor his friend and colleague.

Please save the date and note the special location. A continental breakfast will be served beginning at 7:30 a.m.

Noon Conference

Date Topic Lecturer Time Vendor Room
10/7 Resident’s Townhall –   “Coffee Talk with Armando and Chris” Residency Council 12:00 Saladelia   Sandwiches 2002
10/8 Adrenal   Insufficiency Lillian Lien 12:00 Bullock’s   BBQ 2002
10/9 COPD Peter Kussin 12:00 Moe’s   Burritos 2002
10/10 Global   Health Gallops Global Health   Residents 12:00 Sushi 2001
10/11 Chair’s   Conference Chiefs 12:00 Rudino’s MEDRES

From the Residency Office

DOCTOBERFEST IS HERE !

“Building Our Community”  October 1-31, 2013

We hope everyone enjoyed the cider and donuts that were delivered to the clinics, gen med services, and program office to kick off the month.  Hats off to Jen and Lauren who trucked in 18 dozen donuts and gallons of cider.Before Renovation

So, what’s next?

The fund raiser is up and going – and on behalf of Renovated HousesErin and the Friendship House and Jubilee House here in Durham, thanks for the support.  A lot has all ready been done – here are just two pictures of the before renovation and after renovation to show what can ba accomplished.

Thus far we have raised $126 towards our goal of $1,200 – with Summo Wrestling by the Chiefs and Dr Zaas leading the way. 

Recognition of our nurses are coming in and posted to the wall of fame in the program office.  Keep them coming – using the following link:  https://www.surveymonkey.com/s/doctoberfest2013_greatnurses

October 15 Join us at noon conference for a traditional “beer” garden treat!

October 31 Halloween Tricks and Treats! Join us at Noon Conference for some Halloween goodies and for the announcement of our fundraiser’s “winning” Chief!

We look forward to celebrating with and honoring our incredible Duke Medicine community all month long!

Fit Testing – T-Dap- TB – Flu Shots

Take note of the schedule posted below for easy access to these services in Duke N, or check out where to find them elsewhere using the following link:   http://www.hr.duke.edu/about/departments/eohw/

October 2013 Resp Fit Testing-T-Dap-TB Skin Testing Flyer

 

New BLS Challenge Class Available

New BLS Challenge class has been added on a trial basis. Class will be on Nov. 5th. This course will offer the Healthcare provider the opportunity to renew their BLS (CPR) skills according to American Heart Association Standards and receive the AHA card valid for 2 years. Pre-Work/skills necessary for participation See attached flyer for more information. Questions, contact 919-684-4293.

BLS Blitz Schedule

BLS Blitz is scheduled for November 18-21, 2013. See instructions in flyer to register for classes. Remember absolutely no participant will be allowed in class after the session begins or if the participant does not have their manual with them.

BLS Blitz flyer 11-2013        BLS Challengeflyer

 

How do You Ask Patients About Their Code Status

(Tufts Medical Center)

“How do residents ask patients about code status? Do they think this discussion is the responsibility of a resident or an attending? We ask these and other questions in a nation-wide survey of Internal Medicine residents on how they approach discussions of code status with patients with advanced cancer. I am writing to ask your permission to distribute a brief online survey to your residents. This project has been reviewed by the Tufts Medical Center IRB. There is a lottery for prizes for participants, including $10 and $25 Amazon and iTunes gift certificates.”

https://bostonu.qualtrics.com/SE/?SID=SV_afnZ9hvaidkjvFz

Sincerely, David Einstein, MD (PGY-3, Internal Medicine, Tufts Medical Center)

 

Kraft Fellowship in Community Health

The Kraft Fellowship is a two-year, multidisciplinary program providing formal academic training in Community Health leadership while immersing fellows in community health center practice.   It is open to graduates of residency training in primary care/internal medicine, pediatrics, family medicine, obstetrics/gynecology and psychiatry.  More details are available below and at: http://www.kraftcommunityhealth.org/Participate/Physician-Fellowship-Program/Default.aspx

Information/Opportunities

Raleigh Medical Group, PA part-time MD letter 2014

Raleigh Medical Group, PA part-time MD position 2014

Hospitalist – Georgia

 

Upcoming Dates and Events

  • October 18:  SoM Clinical Science Day
  • October 28:  Annual Recruitment Kickoff
  • November 13:  Networking Event at Dr. Klotman’s! (An opportunity for JAR’s, fellowship directors, and division chiefs to connect!)
  • November 28:  Annual “Turkey Bowl”
  • December 4:  “Voices in Medicine”

Useful links

by · Posted on October 6, 2013 in Chief Residents, Internal Medicine Residency, Medical Education, Uncategorized, Weekly Update · Read full story · Comments { 0 }

Internal Medicine Residency News: September 30, 2013

From the Director

DUKE.RESEARCH.NIGHT.03 (1)“Hi everyone!

Looking forward to DoctoberfestSaumil started us off with Pumpkin Spice M and M’s –  curiously good! On Saturday, We had a pre-Doctoberfest kickoff with housestaff vs faculty paintball! Fun had by all (including those of us who were here rounding instead – we were thinking of you!). Pretty certain a rematch will be called by disgruntled faculty. Thanks again to Chris Hostler for working so hard to plan this event! Turkey bowl trash talk has begun. Who knew DRH had cheerleaders??? Hope you all an make it to practice on Sundays!

Kudos to everyone for our amazing flu shot compliance rate. Details below, but the interns are about to hit 100% as is the Warren and Martin societies. Our goal is Oct 1 so if the remaining 11% of residents could find their way to ANYWHERE in Duke, DRH or the DVAMC or the clinics by Tuesday, we will accomplish this. It’s easy, and it protects our patients!

Block change tomorrow for the SARs – strong work by all this month. Being on gen med, it’s been great to see all the teaching by Bobby Aertker, Wendy Chan, Jeremy Gillespie, Ben Heyman and Mandar Aras. Plus, we have opened up the 4300 floor and workroom – come visit gen med 4 in our new home!

Be on the lookout for the residency values google DOC from the chiefs. We are very committed to putting the vision for the program into words and YOUR input is critical! Look for more updates on this exciting project soon.

Pubmed from the program this week goes to VA Chief Vaishali Patel for her upcoming poster presentation at ACG:  De Novo Tuberculosis Infection presenting with Ocular Granuloma in a Patient on Infliximab for Crohn’s Disease;  Vaishali Patel, Dr Roger Liddle

Have a great week! Happy Doctoberfest !!!

Aimee.

QI Corner

Flu Shots – the Home Stretch

The number of residents who have not received their vaccinations is dropping by the hour – and the race is on for the 1st Stead Group to hit 100%.  October 1 is next Tuesday – let’s see who rings the bell first!

flu data_9 27 13

flu data_9 27 13

 

 

 

 

 

 

 

 

 

 

QI Conference

Thanks to Dan Kaplan for leading us through a discussion of appropriate test ordering using syncope as an example.  Thanks also to our residents for learning and participating – these are not easy topics and there are no easy answers!

QI Champion

Congrats to Aparna Swaminathan, our Champ of the month, for her role in designing our We Follow-Up campaign and taking on a leading role at PRIME.

QI Craigslist

Join Aparna and help us improve our appropriate lab follow-up rate at the DOC and Pickett Road – contact Jon or Joel if interested!

Baldrige Site Visit

As you well know, next week we will receive a site visit by a team of Malcolm Baldrige National Quality Award examiners. This year, only 10 U.S. sites were chosen across all industries to receive site visits; eight of those sites are from the health care industry.

From Monday, Sept. 30 through Wednesday, Oct. 2, eight examiners will be onsite to talk to you and find out more about how our team delivers the Duke Experience to our patients, their loved ones and each other.

We want you to keep doing the excellent work you do every day, and we want your responses to be guided by your passion for patient care.

To learn more about our Journey to Excellence, and to review site visit prep materials including videos and potential site visit questions, visit the Journey to Excellence website from any Duke Hospital-based computer.

We’re proud of the work our team does every day, and we’re pleased that others outside the organization are also recognizing you for all you do.

Thank you for being an important part of the Duke Experience.

Visit the Journey to Excellence Website: https://intranet.dm.duke.edu/baldrige/SitePages/Baldrige%20and%20NCAfE.aspx

Follow Us on Twitter

– @DukeMarines – Duke Chief Resident Updates – @JonBae01 – QI and Patient Safety (general news and program updates) – @DukeDOMQuality – Duke DOM Quality Updates – @bcg4duke – Maestrocare and health informatics

 

What Did I Read This Week

Submitted by Sharon Rubin, MD

Screening for Lung cancer with low dose Computed Tomography: a  systematic review to Update the US preventative Services task Force recommendation

Humphre LL, Deffebach M. Pappas M, Baumann C, Artis K, Mitchell JP, Zahker B, Fu R, Slatore CG. Annals of Internal medicine September 17, 2013

Why did I read this? I first heard about this in the news in August and looked on the USPSTF home page210_RubinSharon and finally the article has been in print. Lung cancer is the 3rd most common cancer and the leading cause of cancer related death in the US . If there is any way primary care doctors can prevent this, we should try. The debate has raged on to screen with chest xray/Ct scan or not to screen.  The pendulum from the article supports screening.

What did the authors do? Review of 4 major trials: 1 US (majority of patients) and 3 European trials, looked at mortality reduction with LCDT screening.  The conclusions were mainly driven by the US study National Lung Screening Trial. Conclusions that LCDR screening decreased mortality in 20% smokers/former smokers age 55-75.

Why is this study important? This has up dated the USPSTF 2004 recommendation that low dose computed tomography (LDCT) from insufficient to strong evidence to screen. This review has been more comprehensive in terms of patients and studies.  Overall the reductions in lung cancer and all cause mortality suggest benefit of screening out weigh harm of over diagnosis.

Intervention Outcome NNT
Breast cancer screen MMG Prevent one breast cancer death women 50-59 after   11-20 years follow up 1339
Cervical cancer screening Prevent one death over ten years 11402
Flex Sig Prevent one colon cancer death 8176
Antihypertensive therapy Prevent one stroke, MI, death over one year 7001
LCDT screen lung cancer Prevent 1   lung cancer death NNS 3207
LCDT screen lung cancer Prevent 1   death over all (6.5 years) NNS 2197
Statins Prevent one death over five years 1071
GP brief advice to stop smoking (3  – 5 minutes) Prevent one premature death* 803
Add pharmacological support Prevent one premature death* 38-564
Add behavioural support Prevent one premature death * 16-405,6
In all smoking cessation Smoking related disease 10

*Over half of all continuing smokers will die prematurely from a smoking-related disease.  For every two long term quitters, one premature death is avoided (Doll and Peto).  1 Bandolier. 2 Gates, Amer Fam Phys 2001. 3 West 2006. 4 Bandolier 2006. 5 Cochrane 2007.  6 Anthonisen, Ann Inter Med 2005. 7 Schoen NEJM 2012. 7. Church NLST N Eng J Med 2013

Who to screen and other lingering questions? Still awaiting the final recommendation from USPSTF: high risk patients ages 55 to 74 screen with LDCT yearly ? Radiation exposure for LCDT 0.61-1.50 mSv  = similar to mammography mSv but for 10-20 years? Subsequent procedures from screening, false positive, concern for over diagnosis and overtreatment? Consider the psychological consequences of screening. Is this generalizable to women and other racial groups?

Bottom line: Smoking cessation and discuss with your patient risks and benefits of radiation with LDCT to screen smokers/former smoker for lung cancer. I am still waiting for the official recommendations and I still wary of CT scan for all smokers even at low dose for 20 years to screen for cancer.

From the Chief Residents

Grand Rounds

Date:  October 5, 2013

Presenter:  Gowthami Arepally, MD;  Apheresis

Noon Conference

Date Topic Lecturer Time Vendor Room
9/30 Staph Aureus   Bacteremia – Essentials of Management Vance Fowler 12:00 Picnic Basket 2002
10/1 Peripheral   Blood Films Murat Arcasoy 12:00 Saladelia Salad 2002
10/2 PFT   Interpretation Talan Dahhan 12:00 Moes Quesadillas 2002
10/3 DNR   Discussions: Fun Role Play with Dr G. Tony Galanos 12:00 Dominos 2001
10/4 Chair’s   Conference Chiefs 12:00 Chic-fil-a MEDRES

Note from the Chiefs:

Thank you to everyone who was able to attend the Town Hall noon conference where we presented what goes on behind the scenes in the program with regards to duty hours, scheduling, and some of the improvements we are working on this year!  Was the presentation helpful?  Were there topics that we did not cover about which you want more information?   Please feel free to reach either the Chiefs or ACRs directly, or contact your Residency Council representatives with your questions!   They can find out the answers to your questions from us on your behalf and get back to you.  Alternatively, you can use the confidential comment line!  Whatever you choose, we would love to hear any feedback or questions that you have about the content we presented!

From the Residency Office

Lunch – Things we Learned at Conference on Wednesday

Thank you all for persevering through our first attempt offering Chinese food at noon conference.  Comments that we heard included:  “amazing”, “let’s try Thai food next”, and “let’s have a repeat performance”.  We also learned that the best plans do not always work out, and Panda Express is sincerely apologetic for NOT delivering at the appointed time.  So, a few take aways to consider, and yes – we will do this again.

  • Timing is crucial, and we will continue to make every to have our vendors to be on time
  • Be considerate of your fellow residents – some of the folks who actually attended noon conference Wednesday didn’t get any food because other people left with a heaping plate of food (as in over flowing) without attending conference.  Please be mindful of the fact that when you do this, someone else does not get to eat.
  • Our office staff are not there to pick up or mop the floors.  If you drop something or accidents happen, you need to help take care of the problem – not just walk away

Lauren and Lynsey are working on plans for October.  With your help we will give it another try.

 

DOCTOBERFEST IS COMING!

“Building Our Community”  October 1-31, 2013

Join the Internal Medicine Residency Program in our annual celebration as we recognize members of our Duke Medicine community and give back to our neighbors in the Durham community!

October 1, 2013 will mark the start of our 2nd Annual “Doctoberfest” celebration!

Fundraiser As part of our effort to give back to our friends and neighbors in our local community, we will be having a fundraiser to benefit a local charity in Durham (below)

October 15 Join us at noon conference for a traditional “beer” garden treat!

October 31 Halloween Tricks and Treats! Join us at Noon Conference for some Halloween goodies and for the announcement of our fundraiser’s “winning” Chief!

We look forward to celebrating with and honoring our incredible Duke Medicine community all month long!

Open the following PDF for more details, click on the pumpkin tab at the bottom- and see which Chief Resident you think belongs to which pumpkin!!

DOCTOBERFEST IS COMING

Building our Community – Doctoberfest Fun(d)

Submitted by Erin Payne

Alex WelcomeThe Northstreet community started with a few families gathering together to dream about what it could look like for their children with intellectual and developmental disabilities to live in community. To be in a place where they could have greater independence, be deeply valued, and truly thrive. Just a few years later, we are being given the incredible gift of seeing this dream become a reality and I have the honor of being a part of it!

This community is rare; in fact, it’s the first in North Carolina! 18 houses in downtown Durham that were abandoned and drug infested are being renovated and have already brought such new life to the area. Each person and home is unique- adding such beauty in diversity. Not all of the houses have been completed yet but it’s a combination of two Friendship Houses (Duke students doing life with and building close friendships with adults with special needs), a community house (an open space to build community not just within the neighborhood but more so with Durham as a whole), a Jubilee House (a home where young men who have been incarcerated can transition and be built up/taught independence), families, care givers, and a large amount of adults with and without developmental disabilities. All of us have very different stories of why we are here but come together with the common realization that each person is a gift in which we have a lot to learn from! That we flourish that much more when the people around us are flourishing as well!

AMAZING things are happening and it’s still just the beginning! There is a lot of joy even in the small things; such as Sloan and Wendyblock parties, street soccer, magnet making, karaoke nights, tutoring, meals together, etc.

As mentioned above, a huge part of our community is having a place where many who are often overlooked and pushed aside can belong! Currently my friend Sloan who lives in my house and many of our friends who are in wheelchairs are held back from fully engaging because only 2 of the 18 houses currently have handicap ramps. We need your help!!

Our hope is to raise money to buy a portable ramp ($1,239.99) so that all of our friends ALWAYS have the option of joining in on the fun that’s going on! http://www.discountramps.com/roll-a-ramp.htm

 

Residents! Recruiting Ideas! (submitted by Erin Payne)

We are looking for volunteers to help with the recruitment of applicants who are especially interested in Duke and would greatly appreciate your participation! The goal is to pair each applicant with a resident that has similar interests. The idea is that the resident could then provide more information about how they were able to explore those interests at Duke. We hope that by adding this personal touch, applicants can get a clearer sense of what they can accomplish here!

If you are willing to help us recruit, please fill out a few basic questions about yourself through the following link: https://www.surveymonkey.com/s/X566W59.

 

Harvard Biomedical Informatics Research Training Program

Infomatics is a major theme and methodology for biomedical science as well as for health care delivery, public health, and health care education. Biomedical Informatics is the convergence of biomedicine, at every level of biological scale, with a variety of technological and quantitative disciplines, including computer and information sciences, biostatistics, and cognitive science.

Applications for the 2014-2015 academic year, with a start date of July 2014, are now being accepted. The deadline for applications is October 28, 2013. The fellowship program is funded by a grant from the NIH’s National Library of Medicine and is, therefore, open only to US citizens and permanent residents.

Please see the attached document for additional information.

Harvard_Biomedical_Informatics_Training_Program

  • Alexa T. McCray, PhD
  • Associate Professor of Medicine
  • Harvard Medical School
  • Director, BIRT program
  • Co-Director, CBMI

1st Annual Advanced Heart Failure Symposium

REGISTER NOW

October 5, 2013

Details / registration link on the attached flyer

Heart Failure Sumposium – REGISTER NOW

 

Duke Cardiovascular Research Center Seminar Series

October 2, 2013 – 4:00pm; 143 Jones

Sudha Shenoy, PhD, Associate Professor in Medicine, Assistant Professor in Cell Biology, Department of Medicine, Duke University

“Ubiquitination of Seven-Transmembrane  Receptors and Beta-Arrestin : Impact on Signaling and Physiology”

October 9, 2013 – 4:00pm; 143 Jones

David Pollock, PhD, Regents Professor, Section of Experimental Medicine, Department of Medicine, Georgia Regents University

Endothelin and sodium regulation: Implications for salt-dependent hypertension”

October 16, 2013 – 12:00pm; 143 Jones

Howard Jacob, PhD, Director, Human and Molecular Genetics Center, Warren P. Knowles Chair of Genetics, Professor, Department of Physiology & Pediatrics, Medical College of Wisconsin, Vice Chair of Research, Department of Pediatrics, Children’s Hospital of Wisconsin

“Use of Whole Genome Sequencing in Clinical Medicine”

 

Information/Opportunities

Sourtheast Opportunities

Upcoming Dates and Events

  • October 1:  Duke’s Global Health-Internal Medicine Residency  deadline to submitt applications
  • October 18:  SoM Clinical Science Day
  • October 28:  Annual Recruitment Kickoff
  • November 13:  Networking Event at Dr. Klotman’s! (An opportunity for JAR’s, fellowship directors, and division chiefs to connect!)
  • November 28:  Annual “Turkey Bowl”
  • December 4:  “Voices in Medicine”

Useful links

by · Posted on September 29, 2013 in Internal Medicine Residency, Weekly Update · Read full story · Comments { 0 }

Internal Medicine Residency News: September 23, 2013

From the Director

DUKE.RESEARCH.NIGHT.03 (1)Hi everyone!  Happy Fall! We are moving into Block 4 for the interns, turkey bowl practice is starting and over 3000 applications have been downloaded from ERAS! The chiefs, Randy and I are looking forward to the “feedback from the program noon conference tomorrow, plus we have our second installment of high value cost conscious care on the 25th with Dan Kaplan! Then get ready for paintball on the 28th.

Kudos this week to Bronwen Garner for leading chairs conference 21st century style on video from DRH, to Carter Davis from the team at the DOC for outstanding work in a tough case, and to the amazing effort that has 49% of the medicine residents already vaccinated for flu! The blitz was a success and we know we can get the rest of you vaccinated by our target date of Oct 1!

Thanks to all who got their global health rotation applications in. The global health team looks forward to talking with you in the next few weeks!

Pubmed from the program this week goes to Mike Woodworth:  Predictors of Disease Severity in Patients Admitted to a Cholera Treatment Center in Urban Haiti; Claude-Lyne Valcin, Karine Severe, Claudia T. Riche, Benedict S. Anglade, Colette Guiteau Moise, Michael Woodworth;  tropmed130170

Have a great week

Aimee

QI Corner

QI Conferences A big thank you to the always entertaining Dan Ariely who let us all know that everyone but me is a total liar.

This coming Wednesday, 9/25, we have Dan Kaplan bringing us the next in our high-value, cost-conscious care series.  Dr. Kaplan will be discussing “Healthcare Costs, Wastes, and Over-Utilization of Tests”

Food to be provided by Panda Express (SPECIAL REQUEST)

Flu Vaccination Campaign Thanks to everyone who already has received their flu shot this year – we are still shooting for fewer than 35 days to reach 100% compliance, as long as Kempner pulls it off one day faster than everyone else. . .Flu Sept 20 Stead

As of 3PM 9/20/2013, our vaccination rate for the program (w/results still coming in) was 49%!

 

And it looks like Stead Society – Warren was dominating the competition.  Take a look at Stead Leader Whitson getting in the game to get her society vaccinated!

Flu Flyer - Sept 20Flu flyer 2 - Sept 20

 

 

 

 

 

 

 

Site Visit for QI Award Duke has an upcoming visit for the Baldrige Award, which is the national award for patient safety and quality of care.  It is a HUGE honor to even be considered, and you will see visitors around between 9/30 and 10/4.  If you are a resident interested in participating in some of the planning over the next week or two, please contact Aimee, Jon, and/or myself.

Some quick details on the Baldrige Award:

Duke is in consideration for THE award in Patient Safety and Quality.  It is a HUGE honor to be considered, as only 10 institutions are being considered this year.
As part of the consideration, eight site visitors representing the Award are scheduled to visit 9/30-10/4.  They will be meeting formally with certain program representatives across the Medical Center, but they will also be visiting the wards and likely asking to discuss safety/quality topics with housestaff and attendings.
Things to keep in mind as they visit –

First, there is a safety reporting system in place (known as SRS).  Anyone can place a report, from students to faculty, and they are intended to be used to identify processes we can influence at a systems-level.  Bad events aren’t the only target – we REALLY want both more near misses and more entered by our housestaff and attendings.

Second, we have a robust quality education curriculum and improvement infrastructure compared to many peer institutions.  All our housestaff participate in the QI curriculum of lectures and modules, and all JARs/SARs participate in a program-level initiative annually (this year, the ‘We Follow-Up’ labs campaign).  This is in addition to the numerous resident-led projects ongoing (10-15 at last count)

Key Areas of focus:

o   The Duke Experience (Living our Values, the Mission, Vision, and Values statement) o   Commitment to Delivering Highest Quality Care (Multidisciplinary teams) o   Patient Focused Culture (Rounding, Community support) o   Alignment of Goals and Objectives (Balanced Scorecard) o   Financial Stewardship (Expense management, community support)

Examiners goal is to speak to 10% of DUH Staff (700-800 people) including residents!  Visit the Journey to Excellence Website (under quick links on the DUH Intranet homepage) to find prep materials.

QI Craigslist The latest need is for one PICKETT ROAD and one DOC resident to join Aparna Swaminathan as a site-based champion for this year’s Sharepoint ‘We Follow-Up’ project.
Goal:  Increase awareness of appropriate ways to send results to patients and the timeline in which to do so, and IMPROVE PATIENT CARE!!!
Time:  1-2 hours/month
If interested, please contact me and/or Jon Bae.Wash Hands
Hand Hygiene Update Actual Hand Washing Rate for August = 86% (Goal = 91%) ONLY 8100 MET THE GOAL FOR OUR SEVEN WARDS!!! REMEMBER . . .

Follow Us on Twitter

– @DukeMarines – Duke Chief Resident Updates – @JonBae01 – QI and Patient Safety (general news and program updates) – @DukeDOMQuality – Duke DOM Quality Updates – @bcg4duke – Maestrocare and health informatics

 

What Did I Read This Week

Submitted by Suzanne Woods, MD

A Host-Based RT-PCR Gene Expression Signature to Identify Acute Respiratory Viral Infection Science Translational Medicine 18 Sept 2013 Vol 5, Issue 203, p 203ra126 ra126  

Authors:  Aimee K. Zaas, Thomas Burke, Minhua Chen, Micah McClain, Bradly Nicholson, Timothy Veldman, Ephraim L Tsalik, Vance Fowler, Emanuel P Rivers, Ronny Otero, Stephen F Kingsmore, Deepak Voora, Joseph Lucas, Alfred O Hero, Lawrence Carin, Christopher W Woods, Geoffrey S Ginsburg   http://stm.sciencemag.org/content/5/203/203ra126

Why did I read this article: Well a few obvious reasons….this article received a lot of publicity this week in the media, this is a Duke publication, I know and work with many of the authors and happen to be married to one of them!  Plus as Med-Peds primary care physician, if there a way to diagnosis the cause of sniffles, sneezes and wheezes it would be very helpful in the clinical setting.

The Challenge: Diagnosis of acute viral respiratory infections

Goal:  Early differentiation between viral and bacterial etiologies of respiratory symptoms.  This can help to then direct more appropriately therapy and minimize the overuse of antibiotics.  Such differentiation could also play an important role in triage of a potential viral pandemic. 

Hypothesis:  A host response-based diagnostic could be used to differentiate viral from nonviral etiologies of respiratory infection.   This is because the immune response of humans differs based on the infecting pathogen class (bacterial vs viral). 

Study:  The authors previously derived a host gene expression signature based on multiple human viral challenges (influenza , respiratory syncytial virus, and human rhinovirus).  This “gene signature” was initially validated on a microarray platform that would not be useful in a clinical setting.  The authors now have transitioned the gene “signature” to a reverse transcription polymerase chain reaction (RT-PCR) assay which could be used in a diagnostic capacity.   This new assay’s performance was first assessed in two healthy human volunteer influenza challenges with both H3N2 and H1N1.  The assay was then validated in a cohort of emergency department patients with either a confirmed respiratory viral infection or a systemic bacterial infection.

Results revealed that: The RT-PCR assay accurately classified patients from the human challenge studies with H3N2 (100%) and influenza H1N1 (87%).  Furthermore, the assay performed extremely well in the emergency department cohort (89% sensitivity, 94% specificity).

Importance:  The development of this new assay and validation with patients is a very exciting and important development because RT-PCR assays are widely available in clinical laboratories.  Although the current turnaround time is still estimated to be about 12 hours, the authors hope that improvements in the technology, particularly extraction, will allow for the test to be available during an acute care or emergency department visit.  In that setting, the test could greatly benefit clinical decision making, leading to a reduction in inappropriate antibiotic use and potentially more directed antiviral use.  The authors also allude to potential use in detection of new pandemic viruses.  This new assay signals a major shift in our approach to infectious disease diagnostics.  It will certainly not replace pathogen based approaches, but could prove to be a strong complement.

Great job Aimee et al!

From the Chief Residents

Grand Rounds

Date:  September 27, 2013

Presenter:  David Boyte, MD;  Perioperative Assessment

Noon Conference

Date Topic Lecturer Vendor Room
9/23 Your Residency   – Behind the Scenes Chiefs The Pita Pit 2002
9/24 Electrolyte   abnormalities Dave Butterly Bullock’s BBQ 2002
9/25 QI   Patient Safety Noon Conference – HVCC Syncope Mgmt Dan Kaplan

Panda Express

2002
9/26 PFT   Interpretation Talal Dahan Moe’s Burritos 2001
9/27 Research   Conference Panera 2002

From the Residency Office

We Do Listen – Really

We received a request on the comment line to offer either Chineese or Tai at noon conference.  So, we are giving it a try – Wednesday of this week.  Thanks go to Lauren for sourcing the vendor (Panda Express).

One request:  Please take extra effort to clean up at the end of conference and not leave anything behind. Coffee

Enjoy!

And, in case you missed it – Lauren found another treat that is now available in the Med Res Office –

DOCTOBERFEST IS COMING!

“Building Our Community”  October 1-31, 2013

Join the Internal Medicine Residency Program in our annual celebration as we recognize members of our Duke Medicine community and give back to our neighbors in the Durham community!

October 1, 2013 will mark the start of our 2nd Annual “Doctoberfest” celebration!

Fundraiser As part of our effort to give back to our friends and neighbors in our local community, we will be having a fundraiser to benefit a local charity (TBD) in Durham. .

October 15 Join us at noon conference for a traditional “beer” garden treat!

October 31 Halloween Tricks and Treats! Join us at Noon Conference for some Halloween goodies and for the announcement of our fundraiser’s “winning” Chief!

Be sure to read “Med Res News” each week for more Doctoberfest Updates

We look forward to celebrating with and honoring our incredible Duke Medicine community all month long!

Open the following PDF for more details, click on the pumpkin tab at the bottom- and see which Chief Resident you think belongs to which pumpkin!!

DOCTOBERFEST IS COMING

Clinical Science Day

Clinical Science Day will take place on Friday, October 18 in the Great Hall of the Mary Duke Biddle Trent Semans Center during Medical Alumni Weekend with the goal of bringing together alumni, faculty, and trainees to celebrate clinical research and the vast and diverse array of activities taking place across our campus, showcase these activities, and encourage collaborations.

  • Poster Session and Competition.
  • Registration is required.
  • Visit the website to register.

This activity has been approved for a maximum of 3.0 AMA PRA Category 1 Credit(s).

Free Help with Your Student Loans

Paul Garrard, an independent student loan consultant and national expert on educational debt management, will be at the DUMC October 7 through October 9.  He will be providing individual consultations to medical students, residents, and fellows who have questions about their student loans and subsequent repayment strategies.

Mr. Garrard is a frequent visitor to Duke and you will not want to miss this opportunity to spend some time with him.  You can access the online sign up for individual consultation times with him via this link:

http://www.signupgenius.com/go/10C0C45ACAF238-fall1

He is planning to return the last week in February so, should you miss him in October, you will have another chance at that time.

If you have any questions, please contact Amy Coppedge at amy.coppedge@duke.edu.

9th Annual Patient Safety & Quality Conference

  • Thursday – March 13, 2014
  • Fuqua School of Business, Durham NC
  • Early call for abstracts – details on the attached flyer

Early Call for Abstracts_March 2014 (3)

 

Faculty-Resident Research Grant Request for Applications

REQUEST FOR APPLICATIONS

Purpose:

To provide funding for Internal Medicine Residents to develop their skills in clinical or laboratory-based research, to carry out research projects, to present their research findings at scientific meetings and to publish their work

Application Instructions

Eligibility:

  • Interns and residents in the Department of Medicine, Med-Peds, Med-Psych are eligible
  • Clinical or Basic Science research proposals are acceptable
  • Research project must be performed at Duke under the direction of a Duke faculty member

Funding Mechanism:

  • Grants will be funded up to $2,000
  • The term of the award must NOT extend beyond the residency training period at Duke. The beginning date for funding is July 1, 2014 and end date is June 30th 2015. Interns who are awarded may apply for extension to use the funds for use during their SAR year.
  • An itemized budget must be included with the application (use attached forms)

Application Process:

  • Application deadline is April 11, 2014 by email to murat.arcasoy@dm.duke.edu
  • Late or incomplete applications will not be accepted. Please submit on time!
  • A faculty committee will review applications for scientific merit
  • Letter of support from faculty mentor is requested and must accompany grant please, Letter addressed to “Award Review Committee, Faculty Resident Research Grant”
  • Use application forms online and follow instructions please.  Scientific proposal – strict 3 page limit with tables and figures (excluding references, budget page, and human subjects sections)  http://residency.medicine.duke.edu/duke-program/resident-research/research-funding
  • Itemized budget may include but is not limited to research supplies, reagents, temporary personnel time for data collection, data analysis costs and statistician time, poster preparation, travel expenses to present abstract at scientific meeting, publication costs of research project

Please e-mail application and any questions to:   Murat O. Arcasoy, MD, FACP, Associate Program Director at murat.arcasoy@dm.duke.edu

Faculty Resident Research Awards 2013. doc

Faculty Resident Research Grant Application Forms 2013-2014

Faculty Resident Research Grant Instructions 2013-2014

 

Information/Opportunities

SENTARA OBICI HOSPITAL AND SOUND PHYSICIANS

Mint Physicians Providers

CMH_Site Profile_2013   CMH procurement 2

Upcoming Dates and Events

  • September 17:  Application deadline for Global Health Electives
  • September 18/19:  Flu Shot Blitz
  • October 1:  Duke’s Global Health-Internal Medicine Residency  deadline to submitt applications
  • October 18:  SoM Clinical Science Day
  • October 28:  Annual Recruitment Kickoff
  • November 28:  Annual “Turkey Bowl”
  • December 4:  “Voices in Medicine”

Useful links

by · Posted on September 22, 2013 in Chief Residents, Internal Medicine Residency, Medical Education, Uncategorized, Weekly Update · Read full story · Comments { 0 }

Med Res News: September 16, 2013

From the Director

DUKE.RESEARCH.NIGHT.03 (1)Hi Everyone!

Hope many of you got to enjoy some of this beautiful weekend outside! Or in the beautiful halls of Duke, DVAMC or DRH! We have a busy week coming up, with the FLU BLITZ on Wednesday…I hope you got a chance to see the flu posters made by the Stead Leaders, The QI Council and the chiefs and I.  Thanks Jon Bae for bringing out the dormant photoshop skills.   We have Dan Ariely at noon conference on Wed and you will have the opportunity to hear an amazing lecture from a best selling author and economist AND get a flu shot.  And lunch.  What a deal.

Kudos this week go to Alex Fanaroff for at “cat”-tastic chairs (and to Angela Lowenstern for getting the diagnosis in 3.7 seconds, leaving us to discuss many unlikely but interesting other neuro disorders) and especially for Alex getting the functional pagers to VA Gen Med.  We hope to improve patient safety and resident well being through functional pagers! Other kudos go to Brian Sullivan — we received an email from an outside rehab stating that he had written the best DC summary they had ever seen! I was also stopped by Chet Patel to say how wonderful Matt Atkins and Stephanie Giattino are doing on his CAD service and by the 9300 fellow for compliments to Yi Qin and Jonathan Buggey.  Other high fives go to those who continue to help cover colleagues for interview season.

Looking forward to JAR dinner this week, as well as the official ERAS download! Interns — there is a new wave of eager 4th year med students coming. Hard to believe it’s been a year since that was you.  We have our recruitment kickoff coming up and we had a great time hosting the 4th year students who are applying in med and prelim med last week.  Great turnout from students, ACRs, chiefs and faculty!

This week’s pubmed from the program goes to Howard LeeIndividualized Therapy for Hepatitis C Infection: Focus on the Interleukin-28B Polymorphism in Directing Therapy. Lee TH, Tillmann HL, Patel K, Mol Diagn Ther. 2013 Sep 11. [Epub ahead of print] PMID:

QI Corner

It’s HERE – the annual FLU BLITZ will be  held on September 18 and 19, and it looks like the Stead Leaders are all planning to be first in line.

Flu vaccinations will be available before and after noon conference on the 18th – so PLEASE make a point to be there – and come early.

Final Flu Poster

htts://intranet.dm.duke.edu/influenza/SitePages/Home.aspx

Follow Us on Twitter

– @DukeMarines – Duke Chief Resident Updates – @JonBae01 – QI and Patient Safety (general news and program updates) – @DukeDOMQuality – Duke DOM Quality Updates – @bcg4duke – Maestrocare and health informatics

 

Why Did I Read This?  It is FLU (VACCINE) SEASON! We have our flu blitz this week (Wednesday!)  What better time is there to read about flu vaccines?  IN addition, flu is expensive and vaccines are generally effective.  One national study estimated the annual economic burden of seasonal influenza in the United States to be $87.1 billion, including $10.4 billion in direct medical costs. Influenza vaccination has been shown to be a cost-effective tool for reducing morbidity and mortality associated with influenza among adults.

What DId the Authors Do?  The authors were doing a large epidemiological study using the NHIS database, and wanted to ask the question of how many members of the US population received influenza vaccination during each of the 6 seasons studied.  They also wanted to evaluate rate of vaccination by age, gender and ethnicity.

What is the NHIS?  it is a CDC run face to face weekly survey of a probability sample of US households where a variety of data is collected.

How did these authors use the NHIS? In this data-dredge, the authors were looking at influenza vaccination status as well as health literacy. They sliced the samples so that they captured the flu season each year as well, as a better sampling of vaccination status. They were then able to calculate point estimates for vaccination status by each group they studied, and also use a t test to see if trends were apparent in vaccination status over the years of the study.  For example, the CDC did not recommend universal vaccination in those 18-49 until 2010-11.

How are we doing as a country on flu vaccination? Pretty good overall.  Influenza vaccination coverage among adults aged ≥18 years, 18–64 years, 18–49 years, and 50–64 years increased significantly from 27.4%, 20.0%, 15.2%, and 32.5%, respectively, during the 2005–2006 season to 38.1%, 31.5%, 26.1%, and 43.7%, respectively, during the 2010–2011 season, with annual average increases of 2.2%, 2.3%, 2.2%, and 2.3%, respectively (P-trend < 0.05).  Health care workers hover around the 60% rate; and the elderly (65%) and chronically ill (45%) are not close to the target of 90% vaccination rate.  Disparities by race exist, with non Hispanic whites having the highest rates of vaccination.

Why is this study important? We are doing better overall with flu vaccination, but not good enough.  Authors give varied means to improve vaccination, especially in high risk groups (like health care workers).  They even mention having vaccine be free at work and offered convenient to the actual site where you work (like at noon conference) is one way to increase vaccination of HCWs like ourselves. The obvious limit of this study is self report, with the bias towards over reporting your vaccine status to an NHIS interviewer rather than underreporting.

SO>>>get your shot unless you are medically exempt!

From the Chief Residents

Grand Rounds

Date:  September 20, 2013

Presenter:  Ken Lyles, MD

Noon Conference

Date Topic Lecturer Vendor Room
9/16 Managing the   sickle cell crises Laura De Castro Saladelia   Salads 2002
9/17 MED-PEDS   Combined: Sexually transmitted infections OR Difficult Death Debrief Richard Chung / Tony Galanos Saladelia Sandwiches 2002 OR DN9242
9/18 QI Patient Safety Noon Conference Dan Ariely Moe’s   Quesadillas 2002
9/19 Unstable   SVTs – Acute management Al Sun Domino’s MEDRES
9/20 Chair’s   Conference Chiefs Chick-fil-A

MEDRES

Holiday Schedule Posted

We have completed the holiday schedule and your individual assignments are listed on Amion and will be posted to your MedHub Schedule (not a file).

We did everything we could to give you your preference and ~90% of all residents got their first choice holiday off!  For those who did not, we are sorry! There were more requests for Christmas off than possible and so for the continuity of patient care we needed to place you elsewhere.

A couple of quick reminders:

  • Christmas Block is from 12/22 to 12/27 (or morning of 12/28 if on night shift or on overnight call on 12/27).
  • New Year’s Block is from  12/28 to 1/2 (or morning of 1/3 if on night shift or on overnight call on 1/2).
  • There are NO days off during the holiday block! Please keep the above dates in mind when making travel plans, you are required to be present for 100% of that time!!
  • Given the complexity of the schedule making, we cannot accept any schedule change requests or trades.   If there is an EXCEPTIONALLY IMPORTANT CONFLICT or we have overlooked an important request please let us know by the end of the weekend.  Please do NOT send any requests/issues to Lauren, Jen, or Randy.

Best,

Krish, Vaishali, Stephen

 

G-Briefing Session (with Dr. Galanos)

This month we will start our G-Briefing sessions on Tuesday, September 17th! Dr. G would like to help create space and time for Internal Medicine house staff to meet to allow you to debrief around the issue of deaths that you’ve witnessed or feel strongly about as part of your work here.

This WILL NOT be in place of noon conference but you have the OPTION of grabbing a lunch from the second floor and joining this session in conference room 9242 instead of noon conference.

Conversation will start at 12:10! Please note- these will continue to be every 3RD Tuesday from 12:10 to 1:00 each month.

Both Dr. Galanos and your programs leaders hope that this is of great value and significance to you!

Mark your calendars!

 

VA Gen Med Pagers – NEWS FLASH!

(submitted by Vaishali Patel)Alex F

Have you ever been paged at home about a VA inpatient that you took care of a week ago?  Did you have to call back and tell them you were not the doctor on Red 3 any longer?   Well, fret no more about those 4-digit callback numbers!!

VA GEN MED TEAMS NOW ALL HAVE FUNCTIONAL PAGERS!!   We have rolled out the functional pagers at the VA this week. This will undoubtedly improve communication between nurses and residents, and will be better for patient safety.  A BIG thanks goes to the current VA ACR, Alex Fanaroff, who made this happen!

Cardiology Grand Rounds

We are delighted to kick off the 2013 Duke Cardiology Grand Rounds series next Tuesday at 5pm in DN2002.  With mixed emotions, we will have Dr. Richard Becker present before accepting a new position at his alma mater, the University of Cincinnati College of Medicine. As you know, he will serve as the Mable Stonehill Endowed Chair for the Division of Cardiovascular Health and Disease; director of the Heart, Lung, and Vascular Institute; director of the Cardiovascular Center of Excellence in Research; and chief of Cardiovascular Services at West Chester Hospital. The title of his talk is: ” Where is Osler?”

Afterwards, there will be a reception for Dr. Becker outside of DN2002 with food and drink.  Please make every effort to attend.

If you missed our last Grand Rounds, visiting professor Dr. Les Miller spoke on stem cell and gene therapy for cardiovascular disease.  You can see it here.

Zubin Eapen, MD, MHS
Assistant Professor of Medicine
Medical Director, Duke Heart Failure Same Day Access
Director of Education IT Innovations, Department of Medicine

From the Residency Office

Conference Recordings/Presentations

Thanks to everyone who logged in and provided feedback as to the use of conference recordings that we upload to MedHub.  We’ll leave the survey open one more week, but so far we are seeing two categories of responses:

  • Those who did not know they were available or how to find them
  • Those who see a lot of value in having them on line

Please share any additional comments that you have before the end of this week.  Just 3 questions on the survey, and your answers will help keep us going in the right direction.

https://www.surveymonkey.com/s/Conference_Recordings

 

Duke Internal Medicine Residency Program Fleece – Time To Place Your Order

Reminder that the opportunity to place orders for a fleece this year closes on Sunday, September 22, 2013.   Sample jackets are available to check out/try on in our office.

Contact lynsey.michnowicz@duke.edu if you have any questions, and just in case you missed the first email – we are sending out the link agian on Mondauy to residents and senior program leadership.

 

hyc_logo_lrg

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

Global Health Elective Rotations, Application Deadline is this week!

The Hubert-Yeargan Center for Global Health (HYC) is accepting applications for Global Health Elective Rotations for July 2014 and March 2015. 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.

(Application addendum is available by request – tara.pemble@duke.edu)

Global Health - FinalHow are residents selected to participate in a Global Health Rotation?

Following the application period, each resident will be assigned one or more interviews with HYC faculty and/or staff.  After all interviews are complete, a selection panel is convened including Program Directors, HYC faculty and staff.  The HYC takes many things into consideration when selecting residents for Global Health rotations including feedback from chief residents and program directors, strength of clinical skills, the significance of a rotation to the resident’s career goals, maturity, responsibility and cultural sensitivity. Preference will be given to individuals who have already demonstrated a commitment to global health issues, specifically within the developing world.

Application deadline is September 17, 2013

Interviews will be held in late September/early October. 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.

 

Faculty-Resident Research Grant Request for Applications 2014

REQUEST FOR APPLICATIONS

Purpose:

To provide funding for Internal Medicine Residents to develop their skills in clinical or laboratory-based research, to carry out research projects, to present their research findings at scientific meetings and to publish their work

Application Instructions

Eligibility:

  • Interns and residents in the Department of Medicine, Med-Peds, Med-Psych are eligible
  • Clinical or Basic Science research proposals are acceptable
  • Research project must be performed at Duke under the direction of a Duke faculty member

Funding Mechanism:

  • Grants will be funded up to $2,000
  • The term of the award must NOT extend beyond the residency training period at Duke. The beginning date for funding is July 1, 2014 and end date is June 30th 2015. Interns who are awarded may apply for extension to use the funds for use during their SAR year.
  • An itemized budget must be included with the application (use attached forms)

Application Process:

  • Application deadline is April 11, 2014 by email to murat.arcasoy@dm.duke.edu
  • Late or incomplete applications will not be accepted. Please submit on time!
  • A faculty committee will review applications for scientific merit
  • Letter of support from faculty mentor is requested and must accompany grant please, Letter addressed to “Award Review Committee, Faculty Resident Research Grant”
  • Use application forms online and follow instructions please.  Scientific proposal – strict 3 page limit with tables and figures (excluding references, budget page, and human subjects sections)  http://residency.medicine.duke.edu/duke-program/resident-research/research-funding
  • Itemized budget may include but is not limited to research supplies, reagents, temporary personnel time for data collection, data analysis costs and statistician time, poster preparation, travel expenses to present abstract at scientific meeting, publication costs of research project

Please e-mail application and any questions to:   Murat O. Arcasoy, MD, FACP, Associate Program Director at murat.arcasoy@dm.duke.edu

Faculty Resident Research Awards 2013. doc

Faculty Resident Research Grant Application Forms 2013-2014

Faculty Resident Research Grant Instructions 2013-2014

 

Annual Healthcare Conference (submitted by Tarika Mansukhan)

I’m reaching out because the Healthcare Club here is hosting it’s annual Healthcare Conference. We’re looking forward to bringing students from neighboring schools, both MBA and other, as well as several healthcare focused businesses to Fuqua for the event on November 16th. The conference centers on The Evolving Healthcare Landscape this year. Attached you can find details regarding the keynotes, agenda and panel, and below is the registration link for the conference:

https://fuqua.campusgroups.com/Health/rsvp?id=175385

HC Conference Flyers

Tarika Mansukhani
Candidate for MBA, Class of 2014
Duke University, The Fuqua School of Business
Tel +1.740.281.9395
Tarika.Mansukhani@fuqua.duke.edu

 

BLS Challenge Course

A BLS Challenge Course wil be held at Duke on  November 5.  For more information please call 919-684-4293.

 

Information/Opportunities

Louisiana Internal Medicine Central

Upcoming Dates and Events

  • September 17:  Application deadline for Global Health Electives
  • September 18/19:  Flu Shot Blitz
  • October 1:  Duke’s Global Health-Internal Medicine Residency  deadline to submitt applications
  • October 18:  SoM Clinical Science Day
  • October 28:  Annual Recruitment Kickoff
  • November 28:  Annual “Turkey Bowl”
  • December 4:  “Voices in Medicine”

Useful links

by · Posted on September 15, 2013 in Chief Residents, Internal Medicine Residency, Medical Education, Uncategorized, Weekly Update · Read full story · Comments { 0 }

Meet your chief resident: Stephen Bergin, MD

Stephen Bergin, MD

Stephen Bergin, MD

As chief resident for Duke Regional Hospital and ambulatory medicine, Stephen Bergin, MD, spends a lot of time thinking about how to maximize learning opportunities for residents.

“A good bit of my time is dedicated to the ambulatory setting, making sure that our continuity clinic experiences are meaningful and that our residents are truly developing a good understanding of what it means to be a primary care physician,” Dr. Bergin said.

Bergin looks for opportunities to improve these learning experiences, taking advantage of the vast knowledge of Duke faculty and making sure residents have opportunities to develop relationships with their patients.

Continue Reading →

by · Posted on September 12, 2013 in Chief Residents, Internal Medicine Residency · Read full story · Comments { 0 }

Med Res News: September 9, 2013

From the Director

DUKE.RESEARCH.NIGHT.03 (1)Hi everyone! Pumpkin spice lattes are back (and it’s apparently the 10th anniversary for them).  Don’t mind my shameless advertising…with PSL’s (not to be confused with one of our favorite attendings PSK), there are a lot of things “fall” happening! See below for information about the flu blitz as well as fleece orders.  Haiku’s (in honor of Chris Hostler) have been flying around regarding both of these events…SAR Phil Lehman offers the following…”On Tuesday I cried; for the obvious reason; Bye stripes, its been fun”.  Of course, we can remember “Fear not, preppy ones; Seersucker makes a comeback; Memorial Day”, and the all important “Alas, it is fall; no more white striped pants for me — MUST ORDER DUKE FLEECE!”

You will hear about flu shots until you feel flu-like from hearing about them.  Many of you are aware that the medicine residency program has led the way in getting 100% of the house staff vaccinated for the past 2 years (when it wasn’t a mandatory condition of employment).  Last year, we were able to reach our 100% vaccination status by OCTOBER 23rd! This year, we are setting the ambitious goal of vaccination by OCTOBER 1st! As a Stead competition, the Kerby Society (led by Heather Whitson) has won both years by being the society to have all members vaccinated first.  Competition is on, and Matt Crowley and the Kempner Society are starting to talk some trash.  “Flu season awaits; vaccines remain free this year; Steads, immunize fast!”

Kudos this week go to our 5 gold star winners Nancy Lentz, Matthew Summers, Trevor Poseneau, Armando Bedoya and Lindsay Boole! Gold stars were awarded by patients who appreciate your care. Congratulations to you all! Also congratulations to Med Peds 2013 graduate Steve Dolgner and Med Peds SAR Anna Teeter Dolgner on the birth of Andrew.  We are excited to welcome another baby into the Duke family.

Pubmed from the program this week goes to JAR Mike Woodworth for his article in Academic Medicine! “The Design of a Medical School Social Justice Curriculum”  Alexandra Coria, T. Greg McKelvey, Paul Charlton, Michael Woodworth, MD, and Timothy Lahey, MD, MMSc  Academic Medicine 2013; 88.

Have a great week!

Aimee

QI Corner (submitted by Joel Boggan, MD)

 

Flu Flyer 2

Flu Vaccination Campaign
Our flu blitz kicks off 9/18 at our next High Value, Cost-Conscious Care noon conference led by Duke’s most frequent NPR contributory, Dan Ariely.  As part of the conference, flu shots will be given both before and after outside DN 2002.  We had 100% compliance last year within 35 days of the kickoff, and we’re planning on doing even better this year.  IF YOU NEED AN EXEMPTION, THAT IS DUE BY 9/13.  IF YOU HAVE QUESTIONS ABOUT EXEMPTIONS, PLEASE EMAIL US!!!  As per last year, the Stead Societies will be competing to see who can reach 100% first . . . and the Kempner society plans to have Matt Crowley wearing the belt . . .

Final Policy Flyer 2013 Med Res

https://intranet.dm.duke.edu/influenza/SitePages/Home.aspx

Patient Safety and Quality Council Meeting
We will be having our next monthly meeting this coming Wednesday, 9/11, at 5:30 in the Med Res Library.  Come and check out the latest Sharknado sequel follow-up and create your own animal-natural disaster hybrid.  Also, we’ll discuss high value, cost-conscious care projects and how to get information to residents.

Hand Hygiene and the Incentive Program
You’ll be seeing information out in front of you soon from our Hand Hygiene Champions, Emily Ray, Jessica Seidelman, Stephanie Giattino, and Jonathan Hansen.  Here’s just a taste – the August monthly aggregate data – we were close (total observations = 120), but not there yet!

Actual Hand Washing Rate = 86%
Goal = 91%

Follow Us on Twitter

– @DukeMarines – Duke Chief Resident Updates
– @JonBae01 – QI and Patient Safety (general news and program updates)
– @DukeDOMQuality – Duke DOM Quality Updates
– @bcg4duke – Maestrocare and health informatics

 

What Did I Read This Week

Submitted by Murat Arcaosy, MD

Physical Examination Education in Graduate Medical Education- a systematic review of the literature by Mookherjee et al.  Journal of General Internal Medicine 28: 1090-1099, 2013

What did the authors do?Murat Arcasoy

The authors from three academic centers reviewed the literature (1951-2012) to determine effectiveness of published methods to teach PE in GME, focusing on the use of deliberate practice.  In this method, the trainee repetitively practices skills and undergoes assessment with feedback, resulting in observed improvement of the skills. The eligibility criteria for studies included description of GME study population, description of an intervention, assessment of efficacy, inclusion of a control group and report of data analysis. Out of 15,759 articles, it was striking that only 14 studies met inclusion criteria (only 8 included Internal Medicine residents).

Why did the authors perform this review?

Training in PE skills is a core element of undergraduate medical education, but in GME, the teaching of PE is inconsistent. PE skill deficiency in GME does not only involve issues with performance of maneuvers or identification of abnormalities. Residents sometimes struggle to understand the significance of PE findings, tend to have low confidence in their PE skills, and may spend a short time actually performing a PE. Going through a residency training program in itself is not expected to resolve these deficiencies, therefore, PE education must be improved.  The question is which PE teaching methods are optimal in the GME setting (this review did not answer this question).

What did the authors find?

Twelve studies assessed knowledge and skill. Two studies assessed changes in behavior. Seven studies examined resident and human examinee interaction and four of these were actual patients in a clinical context (genital exam in continuity clinic, bedside rounds with medicine residents (yaay!), breast exam in breast care clinic, pelvic exams in pediatric clinic). Two studies used teaching associates (as examinees) who were also responsible for teaching the residents.  Seven studies targeted cardiac exam and the educational material did not involve patient interaction.  Of the seven studies where residents interacted with human examinees as part of curriculum only one did not show improved educational outcomes. The great majority of studies with definite use of deliberate practice showed beneficial outcomes.

What did the authors conclude (or not)?

The authors could not conclude that one teaching method is superior to others. They suggested “attention to deliberate practice when designing PE curricula and that interaction with human examinees may be useful to residents” (Hmmm).

What is my take?

I read this article as part of an effort to educate myself on the published experience on the teaching of PE skills and to learn about novel methods of PE skills education, an area of medical education I have felt so passionate about throughout my career.  I remember how I learned (and continue to learn) PE skills during med school and beyond, the faculty and patients who so graciously taught me, so that I could formulate a reasonable clinical diagnosis, order laboratory investigations rationally, and perhaps most importantly, to make that essential human connection to the patient, thus laying the foundation of a doctor-patient relationship based on mutual respect and trust.

What do you think ?

May I suggest please that you take a moment to reflect upon how it is that you were taught PE skills and how you continued to learn/improve? If you are a current Intern, how do you teach your med student at the bedside? how do you teach PE skills to multiple junior trainees as a team leader JAR at the VA or a SAR at Duke? how do you make time during the day to keep going back to your patients, resisting the multiplicity of forces that pull us away from the bedside? how do you prepare for bedside rounds as team-leader and encourage deliberate practice of PE skills?

..” the best way to learn is to teach, the best way to teach is to keep learning, and that what counts in the end is having had a shared, reflected experience.” …(attributed to Frank Oppenheimer (1912-1985), Science magazine, 1998)

From the Chief Residents

Grand Rounds

Date:  September 13, 2013

Presenter:  Dr. Rob Keenan, Division of Rheumatology

 

Noon Conference

Date Topic Lecturer Time Vendor Room
9/9 PWIM noon   conference Chad Kessler 12:00 The Picnic Basket 2002
9/10 Evidence   Based Hypertension Mgmt Daniella Zipkin 12:00 Moe’s Burritos 2002
9/11 Schwartz   Rounds Lynn O’Neill, Lynn   Bowlby 12:00 Jersey Mike’s 2002
9/12 How   To Give a Talk Zaas 12:00 Sushi 2001
9/13 Chair’s   Conference Chiefs 12:00 Rudinos MEDRES

 

Time for PAINTBALL (submitted by Chris Hostler)

paintball_tarifa_8

Reminder to sign up today for the upcoming White Coat Paintball Game on 9/28/13 from 12-4.  Either respond to the calendar event via Outlook or email Chris Hostler by 9/21.

Thanks, Chris

 

From the Residency Office

Conference Recordings/Presentations

Did you know we upload conference recordings to MedHub?  Do you know where to find them, and do you find them useful?

We really would like to know.  If you would, please take 20 seconds to click on the following link and give us your feedback.  Just 3 questions, but your answers will help keep us going in the right direction.

https://www.surveymonkey.com/s/Conference_Recordings

 

Duke Internal Medicine Residency Program Fleece – Time To Place Your Order

The sun is settling lower in the sky, the seersucker is safely tucked away, and the mornings are starting to get chilly – which can only mean one thing – time to pull out your  Med Res Fleece.  Back by popular demand our office will again facilitate collecting fleece orders.   We will be sending an email to our residents and senior leadership on Monday with the details – including the link and detail directions as to how to place orders.  Sample jackets will also be available to check out/try on first of the week in our office.  Lynsey will be the point person managing the project this year.

NOTE:  Fleece orders will only be collected for the next two weeks, so PLEASE watch your email so you do not miss this opportunity.

 

hyc_logo_lrg

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

Accepting Applications for Global Health Elective Rotations

The Hubert-Yeargan Center for Global Health (HYC) is accepting applications for Global Health Elective Rotations for July 2014 and March 2015. 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-Global Healthhealth-elective-rotation.

(Application addendum is available by request – tara.pemble@duke.edu)

Application deadline is September 17, 2013. Interviews will be held in late September/early October. 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.

 

Crime Prevention Briefings

In light of the incidences that took place this summer, the Duke University Police Department will be offering safety briefings at three different locations and times on campus. The briefings will cover building safety, parking deck safety and personal safety.

Friday – Sept 13 from 11 – 12 in MSRB 1, Room 001

Tuesday – Sept 17 from 1:30 – 2:30 in 143 Jones Building

Wednesday – September 18 from 11 – 12 in Classroom 4, Trent Seamans Center

For more information, contact Duke Crime Prevention at (919) 684-2444.

Contact Information/Opportunities

Global Health Hospitalist Position — Harvard Medical School & Nyaya Health

Nyaya Health and Harvard Medical School are excited to announce that we are now accepting applications for a position that will be divided half-time between the Brigham & Women’s Hospital (Boston, USA) and Bayalpata Hospital (Achham, Nepal). This is an ideal position for an Internal Medicine or Medicine/Pediatrics-trained physician interested in launching a career in global health hospital medicine and medical education. While in Boston, the candidate will serve as an associate physician at Brigham & Women’s Hospital — a Harvard University teaching hospital. In Achham, the candidate will be responsible for programmatic development, medical education of Nepali clinical staff, quality improvement initiatives, and implementation research regarding best practices for healthcare in resource-poor settings.

Applications will be accepted from August 26th, 2013 on a rolling basis. The interview and hiring process will be finalized by October, 2013. Start date will be July, 2014, and minimum contractual agreements will be for one year (12 months); however, longer contractual agreements are preferred.

For more information about the position, please see attached, or: http://bit.ly/16vvWf9
For additional information about Nyaya Health and Bayalpata Hospital: http://www.nyayahealth.org

For additional information about the Brigham & Women’s Hospital: http://www.brighamandwomens.org/

Interested applicants should send a cover letter and CV to hospitalist@nyayahealth.org

Nyaya Health Clinical Advisor & BWH Hospitalist RFA 2013

 

Chapel Hill CareerMD – Career Fair:

physicians-in-training will be able to connect with representatives from leading healthcare organizations across the country and learn about the career opportunities available to them.

RSVP by emailing  charles.howell@CareerMD.com or through their website at www.CareerMD.com/ChapelHill

Location: Sheraton Chapel Hill Hotel, One Europa Drive, Chapel Hill,   NC
Date/Time: Thursday, September 12, 2013; arrive any time between 5:00   PM and 8:00 PM
Details: Casual attire, complimentary light refreshments, spouses   and significant others welcome

Upcoming Dates and Events

  • September 17:  Application deadline for Global Health Electives
  • September 18/19:  Flu Shot Blitz
  • October 1:  Duke’s Global Health-Internal Medicine Residency  deadline to submitt applications
  • October 18:  SoM Clinical Science Day
  • October 28:  Annual Recruitment Kickoff
  • November 28:  Annual “Turkey Bowl”
  • December 4:  “Voices in Medicine”

Useful links

by · Posted on September 8, 2013 in Chief Residents, Internal Medicine Residency, Medical Education, Uncategorized, Weekly Update · Read full story · Comments { 0 }