UNIVERSITY OF SOUTH FLORIDA Internal Medicine Residency Program 2022- 2-23 ANNUAL REPORT
MISSION STATEMENT Our mission is to develop our residents into physicianleaders who have a strong foundation in patient care and medical knowledge but are also skilled in teaching, scholarly activity, leadership, and quality improvement. 2
PROGRAM AIMS 1. Equip graduates with the knowledge and clinical skills for excellence in the practice of medicine in their careers. 2. Expose residents to a variety of training sites and embrace the educational opportunities that arise from the diverse pathology and patient populations. 3. Promote individualization of the program to ensure graduate achieve the learning necessary for intended roles/practice 4. Ensure residents will graduate as educators of students, colleagues, patients, and themselves 5. Enhance professional development by providing residents with opportunities for scholarly activity, leadership, medical education and/or quality improvement & patient safety. 6. Conduct residency training in an environment that is collegial, supportive, open to growth and development, and awareness of resident well-being 3
4 EDUCATION TEACHING & LEARNING Academic Half Day – Dr. Mai leading a small group of PGY2’s in the Teaching to Teach workshop
ACADEMIC HALF DAY 2022-2023 TOPICS Workshops: • Professionalism • Intern Bootcamp (PGY1) • Teaching to Teach (PGY2) • End of Life/Palliative (PGY1 + PGY3) • Cultural Humility QI/PS • Mock Root Cause Analysis • Health Disparities Data Review Simulations: • ACLS and BLS (PGY2) • POCUS • Procedure Training/Senior Skills Workshop (PGY1) 5 Scholars Council: • Letter to Editor Workshop • Evidence Based Med Principles • Others TBD Board Review: • Hematology • Infectious Disease – Part 1 • Infectious Disease – Part 2 • Endocrinology – Part 2 Business/Practice of Medicine: • Compliant Level of Care Designation (PGY1) • Clinical Documentation & Improvement for Residents (PGY1) • Contract Negotiation (PGY3) • Billing & Coding • Litigation Avoidance/Mock Deposition (PGY2/3) • Filling out Death Certificates Forums • Alumni Tips for Boards (PGY3) • Evaluation Training for Evaluators • Pre-Med Mentorship Opportunity
6 LETTER TO THE EDITOR WORKSHOP
RESEARCH EDUCATION • Resident attendance and poster presentations at most major academic conferences throughout the country. • Goal to send out regular research newsletters with the upcoming conferences and abstract submission deadlines. • Evidence-Based Medicine didactics to help develop a systematic approach on how to approach and appraise current research. • Goal to continue to go through Evidence-Based Medicine topics throughout the year • Resident Research Guide • Currently being developed to help residents improve their research skills and get connected with research mentors throughout USF - PGY4 Academic & Research Chief, Dr. Naga
JAHVA Outpatient Didactics (Current) • 7:30 AM – 10:30 AM: focus on QI lecture/exercise/project • 10:30 AM – 11:00/11:15 AM: focus on outpatient case presented by either PGY2 or PGY3 during the first Friday didactic session of the CC block • 10:30 AM- 11:00/11:15 AM: focus on New England Journal of Medicine Board Review Questions AND lecture given by Dr. Ramsakal • Topics taught by Dr. Ramaskal during the second Friday didactic session of CC block • Outpatient diabetes management • Acid-Base review • Antibiotics (part I) • Antibiotics (part II) • 11:15 AM- 11:45 AM: focus on wrap-up and completion of view alerts Outpatient topics presented by PGY3 resident since April 2022 1. Hyperlipidemia 2. Dyspnea 3. Thoracic aortic aneurysms 4. Vitamin D deficiency 5. COPD 6. Vaccinations in the primary care setting 7. Management of seizures in primary care 8. Chronic cough 9. Heart failure 10. Hormone replacement therapy Friday AM Didactics Schedule Sample 0730-0830 GEMBA/ Process Map Presentation 0830-0900 Define Slides (2 -Slides) 0900-1000 Waste Identification Slides/Teams Prep for Tollgate 1000-1030 Tollgate Meeting with Dr. Nehaul 1030-1100 Resident Driven Lecture 1100-1200 View Alerts JAHVA CC dates with planned lecture
JAHVA Outpatient Didactics (Upcoming Changes/Goals) 1. Implement shift from PGY3 to PGY2 as leaders of outpatient case presentation. Will eventually transition to PGY1-directed outpatient case presentations starting following the academic year. 2. Possible transition from Dr. Ramsakal to Dr. Mazzarolo “Whiteboard DDx Lecture Series” starting in April 2023. Following dates under consideration: 4/28, 5/5, 5/19, 6/2, 6/16, 6/30 3. Pilot Journal Review Starting April 2023 in place of outpatient case presentation -PGY3, VA Outpatient Chief, Dr. Cavalaris JAHVA CC dates in process April 2023 schedule changes Transition to Dr. Mazzarolo dates
Current State • Chief Resident Lead Board Review from 7:45-8:00 am • QI senior resident lead short presentations on outpatient management of a topic • USPSTF Updates • HTN • NASH/NAFLD • Osteoporosis • PEAC modules throughout the year • Longitudinal QI and discharge clinic for all residents - PGY3 Morsani/HP Chief, Dr. Bilodeau Gandre Future State • Selecting senior residents from each group to champion leading Board Review during the block • Continuing QI senior residents leading outpatient management presentations • Incorporating Yale curriculum and quizzes into AM learning for QI groups • Continuing longitudinal discharge clinic and QI • Incorporating fellow lead specialty lectures into QI learning • Teaching QI principles and background during the first half of each academic year Morsani/HP Outpatient Didactics (Current)
Ideal State • Faculty lead board review each Friday for more nuanced discussion of tips/tricks for board questions • Continue Senior lead and Fellow lead presentations on outpatient management of a topic • Continue PEAC learning modules • Have residents participate in meetings with the TGH QI committees to present projects for the Morsani and HP clinic, or to gather data on quality metrics that may need projects to be worked on Morsani/HP Outpatient Didactics (Current)
In the academic half day, PGY3 Dr. Perez-Melendez, mentored by Dr. Mateja, led a Workshop on Cultural Humility 12 Introduction to Cultural Humility in Healthcare • A new workshop was developed for the resident didactics curriculum for 2022-2023. • The purpose of this workshop was to define culture humility and share with our residents the building blocks to develop cultural humility. • The residents were divided into smaller groups to encourage dialogue and create a safe environment to share about different cultures and traditions. • We also used the opportunity to introduce and discuss health disparities. This lead to the second portion of our didactics in which a case was presented and we sought to address some of the possible barriers to healthcare this individual was facing or would face. • Lastly, our goal is not only to ensure our residents are aware about cultural humility, health disparities, but to share with them the resources our hospital has to address our patient’s social and health needs.
USF Morsani and Healthpark Primary Care Healthcare Screening Data and Care Gaps • Topic: • Discuss most recent breast cancer and colon cancer screening data for USF Morsani and Healthpark from 2019-2021 during resident didactics • Identify racial demographics and disparities within colon cancer and breast cancer screening data • Demonstrate care gap management within the health care system to ensure proper follow-up and documentation of healthcare screening tests • Goals: • Raise awareness of racial disparities and healthcare gaps that have worsened during the global COVID-19 pandemic in Morsani and Healthpark resident clinics • Promote resident education in systems-based practice and maintain compliance of healthcare screenings PGY3, Dr. Soto Del Valle 0.0% 20.0% 40.0% 60.0% 80.0% Not adherent Adherent Colorectal Cancer Screening Adherence 0.0% 20.0% 40.0% 60.0% 80.0% 100.0% Not adherent Adherent Breast Cancer Screening Adherence USF Morsani and HP Patient Cancer Screening Adherence 2019-2021 41.4% 42.9% 36.3% 46.0% 35.0% 28.8% 0.0% 10.0% 20.0% 30.0% 40.0% 50.0% African… White Hispanic/Latino Asian AI/Pacific… Other Percent of Patients Race Percentage of Racial Groups Adherent to Colorectal Cancer Screening 23.3% 21.4% 15.6% 27.1% 7.7% 15.4% 0.0% 5.0% 10.0% 15.0% 20.0% 25.0% 30.0% African… White Hispanic/Latino Asian AI/Pacific… Other Percent of Patients Race Percentage Adherent of Racial Groups to Breast Cancer Screening
14 SIMULATION TEACHING & LEARNING
15 INTERN PROCEDURE TRAINING
SIMULATION ACCOMPLISHMENTS & GOALS Code Blue Sims! • Weekly VA sessions, biweekly at TGH • Expanding target audience of simulations to include prelims and med-peds residents • Sessions scheduled to more closely reflect upcoming ICU location • Long term goal for PGY-1s and 2s for 1 session per 6 months, and one session at each location • Adapting session topics and scope based on resident and facility feedback • Incorporation of VAD ACLS, more focus on rhythm identification and transcutaneous pacing with the Zolls - Dr. Roberts PGY3 Sim Chief
17 PGY2 CODE BLUE TRAINING
POCUS ACCOMPLISHMENTS & GOALS • Expanded scope of noon conference education based on resident interest • Including more organ systems and more focus on direct practice • Expanding clinic access POCUS • Health Park and Morsani now with Butterflies, VA coming soon! • Joined multidisciplinary group to expand and standardize POCUS education and documentation across specialties • Includes IM, Pulm Crit, Gen Surg, Trauma, ER, NICU, Med-Peds; Peds, Rads, Anesthesia, and more coming soon! • Long term goal of expanding and standardizing POCUS education across GME - Dr. Roberts PGY3 Sim Chief
20 Year PGY 2 PGY 3 All Years Program Score Percentile Program Score Percentile Program Score Percentile 2022 2021 72 (Natl avg 68%) 66 73 (Natl avg = 70%) 60 2020 73 (Natl avg 66%) 62 75 (Natl Avg = 70%) 56 72 95 2019 73 (Natl Av = 70%) 62 75 (Natl Av = 73%) 56 74 91 2018 70 59 76 70 74 91 2017 70 56 75 65 73 87 IN-TRAINING EXAM
21 BOARD STUDY SESSIONS Weekly study sessions of board preparation with a primary focus on areas that need improvement based on the program’s ITE results. Study sessions focus on helping develop a comprehensive learning approach to preparing for the boards which include independent learning, board basics, board review videos, MKSAP questions, and UWORLD questions.
22 QI/PS QUALITY IMPROVEMENT & PATIENT SAFETY PGY4 QI/PS Chief Dr. Algarin Troia and rising QI chief, PGY3 Dr. Bildodeau hosting a simulated RCA in the Academic Half Day
VA Inpatient QI/PS Update Accomplishments to date: • 10 Quali-TEAs (Team Event Analysis, miniature RCA^2 from non-sentinel JPSR events) • 2 QI/QA conferences (Quality Improvement/Quality Assurance case discussions ~ M&M) • 7 Q-TIPS (quick hit QI topic reviews at noon conference) • 2 IHI National Forum poster presentations • Ongoing Proactive Risk Assessment/HFMEA (Healthcare Failure Mode and Effect Analysis) of JAHVA New Bed Tower with SimLEARN and JAHVA simulation center • 2 Influenza Vaccination Team Challenges Ongoing Initiatives: • Medicine Team Challenges (Vaccinations) • Decreasing Inpatient Hypoglycemic Events • Decreasing Hospital-Associated Venous Thromboembolism • Decreasing Pre-procedural NPO times • IPSE (Interprofessional Education ) lecture series, total of 8 sessions per every internal medicine clerkship cohort (part 1 with intro to patient safety lecture then human factors engineering, part 2 with pharmacy tracer and environment of care/room of horrors simulation). Patient Safety & Quality Improvement Goals for 2023 • Ongoing proactive risk assessments with New Bed Tower activation • Increasing Trainee Event Reporting through JPSR • Continued growth of Quali-TEA, increased coordination with handoffs to process owners
Quali-TEA Flu shot team challenge
INTERNAL MEDICINE DASHBOARD Baseline data: 5/1/22-9/30/22 Data abstracted from Qlik Dashboard: 1/9/23 Patient SafetyUSHERSS Program GME wide initiative we are participating in Resident engagement in patient safety Conduct safety huddles within program Enhance resident’s knowledge of safety events and how to report System approach to escalating patient safety concerns Monthly Meetings and Discussions Internal Medicine Residency Program GME - Sammy Eichelberger PGY2
Intern Bootcamp- House Officer & Handoff Training House-Officer orientation • Simulated mock pages and patient encounters • Survey project: 82% of survey respondents said House-Officer training and new follow-up sheet improved ability to stay organized • “I loved the HO follow-up sheet and used it every single night. It helped me feel organized and it was nice to be able to check things off a central list to ensure I was not forgetting to follow-up. It also prompted me to follow-up on labs/etc with nursing staff Handoff Training • Defined “handoff” process at TGH, JAHVA, and Moffitt • Practiced handoffs in small groups • Developed a handoff guide to serve as a blueprint for questions -PGY2’s Dr. Eichelberger, Dr. Ponnaganti, Dr. Money
33 GRADUATE SUCCES .
ABIM SUCCESS 34 % Take Boards Board Pass Rate 2022 100% 94% 2021 100% 100% 2020 100% 100% 2019 100% 97% 2018 97% 97% 2017 100% 100% 2016 89% 100% Our residents receive resources in the form of MEDSTUDY, MKSAP, UWORLD to help with board preparation. In addition, during the PGY3 they submit a Board Study Plan in the Fall and the program hosts a 4 day board review in the Spring. This year we added a Forum in the Friday Academic Half Day for the Third Year residents where recent Alumni can come and give their feedback on how they studied and prepared for the boards.
FELLOWSHIP MATCH DAY 37 • Azu Anudu - U Maryland • Charlie Cavalaris – USF • Omar Calderon – U Wisconsin • Wes Wright – West Virginia U • Yassin Naga – UN Las Vegas GASTROENTEROLOGY • Chen Wang – NIH • Hannah Shin – San Diego ALLERGY • Chase Lewellen – USF • Jonathan Marks – USF • Mevin Mathew – HCA Brandon • Aubrey Schley – Indiana (Ped Cards) CARDIOLOGY
38 • Abida Babu – USF • Aryanna Jordan – USF • Kevin Parza – UF Jacksonville • Yiseiry Perez Melendez - MUSC HEMATOLOGY/ONCOLOGY • Emilio de Narvaez – UC San Francisco • Cilia Nazef – USF • Hannah Suddreth – U Maryland • Lauren Rybolt – USF INFECTIOUS DISEASE • Beatrice Wood – Honor Health – Arizona • Michelle Ouellette – Beth Israel • Rachel Eliach – U Michigan HOSPICE & PALLIATIVE CARE • Jorden Smith - USF PULMONARY • Sarah Goodman – Barnes Jewish WashU RHEUMATOLOGY
41 RESEARCH & SCHOLARLY ACTIVITIES
42 RESEARCH Scholarly Activity By Year Peer Review Pubs Abstract Pubs Total Pubs Local/Regional Presentations National/Int’l Presentations Total Presentations 22-23 21-22 62 43 107 29 48 77 20-21 64 56 120 8 69 77 19-20 51 88 139 30 103 133 18-19 30 76 106 20 86 106 17-18 46 75 121 25 88 113 16-17 36 72 108 21 71 92
• Anudu A, Pinizzotto A, Ortiz D, Pearce M, Mhaskar R, Coughlin E,; Seminerio-Diehl J. IBD and Malignancy: Should Treatment Be Altered?” American Journal of Gastroenterology, vol. 117, no. 1, 2022, https://doi.org/10.14309/01.ajg.0000897520.77876.6f. • Ball S, Jain A, Patel P, Wang C, Aguirre L, Schwabkey Z, Hussaini M, Chan O, Yun S, Kuykendall A, Padron E, Sweet K, Lancet J, Komrokji R, Sallman D. AML-488 Impact of Somatic Mutations on Treatment Response and Outcomes in Patients With Core Binding Factor Acute Myeloid Leukemia. Clinical Lymphoma Myeloma and Leukemia, vol. 22, 2022, doi.org/10.1016/s2152-2650(22)01305-2 • Ball S, Jain A, Patel P, Wang C, Aguirre L, Hussaini M, Chan O, Yun S, Kuykendall S, Padron E, Sweet K, Lancet J, Komrokji R, Sallman D. Drivers of Deep Molecular Response and Outcomes in Patients with Core Binding Factor Acute Myeloid Leukemia. Blood, vol. 140, no. Supplement 1, 2022, pp. 6282–6284., doi.org/10.1182/blood-2022-170442. • Cavalaris C, Ponnaganti B, Narayanan S, Patel B, Colizzo J. S1768 Missing the Viewing Angle on Obstructive Jaundice: Lemmel’s Syndrome. American Journal of Gastroenterology, vol. 117, no. 10S, 2022, https://doi.org/10.14309/01.ajg.0000863712.82561.c0. • De Narvaez E, Schoenfeld D, Elshereye A, Tran J, Oehler R. Triple Threat: A Case of Erysipelothrix rhusiopathiae Septicemia Complicated by Multi-Valvular Endocarditis, Spinal Osteomyelitis, and Septic Embolic Stroke. The Cureus Journal of Medical Science. 08/3033 • De Narvaez E, Lee D, Nlandu Z, Baluch A, Klinkova OV. A Tale of Two Rashes in a Bone Marrow Transplant Patient. The American Journal of Medicine. 09/2022 • John J, Reed J, Blonski W. S2070 Mucosal Schwann Cell Hamartoma: A Benign but Obscure Finding. American Journal of Gastroenterology, vol. 117, no. 10S, 2022, https://doi.org/10.14309/01.ajg.0000864920.16370.fa. • John J, Colizzo J. S2015 Cowden Syndrome: An Enigmatic Disease with Many Faces. American Journal of Gastroenterology, vol. 117, no. 10S, 2022, https://doi.org/10.14309/01.ajg.0000864700.24350.fc. • John J, Gill J. S1872 A Case of igg4 Sclerosing Cholangiopathy after Cholecystectomy.” American Journal of Gastroenterology, vol. 117, no. 10S, 2022, https://doi.org/10.14309/01.ajg.0000864128.08852.d6. • John J, Reddy K, Blonski W. S2438 A Rare Cause of Esophageal Varices.” American Journal of Gastroenterology, vol. 117, no. 10S, 2022, https://doi.org/10.14309/01.ajg.0000866392.03924.ec. • John J, and Blonski W. S3276 A Rare Case of Non-Small Cell Lung Cancer Causing False Positive Hepatitis B Surface Antigen.” American Journal of Gastroenterology, vol. 117, no. 10S, 2022, https://doi.org/10.14309/01.ajg.0000869744.74851.9b • Kohn AH, Sivesind T, Schmitt H, Weberschock T, Wu PA, Masood M, Dellavalle RP. From the Cochrane Library: Interventions for Mycosis Fungoides (Preprint).” 2021, https://doi.org/10.2196/preprints.34448. • Lee D, Chandrasekhar S, Jain M, Hansen D, Freeman C, Alsina M, Baz R, Puglianini O, Liu H, Blue B, Davila M, Faramand R, Kumar A, Shah B, Lazaryan A, Khimani F, Nishihori T, Bachmeier C, Locke F, Oliveira G, Alomar M. Cardiac Events after ANTI-BCMA Chimeric Antigen Receptor T-Cell (IDECABTAGENE VICLEUCEL) for Multiple Myeloma. Journal of the American College of Cardiology, vol. 79, no. 9, 2022, p. 1933., https://doi.org/10.1016/s0735- 1097(22)02924-2. • Lee D, Money D, Deshpande A, Samuels B. “A Case of Abiraterone-Related Hypokalemia Leading to Torsades De Pointes and Cardiac Arrest.” Cureus, 2022, https://doi.org/10.7759/cureus.23678. • Marks, Jonathan, and Zachary Stachura. “The Clot Thickens: The Case of a Young Male with Recurrent Pulmonary Embolisms.” Chest, vol. 162, no. 4, 2022, https://doi.org/10.1016/j.chest.2022.08.1937. 43 PUBLICATIONS
• Miller N, Greene J, Finley K, John J. Mediastinitis After Ivor Lewis Resection of Esophageal Cancer. In A58. BACTERIAL INFECTIONS (pp. A1856-A1856). American Thoracic Society, 2022, https://doi.org/10.1164/ajrccm-conference.2022.205.1_meetingabstracts.a1856. • Money D, Hadar A, Lee, D. A Confounding Case of Non-ischemic Cardiomyopathy: Acquired Myocarditis from Covid-19 and Systemic Lupus Erythematosus Leading to Clinical Heart Failure. Journal of General Internal Medicine (2022): S392-S392.A Confounding Case of Non-Ischemic Cardiomyopathy: Acquired Myocarditis from COVID-19 and Systemic Lupus Erythematosus Leading to Clinical Heart Failure • Nusbickel, Alex, and Chase T. Lewellen. “More than a Headache: A Case of Spontaneous Coronary Artery Dissection in a Patient with a History of Migraines on Triptan Therapy.” Journal of the American College of Cardiology, vol. 79, no. 9, 2022, p. 2815., https://doi.org/10.1016/s0735-1097(22)03806-2. • Parasher A, Segarra D, Gliksman M, Lin T, Rudmik L, Quast T. Economic Evaluation of Dupilumab versus Endoscopic Sinus Surgery for the Treatment of Chronic Rhinosinusitis with Nasal Polyps. International Forum of Allergy & Rhinology, vol. 12, no. 6, 2022, pp. 813–820., https://doi.org/10.1002/alr.22936. • Patel P, Logothetis C, Laber D. Six-Month Outcomes in Patients with Complement Mediated Thrombotic Microangiopathy Treated with Complement Inhibitors in the Real World. Blood, vol. 140 1, 2022, pp. 11358–11359., doi.org/10.1182/blood-2022-165375. • Pressendo L, Brewster N, Juan-Guardela B. Systemic Epstein-Barr Virus-Related T-Cell Lymphoproliferative Disorder: A Rare Cause of Dyspnea and Pulmonary Infiltrates in an Immunocompetent Adult. Chest, vol. 162, no. 4, 2022, https://doi.org/10.1016/j.chest.2022.08.1811. • Rybolt L, Sabunwala S, Greene J. Zoonotic Bacterial Respiratory Infections Associated with Cats and Dogs: A Case Series and Literature Review. Cureus, 2022, https://doi.org/10.7759/cureus.24414. • Schoenfeld D, Lee D, Arrington J, Greene J, Klinkova O. Bacillus Cereus Bacteremia Complicated by Brain Abscess in a Severely Immunocompromised Patient: Addressing Importance of Early Recognition and Challenges in Diagnosis. ID Cases, vol. 29, 2022, https://doi.org/10.1016/j.idcr.2022.e01525. • Sepulveda R, Cavalaris C, Zakaria A, Gomez-Esquivel R. S2262 A Rare Case of Metastatic Muscle Invasive Bladder Cancer to the Esophagus.” American Journal of Gastroenterology, vol. 117, no. 10S, 2022, https://doi.org/10.14309/01.ajg.0000865688.19522.1f. • Shultz J, Rojas Y, Alsina M, Gomez-Daspet J. A Case of Delayed Diagnosis of Graves' Orbitopathy Presenting as Bilateral Cranial Nerve VI Palsy. International Journal for Case Reports. Vol 6, no.4. pp 9442 • Smith, J. E. "VULVAR CARCINOMA, A RARE COMPLICATION OF SOLID ORGAN TRANSPLANT." JOURNAL OF INVESTIGATIVE MEDICINE. Vol. 70. No. 4. • Smith J, and Khadilkar A. A Granulomatous Mix-Up.” Chest, vol. 162, no. 4, 2022, https://doi.org/10.1016/j.chest.2022.08.342. • Zaman S, Chen G, Patel A, Segarra D, Protiva P. S213 Intratumoral Human Cytomegalovirus Abundance in Colon Adenocarcinoma Is Associated with Poor Survival Outcomes and Increased Intratumoral Regulatory T-Cell Infiltrate in Elderly Patients. American Journal of Gastroenterology, vol. 117, no. 10S, 2022, https://doi.org/10.14309/01.ajg.0000857492.57792.96. • Zaman S, Chen G, Segarra D, Patel A, Protiva P. “S208 Increased Primary Tumor Sutterella Bacterial RNAseq Signatures Are Associated with Increased M2 Macrophage Abundance and Worse Overall Survival in Rectal Adenocarcinoma.” American Journal of Gastroenterology, vol. 117, no. 10S, 2022, https://doi.org/10.14309/01.ajg.0000857472.84764.69. 44 PUBLICATIONS
LOCAL/REGIONAL CONFERENCE PRESENTATIONS 45 Florida Society of Rheumatology, July 2022 American College of Cardiology Annual Florida Chapter Meeting – Orlando, Florida 08/2022 • Millis, C. Diagnosing New Onset Cardiomyopathy in a Young Male due to Clozapine-Induced Myocarditis. American College of Cardiology - Annual Florida Chapter Meeting. 08/2022 Florida Chapter American College of Physicians Fall Poster Competition 10/2022 • Sachs V, Ahmad Y, Sachs V, Gupta S. A Case of Lupus Nephritis During Pregnancy. 2022 Florida Chapter American College of Physicians Fall Poster Competition. 10/2022 Southern Hospital Medicine Conference • Shakfeh K, Laber D. Anticoagulation for Acute Limb Ischemia with Severe Thrombocytopenia. Southern Hospital Medicine Conference. 10/2022 Southern SGIM Florida Chapter ACP Spring Poster Competition, 3/2023
NATIONAL CONFERENCE PRESENTATIONS 46 Heart Rhythm Society, July 2022 European Academy of Dermatology and Venereology 31st Congress, Milan, Italy 09/2022 • Perez-Chada LP*, Grant C*, Woodbury M, Haberman R, Noe M, Kohn-Kucharik A, Armstrong AW, Eder L, Mease P, Ogdie A, Strand V, Gottlieb AB, Merola J. Development of a patient-reported outcome measure to assess musculoskeletal symptoms in psoriatic disease: the IDEOM MSK Questionnaire (IDEOM MSK-Q). European Academy of Dermatology and Venereology 31st Congress. 09/2022 Society of Hematologic Oncology Annual Meeting, Houston, Texas 09/2022 • Ball S, Jain A, Patel P, Wang C, Aguirre L, Schwabkey Z, Chan O, Yun S, Kuykendall A, Padron E, Sweet K, Lancet J, Komrokji R, Sallman D. Impact of Somatic Mutations on Treatment Response and Outcomes in Patients with Core Binding Factor Acute Myeloid Leukemia. Society of Hematologic Oncology Annual Meeting. 09/2022 Society for Improving Diagnosis in Medicine • Shakfeh K, Shotande F, Meteja C. Cold agglutinin disease and Legionella pneumonia, improvement in diagnosis. Society for Improving Diagnosis in Medicine. 10/2022 American College of Rheumatology Convergence, Philadelphia, Pennsylvania 11/2022 • Holguin Balbuena S, Radisic A, Goodman S, Gor S, Wood B, Shahin A, Samuel K, Mhaskar R, Carter J. Clinical Outcomes of COVID-19 Vaccination and Booster in Patients with Autoimmune Inflammatory Rheumatic Diseases. American College of Rheumatology Convergence. 11/2022
47 American College of Gastroenterology Annual Meeting – Charlotte, North Carolina 10/2022 • Chen G, Zaman S, Segarra D, Patel A, Protiva P. High Intratumoral Hepatovirus Abundance in Colon Adenocarcinoma is Associated with Worse Overall Survival and Increased Intratumoral CD8+ T-Cell Infiltration. Kreinbrook J, Bhaskar S, Anudu A, Wright W, Slone S, Prabakaran S, Mendoza S, Javed A, Foulis P, Colizzo J, Blonski W, Legard K, Lezama J. Following Through on Positive Fecal Immunochemical Testing via FIT Navigation and a Direct -to -Colonoscopy Pathway: Preparing for the Next Wave. • Wright W, Orlick M, Kreinbrook J, Kumar A, Patel B. Positive Fecal Immunochemical Testing (+FIT) in the COVID -19 Pandemic: Resilient Systems in Troubled Times. • Wright W, Orlick M, Kreinbrook J, Kumar A, Patel B. Diagnostic Utility of Inpatient Fecal Occult Blood Testing. • John J, Reddy K, Blonski W. S2438 A Rare Cause of Esophageal Varices. • John J, and Blonski W. S3276 A Rare Case of Non-Small Cell Lung Cancer Causing False Positive Hepatitis B Surface Antigen. • John J, Reed J, Blonski W. S2070 Mucosal Schwann Cell Hamartoma: A Benign but Obscure Finding. • John J, Colizzo J. S2015 Cowden Syndrome: An Enigmatic Disease with Many Faces. • John J, Gill J. S1872 A Case of igg4 Sclerosing Cholangiopathy after Cholecystectomy. • Miller N, Frank B, Jacobs J. S2312 Esophageal Stricture Secondary to Mycophenolate Mofetil-Induced Injury. • Zaman S, Chen G, Patel A, Segarra D, Protiva P. S213 Intratumoral Human Cytomegalovirus Abundance in Colon Adenocarcinoma Is Associated with Poor Survival Outcomes and Increased Intratumoral Regulatory T-Cell Infiltrate in Elderly Patients. • Sepulveda R, Cavalaris C, Zakaria A, Gomez -Esquivel R. S2262 A Rare Case of Metastatic Muscle Invasive Bladder Cancer to the Esophagus. • Cavalaris C, Ponnaganti B, Narayanan S, Patel B, Colizzo J. Missing the Viewing Angle on Obstructive Jaundice: Lemmel's Syndrome. • Zaman S, Chen G, Segarra D, Patel A, Protiva P. S208 Increased Primary Tumor Sutterella Bacterial RNAseq Signatures Are Associated with Increased M2 Macrophage Abundance and Worse Overall Survival in Rectal Adenocarcinoma.
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51 CHEST – Nashville, Tennessee 10/2022 • Smith J, Khaldikar A. A Granulomatous Mixup. • Hayes (Pressendo) L, Brewster N, Juan-Guardela B. Systemic Epstein Barr Virus Related T cell Lymphoproliferative Disorder: A rare cause of dyspnea and pulmonary infiltrates in an immunocompetent adult. • Marks, Jonathan, and Zachary Stachura. The Clot Thickens The Case of a Young Male with Recurrent Pulmonary Embolisms. • Money B.
52 Advances in Inflammatory Bowel Disease – Orlando, Florida 12/2022 • Anudu A, Pinizzotto A, Ortiz D, Pearce M, Mhaskar R, Coughlin E, Seminerio-Diehl J. IBD and Malignancy: Should Treatment Be Altered?”. Advances in Inflammatory Bowel Disease. 12/2022 American Society of Hematology Annual Meeting – New Orleans, Louisiana 12/2022 • Ball S, Jain A, Patel P, Wang C, Aguirre L, Hussaini M, Chan O, Yun S, Kuykendall S, Padron E, Sweet K, Lancet J, Komrokji R, Sallman D. Drivers of Deep Molecular Response and Outcomes in Patients with Core Binding Factor Acute Myeloid Leukemia. American Society of Hematology Annual Meeting. 12/2022 Institute of Healthcare Improvement – Orlando, Florida 12/2022 • Shakfeh K, Khadilkar A, Parza K, Cummings J, Nehaul R. Improving flu vaccination rates in veterans 65 and older. Institute for Healthcare Improvement. 12/2022 Annual Assembly of Hospice & Palliative Care – Montreal 3/2023 • Ouellette M, Gross C, Oller KL, Cacioppo J, Wilson Morris A, Braverman J. Impact of Organized Palliative Didactic Curriculum on Internal Medicine Resident Comfort with Topics in Palliative Care.
54 x TOTAL PUBLICATIONS x TOTAL PRESENTATIONS
AWARDS & RECOGNITION • ACP Doctor’s Dilemma Team Competes – March 2023 • GME Culture Coin Award • Jameson Kuang • GME Grant Winner • Jerrin Joy Pullukara • Parth Patel • 55
SENIOR TALKS 56 Date Name Topic 7/25/22 Michelle Ouellette Herbal Medications 8/8/22 Alan Roberts Diastolic Heart Failure Updates 8/15/22 Cristiana Cavallari Hepatitis 8/22/22 Jason Gandre Allergy 101 8/31/22 Sam Gidanian Migraines 9/12/22 Hannah Shin Rash in POC 9/19/22 Nicole Dinescu MSK conditions 9/19/22 (slot 2 - 12:30 PM) Frank Soto intermittent/keto/paleo diet 9/26/22 Emilio De Narvaez Infections in travelers 10/3/22 Lauren Rybolt Infections related to disaster or water borne 10/10/22 Chris Millis Pressors 10/17/22 Chase Lewellen Immunotherapy induced myocarditis 10/17/22 12:30 Anna Radisic Ear nose and throat conditions 11/7/22 Anamarys Rodriguez Camacho Management of Acute Lupus Nephritis 11/14/22 Jenna Bilodeau GDMT 11/28/22 Ethan Nowell Animal bites and such 12/5/22 Jonathan Marks 12/12/22 Charlie Cavalaris Incidentalomas 1/16/2023 12:30 PM Erika Dickinson NASH management 1/18/23 (slot 1 = 12:00 PM) Richard Nguyen 1/23/23 Jorden Smith Lung Transplant 1/30/23 Cilia Nazef TB 2/6/23 Juan Enciso Structural Heart 2/15/23 Mevin Mathew EP 2/20/23 Jameson Kuang Insulin 2/27/23 Hannah Suddreth 3/6/23 Wes Wright C. Diff 3/15/23 (slot 1 = 12:00 PM) Vandan Patel Non insulin Tx 3/15/23 (slot 2 = 12:30 PM) Aubrey Schley Pregnancy for IM 3/20/23 Aryanna Jordan PD1 inhibitors 3/27/23 Yiseiry Perez Melendez Hypercoagulability 4/3/23 Omar Calderon Biliary disease 4/12/23 Andrew Graves Vitamin and mineral deficiencies 4/17/23 David Schoenfeld Opportunistic infections in HIV 4/24/23 Abida Babu DOACs 5/1/23 Blake Brown Lung abscess/empyema 5/1/23 12:30 PM Sarah Goodman Extraarticular manifestations of rheumatological diseases 5/10/23 (slot 1 = 12:00 PM) Beatrice Wood VTE in cancer 5/10/23 (slot 2 = 12:30 PM) Chen Wang HLH
57 ROTATIONS CLINICAL
ON THE SPOT EVALUATIONS 58 TGH VA Moffitt other TGH Card Consults TGH Cards Echo (Imaging) TGH Critical Care Cs TGH Endo Consults TGH ER TGH GI Consults TGH Gynecology Clinic TGH Hem/Onc Consults TGH Hospitalist TGH ID TGH Nephro TGH Neuro Consults TGH Optho TGH Palliative TGH Psychiatry TGH Pulm Consults TGH Radiology TGH Rheum TGH Stroke TGH Hepatology VA Ambulatory Clinic VA Card Consults VA Derm Clinic VA Endo VA Endo Consults VA ER VA GI Ambulatory VA GI Consults VA Hospitalist VA ID VA Nephro VA Neuro Clinic VA Neuro Consults VA Neuro Consults (Bay Pines) VA Ophtho VA Ortho (PMR) VA Psychiatry (Bay Pines) VA Pulm Consults VA Radiology VA Rheum Clinic VA Subspecialty Clinic VA Urgent Care VA Women's Health MCC BMT and Cell Therapy MCC Heme Amb Clinic MCC ID MCC Onc Amb Clinic MCC Onc Endo Clinic MCC Palliative MCC Pulm Consults Brandon Ambulatory (MedPeds) Kennedy Ambulatory Morsani Allergy Morsani GI Continuity Clinic: Once per block (can be CC attending or subspecialty attending) Morsani CC VA CC HP CC 0 10 20 30 40 50 60 70 80 90 July August September October November December Submitted Evaluations Evals This academic year, in a initiative to increase feedback conversations in electives and clinic blocks, we started an “On the Spot” formative evaluation form. Residents brought to faculty to gain feedback even on one half day, one consult, one clinic visit on the following rotations. We saw great improvement in feedback conversations. We anticipate the dip in October was due to Hurricane Ian impacting the end of some rotations when residents were planning to get feedback. In the first half of the year 370 evaluations were submitted.
James A Haley VA Updates • Return to in-person Conference • This year we have returned to the medical conference room for in-person conferences. Resident and attending attendance has been great which has promoted a vigorous interactive educational experience. Hospitalist attending and IM subspecialist participation with morning report case presentations have facilitated interesting discussions with the development of important clinical pearls. Dr. Lezama’s Board Review sessions have also returned to in- person. • Subspecialty Didactics • Revamped noon conference to pre-COVID times by once again including subspecialty lectures. Lectures include the return of EKG conference with Dr. Bowerman, the development of the radiology lecture series for IM, and additional subspecialty lectures in infectious disease, cardiology, rheumatology, endocrinology, immunology, etc. • Opening of the New Bed Tower- TBD • New team rooms which are much larger and nicer! • New Cafeteria • Nicer single-patient rooms
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TAMPA GENERAL HOSPITAL 64 Didactic Initiatives: Fellow Talks • Designed to bring fellows from each specialty in to teach resident didactic sessions during noon conference Didactic Initiatives: IDT Talks •Designed to bring in interdisciplinary team members to teach basics about various topics in their specialties •Upcoming talks planned from Diabetes Education and Nutrition Didactic Initiative: Subspecialty Attendings talks • Numerous talks from different subspecialty experts including but not limited to the following: Other initiatives: •Patient safety presentation, QI Updates every block by Dr. Peek •Documentation workshops every block by Dr. Gupta and Mateja •CDI every block by Dr. McIntosh •POCUS Workshops taught by Chief Alan Roberts or Jorden Smith •Code Blue Simulations organized by Chief Alan Roberts and Dr. Schwartz for residents on House Officer/ MICU/ CCU prior to starting the rotation - TGH PGY3 Chief, Dr. Ouellette Date Fellow Specialty Lecture Topic 9/20/22 Sonny Pham Palliative Care Symptom mgmt jeopardy 10/24/22 Ricky Patel Cardiology Echo findings Conference 11/15/22 Brian Schlick Heme/Onc Pancytopenia/leukemia 12/19/22 Sam Slone GI GI Bleeds 1/10/23 Lori Le Sleep Medicine Obstructive/Central Sleep Apnea 2/13/23 Matt Rudd Sleep Medicine Insomnia 3/7/23 Stacy Bagrova Rheumatology SLE Basics for Internists 4/10/23 TBD 5/2/23 TBD 6/5/23 TBD Date Department Topic 8/10/2022 PT Overview of PT 9/7/2022 PT PT Discharge Recs 10/5/2022 PT Nystagmus and Vertigo 11/2/2022 Diabetes Education Overview of DM Education