When I was a resident, I wrote an MS Access based database to manage all the hospital consults. I believe to this day, it's still used by my residency program. I had a simple ToDo list for each patient, when one ToDo is done, the resident check it, it will disappear from the list. I agree with Jason - I don't like to use noticeboard or tickler or messaging for ToDo purpose. I am using an MSAccess add-on I wrote myselfto my EMG software for my reports. I am actually thinking of writing a similar one to attach to Synapse database. I have several specific needs, though, to integrate to this add-on database. I need a tracking system for the Mindstreams cognitive assessment test, for example, so the secretay can keep track of the pre-certs, charges, etc. Don't know when I will have time to get to it.