REED NATIONAL MILITARY EDICAL CENTER … · walter reed national military medical center bethesda...

WALTER REED NATIONAL MILITARY MEDICAL CENTER BETHESDA

NATIONAL CAPITAL CONSORTIUM INTERNAL MEDICINE RESIDENCY PROGRAM

2016-2017

Residency Overview

• Mission and Vision Statements • History of Our Program • Program Structure • Research Opportunities • The DC-Baltimore Area • Program Leadership/Contact information

To guide the next generation of military leaders in patient care, research, and medical education,

preparing clinicians to meet tomorrow’s challenges in military

and civilian healthcare

Residency Mission

Walter Reed Vision The patient is at the center

Our patients today… …and our patients tomorrow

Clinical care excellence Quality, safety, and exceptional care experience

Scholarship Research, collaboration, and dissemination

Education Teaching, coaching, and mentorship

Leadership Creating military internists ready to lead change in

health care, both now and in the future

Residency Pillars

Clinical care excellence Quality, safety, and exceptional care experience

Scholarship Research, collaboration, and dissemination

Education Teaching, coaching, and mentorship

Leadership Creating military internists ready to lead change in

health care, both now and in the future

Residency Pillars

PROGRAM HISTORY (BRAC 2011)

Two programs, two facilities — each with a rich history — that have come together

History —

Walter Reed General Hospital first opened in 1909

GME programs started in 1920 with first class of 5 interns

Major Walter Reed was famous for his work on Typhoid, Yellow Fever, and Malaria but died young of a ruptured appendix. Hospital was subsequently named in his honor.

History—NNMC Bethesda

1942 – Naval hospital opened at Bethesda

Named Bethesda for small spring-fed pond that reminded President F. D. Roosevelt of the biblical “pools of Bethesda”

Much of initial design from FDR’s ideas

1973 – IM Residency accredited by ACGME

WRNMMC Hospital Capabilities Premier military hospital in the country

Anchors network of 34 military hospitals/clinics 274 beds, 50 ICU beds, 27 ER beds, 6 story outpatient bldg Extensive subspecialty representation with diverse clinical,

teaching, and research exposure July 2011—merged Army/Navy IM Residency Program

Service-specific slots NEW: Categorical AF slot opened 2016-2017 Officially “Quad-Service” (Army, Navy, AF, USPHS)

ACGME-approved for 93 resident capacity in IM 88 straight IM and 10 IM/Psych (.5 each in dual program)

Patient Population Active duty service members Wounded warriors Retired service members Veterans (VA rotation, VA/DoD sharing agreement) Family members (dependent beneficiaries) Foreign military and dignitaries Members of Congress and the Supreme Court POTUS

PROGRAM STRUCTURE

77 internal medicine residents 30 transitional year interns (co-sponsored) 12 Fellowships – 80+ Fellows 150+ high-quality, invested clinical faculty

USU, VA, FBCH, WRAIR, FDA, NIH, etc. Virginia HC, Washington HC, INOVA Fairfax

Incredible administrators & clinical support staff

Department of Medicine

Residency Program Structure 77 Residents (currently)

30-35 PGY-1 15-20 PGY 2 15-20 PGY 3 3-5 Medicine-Psychiatry combined residents

Click Here for NCC IM/Psych Program Army, Navy, AF, & PHS residents in 2015

Rotation and Faculty Affiliations

Uniformed Services University USUHS faculty attend at WRNMMC WRNMMC is core site for USU IM Clerkships

Opportunities to teach medical students from across country

Academic appointments for residents

“4+1” Ambulatory Block Scheduling Inpatient Medicine shift to day/night team schedule Expanded collaboration with partners (VA, WHC, VHC, FB) Conferences and Academics

Academic Half-Day Grand Rounds Resident Research & QI/PS Curriculum EBM/Journal Club

Improved on-line resources (e.g. Sakai) Outcomes: 100% board pass rate, top 20% of residencies on ITE

Recent Innovations

Intern Rotations Ward Medicine (~12 wks) Inpatient Cardiology (~4 wks) Inpatient Oncology (~4 wks) Medical ICU (~4-6 wks) Emergency Medicine (~4wks) Night Medicine (~2 wks) Sports Medicine (~2 wks) Psych & Gynecology (~2 wks) Elective/Vacation (2-4 wks) Medical Home Ambulatory Medicine – 10 separate weeks

“4+1” Sample Resident Schedule Wk 1 Wk 2 Wk 3 Wk 4 Wk 5 Wk 6 Wk7 Wk8 Wk 9 Wk10

Cohort Orange

Clinic MICU MICU MICU MICU Clinic Wards Ward Wards Wards

Cohort Yellow

Wards Clinic MICU MICU MICU MICU Clinic Ward Wards Wards

Cohort Green

Spec Spec Clinic Heme Heme Heme Heme Clinic Wards Wards

Cohort Blue

ER ER ER Clinic Ward Ward Ward Ward Clinic Elec

Cohort Red

MSK MSK MSK MSK Clinic CCU CCU CCU CCU Clinic

Daily Conferences Daily Report at Noon

Clinical Cases Split Intern/Resident Report

Weekly Medicine Department Conferences Internal Medicine Grand Rounds M&M/Quality Improvement Conferences Clinical-Pathologic Conferences (CPCs)

Clinic conferences Mondays & Wednesdays at 1315

Ambulatory resident-led Journal Club Fridays at 1300

Academic Day Half-Day Interns – Tuesday 1300-1600 Residents – Thursday 1300-1600 Dedicated specialty-specific didactic time

Mystery case for following week High value cost-conscious care “lab machine”

Interactive teaching workshops with faculty facilitation Directed readings Time-Spaced Learning

Academic Day Half-Day

Four week blocks; 5 ward teams, 1 inpatient oncology team

Team = 1 attending, 1 R2/R3, 2 interns, 1 sub-I, 1-2 MS-3

No overnight call (NF team – 1 resident, 2 interns)

Clinical Librarian & PharmD support

Geographic, interdisciplinary rounding with RNs

WRNMMC Wards

RESEARCH OPPORTUNITIES

Housestaff Research Potential to present at national conferences USU & NIH affiliations

Unity of Effort for clinical research funding Academic facility with emphasis on

research and engaged mentorship Research Coordinator: MAJ Charlie Magee,

MD, MPH, USA

See more about resident research/scholarship

Resident Research

ADDITIONAL OPPORTUNITIES

Residency Opportunities… Humanitarian Assistance/Disaster Relief

Landstuhl RMC Wards (Germany)

Naval Hospital Guam ICU

Tactical medicine rotation with DC Park Police

Away research rotations in Kenya, Peru, Djibouti, Honduras, etc.

ICU at Washington Hospital Center (WHC), Virginia Hospital Center

Advanced Heart Failure rotation (WHC)

Elective opportunities in palliative care, HIV clinic, Arlington Free Clinic, NIH Undiagnosed Diseases Program, and others

USNS Comfort Hospital Ship

Teaching

ACP Medical Jeopardy (Doctor’s Dilemma)

2015 MD ACP 1st Place

2014 Army ACP Judges

2014 Army ACP 1st Place

2015 National ACP Finalists

MORALE BOOSTERS

Hospital Dogs

Team Building

Navy Medical Corps Ball

LIFE AFTER INTERNSHIP AND RESIDENCY

2015 PGY-1 Graduates: Internal Medicine Residency (11) Flight Surgery (4) Undersea Medicine FMF Marines (Camp Lejeune) San Diego (2)

SeaBees Naval Training Center

Where Do Navy Interns Go?

Recent Navy Interns (2013 & 2014) Internal Medicine Residency (16)

Flight Surgery (9) Undersea Medicine (3) FMF Marines (6) Okinawa (2) Camp Lejeune (4)

USS Wasp Pathology Residency

Where Do Army Residents Go? 2015 Graduates:

IM Fellowships (3) ID (2), All/Imm

CONUS Hospitals (4) WRNMMC (2), Ft. Belvoir (VA), Ft. Eustis (VA)

168th Med Battalion, Camp Red Cloud, Korea Chief of Residents

Recent Army Graduates (2013 & 2014) IM Subspecialty Fellowships (9)

Pulm/CC (3), Heme/Onc (3), GI (2), Cards CONUS Hospitals (7)

Ft Bragg (NC), Ft. Drum (NY), Aberdeen PG (MD), Ft. Eustis (VA), Ft. Campbell (KY), Ft. Jackson (SC), Ft. Belvoir (VA)

121st Evac Hospital, Korea Chiefs of Residents (2)

Where Do Navy Residents Go? 2015 Graduates:

IM Fellowships (3) ID, Pulm/CC, Rheum

CONUS Naval Hospitals (3) WRNMMC (2), Great Lakes (IL)

Naval Hospital Guam Chief of Residents

Recent Navy Graduates (2013 & 2014) IM Subspecialty Fellowships (5)

ID (3), Cards (1), Heme/Onc (1) OCONUS Naval Hospitals (4)

Guam (2), Okinawa, Yokosuko CONUS Naval Hospitals (4)

Jacksonville (2), WRNMMC, Oak Harbor (WA) USS America – Senior Medical Officer Chiefs of Residents (2) Office of the Attending Physician, US Capitol

Fellowship Training at WRNMMC Cardiology Gastroenterology Pulmonary Critical Care Sleep Medicine Nephrology General Internal Medicine/MPH or MHPE

Endocrinology

Rheumatology

Hematology/Oncology

Infectious Disease/MPH

Allergy/Immunology

THE WASHINGTON, D.C. AREA

Washington DC/Baltimore Metropolitan Area

Cost of Living Generous tax-free housing

allowance (BAH) Wide range of housing

options Metro Check Program

Max reimbursement well above average costs

WRB is metro accessible (Medical Center Stop)

Rank BAH W/ dependents

BAH W/O dependents

O-3 $2700 $2523

O-4 $3108 $2673

PROGRAM LEADERSHIP AND POINTS OF CONTACT

2016-2017 Residency Program Leadership (click to e-mail)

Program Director: CAPT William Shimeall, USN, MD, MPH, FACP

Associate Program Directors: LTC Joshua Hartzell, USA, MD, FACP LCDR Casey Flanagan, USN, MD, FACC Julie Chen, MD FACP MAJ Renee Mallory, USA, MD, MPH, FACP

IM/Psychiatry APD: MAJ Vincent Capaldi, USA, ScM, MD, FAPA

Assistant Program Directors: Chin Hee Kim, MD FACP (Quality Improvement/Patient Safety) Chiefs of Residents: CPT Hector Medina, USA, MD

LT Brett Sadowski, USN, MD

Program Administrators: Marla Redmond (DOM GME) Mrs. Geraldine Marquez

Chief, Dept of Medicine: Asst. Chief, DOM : Director for Medicine:

CAPT (s) Anthony Nations, USN, MD, MBA FACCP LTC Rose Ressner, USA, MD, FACP COL Stuart Roop, USA, MD, FACCP

Questions? Residency Program Office: (301) 319-8754

America Building, room 3607 Interviews: geraldine.r.marquez.civ@mail.mil

(Mrs. Geraldine Marquez)

Schedule 4th Year Rotations: jacqueline.drake@usuhs.edu (Ms. Jackie Drake) (301) 295-9727

Program Director: CAPT “Bill” Shimeall: (301) 319-8111

See more about what our interns, residents, and faculty are up to...

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