WALTER REED DOM GRADUATE Department of

GME Snapshot Walter Reed Bethesda Graduation Edition 2017

The FUTURE of Military Medicine Graduation Edition 2017

LEADERSHIP TEAM

ALLERGY/

Program Director: COL Maureen Petersen Associate Program Director: LCDR Taylor Banks Program Administrator: Ms. Rachel Jenkins

CARDIOLOGY Program Director: COL Todd Villines Associate Program Director: CDR Matthew Needleman Program Administrator: Ms. Penny Sharps

DERMATOLOGY Program Director: COL Jon Meyerle Associate Program Director: CDR Kent Handfield, MAJ Caitlyn Fink Program Administrator: Ms. Chaconia Agyenkwah RESIDENT AND FELLOW GRADUATES

ENDOCRINOLOGY Fellowship Program Director: CDR Thanh Hoang INTERNAL MEDICINE Associate Program Director: MAJ Nicole Vietor MAJ Amanda R. Duttlinger – Tripler AMC Program Administrator: Ms. Keisha White Graduating interns who are leaving WRB IM MAJ Jacqueline Kircher – William Beaumont AMC LT Paul Cusmano – IM NMCSD MAJ Jason M. Reese – Madigan AMC LT Amoreth Gozo – NH Pensacola LCDR Lauren A. Weber – Walter Reed NMMC Program Director: LTC Dawn Torres LT Anthony J. Greco – Flight Associate Program Directors: CDR Ruben Acosta (FBCH), CPT Julie Heitz (IM-Psych) – pending GMO MAJ(P), Mike Dann, MAJ Ryan Kwok, LCDR LT Kyle Keinath – FMF Camp Lejeune Manish Singla (Academics) CPT Casey M. Chern – Walter Reed NMMC Capt. Andrew Kim – WRB CPT Rachel C. Falkner – Darnall AMC Program Administrator: Ms. Keisha White LT Daniel Kozicki – FMF Camp Lejeune LT Shayna C. Rivard – Naval Guam LT Benjamin Little – FMF Camp Lejeune LCDR Bradley M. Taylor – Naval Hospital Okinawa INTERNAL MEDICINE RESIDENCY LT Vince Lubetski – FMF Camp Lejeune CPT Richard R. Pierce – Womack AMC Chief Residents: CPT Sarah Ordway, LT Thomas Mellor LT Kristin Mangalindan – FMF Okinawa Program Director: CAPT William Shimeall LT Dinh Ngo – USS Wasp LHD1 Associate Program Directors: CDR M. Casey Flanagan LT Alan Nicotra – Flight Surgery (USN), Dr. Julie Chen (CIV), CPT Adam Barelski LT Sydney O’Malley – Flight Surgery MAJ Terry Shin– Walter Reed NMMC (USA), Dr. Chin Hee Kim (CIV) LT Tanner Slayden – FMF Okinawa CPT Matthew H. Kemm – San Antonio MC Assistant Program Director, EBM: CPT Blair Glasgo (USA) LT Keenan Wheeler – Flight Surgery Program Administrators: Geraldine Marquez, Bernadette

Roach, Marla Redmond (DOM GME Supervisor) GASTROENTEROLOGY

MAJ Dustin M. Albert – Eisenhower AMC Graduating Seniors – new PCS location MAJ Noah M. Hall – SAMMC - CPT Noah Choi – Korea Program Director: LTC David Van Echo MAJ Charlene A. V. Hauser – Darnall AMC CPT Ben Collen – SAMMC Associate Program Director: MAJ Mary Kwok LT Jeannette Collins – NCC Pulm/CC Program Administrator: Ms. Penny Sharps LT Camille Costan-Toth – Fort Belvoir CH HEMATOLOGY-ONCOLOGY

CPT Alex Dew – NCC Heme/Onc MAJ Joseph Roswarski – Tripler AMC INFECTIOUS DISEASE LCDR Ian Grasso – NCC Pulm/CC LCDR Karen Zeman – Walter Reed NMMC Program Director: LTC Rose Ressner LT Johnny Greenwald – Naval Hospital Okinawa Associate Program Director: LTC Jason Blaylock LT Shanley Ignacio – Walter Reed NMMC Program Administrator: Ms. Penny Sharps INFECTIOUS DISEASE CPT Zach Junga – NCC GI MAJ Nathanial K. Copeland – WRAIR LT Ben Kurth – Walter Reed NMMC MAJ Matthew J. Perkins – William Beaumont AMC LT Alison Lane – NCC ID Program Director: LTC Lisa Prince LT Tom Mellor – IM Chief of Residents Associate Program Director: Dr. Christina Yuan LT Kyle Mikals – Walter Reed NMMC NEPHROLOGY Program Administrator: Ms. Keisha White LT Pat Moon – NMCSD Pulm/CC Capt Evan I. Fisher, USAF – Wright Patterson AFB

CPT Sarah Ordway – IM Chief of Residents PULMONARY & , LT Rob Park – NH Yokosuka PULMONARY & SLEEP MEDICINE, CRITICAL CARE CPT Cynthia Philip – NCC Cardiology CRITICAL CARE Program Directors: CPT Bryan Wilson – MAMC MAJ William A. Londeree – Tripler AMC Pulmonary Critical Care: COL John Sherner CPT Daren Yang – SAMMC Associate Program Director: LCDR Joe Zeman MAJ Michal J. Sobieszczyk – SAMMC CPT Yu-Ching Yeh – pending (JAN 2018) Critical Care: COL Jeffrey Mikita Maj Charles G. Stahlmann – Nellis AFB

Associate Program Director: MAJ Paul Clark

Sleep: LTC Jacob Collen /IMMUNOLOGY Associate Program Director: COL Brian Robertson MAJ Jeannie L. Bay – William Beaumont AMC CPT Wayne T. Bailey – Fort Belvoir CH Program Administrator: Ms. Moszella Humphrey CPT Camellia L. Hernandez – Tripler AMC LT Jeffrey C. Eickhoff – NMC Portsmouth

MAJ Evelyn M. Lomasney – Womack AMC CPT Rodger S. Stitt – Walter Reed NMMC RHEUMATOLOGY Program Director: COL Jess Edison

Associate Program Director: MAJ Christopher Forster SLEEP MEDICINE

Program Administrators: Ms. Marla Redmond CPT David P. Shaha – Womack AMC

CPT Jennifer M. Slowik– Madigan AMC

UNIFORMED SERVICES UNIVERSITY MAJ Patrick R. Smith – Madigan AMC

Department of Medicine Chair: Louis Pangaro, MD

EDITOR — Sean M. Lynch Graduation Edition 2017

Contents

20 7 16

HIGHLIGHTS PUBLICATIONS HAILS, FAREWELLS AND PROMOTIONS 4-6 Resident, Intern and Fellow 12 Remarkable Scholarly Activity Graduates 18 Newly Selected 12-13 Just Published—Chief of Gastroenterology Service Chief 7 Welcome New Interns Residents, and ID Fellows 18 Promotions RESEARCH AND EDUCATION, SCHOLARSHIP ACADEMIC SUCCESS AND OUTREACH 18 Passing the Baton in General Internal Medicine Service 8 IM Residents Present Their Year- 14 New Educational Curriculum long, Interdisciplinary Process CHECK IT OUT Improvement Work 14 Important Discussion for Interns, Residents and Fellows 19 IM Residency Lampoon 9 First Place Clinical Vignette and Banquet Podium at the Maryland ACP 15 Crowdsourcing Idea Gains Tremendous Support 20 Resident Perspective 9 SGIM Young Scholars and Innovations in Medical 15 IM Resident Team’s Pilot 20 Emotional Intelligence Education Session Program Shows Early Success 10 Medicine Trainees Showcased at Research and Innovation WELL-DESERVED RECOGNITION Competition 16 Twelve DOM Clinical 10 Student Highlights Personnel Recognized as Master Clinicians 11 Hem/Onc Fellow News 16 Chief Resident Selections 11 Notable Events in the Rheumatology World 17 Great Handoff During Patient Transport 18 17 Resident Teacher of the Year

resident and intern graduates

Navy IM Resident Graduates: (back row L-R) LCDR Ian Grasso, LT Patrick Moon, LT Shanley (L-R) LT Jeannette Collins and Dr. Julie Banaag, LT Benjamin Kurth, (front row L-R) LCDR Hyun (Robert) Park, LT Thomas Mellor, Chen enjoying the celebration LT Alison Lane, LT Jeanette Collins and LT Kyle Mikals

Graduation was held at The Strathmore Music Center on June 23, 2017. The program of events started off with the traditional academic procession, presen- tation of colors, the “national anthem,” presented by The United States Navy Band, and the Invocation. COL Michael S. Heimall, MSC, USA, Director of Walter Reed National Military Medical Center, then made opening remarks reflecting on his 30 years of active duty service before introducing the keynote speaker. Chiefs (CPT Hector Medina and LT Brett Sadowski) with PGY-1 RDML Ronny L. Jackson, MC, USN. RDML graduates LT Kristin Mangalindan and LT Tanner Slayden, who are off on Jackson, to the President (to new adventures at Camp Kinser and Camp Hansen (Okinawa) read RDML Jackson’s biography, please respectively. see the Graduation Program using the link below.) highlighted the unique roles military serve worldwide. RDML Jackson and COL Heimall went on

of Military Medicine Military of to present twenty awards to graduates,

faculty and staff before conferring certificates to over 190 , residency and fellowship graduate. We are extremely proud of our graduates as they capably matriculate to operational, educational, and clinical roles.

FUTURE See the Graduation Program for the com- plete list of National Capital Consortium Intern, Resident and Fellow Graduates:

https://learning.usuhs.edu/x/yKH3oa The The

Army IM Resident Graduates: (back) CPT Zachary Junga, (middle row L -R) CPT Collen Benjamin, CPT Noah Choi, CPT Daren Yang, (front row) CPT Cynthia Philip, CPT Sarah Ordway and CPT Alex Dew 4 Graduation 2017 fellowship graduates

Fellows fill a unique role at Cause for Celebration Walter Reed Bethesda as trainees who also serve as trusted coaches, educators and mentors for Walter Reed housestaff and students. Through clinic interactions, inpatient wards, academic half day didactics, and through side by side work on countless research projects, fellows are an integral part of GME at Walter Reed. Those graduates leaving for Cardiology unleashed! (L-R) MAJ Jason Reese, LCDR Lauren Weber, MAJ Amanda Duttlinger, MAJ Jacqueline Kircher, other duty stations will be COL Todd Villines, Program Director, NCC Cardiovascular Diseases Fellowship missed greatly.

Endocrinology fellow graduates with Fellowship Director CDR Thanh Hoang (Center) (Left: CPT Nephrology Fellow graduate Capt Evan Fisher, Allergy/Immunology Program Director COL Maureen Matthew Kemm and Right: MAJ Terry Shin) USAF (left) with Program Director (LTC Lisa Petersen, USA (Left) with LCDR Taylor Banks, USN Prince, USA) (Right) enjoying the graduation activities

Pulmonary and Critical Care Fellow Graduates (Left to Right: MAJ Graduating Infectious Disease Fellows MAJ Matthew Perkins and MAJ Nathanial Copeland pose with LTC Rose Ressner, Program Director, NCC Charles Stahlmann, 5 USAF; MAJ Graduation Michael Sobieszczyk, 2017 USA; MAJ William Londeree USA) ID Fellowship graduation awards

Members of the Internal Medicine GME Team enjoying the celebratory atmosphere of graduation: (L-R) CDR M. Casey Flanagan, Ms. Geraldine Marquez, CAPT Bill Shimeall, Dr. Julie Chen, Ms. Bernadette Roach and CPT Adam Barelski

DOM SUPPORTED GME INTERNS, RESIDENTS, FELLOWS AND FACULTY HONORED AT JOINT GRADUATION CEREMONY Robert A. Phillips Award Among the Winners at the National Capitol Region Military Research Competition: CPT Elizabeth Cleveland, MC, USA, Transitional Year Intern Every year we honor the trainees and faculty who have demonstrated and rising Dermatology Resident excellence in clinical care, leadership and scholarly activity. The follow- ing earned special recognition at the 2017 Graduation Ceremony: The Robert A. Phillips award recognizes the outstanding individual research projects in both staff/fellow and resident categories presented during the annual National Capital Region Military Research Competition. This award honors the Graduation Awards memory of CAPT R. Phillips, MC, USN. CAPT Phillips was a distinguished medical scientist who played a key role in the establishment of Navy Medical Research

Units throughout the world. He is credited with the development of an oral Outstanding Intern Award rehydration solution used to treat patients with cholera and other diarrheal LT Sean A. Lacey, MC, USN, Transitional Year illnesses, resulting in millions of lives saved annually. The outstanding intern is selected by the intern program directors. These individuals are judged to have the best academic performance, compassion for patients and outstanding interpersonal skills.

Outstanding Faculty Award Lieutenant Neil Holland Award CPT Adam M. Barelski, MC, LT Serennah E. Harding, MC, USN, Internal Medicine PGY-2 Resident USA, Associate Program The Lieutenant Neil Holland award is presented annually to the Walter Reed Director, Internal Medicine National Military Medical Center house staff Member who best exemplifies This award is presented teaching excellence and humanitarianism, ability as clinician, instructor, counselor annually to the staff and mentor voted on by the intern class. physician who is voted by

the current intern class to be Vice Admiral James A. Zimble Award the most outstanding COL Jeffrey A. Mikita, MC, USA, Program Director, Critical Care Medicine physician, teacher and role The Vice Admiral James A. Zimble Award is presented to recognize the Program model. The award is based Director whose contribution, dedication and interest in teaching have significantly on the physician’s supported the WRNMMC Graduate Medical Education Program. In addition to demonstrated abilities as a teaching, all candidates for consideration of the Vice Admiral Zimble award must clinician instructor, have demonstrated scholarly activities including publications, invited lectures, counselor and mentor. membership and/or fellowship in national/international societies.

Graduate Medical Education Mentor Award

Anuradha Ganesan, MD, MPH, Infectious Disease Faculty Click here to view the This award recognized a WRNMMC/NCC faculty member who has had a profound Graduation Program for the impact on an individual or group of individuals as a mentor. The award is based on complete list of awards cumulative mentoring impact to include testimonials, success of mentors, mentoring awards, or mentoring that extends beyond one department.

Parker J. Palmer Courage to Teach Award CAPT William T. Shimeall, MC, USN, Program Director, Internal Medicine The Parker J. Palmer Courage to teach award is an Accreditation Council for Graduate Medical Education (ACGME) award that honors Program Directors who CPT Barelski receives the foster innovation and improvement in their programs and served as exemplary Outstanding Faculty Award role models for residents.

6 Graduation 2017 intern orientation

– found the

CPT John Curtin, CPT Shane Hodson, CPT Mary Gasser, CPT Jendy Weppler, and LT Ryan Azzam (Blue team) at the National Zoo largest spider.

dessert competition, as judged by INTERNAL MEDICINE New interns from , , transitional year join the new internal medicine the chief residents. The red team, LTs Bobeck, Oumet and Barba and interns for an internal-medicine specific orientation. CPT Carbone and Khan captured Welcome first place with an astounding 130 points!. Congratulations to all and good luck in the upcoming New academic year!

Orientation Thank You’s Interns! Thanks Tyler Church, Kim Fabyan, Tanner Slayden and Mike Godar for your efforts in preparing the June is an exciting time for next crew of interns to perform the hospital as graduates safe and effective transitions of Blue team again with an orangutan hanging above them. complete their training and care. Your efforts are truly appreci- the new interns arrive for ated. Thanks Dr. Jennifer Hepps for your leadership in implementing orientation. iPASS across the command.

Thank you to the new Chiefs, Drs. Ordway Mellor for planning and The famed running such a terrific orientation, “Tour de DC” and thank you to all of the wonderful speakers: Dr. Shimeall, Ms. Roach, Ms. Marquez, and Ms. The new internal medicine interns Redmond, Drs. Adam Barelski, arrived in June and festivities began Julie Chen, Bill Kelly, as well as Most of the teams found Dr. Casey Flanagan – immediately! After completing Kelli Bankard from , Red Team (pictured here) has a proof of date. check-in, physical fitness tests, Sarah Cantrell from Library Services Essentris and ALTHA computer & Medical Applications, Ms. Carol training, ACLS/BLS, and military Alstatt from Social Work, and Dr. LT Thong Tran, CPT Michael Bobeck, LT specific training, the finale of inter- Leca from Life Curriculum/IHS. Zach Grice-Patil, LT Matt Nelson and CPT nal medicine orientation included a Chris Macomb (Yellow team) with a friend. competitive scavenger hunt: "Tour de DC." Each team honed team- work skills and developed friend- ships as they foraged the hospital and then greater Washington DC at large or famous statues, the state flags of the chief residents, hospital dogs, discharge planners, the echo reading room and an unannounced ‘selfie’ with the esteemed Dr. Casey Flanagan. They also voyaged to the Arlington Cemetery, local cross-fit gyms and the National Zoo before finally heading to Ellicott City, MD for a dinner sponsored by CAPT Shimeall. The metaphorical cherry on top of the evening was a best

LT Kevin Bobeck, LT Sean Ouimet, CPT Tom Carbone, CPT Hassan Khan and LT Laura Barba (Red team) using the metro to accomplish their mission. LT Erik Anderson, CPT Michael Roth, CPT Kimberly Staudt and LT Patrick Bagley (Purple team) with one of the discharge 7 Graduation 2017 planning nurses on the wards! research and academic success

“Sweet victory: Managing DKA with precision,” Team members: Serennah Harding (Leader), Andrew Spiro, Shanley Banaag, Matt Biscotti, Mcclintick, Stacey, Vince Lubetski, Paul Clark (Faculty Mentor)

“Improving adherence with pharmacy intervention,” Team members: Rob Wauters (Leader), Kyle Mikals, Rob Park, Noah Choi, Joan Ritter (Faculty Mentor)

A blurry but representative picture of the QI presenters and judges at the end of a successful fair! “Impact and prevention of resident burnout,” Team

Over a dozen outstanding resident-led Quality Im- members: Daren Yang (Leader), Yu-Ching Yeh, Bryan 5th annual IM Residency provement Projects were presented, including the Wilson, Ben Collen, Casey Geaney (Faculty Mentor) top three, as determined by our panel of judges: Quality Improvement “Improving resident confidence and clinical outcomes Co-winner: “High value cost conscious care: multiple in the resident continuity clinic with educational Poster Fair and Competition interventions for sustainable reduction of unnecessary intervention,” Team members: Zach Junga (Leader), Todd Looney, Paul Cusmano, Julie Heitz, Kristin diagnostic tests,” Team members: Sara Robinson Mangalindin, Julie Chen (Faculty Mentor) (Leader), Alison Lane, Becky Wetzel, Nora Maddy,

The Department of Medicine and Internal Medicine Brett Sadowski (Faculty Mentor) Residency Program were proud to sponsor the 5th “Reducing inappropriate thrombophilia testing in Annual Quality Improvement Poster Fair and initial unprovoked VTE,” Team members: Dan Selig Competition on Wednesday, May 31st (Leader), Tom Mellor, Jason Unger, Aaron Tallant, Carlie Cerne, Shane Goller, Christina Brzezniak The Internal Medicine residents presented their year (Faculty Mentor) -long, interdisciplinary process improvement work in “Improving advanced directives in the outpatient a poster format. Many of our projects are patient- environment,” Team members: Greg Czaja (Leader), centered and have been recognized nationally Cathy Popadiuk, Keenan Wheeler, Joan Ritter through publication and podium presentations at professional societies. (Faculty Mentor)

Thank You “Mobile health application in modern military Thank you everyone again for coming to support our medicine,” Team members: Pat Moon (Leader), residents and learn about all the innovative ideas to Joe Zeman (Faculty Mentor) improve patient care at WRNMMC and beyond. “7W Signout Standardization,” Team members:

Allison Webb (Leader), Patcho Santiago (Faculty In particular, many thanks to Dr. Chin Hee Kim, Mentor) (Hospitalist, Assistant Chief, General Internal Medicine (WRB) and Assistant Program Director for Quality and Patient Safety, National Capital Region). Chin Hee has “Improving procedure completion rates for internal spearheaded this annual event/QI curriculum over the medicine residents,” Team members: Alex Dew past six years with projects growing in size and impact (Leader), Camille Costan-Toth, Jeannette Collins, annually. Topics are aligned with issues that our Cynthia Philip, Sydney O’Malley, Kim Fabyan, Chin residents and faculty are passionate about. Chin Hee, Hee Kim (Faculty Mentor) we are so glad you will continue to inspire and to work At the QI Fair, LT Sara Robinson was with us in your new role as IM Associate Program recognized for her QI leadership and command “Preventing Patients from Knocking on Heavens Door: Director. impact with a Joint Service Achievement Medal Reducing Door to Antibiotics Time,” Team members: Also, much gratitude to our Faculty mentors, as well David Zusin (leader), Rita Rein, Mark Pilar, Paul Clark as to our (celebrity) guest judges who have volun- (Faculty Mentor) teered their time to judge the competition: CAPT Co-winner: “Improving Rounding Efficiency with Mo- Anthony Nations, Director for Medical Services; LTC bile Workstations,” Team members: Paul Happel Downing Lu, Chief Quality Officer for National Capital *Our guest judge, Paul (Leader), Raj Singaraju, Ben Kurth, Johnny Green- Region-Medical Directorate; COL Clifton Yu, Walter Rosen, MD, is the Medical wald, Adam Barelski (Faculty Mentor) Reed Chief of Graduate Medical Education; and Dr. Officer for the Transform- Paul Rosen, MD, Medical Officer for the Transform- Co-winner: “I-PASS in Essentris: Reducing Sign Out ing Clinical Practice Initia- ing Clinical Practice Initiative, Centers for Medicare Errors,” Team members: Mickey Skaret (Leader), Ian tive. At CMS, he serves in and Medicaid Services*. I especially want to thank all Grasso, Ross Humes, Travis Weaver, Harjinder Kumar the Center for Clinical of our judges for your time and attention in support of Standards and Quality (Faculty Mentor) *more on the i-PASS project on page our residents' efforts to improve patient care. It is (CCSQ) in the Quality Im- 16) truly appreciated by the program and the residents! provement and Innovation Group (QIIG). Dr. Rosen - Captain William Shimeall FINALISTS was also a TED Speaker. Program Director, National Capital Consortium “Improving weight-based vancomycin dosing,” Team Internal Medicine members: Andy Miller (Leader), Sarah Ordway, Joe Maciuba, Adam Barelski (Faculty Mentor)

8 Graduation 2017 research and academic success

INTERNAL MEDICINE

Maryland Chapter, American College of Physicians, Mulholland-Mohler Residents Meeting

Congratulations to all presenters, mentors and This year, as part of the activities celebrating judges who helped Walter Reed Bethesda the Mulholland Mohler Residents meeting make an impact at the Maryland Chapter of (held in May 2017), JCHIMP has agreed to Lastly, a big thank you to Dr. Julie the American College of Physicians Mulholland publish the winners from this meeting. The Chen, Dr. Gretta Diemer, LTC Josh -Mohler Residents Meeting on 18 May 2017 at abstracts from the winners of our 2017 Mul- Hartzell, CPT Blair Glasgo, and St. Agnes Hospital in Baltimore an incredible holland Mohler Residents’ Meeting are now in success. According to the MD ACP Governor, publication in the July issue of the Journal of LT Brett Sadowski for serving as Stephen Sisson, MD, FACP, the event “was Community Hospital Internal Medicine Per- judges at the meeting! another amazing meeting, with over 250 oral spectives (JCHIMP).” – per the website below. and research presenters – topping last year’s total numbers.”

Walter Reed presenters, often repre- senting resident teams and mentors First Place Clinical Vignette included: Podium Presentation GENERAL INTERNAL MEDICINE Oral Research/QI: “Gettin’ Crabby Wit’ CPT Joseph Maciuba – “Improving Vancomy- SGIM Young Scholars It” – Anaphylaxis at a cin Initial Dosing” Innovations in Medical Wedding Poster Research/QI: Education Session Special congrats to LT Nora Maddy – “High Value Cost Conscious LT Rob Wauters, Care: A Multi-Step Reduction in Unnecessary who wow'd the Diagnostic Testing” crowd with his first place Podium Clinical Vignette Posters: Presentation Clinical Vignette describing a CPT Abhimanyu Chandel – “HIV-Associated very Maryland- Primary Arterial ” appropriate case of crab-induced Food- LT Jeffrey Gray – “Weil of Misfortune: Severe Dependent Exercise Leptospirosis in an Active Duty Patient” Induced Anaphylaxis (FDEIAn) . CPT Michael Godar – “Nitrofurantoin-Induced Interstitial Pneumonitis”

CPT Hector Medina Thank you to his mentor, LCDR Taylor Banks, CPT Ross Humes – “Venous Thromboembo- Associate Program Director, NCC TY Intern- lism: A Unique Presentation of Cardiac Amyloi- ship, Allergy/Immunology Staff Physician. dosis” To view presentation: https:// learning.usuhs.edu/x/HFVIzG The abstract is LT (PHS) Vinita Puri – “A Malignancy Mimick- Out-going IM Chief of Residents, scheduled to be published in Journal of Com- er: A Case of Lemmel’s ” CPT Hector Medina, was invited to munity Hospital Internal Medicine Perspec- share the Internal Medicine pro- tives in September. CPT Joshua Tunnage – “Lymphoproliferative gram's Nighthawk initiative to im- Disorder Secondary to EBV in a Patient with prove patient safety and resident Hypogammaglobulinemia” education at the Society of Gen- eral Internal Medicine National Congratulations CPT Travis Weaver – “Unexpected Diabetic Meeting in Washington, D.C. A big congratulations Ketacidosis as a Warning Sign for Pancreatic “Nighthawk: Making Night float to LT Paul Happel who Adenocarcinoma” was recognized by our Education and Patient Safety Chief Residents with a Congrats to all! Soar,” H. A. Medina; B. W. Sadowski; W. Shimeall video as our program's Profiles in Excellence Click Here to View All of the Abstracts awardee.

9 Graduation 2017 research and academic success

INTENAL MEDICINE NATIONAL CAPITAL REGION STUDENT CLASS OF 2018

DC ACP Residents Meeting 9th Annual Research and 2017-2018 Resident Accepted to Present at the American College Innovation Month of Physicians (ACP) Annual

Medical Jeopardy Meeting in San Diego Several Department of Medicine trainees were showcased at the Walter Reed National Mili- tary Medical Center Research & Innovation Congratulations Month competitions. ENS Patrick Bagley on being accepted to pre- POSTER PRESENTATIONS INCLUDED TWO IM sent your poster RESIDENTS: in person at the

“Sensawake for Patients with Obstructive Sleep ACP National Congratulations to the Army and Navy Apnea and Post-Traumatic Stress Disorder,” LT Meeting in San ACP “Doctor’s Dilemma” team who had Camille Costan-Toth Diego in April strong showings against DC’s finest. 2018. The Medi- “Effectiveness of Alcohol-Based Hand Sanitizers cal Student Research and Clinical Vignette in Reducing Bacterial Contamination of Stetho- poster competitions took place on Saturday, Walter Reed Navy – Greg Czaja, Jeffery Gray scopes,” LCDR Alison B. Lane and Paul Happel April 1.

Walter Reed Army – Carlie Cerne, Quality Improvement ENS Bagley's case report entitled Joseph Maciuba and Seth Klusewitz "Streptococcus suis Meningitis" was originally (photo above L-R) Second Place Winner: submitted during his fourth year of medical LT Sara Robinson, MC school at the University of New England High-Value, Cost-Conscious Care: Sustainable College of Osteopathic Medicine,. A class of Reduction in Unnecessary Diagnostic Testing 2017 graduate, he has since joined us for with Multi-Step, Systematic Interventions internship at Walter Reed Bethesda. Ben Little Wins Clinical Vignette Evidence-Based Practice: First Place Winner: Podium Competition MAJ Jason M. Reese, MC Patrick took the advice of CAPT Shimeall to An Evidence-Based Practice Improvement submit to the ACP during their interview, back Lieutenant Ben Project Based on the Updated Guidance for the in October, 2016, and came out a winner. Little presented Management of Myocardial Infarction/Acute his clinical case Coronary Syndrome: A Significant Reduction in NEW: ENS Bagley was recently informed that this vignette at the Unnecessary Orderable Testing and Laboratory case, with his primary author, is pending Costs publication in the International Journal of Infectious 2017 DC Chapter, Diseases. American College Case Report - Interns & Residents of Physicians in CPT Elizabeth Cleveland, MC (Transitional Year Washington DC. Intern and rising Dermatology Resident) He presented his Successful Tofacitinib for a Soldier with unique case of Alopecia Universalis HPSP Georgetown Student viral meningitis due to immunosuppressive collaborates with IM Chief of therapy, which was selected for podium To see this complete list of 2017 Research Residents, earns 2nd place, presentation, a remarkable honor. Dr. Little Competition Winners: was chosen as the Top Case Presentation out https://learning.usuhs.edu/x/ETo60O DC ACP Resident Meeting of nearly 100 original resident submissions.

Along with Walter Reed Bethesda, residency Congratulations to ENS Thank you, Ms. Paula Aman (Research Margaret McCarthy for programs from Georgetown and George Technical Writer and Editor, Military Medical capturing second place for Washington Universities, also attended, Research News, Department of Research clinical vignettes at the DC among others. Programs) for providing the details to the chapter of the American Annual Research and Innovation Month College of Physicians Competition. meeting. ENS McCarthy’s

work on Factor XII deficien- Military Medical Research News Vol. 4, Issue 6 ▪ cy was mentored by Chief June 2017: https://learning.usuhs.edu/x/ Resident CPT Sarah Ord-

XYUcSU way, Hematology Fellow CPT Ryan Jones and Hema- tology/Oncology Chief COL ENS Margaret L. Jeremy Perkins. McCarthy

10 Graduation 2017 fellowship corner

SECOND PLACE

Graduating fellows Wayne Bailey and Jeff Eickhoff won second place in the best poster competition at the 11th Annual North American Young Rheu- matology Investigator Forum, 32nd Annual Con- gress of Clinical Rheumatology.

2ND PLACE, BEST POSTER RUNNER UP

Bailey W, Eickhoff J, Keith M. Improving Gout Outcomes in the Primary Care Setting. 11th Annu- al North American Young Rheumatology Investiga- tor Forum, 32nd Annual Congress of Clinical Rheu- matology; Destin, FL, April 26, 2017.

HAIL AND FAREWELLS

CPT Stitt will join the faculty here at Walter Reed Bethesda CPT Bailey will PCS to Fort Belvoir Community Hospital LT Eickhoff will be PCSing to Naval Medical Center (L-R) CPT Wayne Bailey, LT Jeff Eikhoff, CPT Roger Stitt, and Rheumatology Program Director, Portsmouth COL Jess Edison

- Jess Stitt R and Keith M. Why Is My Foot Swollen? JESS D. EDISON, MD, FACP, FACR Colonel, U.S. Army Medical Corps RHEUMATOLOGY 15th Annual Rheumatology Fellows Forum of the Rheumatology Society of the District of Columbia; Program Director, Rheumatology Fellowship Washington, D.C., May 13, 2017. Notable Events in the Sein N and Edison J. An Unusual Case of Parvo- Hematology / Oncology Fellowship Rheumatology World Associated Arthritis. 15th Annual Rheumatol- ogy Fellows Forum of the Rheumatology Society of the District of Columbia; Washington, D.C., May Did You Know? 13, 2017.

Staff/Faculty: Eickhoff J. Edison J. Peng S. Moratz C. Efficacy of Coagulation Pathway Inhibitors in Attenuating Captain Keith completed a 3.5 year term as the Secondary Injury in Lupus Ischemia/ MAJ Joseph Roswarski (PGY-6, third year fellow) Navy Rheumatology Specialty Leader (Consultant) Reperfusion (IR) Murine Model. 11th Annual North was invited to attend the American Society of March 2017 American Young Rheumatology Investigator Fo- Clinical Oncology’s (ASCO) annual meeting in rum, 32nd Annual Congress of Clinical Rheumatol- Chicago from June 2-6 where he led a seminar COL Edison was named Consultant to the Army ogy; Destin, FL, April 26, 2017. (ORAL PODIUM attended by over 30 GME trainees and medical Surgeon General for Rheumatology. He was also PRESENTATION) students entitled “Why I Chose Oncology: Choos- named the American College of Physician's repre- ing an Oncology Fellowship.” sentative to the American Academy of Orthopedic FIRST PLACE Surgeon's Appropriate Use Criteria for Manage- LCDR (s) Jaime Gastwirt (PGY4, 1st year fellow) ment of Osteoarthritis of the Hip Voting Panel. Graduating fellow and current Chief Resident/ was selected by the American Society of Hema- Rheumatology Fellow CPT Medina won 1st Place tology (ASH) to serve a 2 year term as one of the at the poster competition at the 11th Annual 12 members of its National Trainee Council Fellows: North American Young Rheumatology Investigator wehre she will represent trainees and their Forum, 32nd Annual Congress of Clinical Rheuma- needs to the ASH leadership. TOP SCORE IN THE NATION tology. MAJ Chris Drinkwater (PGY-4, 1st year fellow) CPT Rodger Stitt scored the top score in the na- FIRST PLACE, BEST POSTER received the Fellow Teacher of the Year 2016- tion on the rheumatology In-Training Examination 2017 as selected by the Internal Medicine Resi- in the Spring of 2017. Great work Rodger! Medina H, Eickhoff J, Edison J. Thinking Inside the dents. Box: Synovial Tissue Biopsy to Better Target Check- BLUE RIBBON WINNERS point Inhibitor-Induced Arthritis. 11th Annual LTC David C. Van Echo North American Young Rheumatology Investigator Program Director CPT Stitt and MAJ Sein were two of the three Blue Forum, 32nd Annual Congress of Clinical Rheuma- NCC Hematology / Oncology Ribbon Winners at the 15th Annual Rheumatology tology; Destin, FL, April 26, 2017. Fellowship Fellows Forum of the Rheumatology Society of the District of Columbia; Washington, D.C., May 13, 2017.

11 Graduation 2017 publications

WALTER REED NATIONAL MILITARY well-deserved recognition MEDICAL CENTER JUST PUBLISHED

Incredible Rate of UNIFORMED SERVICES UNIVERSITY Scholarly Activity INTERNAL MEDICINE Staff Appreciation By Internal Medicine Residency Program at WRB “Factors Influencing Decisions About a Career in : A Survey of Thank you for all of your hard work Gastroenterology Fellows” and attention to detail The residency program is pleased to announce that 2016-7 was another prolific year in house- Rhonda, staff research and scholarship. Residents pre- A successful year! sented their original research at 17 local, region- One of our new Chief of Residents, Thanks for your work in organizing and al, national and international conferences (not CPT Sarah Ordway, as first author in disseminating the schedule, and making including several research and quality improve- Hepatology Communications sure each speaker each week had what they ment symposiums at Walter Reed). Published online. Should be in pub- needed. Totals: med soon. Co-Authors include: LCDR Dr Pangaro Manish B. Singla, CAPT Patrick E. First-authored Peer Reviewed Publications: 9 Research Podium Presentations: 1 Ms. Rhonda Stout is the Assistant to the Young and MAJ Ryan M. Kwok Research Poster Presentations: 9 Vice Chair and Grants Management Clinical Vignette Poster Presentations: 58 Specialist for the Department of Medicine, Clinical Vignette Podium Presentations: 2 HEPATOLOGY COMMUNICATIONS, VOL. Research Division, at Uniformed Services Quality Improvement Poster Presentations: 4 University of the Health Sciences. She is in Quality Improvement Podium Presentations: 2 00, NO. 00, 2017 charge of The Department of Medicine GRAND TOTAL: 85 Research Seminar Series. She reaches out Despite an unmet need for hepatologists to a vast audience and a large number of in the United States, every year trans- speakers each week. Additionally, there were five articles published plant hepatology (TH) fellowship posi- with residents as supporting authors during the tions remain unfilled. To address this, we 2016-2017 academic year. investigated factors that influence trainee INTERNAL MEDICINE decisions about pursuing a career in Our residents’ outstanding work was also recog- hepatology. We invited current gastroen- nized with two podium first place awards, 3 Outstanding Personnel poster first place awards, as well as numerous terology (GI) and TH fellows from all Ac- second and third place finishes . creditation Council for Graduate Medical Take on Additional Education-accredited programs for the Responsibilities The abundant success of our residents reflects on academic year 2014-2015 to participate their dedication to scholarly activity, research, in an online survey about factors influenc- and quality improvement. Furthermore, it high- ing decisions to train in hepatology. The lights the program’s recent efforts to facilitate same paper-based survey was distributed Appointment as Associate Program presentation opportunities . The IM residency at a nationally recognized GI board review Directors program coordinators deserve special recogni- course. The survey was completed by 180 tion for their herculean efforts to arrange travel participants of which 91% were current GI The National Capital Consortium (NCC) and lodging. We hope to continue to grow op- portunities for scholarship in the near future, or TH fellows and 24% were not aware of Graduate Medical Education Executive focusing on developing high impact QI/Research the pilot 3-year combined GI and TH Committee officially announced the presentations and aligning with the command’s training program. A majority of respond- appointed of CPT Adam Barelski, Staff initiative for high-value, cost-conscious care. . ents (57%) reported that a shorter time (3 Physician, and Dr. Chin Hee Kim, Assistant versus 4 years) to become board certifica- Chief of Inpatient Medicine, as Associate tion eligible would influence their deci- Program Directors (APD) for the NCC A big “Thank You” from the Internal sions to pursue TH. The most common Internal Medicine Residency Program at reasons for not pursuing hepatology were Walter Reed Bethesda. Medicine GME team to Dr. Brett less time (67%), additional Sadowski for creating and maintaining this Scholarly Activity Report. It took length of training (64%), and lack of finan- Congratulations Adam and Chin Hee. We cial compensation (44%)... a lot of effort and time to create and are looking forward to your leadership and working with you on upcoming projects in to maintain a report that captures your new roles as NCC Associate Program everyone’s innovation and hard work Directors. in the form of scholarly activity. Click Here to Read the Full Article

12 Graduation 2017 publications

INTERNAL MEDICINE What a great honor Brett, as well as a great responsibility! Well done! JUST PUBLISHED Scholarly Recognition - Dr. Yu Yu, Clifton E COL USARMY DHA (US)

INFECTIOUS DISEASE Resident Editor to the Editorial Board of Congrats! This is incredible opportunity. - Josh the Journal of Graduate Medical Tropical Diseases, Education (JGME) LTC Joshua Hartzell, USUHS

Travel Medicine

Recently, LT Brett W. Sadowski (previously Congratulations! This is an excellent opportuni- and Vaccines known as one half of “Brector”) was welcomed ty and chance to look under the hood while as a resident editor to the editorial board of contributing to the advancement of GME re- the Journal of Graduate Medical Education search. (JGME) by Gail M. Sullivan, MD, MPH, the Edi- Well done! tor-in-Chief of the Journal of Graduate Medical Congratulations to the Infectious Bill Education. She explained that, “editors on the Disease Service Fellows: CPT Jack CAPT William Shimeall, IM board include a wide variety of education and Hutter, CPT Jen Masel, and LT education research experts in terms of medical Christie Joya, and to CAPT Timothy specialty, geographic location, age/seniority, Whitman and interests. Overall we are focused on nurturing both creators and consumers of GME research. At a time of rapid changes in GME, RHEUMATOLOGY we want to add actual evidence to the discus- “Guidelines for the prevention of sions.” As a resident editor, Dr. Sadowski will travel-associated illness in older be involved in everything from selecting Accepted for Publication adults” reviewers and providing editorial comments, to creating workshops given by JGME editors Abstract: International travel to the at various meetings. developing world is becoming more "Pegloticase for Refractory Crippling common in elderly patients (defined You are going to make a terrific addition to the Gout in a Nonagenarian" here as individuals greater than 65 team Brett!! years old). When providing pre-travel Dr. Noah Choi’s manuscript has recently been counseling, providers must appreci- accepted for publication in the JCR: Journal of Clinical Rheumatology, JCR-17-185, entitled ate the changing physiology, comor- "Pegloticase for Refractory Crippling Gout in a bidities, and pharmacoki- Nonagenarian" netics associated with the aging pro- cess to prepare elderly patients for “The JCR is a peer-reviewed semi quarterly the stressors of international travel. journal listed on Medline and dedicated to the These guidelines present an evidence study of rheumatologic and musculoskeletal -based approach to pre-travel coun- diseases. Each issue contains original articles, seling, immunization, and pharmacol- case reports, reviews, expert commentary, ogy concerns unique to elderly pa- letters to the editors and more, providing use- ful clinical information to practicing clini- tients seeking care in a travel clinic cians…” (http://journals.lww.com/jclinrheum/ setting. pages/default.aspx).

Congratulations on your publication ac- Click her to read the full article. ceptance! Thanks also to your mentors LT Comments: Jeffrey Eickhoff and CAPT Michael Keith. Ex- cellent work! Wonderful news and well-earned honor! I have no doubt you will serve with distinction in this role. Best regards, - Pat CAPT Patrick Young, GI

13 Graduation 2017 education, scholarship, and outreach

UNITY OF EFFORT MILITARY MEDICAL RESEARCH NEWS GRADUATE MEDICAL EDUCATION

New Educational Curriculum New Issue of Newsletter Is It Burnout

With a Focus on or Something Else?

Suicide Prevention Reflective Practice A Good Discussion for Interns,

We adapted and incorporated a Reflective Residents and Fellows Practice Curriculum for the internal medicine The newest issue of the newsletter spotlights some interns and residents, and started in 2017. promising work in suicide prevention – they look at “a new program…in prevention strategies, drawn There was a great training video that is 8 min long The curriculum was originally designed at from years of research on cognitive behavioral that the folks at San Antonio presented at AHME. USUHS and over the past few years has therapy. The story is a hopeful take on a tragic The link is below. spread to several other residency programs situation.” around the country with great success! Link: https://learning.usuhs.edu/x/Y31geQ The research that ACGME published in June is ra- ther interesting. They found that during the first 3- WRIM Reflective Practice 401 Curriculum 4 months of internship, individuals are at the high- provides an opportunity to discuss our "Suicide Prevention Resources," to copy, post and est risk for suicide. I was a bit shocked since this would argue against burnout as a primary cause. successes and challenges in designated small share: https://learning.usuhs.edu/x/nNzKDd Hitting this issue early on and creating a culture groups throughout the year to form our where we encourage our trainees to look out for professional identity, build a sense of one another is a good first step. community, identify our biases and assump- tions and how those might impact care. This video is good for discussion for interns, resi- dents, and fellows. The video actually interviews a Possible discussion topics include: Conflict, UNITY OF EFFORT fellow and faculty member who share their stories: Bias, Mistakes, Death, Grief, Racism, Time Nagy C, Schwabe D, Jones W, et al. "Time to Talk Management, and Communication. Longstanding About It: Physician Depression and Suicide"

WRB Staff Physicians and Fellows have volun- International teered to be trained to serve as faculty Tradition MedEdPORTAL Publications. 2016;12:10508. facilitators. They are dedicated to meeting https://doi.org/10.15766/mep_2374-8265.10508 four times a year with their groups. The groups are composed of about five to six Renee interns/residents and one to two faculty facilitators . Faculty facilitators meet with the Phramongkutklao College of Medicine MAJ Renee Mallory same year group each session. Sessions are General Internist held over dinner, preferably outside the Assistant Professor of Medicine hospital (at faculty/resident home or private USUHS and WRB GME worked together to con- Department of Medicine area of a restaurant. Residents have no tinue a longstanding international tradition of in- Uniformed Services University clinical responsibilities and are protected viting Medical Military Students from Thailand to Walter Reed Bethesda and Uniformed Services from being on-call during each session, so University. USUHS hosted a pair of Thai Medical they can focus on the discussion at hand Military Students from Phramongkutklao College of Joint Service Achievement Medicine in Bangkok Thailand for two weeks in th V/R April. 6 Year Medical Cadets Siravich Thamthiti- Internal Medicine Chief Residents, wat and Annop Kittihaworn were selected to partic- Captain Joe CPT Sarah Ordway & LT Tom Mellor ipate. They completed an observership in internal Maciuba was medicine. Cadets Thamthitiwat and Kittihaworn recognized with spent valuable time in outpatient a Joint Service clinics, on the wards and in the ICU, based on their Achievement interests and experience. Medal. Joe Thank You identified a Thank you to CAPT Kelly, and Ms. Debra Weed at critical gap in in Thank you to all of the volunteers and to the organ- USUHS, and to CPT Hector Medina at WRB, and the women's health izers, Drs. Julie Chen, Associate Program Director, staff at Phramongkutklao College of Medicine for services delivery NCC Internal Medicine Residency Program & Direc- coordinating and facilitating this international ex- in the WRN- tor, Resident Continuity Clinic, Tom Mellor, Sarah change. MMC Patient- Ordway, Chiefs of Internal Medicine Residents centered Medical Home and designed educational

2017-2018, and Dr. Sapperstein (who ran it at Special thanks to iCards’ Drs. Collen, Wilson and opportunities that equipped over 85 interdiscipli- USUHS last year) who have worked so diligently to Greenwald, and to MICU’s Dr. Happel. nary get this up and running so our interns and residents providers with the knowledge and skills necessary can benefit from this thoughtful program. to provide previously unavailable contraceptive

options. BZ Joe!

14 Graduation 2017 education, scholarship, and outreach

INTERNAL MEDICINE / NAVY SURGEON GENERAL Navy SG's Digital Health Idea Crowdsourcing In late 2016/early 2017, initiative on milsuite. IM residents Mickey Skaret, Ian Grasso, Ross Crowdsourcing Idea Raj explained that the project is ongoing - he is Humes, and Travis collecting data for ECOMS and is hoping to get Weaver undertook the Scores Big on MilSuite for approval in December. task of improving the Qualification Program process by which the Here is what Leadership had to say about Dr. inpatient services transi- Singaraju’s innovative program: tion care between day and night teams. Specifically, they observed that the Outstanding! It’s the concept and program which old method of creating a “sign-out” document to are earning the votes. hand off to oncoming housestaff was tedious and I think this is a great way to add value to what we prone to numerous errors in communication. This do in the MHS while improving mission readiness document used to be a Word file on the intranet downrange. and interns had to manually type in patient identi- Strong work Raj! fying information, code status, , etc. and copy/paste the current med lists every day. During V/r, one period of observation in February 2017, 336 CAPT Bill Shimeall communication errors were observed in 524 pa- NCC Program Director, Internal Medicine tient handoffs (64.1% risk of error). Walter Reed Bethesda

This is an extremely worthwhile project that will “a relative risk greatly increase the quality of Corpsmen knowledge throughout the fleet. reduction of 71%”

v/r Douglas G. Hawk CAPT MC USN Working closely with ITD staff from the Systems Service Chief, General Internal Medicine Service Delivery & Sustainment and Collaboration & Ex- LCDR Raj Singaraju Walter Reed Bethesda change divisions, the team was able to dust off and modernize an old prototype for an automated handoff tool embedded in Essentris. This program allows housestaff to manually input patients’ "Corpsman Medical clinical history in the “I-PASS” format into a note Qualification Program" “I expect your suggestion may in Essentris and the program combines this narra- receive robust attention and help tive information with the patients’ data already nurture forward and innovative stored in Essentris (name, location, code status, thinking for the future force. … hope meds, allergies, labs, and more). The end result is The Navy Surgeon General was crowd sourcing that it will help us begin to view the an elegant, user-friendly, reliable handoff docu- ideas from the fleet on Milsuite. LCDR Raj world order differently.” ment that can be passed off to oncoming hous-

Singaraju’s (Internal Medicine PG2) submitted his estaff during transitions of care on the inpatient v/r, idea entitled"Corpsman Medical Qualification services. Program." He had been working on a program RADM Rebecca McCormick Boyle that would allow Corpsmen to credential to work Navy Chief of Staff, Bureau of Medicine Following rollout of this program to two medicine independently and then to transfer those skills and Surgery teams, only 57 errors were observed in 307 pa- from one command to the next. The hope is to tient handoffs — this represents a relative risk improve patient care and expand capacity in the reduction of 71% and a number needed to treat operational setting. Dr. Singaraju needed and (NNT) of only three patients! At this time, all of received about 100 votes to make it to the next the inpatient medicine teams (including the CCU stage. and MICU teams), as well as the inpatient pediat- rics teams, are utilizing this automated I-PASS After submission, their innovative program quickly handoff tool. The team is highly anticipating the received notoriety and was quickly recognized as next step in expanding use of this excellent tool to being a strategic idea that could potentially pro- INTERNAL MEDICINE more inpatient services hospital-wide. vide many significant benefits to individual com- mands. As a result, it was forwarded up the chain to key subject matter experts and stakeholders iPass Essentris Signout who are responsible for establishing the strategic direction in alignment with the Surgeon General’s Development Shows Early guidance and for developing priorities and annual plans for individual commands. Success

This is a project that LCDR Raj Singaraju, LT Brian Tran and others developed to enhance transport- able Corpsman patient care skills at III MEF and is now being piloted elsewhere as well. It is up for IM resident team improves process to review and consideration for further expansion/ reap a relative risk reduction after scaling and funding in Navy Medicine through the rollout of pilot program

15 Graduation 2017 well-deserved recognition

INTERNAL MEDICINE

Chief Resident Selections

IM Residents accept positions as Chiefs of Residents for the upcoming AY 2018-2019 Academic Year

With special thanks to the members of the selection committee, residents, faculty and other program stakeholders COL Heimell, Director of Walter Reed, presents the Master Clinician certificates to (L-R) CDR Casey who provided guidance and input on this Flanagan (IM Associate Program Director), LCDR Amy Frankston (Staff, Nephrology), LTC Lisa decision, I am very pleased to announce Prince (Nephrology Fellowship Program Director) and Dr. Julie Chen (Director, IM Resident Continuity that CPT Joe Maciuba and LCDR (SEL) J. Clinic) Paul Happel have both been offered and accepted positions as Chiefs of Residents 2017 ASSOCIATE MASTER CLINICIANS for the upcoming AY 2018-2019 Academic WALTER REED BETHESDA LCDR Amy Frankston, MC, USN (Nephrology) Year.

Master Clinicians Congratulations Joe and Paul! 2017 MASTER CLINICIANS LTC Jason Blaylock, MC, USA (ID) The other applicants made the decision Julie Chen, MD (GIM, IMR Assoc. PD) LCDR John Childs, MC, USN (Derm Path PD) extremely difficult and I think it is fair to CDR M Casey Flanagan, MC, USN (Cardiology, IM say that the committee felt that we really Peers Recognize Exceptional Providers Residency APD) had no wrong choices at all. CDR Todd Gleeson, MC, USN (ID)

Chin Hee Kim, MD (GIM, IM Residency APD) The Master Clinician Ceremony took place on Fri- Tom and Sarah have continued to build LTC (P) Joseph Lee, MC, USA day, 16 June 2017. Three IM Associate Program on the foundations laid by all of the Susan Marullo, BC-ANP, BC-ADM, CDE (GIMS) Directors, nine other Graduate Medical Education WRBIM Chiefs before them, and we look COL Jon Meyerle, MC, USA (Dermatology) faculty/staff and an Internal Medicine staff member Cecilia Mikita, MD (Allergy) forward to Joe and Paul continuing this received the award. LTC Lisa Prince, MC, USA (Nephrology PD) tradition of excellence and innovation as

the program moves forward. This award recognizes the healthcare providers who Thank you COL Michael Heimall, Director WRB, for excel in the clinical delivery of to our handing out the certificates to all of the staff who beneficiaries, as determined by peer assessment. Thank you all for what you do for our were recognized for their hard work and dedica- Awardees have been chosen amongst all privileged program and patients every day. tion. independent providers at Walter Reed National Military Medical Center based on their clinical productivity, professional experience, proven excel- V/r, lent outcomes, patient satisfaction, and contribu- tions to trainee education and clinical research. Bill

This is a special event in which we have an oppor- tunity to celebrate some of our exemplary clinicians William Shimeall, MD MPH FACP who have been chosen to receive this recognition Captain, Medical Corps, US Navy based on clinical productivity, professionalism, and Program Director, National Capital Con- dedication to teaching and research. sortium - Internal Medicine

V/R CDR Gada

Satyen Gada, MD, FAAAAI CDR, MC (FS/FMF), USN President-Elect of the Medical Staff Assistant Chief, Department of Simulation Staff, Allergy/Immunology/Immunizations Walter Reed National Military Medical Center Dr. Chin Hee Kim, Associate Program Director, IM Residency Program, receives the well-deserved Master Clinician certificate

16 Graduation 2017 well-deserved recognition

CARDIOLOGY AND INTERNAL MEDICINE THE DEPARTMENT OF MEDICINE Outstanding Cardiology Fellow Identified AOA Resident Teacher Great Handoff During Dear Maj Skabelund, of the Year Patient Transport Thank you so much for your note! Taking the time to write this is most appreciated and means a lot to us all. The cardiology fellow was CPT Zorana Mrsic and she is one of the most helpful, enthusi- astic and motivated fellows in our program. I have personally passed along your amazing feed- Air Force Pilot Recognizes back to her and will also broadly share this with Cardiology Fellow for our Departmental Leadership. Also, I am sure Demeanor and Professionalism that she would love to participate in the presenta- tion of this case at the ACP meeting. (letter from Pilot Unit Director) Col Villines, Thanks so much for this!

I am Andy Skabelund, I am one of the CCATT phy- Todd sicians that has been flying patients from CENT- COM AOR and LRCM to WRNMMC. On two occa- TODD C. VILLINES, MD sions I have had the distinct pleasure of meeting COL, MC, USA one of your cardiology fellows. I unfortunately do Program Director, NCC Cardiovascular Diseases not recall her name (by the time I land there I Fellowship have usually been up for 24 hours) but I do re- Director, Cardiovascular Research and Cardiac CT member her demeanor and her professionalism. Program This award recognizes one outstanding resident [Later determined to be CPT Zorana Mrsic]. physician in the military health system for excep- tional achievement related to teaching and mentoring that best exemplify the values of AOA. “…she was easily the best physician (trainee or attending) I have interacted with at WRNMMC” CPT Sarah Ordway,

Congratulations on being selected as the Appreciation Uniformed Services (USU) Chapter – Alpha On both occasions she greeted us either outside Omega Alpha (AOA) Resident Teacher of the the hospital or in the ICU before the patient was Zorana, Year. settled. She is the only physician in my time trans- porting patients to WRNMMC that has been so This is outstanding! Thank you so much for repre- Thanks for all that you do and your service prompt. On both occasions she had obviously senting cardiology and the department of medi- to others! prepared by reading all available information cine with your professionalism and clinical excel- from both lence. downrange and LRMC and she was very knowl- Josh edgeable of the patients. She was quick to help Thank you Maj Skabelund for taking the time to with the patient and she had pertinent and rele- send along the great feedback. I appreciate it! Joshua D. Hartzell, MD, FACP, FIDSA vant questions about the transport of the patient. LTC, MC, USA V/R Staff Infectious Diseases The two patients I dropped off were: Brian Hemann Walter Reed Bethesda Office Director of Internal 1 A patient with a long QTc that had coded and Brian A. Hemann MD FACC Medicine Selectives Associate Professor of gone into torsades LTC(P), U.S. Army Medical Corps 2 A patient with a presumed myocardi- Chief of Medicine Medicine Uniformed Services University tis with complete block. Walter Reed National Military Medical Center Associate Professor of Medicine, USUHS I don't often get great handoffs or responses from trainees/fellows that show up, but she was easily the best physician (trainee or attending) I have interacted with at WRNMMC. I would appreciate One Thing CAN Lead to Another it if you could pass on the positive feedback. As an aside, this may also lead to CPT Zorana v/r Mrsic participating in the case report competition with the second case identified, a patient with a Andy Skabelund, MD presumed infections myocarditis with complete Maj, USAF, MC heart block, for the upcoming Army/AF ACP; 59 MDW ERCC Pilot Unit Director there is a fellows section this year for research, QI and case reports.

17 Graduation 2017 hails, farewells, and promotions

INTERNAL MEDICINE PULMONARY & CRITICAL CARE MEDICINE INFECTIOUS DISEASE SERVICE / USUHS

Passing the Baton Promotion to Colonel Promotion to

In General Internal Dr. John H. Sherner, III, Program Director, Associate Professor Medicine Service NCC Pulmonary & Critical Care Medicine Fellowship, was promoted to Colonel in June by his father, COL(Ret) Sherner. COL Congratulations LTC Jason Blaylock, Sherner works at both Walter Reed National Staff Physician, on your promotion Military Medical Center and Fort Belvoir Community Hospital where he is a valuable to Associate Professor of Medicine, educator to students and housestaff alike. USUHS.

INTERNAL MEDICINE

Marc’s Last Day Newly Selected Service Chief and Vice Service Chief

COL John Sherner Please join me in welcoming and congratu- lating LtCol(S) Brian Neubauer and as the newly selected Service Chief and Dr. Joan Ritter as the newly selected Vice Service Chief for General Internal Medicine at Wal- GASTROENTEROLOGY ter Reed National Military Medical Center.

Dr. Neubauer and Dr. Ritter assumed the Smooth Hand Offs leadership duties in the General Internal Medicine Service from Dr. Doug Hawk and A heartfelt farewell was dedicated to Marc Dr. Heather Grote who have served with Newly Selected Gastroenterology Barredo, distinction as the Service Chief and Assistant Service Chief Service Chief since February 2014 and July

2015 respectively. CAPT Hawk and CDR "A heartfelt farewell was dedicated to Mr. Colleagues, Marc Barredo, our beloved Resident Clinic Grote have brought the General Internal Coordinator, who was instrumental in im- Medicine Service to unprecedented accom- Please join me in welcoming and congratulating plishments, highlighted by the selection as LTC Jeff Laczek as the newly selected Service proving resident clinic experience for all our DOM Service of the Year in 2015. Chief for Gastroenterology at Walter Reed. house staff.

If you haven’t done so already, please pass Dr. Laczek will be assuming the leadership duties We appreciated Mr. Kevin Raymond, an along your congratulations to Drs. Neubauer in the GI service from Dr. Dawn Torres who has enthusiastic, member of the PCMH staff for served most admirably as the Service Chief since and Ritter and sincere thanks to Dr. Hawk getting the year off to a great start; and December 2014. Dr. Torres was recently selected please welcome Mr. Allen Kumru who will and Dr. Grote for their service to the to serve as the Fellowship Director for the Gastro- be leading the effort forward. Department of Medicine. enterology training program - a role in which she

will undoubtedly excel. [Thank you CAPT Pat

Brian A. Hemann MD FACC Young for your steller leadership and service as

LTC(P), U.S. Army Medical Corps PD over the previous years.] Chief of Medicine Walter Reed National Military Medical Center Please pass along your congratulations to Dr. Please Laczek and sincere thanks to Dr. Torres for her welcome service to the Department of Medicine! Mr. Allen Kumru to the Internal Kindest regards, LTC Hemann Medicine GME Team Brian A. Hemann MD FACC LTC(P), U.S. Army Medical Corps Chief of Medicine

18 Graduation 2017 check it out

INTERNAL MEDICINE Pulmonary/Critical Care Tradition and Recognition Golden Sputum Award LCDR Ian Grasso MAJ Jason Unger

IM Residency Lampoon and Banquet USU DOM James J. Leonard Award for Excellence in The annual Internal Medicine Residency Lam- Teaching (L-R) LCDR Mary Andrews presents the Leonard Award CPT Sarah Ordway, LT Serennah

Harding, and LT Tanner Slayden poon and banquet was a night of fantastic Intern: food and festivities! This traditional event was LT Tanner Slayden; orchestrated by the Social Chairs (Tanner LT Jeffrey Gray Slayden, Greg Czaja, and Jed Mangal) and the outgoing Chiefs (Hector Medina and Brett Resident: Sadowski). We celebrated and recognized LT Serennah Harding; the our graduating Interns and Residents for CPT Sarah Ordway their exceptional performance and we also recognized the Infectious Disease department Ward Attending: as the Outstanding Teaching service of the CPT Hector Medina year! This event also marked the official pro- gram hand-off to the 2017-2018 Chief of Resi- IM PROGRAM AWARDS (left) CPT Sarah Ordway and (right) LT Mellor receive are recognized dents Sarah Ordway and Tom Mellor). A for their GI achievements special thank you to the covering Walter Reed fellows (Zorana Mrsic, Nicole Harrison, and Intern of the Year Mike McMahon) for holding down the fort/ LT Jeffery Gray manning the ship during the event! Navy GIM Dr. John Eisold Clinic Award LT Alison Lane Hector A. Medina, MD, CPT, MC, USA WRNMMC Rheumatology Fellow (PGY4) Army GIM Dr. Kurt Kroenke Clinic Award – CPT Sarah Ordway

Outstanding Teaching Resident AWARDS CPT Zachary Junga

Fellow Teacher(s) of the Year Resident Researcher of the Year CPT Ryan Haley (Cardiology) and CPT Chris LCDR Ian Grasso LCDR Cheringal (left) presents CPT Drinkwater (Hematology/Oncology) Brian Cuneo Award Becky Wetzel with the Jamshidi award LT Jeanette Collins Fellow Mentor of the Year Most Dedicated Resident LCDR Hampton Crimm (Cardiology) LT Jeanette Collins

Outstanding Teaching Attending Outstanding Graduating Resident CPT Adam Barelski (General IM) LT Alison Lane

Mentor of the Year The Chief Residents (2016-2017), CPT Hector LCDR Manish Singla (Gastroenterology) Medina and LT Brett Sadowski were recog-

nized for their dedication and leadership. Chief Residents’ Award for Outstanding Teaching Service LT Gray (center) Intern of the Year Infectious Disease Service (Two years in a row!)

SUBSPECIALTY RESIDENT AWARDS

Platinum Jamshidi CPT Becky Wetzel

Outstanding GI Performance CPT Sarah Ordway LT Tom Mellor (L-R) 2016-2017 IM Chiefs of Residence LT Brett Sadowski and CPT Hector Medina presenting the Outstanding Graduate Resident Award to LT Alison Lane COL Kelly congratulating LCDR Grasso

19 Graduation 2017 check it out

gently to maintain our DEPARMENT OF MEDICINE integrity by “doing the right hard thing”, what- ever that may be in our Emotional Intelligence present situation. By doing so, we will be investing in our own reward. Sometimes CAPT Patrick Young, serving as the Program those rewards come in Director for the GI Fellowship Program at the the tangible ways you time, recently delivered an insightful and hope for, and other practical presentation on Emotional times, they come in the Intelligence at Grand Rounds. You can view more unexpected ways. his slides and see you score on the emotional Whatever might be scale survey below. your personal motiva- tion, I would encourage An Overview: LT Serennah Harding you to think on it daily; on the metro or car ride in to work, on the “The ability to recognize and appropriately INTERNAL MEDICINE elevators between cases, and in the respond to emotions - both your own and stairwells as you run to a Code. those of others - is a critical leadership skill. High emotional intelligence has been associ- Resident Perspective Your reward may come in the form of a ated with decreased burnout and enhanced Thank You from a colleague or a pa- patient satisfaction, and is a trait shared by tient, or it may be the self-sustaining 90% of "c-suite" level leaders. The best news- awareness of your own “job well it can be learned! Unlike your general intelli- done.” We can also count on the finish gence, which is relatively fixed, your emotion- Doing the Right Hard Thing line of residency graduation, I trust. al intelligence is

Doing the right hard thing on a daily malleable and can be consistently improved - Inspired by the Internal Medicine Residents basis at work is the motivating culture starting today."

amongst Walter Reed’s Internal Medi- There is a saying that goes, “the right cine Staff and Residents. It is apparent thing to do and the hard thing to do are and contagious throughout the Pro- Click here to view CAPT Young’s usually the same.” gram. I am honored to be among such presentation As one of the many medical trainees in a caliber of people. our program, we often find ourselves in Best, situations which challenge our integri- See how you score on the Assessing Emotions ty. For the sake of this article, I would Serennah Scale survey : https://learning.usuhs.edu/x/ suggest synonyms for integrity to be Serennah Harding, D.O. sOYM9S grit, professionalism, and resilience. LT FMF MC USN From one resident to another, whose Internal Medicine Resident limits are daily still being established Year 3 The topic Dr. Young covered is part of the and challenged, I find that maintaining LEAD 2.0 series, and is an extremely valuable integrity in one’s work is the founda- for Faculty Development as well as GME tion of professional satisfaction. LT Serennah Harding appears in the GME trainee development. Also, note the schedule for the coming AY 2017-2018 LEAD 2.0 ses- We have many demands on our time. newsletter three times: receiving the Neil sions and their reduction to the one hour We have friends and family to balance Holland Award, as a finalist in the QI Poster time slot. with work. And, we have academic Fair, and for her writing this Resident Per- milestones to reach which sometimes spective. seem unsurmountable. That being said, we are faced with the daily human need of wanting reward, recognition, and satisfaction in our work. Staff phy- Thank you Dr. Harding for all of your sicians and residents alike, work a tre- hard work, including writing this mendous amount of hours and do thoughtful passage. You have now make numerous personal sacrifices for their patients who entrust us with their joined the other greats, including Dr. care. One way to cultivate present and Mickey Skaret and Dr. Zach Junga. future satisfaction in our work is to, no matter how hard at the time, fight dili-

20 Graduation 2017