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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 Residency Mission 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 Walter Reed Vision The patient is at the center Our patients today… …and our patients tomorrow 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 . 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 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 Department of Medicine . 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 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 Recent Innovations . “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 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 Clinic MICU MICU MICU MICU Clinic Wards Ward Wards Wards Orange Cohort Wards Clinic MICU MICU MICU MICU Clinic Ward Wards Wards Yellow Cohort Spec Spec Clinic Heme Heme Heme Heme Clinic Wards Wards Green Cohort ER ER ER Clinic Ward Ward Ward Ward Clinic Elec Blue Cohort MSK MSK MSK MSK Clinic CCU CCU CCU CCU Clinic Red 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 WRNMMC Wards . 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 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 Where Do Navy Interns Go? . 2015 PGY-1 Graduates: . Internal Medicine Residency (11) . Flight Surgery (4) . Undersea Medicine . FMF Marines (Camp Lejeune) . San Diego (2) . SeaBees . Naval Training Center 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 Endocrinology Gastroenterology Rheumatology Pulmonary Hematology/Oncology Critical Care Infectious Disease/MPH Sleep Medicine Allergy/Immunology Nephrology General Internal Medicine/MPH or MHPE THE WASHINGTON, D.C. AREA Washington DC/Baltimore Metropolitan Area Cost of Living Generous tax-free housing allowance (BAH) BAH W/ BAH W/O Rank dependents dependents Wide range of housing options O-3 $2700 $2523 Metro Check Program Max reimbursement well above average costs O-4 $3108 $2673 WRB is metro accessible (Medical Center Stop) 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: CAPT (s) Anthony Nations, USN, MD, MBA Asst. Chief, DOM : FACCP LTC Rose Ressner, USA, MD, FACP Director for Medicine: COL Stuart Roop, USA, MD, FACCP Questions? Residency Program Office: (301) 319-8754 America Building, room 3607 Interviews: [email protected] (Mrs. Geraldine Marquez) th im strong Schedule 4 Year Rotations: [email protected] (Ms. Jackie Drake) (301) 295-9727 im strong Program Director: CAPT “Bill” Shimeall: (301) 319-8111 im strong See more about what our interns, im strong residents, and faculty are up to... (Click to see recent newsletters) Social Media • Facebook: – https://www.facebook.com/WRBChiefs/ • Twitter: – https://twitter.com/wrbchiefs .
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