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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: [email protected]
(Mrs. Geraldine Marquez)
Schedule 4th Year Rotations: [email protected] (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...
(Click to see recent newsletters)
im strong
im strong
im strong
im strong
Social Media
• Facebook: – https://www.facebook.com/WRBChiefs/
• Twitter: – https://twitter.com/wrbchiefs
