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3 Resident Perspectives…Patient Load and Complexity 9 Great performance by NCC Dermatology Resident Jeopardy Team 6 Military Medicine Dominates at American College of Chest Physi

Trang 1

IM Residents and Faculty Advance in Regional Innovation Competition

Internal Medicine Residents and Faculty presented Innovation Proposals during the National Capital

Region – Medical Directorate round 2 of “Shark Tank” style Innovations, overseen by NCRMD

Di-rector RDML David Lane Twelve projects were presented, with Team IM earning three of the six final third round selections 3

Resident Perspectives…Patient

Load and Complexity 9

Great performance by NCC

Dermatology Resident Jeopardy

Team 6

Military Medicine Dominates at

American College of Chest

Physi-cians 4

USU Clerkship Director Receives

Kudos for Exceptional Workshop 10

highlights December 2016

WALTER REED DOM

GME Snapshot GRADUATE MEDICAL EDUCATION Department of Medicine

Walter Reed Bethesda

Gastroenterology Faculty and Fellows Present to World-Wide Audience 2

Six IM Residents Promote Science-based Education

at Area High School 10 Resident Shows

Initiative and Leadership at National Level 11

IM Resident Awarded Joint Service Achieve-ment Medal for Excep-tional Leadership and Humanism 11

DOM team members recognized for pro-fessionalism and dedication to mission

at Walter Reed Bethesda 12

Endocrinology — Hail to the new Program Director - virtues of compassion, commit-ment and understanding 15

Joint Services GME Selection Board Results 15

Rheumatology –

Publication Powerhouse 8

Internal Medicine’s Annual Holiday Party –

a special occasion 16

Team Cardiology Wins ACC Cardiology Fellows Jeopardy Competition 5

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research and academic success research and academic success

GASTROENTEROLOGY

FELLOWSHIP PROGRAM

Faculty and Fellows Present

to World Wide Audience

ACG Annual Scientific Meeting

Our faculty and fellows presented to more

than 5,000 gastroenterologists and other

health care professionals from around the

world at the 2016 American College of

Gas-troenterology’s (ACG) 81st Annual

Scien-tific Meeting in Las Vegas, where the most

recent scientific advances in

gastrointesti-nal research, treatment of digestive

diseas-es and clinical practice management were

reviewed

Walter Reed Bethesda's Department of

Medicine was well represented! Seven

fellows and five residents presented

post-ers on cases and research mentored by the

attendings from Division of

Gastroenterol-ogy, and CAPT Patrick Young won the

Board of Governors Service Award!

PLENARY PRESENTATION

CAPT Patrick Young (GI Program Director), Dr Fouad

Moawad (former WRNMMC and USU Faculty) ̶

“Development and Validation of a Prediction Model

Associated with Neoplastic Progression of Barrett’s

Esophagus (BE): Data from a Multi-Center Prospective

Cohort.”

POSTER PRESENTATION

WRNMMC GI Fellows:

Dustin Albert ̶ "Positive predictive value of physician

database diagnostic codes for identifying Crohn's

disease"

Jonathan Francis ̶ "Two Cases of Brunner's Gland

Hamartoma: A Potentially Difficult to Recognize

Duo-denal Lesion"

Jisun Hahn ̶ "Confounding Presentation of Small

Bowel Ischemia in an IBS Patient and Diagnosis and

Treatment Utilizing CO2 Angiography"

Noah Hall (GI Fellow) ̶ “A Chylous Mesenteric Cyst

Masquerading as a Pancreatic Mass”

Phillip Lindholm ̶ "CMV Collitis Presenting as

Pseudo-membranes"

Charlene Vestermark ̶ "Salmonella-associated

Clos-tridium difficile Infection Presenting as New Onset Ascites for Adults with Inflammatory Bowel Disease"

Charlene Vestermark ̶ "Uncovering the Mask: A Rare

Presentation of Autoimmune Hepatitis Type 2 in a 54-Year-Old Man"

Noah Hall ̶ "A Validation Study on the Diagnosis of

Celiac Disease in Military Service Members"

Kimberly Zibert ̶ Isolated Jejunal Vasculitis in a

Young Male Treated with Exchange Blood Transfu-sion"

Kimberly Zibert ̶ "Males with Inflammatory Bowel

Disease Have a High Prevalence of Hypogonadism and Erectile Dysfunction"

Kimberly Zibert ̶ "An Elusive Fishbone: The Role for

Repeat Imaging and Rigid Endoscopy"

WRNMMC IM RESIDENTS:

Benjamin Collen ̶ Acute Sickle Cell Intrahepatic

Cholestasis (SCIC) Successfully

Zachary Junga ̶ Rare Malignancy Found on

Endosco-py for GERD Associated with Dysphagia

Alison Lane ̶ More Than Skin Deep: A Rare Cause of

Dysphagia

Sarah Ordway ̶ Hepatic Granulomas: An Unusual

Presentation of Sarcoidosis

Michael Skaret ̶ Colonic Extramedullary Leukemia: A

Liquid Tumor Solidified

AWARDS

INTERNAL MEDICINE

Twenty-Eight Presenters

at Navy ACP Meeting in Norfolk, VA

Congratulations to the following Residents and Recent Internship Graduates for the their selection

to present abstracts as posters and podiums at the upcoming Navy American College of Physi-cians Scientific Meeting in Nor-folk, VA on 13-14 January (results not available at press time)

Click here to see the complete list of twenty-eight presenters:

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

niXyL0 The abstracts include everything from Near Lemierre"

to "Food Fright."

Also speaking at the meeting, Navy ACP Governor and Rheu-matology Service Chief CAPT Michael Keith, BUMED Chief Medical Officer and former DOM Chief CAPT Kevin Dorrance, and WRB Chief of Medical Residents Brett Sadowski

CPT Zachary Junga

CAPT Patrick Young ̶ Board of

Governor’s Service Award

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NATIONAL CAPITAL REGION

IM Residents and Faculty Advance to Round 3 of Regional Innovation Competition

“Shark Tank” Style Innovations

Three projects from Internal Medicine were chosen to move forward to Round 3!

Presenters were given 5 minutes to “pitch” their ideas, including a problem description and

pro-posed solution with scope and mission applicabil-ity Each presenter then answered key questions from judges and RDML Lane

Dr Julie Chen (IM Associate Program

Director): “Promoting Provider Well-being and Mitigating Burnout in

Medi-cine Providers”

LT Krystle Salazar (Pulmonary/Critical

Care Fellow), LCDR Raj Singaraju (IM

Resident): “Required end of life training and documentation”

LT Patrick Moon (IM Resident): “Mobile

Health Applications in Modern Military Medicine”

Congrats to presenters and their men-tors It was a fun morning and great to see all of our residents, fellows and fac-ulty move forward in the competition!!

What’s next?

For those who advance to Round 3 of the Innovation Competition, NCRMD provides business support to write out each candidate’s pilot proposal to en-sure that all bases are covered for the business case and feasibility Once pilot studies are developed (late January/

early February time frame), they will be presented to Rear Admiral Lane and his board of directors (all of the Command-ing Officers/Directors across the NCR) to

determine which pilots move forward for support and execution across the region

Good luck with Round 3!!

Previously, and just as Impressive:

Before the 2nd Round, innovators were hand selected by RDML Lane, from 42 submis-sions for the Shark Tank Style Event, based

on alignment with strategic goals for the region The majority of the ideas were se-lected from the across the region at the NCRMD Quality Symposium RDML Lane had also attended proposal presentations for the Internal Medicine Residency Quality Improvement Program and encouraged trainees to submit their work Their ideas strongly align with the quadruple aim of the NCRMD, and show great potential for the region According to panel members, LCDR Singaraju and LT Salazar also deserve credit for “bravely addressing an incredibly im-portant” topic

Very Respectfully, Michelle Hartman Lane, Ph.D

LT, MSC, U.S Navy Flag Aide to RDML David Lane NCRMD/DHA

research and academic success research and academic success

L-R: Dr Julie Chen, LT Krystle Salazar, LCDR Raj Singaraju, LT Patrick Moon move to Round 3

Innovation Contestants in Round 2 (L-R): LCDR Raj Singaraju (IM Resident), Dr Julie Chen (IM Faculty), LT Paul Tanjutco, Mr Ted Mueller (IM), LT Krystle Salazar (Pulmonary/Critical

Care Fellow), LTC Mike McCown (Pediatrics), LT Pat Moon (IM Resident), Ms Gayathri Vemuri (Social Work), CAPT Moira McGuire (IM)

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research and academic success

DIVISION OF PULMONARY,

CRITICAL CARE, AND

SLEEP MEDICINE

WRNMMC-SAMMC CHEST 2016

Military Medicine Makes Impact at

American College of Chest Physicians

The Walter Reed Bethesda Division of

Pulmo-nary, Critical Care, and Sleep medicine had a

very successful performance at the American

College of Chest Physicians annual meeting in

Los Angeles this past October Internal medicine

residents CPT Ross Humes, CPT Rebecca Wetzel,

MAJ Jason Unger, LT Benjamin Kurth, and LCDR

Bob Chiaruttini all presented posters LT Camille

Costan-Toth presented original sleep research

with her mentor LTC Aaron Holley They were

joined by PCCM fellows MAJ Mike Sobieszczyk

who presented a podium presentation, USAF

Capt Whitney Warren who mentored Dr Humes

and also served as faculty in a faculty

develop-ment course, and MAJ Billy Londeree who

pre-sented a poster

LCDR Andrew Philip (PCCM Associate Program

Director) was selected as Fellow in the American

College of Chest Physicians Walter Reed

Be-thesda staff leading multiple educational ses-sions during the meeting included LTC(P) John Sherner (PCCM Program Director), COL Lisa Moores (USU), and COL William Kelly (USU)

CHEST 2016 - WRNMMC/USU Accomplishment Details

Fellows, Residents and Staff

MAJ Mike Sobieszczyk

“Biopsy of a Peripheral Nodule Using

Navigation-al Bronchoscopy and an Off Airway Access Tool”

COL Lisa Moores (USU)

“Effective Small Group Teaching”

Update: "The Antithrombotics Living Guidelines"

COL William Kelly (USU)

“Remediating Deficiencies in Medical Knowledge (Part of: The Art of Teaching Medi-cine Clinician Educator Symposium.)” And over

1300 meeting attendees played one or more of

Dr Kelly's medical knowledge arcade-style and

live games

LTC John Sherner

Case Based Interactive Discussion: Clinical Use

of Non-Vitamin K Anticoagulants in 2016

Capt Whittney Warren

Faculty Development Seminar: "Teaching the

Teacher"

CPT Ross Humes

Poster: "A Lady and Her Bird"

LCDR Bob Chiaruttini

Poster: "Primary Pulmonary Choriocarcinoma"

CPT Rebecca Wetzel

Poster: "Doctor's Orders: A Case of

Unintention-al Overtreatment"

MAJ Jason Unger

Poster: "A New Case of Cerebral Angiitis in the

ICU"

LT Benjamin Kurth

Poster: "Consider What's below the diagphragm

when evaluating Pulmonary Hypertension"

LTC John Sherner

Faculty Panel Multidisciplinary Session Cased

Base Reviews: Evidenced Based Guidelines for

Diagnosis, Staging, and Specimen Acquisition and Treatment of Late Stage Lung Cancer"

Capt Whittney Warren

Faculty Development

Seminar: "Teaching the

Teacher"

CPT Billy Londeree

Poster: "Balloon

broncho-plasty for radiation in-duced bronchial stenosis"

COL Lisa Moores

Presentation: CHEST Foundation 101 Flipped Classroom Work-shop: Effective Mentoring

LTC Aaron Holley, LT Camille Costan-Toth

Podium presentation: "Using a novel cpap

deliv-ery platform to improve compliance in patients diagnosed with OSA and co-morbid PTSD"

Ses-sion: Research investigations in obstructive sleep apnea

research and academic success

LT Camille Costan-Toth delivered a wonderful research podium presentation

LT Benjamin Kurth proudly stands in front of his poster

CPT Rebecca Wetzel

Capt Whittney Warren CPT Ross Humes

LCDR Andrew Philip in Fellow Regalia

posing with his family

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research and academic success research and academic success

American College of Allergy, Asthma, and Immunology

2016 Annual Meeting

IM Resident LT Hyun “Robert” Park and Allergy Fellow CPT Camellia Hernandez

presented the following cases at the ACAAI Conference in San Francisco in November:

LT Park’s poster was entitled, “Metastatic

Cancer Treatment In A Pediatric Patient Causes Life Threatening Reaction: No Plan B.” Click on this link to view LT Park’s

poster: https://learning.usuhs.edu/x/

Gpv5Df

CPT Camellia Hernandez’s poster was

entitled, “Barley Allergy Manifesting as

Beer Anaphylaxis”

Congratulations to both of you and your mentors!

Impressive Showing by Cardiology

Fel-lows (L-R) MAJ Jason Reese, LCDR

Lau-ren Weber and CPT Jeremy Docekal

who represented us at the Mid-Atlantic Capitol Cardiovascular Sympo-sium (MACCS)

[In mid November], our team participated

in and WON the ACC cardiology fellows Jeopardy competition for DC/Maryland, crushing teams from the Washington Hos-pital Center and an all-star team that was a combined Johns Hopkins/University of Maryland team (team Baltimore)

As a result, our Walter Reed Bethesda team will represent Maryland and DC in the national fellowship cardiology Jeopardy competition at the 2017 ACC meeting in D.C I am thinking that this team has the makings of a national champion? As you

can see in the photo above, this is an im-pressive team! Additionally,…they

compet-ed in an exhibition match against the win-ning teams from the states of Pennsylvania and Virginia and were edged out by a single point

Finally, Jason Reese moderated a session at the meeting where he and other fellows from the Mid-Atlantic region reviewed key studies from the recent AHA scientific ses-sions

Thanks to all!

Todd

TODD C VILLINES COL, MC, USA Program Director, NCC Cardiovascular Diseases Fellowship Director, Cardiovascular Research and Cardiac CT Program

Good Luck at the

2017 ACC in DC!!

Cardiology Team Wins the ACC Cardiology Fellows Jeopardy Competition for DC/Maryland

Congratulations Colonel Jess Edison with an academic promotion at USU to Associate Professor in the Department of

Medicine, SOM

CPT Camellia Hernandez

LT Hyun “Robert” Park

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research and academic success research and academic success

DERMATOLOGY

NCC Dermatology Resident

Jeopardy Team Came

in 2nd Place

American Society of

Dermatological Surgeons

Walter Reed Bethesda

Dermatolo-gy Residency had a strong

perfor-mance at the American Society of

Dermatological Surgeons in the

New Orleans In the premier

na-tional dermatological surgical

com-petition, LT John W Roman and LT

Thomas Evans competed against

top programs in the nation and

earned a silver medal in the

Gold-en Scalpel Knowledge Bowl They

demonstrated their knowledge in

dermatology and surgical

princi-pals to outperformed 12 of the

leading dermatological residencies

in the nation

Congratulations on performing so

well in such a competitive

compe-tition!

MEET THE TEAM

ID Week 2016

Infectious Disease Fellows and Internal Medicine Resident Present Their Post-ers

ID Fellow CPT Evan Ewers - "Preliminary

Clinical and Microbiological Characteristics of Campylobacter Infection at a Military Medi-cal Center in Hawaii" Click on the link to

view the abstract:

https://learning.usuhs.edu/x/1C2qvc

ID Fellow CPT Jack Hutter - "Acid

Suppres-sion with Histamine[H2] Blockers and Proton Pump Inhibitors[PPIs] is not Associated with

an Increased Risk of Traveler's Diarrhea [TD]"

Click on this link to view the poster:

https://learning.usuhs.edu/x/Qh4m3Y

IM Resident LT Alison Lane - “Effectiveness

of Alcohol-Based Hand Sanitizers in Reducing Bacterial Colonization of Stethoscopes” Click

on this link to view the poster:

https://learning.usuhs.edu/x/USA9kz

INFECTIOUS DISEASES

American Society of Tropical Medicine and Hygiene

(ASTMH 2016), 13-17 November, Atlanta, GA

POSTER

“Post-artesunate delayed hemol-ysis in a returning traveler”

LT Sara Robinson, MD, CPT Na-thanial Copeland, MD, MAJ Jason Blaylock, MD, Dept of Internal Medicine & Infectious Diseases, Walter Reed National Military Medicial Center, Bethesda, MD

Congratulations

LT Robinson and mentors!

ID Fellow CPT Jack Hutter, IM Resident LT Alison Lane, ID Fellow CPT Evan Ewers

LT Thomas Evans

LT John

W Roman

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research and academic success

IM Residents Deliver

Resident QI projects

Project Proposals to Improve Patient Safety, Efficiency, and Resource Utili-zation

On three separate occasions In No-vember/

December, we learned about the WRB internal med-icine resident qual-ity improvement project proposals

14 different pro-jects aimed to im-prove patient

safe-ty, efficiency, and resource utiliza-tion Attendees, including RDML David Lane, Director of NCRMD, provided sup-port and feedback to our residents as they refined their projects

Some of the proposals included,

“Automation of the I-PASS Tool to Reduce Errors in Transitions of Care,” “Improve procedure completion rates for internal medicine residents,” and “Improving weight-based vancomycin dosing.”

To view the complete list of 2016-2017 QI Teams and proposals:

https://learning.usuhs.edu/x/pjlM6a

Thank you Dr Chin Hee Kim (Assistant Chief, General Internal Medicine, Inpa-tient Medicine), the IM Chiefs of Resi-dents LT Brett Sadowski and CPT Hector Medina, and others who led this effort

Impressive Accomplishment!

Intern LT Richard Wu Selected for Chrysalis Project

The Chrysalis Pro-ject presents a great opportunity

to explore a ca-reer in allergy / immunology The core of the pro-ject is a program that takes place during the Ameri-can Academy of Allergy Asthma & Immunology (AAAAI) Annual Meeting, the premier allergy / immunology event of the year Participant selection is based on research experience, publications, presentations and a career goals statement.*

* http://www.aaaai.org/about-aaaai/

service-and-stewardship/chrysalis-project

“Hymenoptera Venom Hypersensiti Evalu-aation (HVHE): A prospective study”

Richard Wu (a), Jeannie Bay (b) DO, Cecilia Mikita (b) MD, Sarah Spriet (b) MD, Douglas Beakes (b) MD

(a) Uniformed Services University of the Health Sciences, Bethesda, MD, United States (b) Walter Reed National Military Medical Center, Bethesda, MD, United States Click here to view the poster:

https://learning.usuhs.edu/x/7i5qFa

Strong work! This is a great accom-plishment and we are happy to see you have this success in your field of interest

research and academic success

INTERGRATED HEALTH

The Mindful Minute

Small changes can have a big impact!

Coming soon: The Mindful Mi-nute presents practical skills for improved health and well-being through weekly podcasts and videos via the intranet In just 60 seconds learn tools and tech-niques to support a healthy life-style, promote wellness, and maintain good health The pro-gram launches in January

You’ll find a link to the Mindful Minute by clicking on the Quick

Link Icon for Staff Information

Join the Integrative Health &

Wellness Team every Wednesday morning for your Mindful Mi-nute!

For more information, please contact:

Lynne Valdes, MS, C-IAYT Mind-Body/Yoga Therapist Integrative Health and Wellness Services (IHWS) lynne.m.valdes.ctr@mail.mil office: 301.295.8752

LT Mickey Skaret presents his QI project

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education scholarship, and outreach publications

RHEUMATOLOGY

Publication Powerhouse

Big Publication Quarter for Rheumatology

Former Fellow: Vanya Wagler Staff: Robert O'Brian

Wagler, Vanya D; Mitchum, Marsha D; O'Brian, Robert J “Proton

PumpInhibi-tor-Associated Subacute Cutaneous Lupus Erythematosus in a Patient With

Granulomatosis With Polyangiitis.” Journal of Clinical Rheumatology 2016;

22(8):436-437 PMID 27870768

Fellow: Jeff Eickhoff Staff: Jess Edison

Eickhoff JC, Smith J, Landau M, Edison JD “Iatrogenic thenar eminence

atro-phy after Botox A injection for (Secondary) Raynaud's Phenomenon.” J Clin

Rheumatol 2016 Oct;22(7):396-7 PubMed PMID: 27410925

Fellow: Rodger Stitt Staff: Christopher Tracy, Jess Edison

Stitt R, Edison JD, Tracy C “An Unusual Case of a Swollen Elbow Arthritis

Rheumatol.” 2016 Oct 9 doi: 10.1002/art.39949 [Epub ahead of print]

Pub-Med PMID: 27723278

Staff: Jess Edison, Chris Tracy

Former Fellows: Melissa Butts, Sharon Frattalone

Edison J, Frattalone S, Tracy C, Woodard GE, Butts M, Moratz CM “Inhibition

of Sphingosine-1-phosphate receptors in ischemia reperfusion injured

autoim-munity-prone mice.” Cell Immunol 2016 Oct 27 pii: S0008-8749(16)30120-4

doi: 10.1016/j.cellimm.2016.10.005 [Epub ahead of print] PubMed PMID:

27816167

Abstract at the American College of Rheumatology Annual Scientific meeting

Staff: Jess Edison

Robbins RC, Tracy C, Edison J, Peng

S, Moratz C “Coagulation Pathway

Function in Ischemia/Reperfusion Tissue Injury in Autoimmune Prone Mice [abstract].” Arthritis

Rheu-matol 2016; 68 (suppl 10) http://

acrabstracts.org/abstract/

coagulation-pathway-function-in- ischemiareperfusion-tissue-injury-in-autoimmune-prone-mice/ Accessed November 30, 2016

Former Fellow: Vanya Wagler Staff: Michael Keith

Kurth BJ, Wagler V, Keith M

“Cardiac tamponade as a manifesta-tion of severe dermatomyositis.”

BMJ Case Rep 2016; Sep 23 PMID

27664227

Former Fellow: Patricia Papadopoulos Staff: Michael Keith Affiliate Staff: William Gilliland

Bardenheier BH, Duffy J, Duderstadt SK, Higgs JB, Keith MP, Papadopoulos PJ,

Gilliland WR, McNeil MM “Anthrax vaccine and the risk of rheumatoid

arthri-tis and systemic lupus erythematosus in the US Military: A case-control study.” Mil Med 2016:181(10):1348-1356 PMID 27753574

Staff: Michael Keith

“Dysregulation of innate and adaptive serum mediators precedes systemic lupus erythematosus classification and improves prognostic accuracy of autoan-tibodies.” Lu R, Munroe ME, Guthridge

JM, Bean KM, Fife DA, Chen H, Slight-Webb SR, Keith MP, Harley JB, James JA

J Autoimmun 2016 Nov;74:182-193

PMID: 27338520

Staff: Michael Keith

“Altered type II interferon precedes autoantibody accrual and elevated type

I interferon activity prior to systemic lupus erythematosus classification.”

Munroe ME, Lu R, Zhao YD, Fife DA, Robertson JM, Guthridge JM, Niewold

TB, Tsokos GC, Keith MP, Harley JB, James JA Ann Rheum Dis 2016 Nov;75 (11):2014-2021 PMID: 27088255

Also see Rheumatology’s Jeff Eickhoff,

helping out at USU Specialty Night on

page 9 Chris Forster, and Nancy Sein

also helped (not shown in picture).

COL Jess Edison, Program Director, Rheumatology Fellowship, and CPT Rachel Robbins

Left to right: Jason Weiner - he's doing an outservice fellowship at Duke University, Jeff Eickhoff - 2nd year fellow, Michael Keith,

Christopher Forster, Rachel Robbins (Back Row) - graduate / staff at DDEAMC, Nancy Sein - 1st year fellow, Nick Kortan (back row) -

graduate / staff at LRMC, Sharron Frattalone = graduate / staff at SAMC, Robert O'Brian (Back row), Rodger Stitt - 2nd year fellow,

Patrick Mastin (Back row) - 1st year fellow , Jess Edison

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education scholarship, and outreach

Internal Medicine Was Well Rep-resented at USU Alpha Omega Alpha (AOA) Military Medical Specialty Night

The WRB Internal Medicine Residency Program and associated subspecialties were well represented at the recent Mili-tary Medical Specialty Night held Novem-ber 15th at the Uniformed Services Uni-versity (USU), hosted by the USU Gamma chapter of AOA Over 250 medical stu-dents from 35 different medical schools attended the event, including USU and HPSP students from all branches of the military and from around the country

Students had the opportunity to discuss career goals with program directors rep-resenting all military graduate medical education programs One of the most popular events was Iron Med, a picture-based challenge organized by WRB IM residents to spark interest in internal medicine

LT Jeff Gray & LT Alison Lane WRB IM Residents

Alliance for Academic Internal Medicine Skills Development Conference (AIMM)

For the Alliance for Academic Internal Medi-cine Skills Development Conference on

Oct.20th, 2016, (photo L-R) Dr Monica Yepes -Rios (USU DOM Faculty), MAJ Renee Mallory (USU DOM Faculty) and Dr Julie Chen (WRB

Internal Medicine Residency Associate Pro-gram Director) led a workshop entitled

"Faculty Development: Evaluation and Effec-tive Feedback in the Continuity Clinic - Chal-lenges and Innovations in an X+Y Block Sys-tem." The workshop outlined use of an

inno-vative tool for evaluation, which helps miti-gate the decrease in continuity that comes with an X+Y block system, while

concomitant-ly promoting meaningful feedback in the clinic setting

Academic Mission and Patient Care

Internal Medicine Realigns, Restructures for Enhanced Academic Mission and Delivery of Primary Care

Internal Medicine is in the process of restructuring for better alignment with its academic mission and enhanced delivery of its Patient-Centered Medical Home (PCMH) model of primary care It is moving from a structure that embeds interns and residents

in all of its nine medical home to one that focuses them in just four teams

By focusing its GME efforts on just four teams, leadership anticipates a more tightly integrated structure among residents and core faculty, aca-demic schedules, rotations, and the demanding requirements of a robust program in the context of

a complex clinical setting

The six additional PCMH teams, which will still accommodate medical, Physician Assistant (PA) and Nurse Practitioner (NP) students, will gain the flexi-bility needed to implement the PCMH model with better adherence to military guidelines and for more effective patient health outcomes

The restructuring effort, slated to begin the end of December, is expected to be completed by early January 2017

publications

RESIDENT PERSPECTIVES…

Walter Reed Bethesda Offers Pa-tient Load and Complexity in Resi-dent Training Program

My name is Zach Junga and I am a

PGY-3 in the Internal Medicine Residency Training Program at Walter Reed Na-tional Military Medical Center (WRNMMC) in Bethesda, MD In my 2.5 years training here, the patient load and complexity have increased significantly As an intern in 2014, I was impressed by the patient complexity at WRNMMC, but there were some slow times throughout the year Since that time, there has been a steady increase

in our patient numbers and the com-plexity has risen with it This has been especially apparent in the medical intensive care unit where we have seen the number of critically ill patients reach new levels Concerns over pa-tient numbers and complexity are im-portant but you need not have them here at Walter Reed Bethesda

Ultimately your training is what you make of it, and at WRNMMC, you will have every opportunity to work with the best physicians with some of the best resources at your disposal on a patient population that is complex and varied

- Internal Medicine PGY3 Zach Junga

A packed house for AOA specialty night to showcase military medicine’s training programs to medical students traveling from near and far

Jeff Eickhoff (Rheumatology) shows senior physicians the value of ultrasound while trying to diagnose Adam Barelski’s aches and pains

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well-deserved recognition education scholarship, and outreach

INTERNAL MEDICINE

USU/WRB Inpatient Clerkship Director

Receives Kudos for Exceptional

Workshop

LCDR Mary Andrews, Uniformed Services

Universi-ty/Walter Reed Bethesda inpatient clerkship

direc-tor (who is GIM Fellowship trained), presented a

workshop on developing improvement plans for

residents at Alliance for Academic Internal

Medi-cine Skills Development Conference in October in

Maryland, and received some very complementary

kudos on the AAIM/APDIM List-serve stream The

excerpt is pasted below

Link to meeting website for materials:

http://www.im.org/p/cm/ld/fid=1466

Link to Dr Andrew’s workshop materials:

http://www.im.org/d/do/7931

KUDOS:

“Dr Andrews' presentation was based on ongoing work that she is doing with collaborators COL Wil-liam Kelly (USU) and COL Kent DeZee (TAMC) I attended her workshop and it was exceedingly well done and had the room buzzing Mary, a nice demonstration of real-time impact of your ground-breaking work!”

- A better-educated attendee

“At the AAIM Skills Develop-ment Conference last week, I also attended a great work-shop by Mary Andrews and colleagues at Uniformed Services University (I think

#110) on self-regulated learning There materials on the AAIM website include a worksheet and the materials are quite thorough I am using this now and find it to

be a wonderful resource to help me help my residents.”

- Jacqueline Darcey, MD

INTERNAL MEDICINE

Army and Navy Medicine

Community Service

IM Residents Promote

Science-Based Education

Six Internal Medicine Residents participated

in a conference attended by hundreds of high school students across Howard County to promote awareness about the importance and applications of a science-based educa-tion

Sarah and team,

Thank you for coordinating our presence and vol-unteering at this great opportunity to show a bunch of talented high school students some of the possibilities that military medicine has to offer

You clearly gave them a great view of the future of Army and Navy Medicine Cathy ('Chili Dog') Po-padiuk, is that your flight helmet that I saw on the table?

Strong work!

V/r, CAPT Bill Shimeall

IM Program Director

As a part of the Walter Reed Action Group,

I'd like to acknowledge and thank IM Residents CPT

Joe Maciuba, LT Jeff Gray, LT Mickey Skaret, CPT Cynthia Philip and LCDR (SEL) Cathy ‘Chili Dog’

Popadiuk for volunteering for 4 hours last

Thurs-day by leading 2 panel discussions at the Science in Society Conference at River Hill High School (RHHS)

in Maryland The conference was held for approxi-mately 300 high school students across Howard County to promote awareness about the im-portance and applications of a science-based edu-cation to high school students They each discussed why they chose careers in medicine and shared some of their experiences They encouraged the students to consider careers in military medicine, and represented Walter Reed Bethesda with pride and professionalism

Thank you again for volunteering your precious time to potentially make a difference in the lives of these high school students!

V/R Sarah,

CPT Sarah Ordway Founder of Walter Reed Action Group (WRAG)

2017 IM Chief of Residents

IM Residents LT Mickey Skaret, , CPT Sarah Ordway, LT Jeff Gray, LCDR (SEL) Cathy ‘Chili Dog’ Popadiuk, CPT Cynthia Philip, and CPT Joe Maciuba

volunteering by leading two panel discussions at the Science in Society Conference at River Hill High School in Maryland

LT Mickey Skaret and CPT Joe Maciuba talking with

two RHHS students during the conference. Also see page 11 to read about how CPT Sarah Ordway

received the Joint Service Achievement Medal.

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