Feb/Mar 2016

Graduate Medical Education
WALTER REED DOM GME
Snapshot
Department of Medicine
Walter Reed Bethesda
Feb / Mar 2016 - a recurrent and evolving snapshot of GME/UME news & highlights
OF THE PEOPLE, BY THE PEOPLE, FOR THE PEOPLE of dom gme
highlights
Walter Reed Bethesda Dermatology
Flexes Its Muscle at the International Society
of Dermatopathology (ISDP) Joint Meeting and
American Academy of Dermatology Annual Meeting.
Hail to CAPT Whitman and Farewell
to CAPT Burgess p 13
DOM GME will have a
record presence at the
upcoming national
meeting of the American
College of Physicians
(ACP), Internal Medicine
Meeting 2016, being held
at the Walter E. Washington Convention Center,
in downtown
Washington, D.C.
LT Patrick Moon from
USUHS graduation 2014
Please come cheer on the Walter Reed IM
Residency (Army) at the annual Doctors
Dilemma competition (Medical Jeopardy)
as they compete against 40+ chapter finalists teams from around the globe. A record
eight Walter Reed IM Residents will also
be presenting their scholarly work at the
meeting, including LT Patrick Moon, who is
among the top 20 abstracts selected overall as winners in the 2016 National Abstract Competition and who will be presenting his research as a podium
presentation.
Dermatology Residents from left to right: CPT Casey Chern (PGY-3),LT Michael Austin, CAPT Kara
Hoverson (PGY-2),Dermatopathology Fellow LCDR Jean Kemp, LT Jeptha Johnson Pathology, CPT
Mark Lincoln, Pathology, CPT Briana Barber (PGY-2), CPT Christopher Lowe (PGY-4),LT Elaine Keung
Pathology, LT John Roman (PGY-2), CPT David Martell (PGY-2), and CDR Michael Dent (PGY-4)
pp 2 - 4
LT Alison Lane, CPT Sarah Ordway (IM Residents)
To read more about Dermatology’s presentations, posters, CPT David Martell’s Fox Award, and Derm Residents
LT Shayna Rivard and CPT Christopher Lowe’s Resident
Jeopardy Championship, see p 5
Nephrology Fellowship Program
Leader in publications, and announces
four fellows starting in July p 7
Academic Awards
Clerkship Curriculum, Class 2017 p 11
1
Feb/Mar 2016
Walter Reed DOM GME Snapshot
research and academic success
Internal Medicine
Upcoming National American College of Physicians
(ACP) Meeting Highlights for Walter Reed Bethesda
O
ur podium winner representative from the Navy Chapter meeting is LT Ian Grasso, who will be presenting his
first place abstract as a poster at the National Meeting.
We also have an unprecedented seven other residents who
have been selected to present at the meeting, including LT
Patrick Moon, who is among the top 20 abstracts selected
overall as winners in the 2016 National Abstract Competition.
LT Moon will present his abstract, entitled, "Long Term Mortality Associated With Coronary Artery Calcium," as a podium on
Friday, May 6, 2016 in the Walter E. Washington Convention
Center, Rooms 204A and 204B. The presentations will begin at
12:45 PM FYI. He will also present a clinical poster.
Three of our presenters are interns. All eight will be recognized as ACP “Young Achievers” in the program below, including:
LT Ayeetin (Ayee) Azah
LT Dean Drizin
CPT Zach Junga
LT Brett Sadowski
LT Alison Lane
LT Michael (Mickey) Skaret
LT Laura Gilbert
Come join them and look
out for the presentations.
http://im2016.acponline.org/
Additionally, we will have several USU and area HPSP students
attend the meeting, and at least 30 IM residents have been
cleared to attend the Friday portion of the meeting for free,
thanks to the ACP's program to reach out local GME programs.
DOM leadership is supporting several of our Faculty and Chief
Residents to attend this local meeting opportunity as well.
We are also sending our Army Jeopardy Team, which bested a
field of six Army IM programs (and beat 11 teams including two
programs each from Johns Hopkins and the University of Maryland to win the MD ACP chapter— see January’s GME newsletter for details) , to compete in the National IM 2016 Doctor's
Dilemma finals, as well. As a result I regret that I will only be
able to root for the NMCP Navy team to go so far in the competition....
P.S.
Here is the competition bracket for the National ACP Meeting Doctor's
Dilemma (Jeopardy) Competition:
https://learning.usuhs.edu/x/Qb0vjA The field is up to 50 and includes Chapter winning teams from across the U.S. and territories as
well as from Saudi Arabia, Canada, Central America, Southeast Asia
and Japan. The Walter Reed (U.S. Army) Team is in a tough elimination round match-up on Thursday, May 5th against Chapter Winners
from West Virginia, Tennessee, Northern Illinois, and Northern Texas.
The Navy (NMCP) Team and Air Force All-Star Team are also in the
hunt, as well as the Maryland team from Harbor Hospital, which was
beaten by both our Walter Reed Navy and Army teams earlier this year
in a friendly contest for pride at the Maryland ACP meeting.
More to follow in the next issue.
Upcoming National ACP Meeting Highlights
for Students, Residents, and Fellows
Events for Early Career Physicians,
Residents/Fellows, and Medical Students
Internal Medicine Meeting 2016 offers a special three-day program of ancillary events and workshops specifically for early
career physicians, residents and fellows-in-training, and medical students. http://im2016.acponline.org/
ACP Doctor’s Dilemma
Resident/Fellow Abstract Luncheon
Thursday-Saturday • CC
Friday • 12:45-2:15 p.m. • CC
ACP Posters Hospitality Area
Medical Student Mentoring Breakfast
Thursday-Saturday • CC
Saturday • 7:00-9:00 a.m. • HQ
Resident/Fellow Member Luncheon
Medical Student Abstract Luncheon
Forum: "Resident Heal Thyself: How to
Saturday • 11:00 a.m.-12:30 p.m. • CC
Beat Burnout"
Recognition Reception for ACP Young
Thursday • 12:45-2:15 p.m. • CC
Achievers
Early Career Physicians Mentoring Lunch
Saturday • 6:30-7:30 p.m. • CC
Thursday • 1:00-2:00 p.m. • HQ
I look forward to seeing everyone in DC.
V/r,
Bill
CAPT Bill Shimeall
2
Continued next page...
Feb/Mar 2016
Walter Reed DOM GME Snapshot
community service
research and academic success
Internal Medicine cont.
Walter Reed Action Group (WRAG)
makes a holiday more enjoyable
Here are some
pictures from
some residents
volunteering
making Easter
lunch for the men
who live at a local
temporary
house .
LT Alison Lane, CPT Sarah Ordway (IM Residents) help
conduct the now-famous IRON MED challenge.
W
alter Reed Bethesda had a major presence at
the American College of Physicians Maryland
Chapter Winter Scientific Meeting
TO: Student committee, Program Directors, Chairs of Medicine
& CRAB Members
Congratulations to our local ACP chapter on a highly successful
Winter Scientific Meeting held in Ellicott City on 29-30 January.
The theme of the meeting was “The RIGHT Care at the Right
TIME and PLACE” and highlights included

A call for physician action in the community from our Baltimore City Health Department Commissioner, Dr. Leana
Wen. Hear more from Dr. Wen at https://
bhealthyinbmore.wordpress.com/ or on Twitter at:
https://twitter.com/BMore_Healthy?ref_src=twsrc%5Etfw

The Best of Morning Report by Drs. Dobbin Chow, Sapna
Kuehl and Richard Williams

Residents from across Maryland participated in the nowfamous Walter Reed IRON MED challenge, conducted by
IM Residents LT Alison Lane, CPT Sarah Ordway, and a
team of residents at the meeting.

And of course the Maryland ACP “Doctors Dilemma” competition, where the Walter Reed Army Team bested a field
of 12 teams, including Johns Hopkins, the University of
Maryland, and of course the Walter Reed Bethesda Navy
team in the semi-final round.
Daren Yang (PGY2) preparing lunch for residents at
The local tempoa local halfway house
rary house for
homeless men
with medical illness has asked a few of us to come every fourth
Sunday to help prepare & serve lunch to the residents.
New WRAG signup link - people
can add their
name and email
directly into the
excel sheet to sign
up to volunteer at
Arlington Free
Clinic or the Christ
House (each event
has a different
sheet at the
bottom):
www.tinyurl.com/
wragsignmeup
From left to right: Jordan Lane (Transitional Year),
Krystle Salazar (PGY-3), Daren Yang (PGY-2)
“WOUND MAN”
(see illustration on page 7) Popularly known as "Wound Man", this
illustration which first appeared in European surgical texts in the Middle Ages. It laid out schematically the various wounds a person might
suffer in battle or in accidents, often with accompanying text stating
treatments for the various injuries. It first appeared in print in Johannes de Ketham's Fasciculus Medicinae (Venice, 1492) and was used
often in surgical texts throughout the sixteenth century and even into
the seventeenth century.
Click here to see two recent acquisitions by the Historical Collections
branch of the National Library of Medicine have examples of the
"wound man":
3
Feb/Mar 2016
Walter Reed DOM GME Snapshot
research and academic success
Cardiology
Congratulations LT Moon – with a big assist
from his mentors in Cardiology!
American College of Physicians selected LT Patrick Moon’s “Long
Term Mortality Associated With
Coronary Artery Calcium,” as one of
the top 20 abstracts selected as
winners in the 2016 National Abstract Competitions.
The ACP Resident/Fellow Competition Winners will be highlighted on
Friday, May 6, 2016 in the Walter E.
Washington Convention Center,
Rooms 204A and 204B. The presentations will begin at 12:45 PM.
LT Patrick Moon from
USUHS graduation 2014
ABSTRACT
“Long Term Mortality Associated With Coronary Artery Calcium”
LT Patrick S. Moon, MD, Member, CPT Robert Paisley, MD,
Member, MAJ Joshua D. Mitchell, MD, FACP, LTC Todd C. Villines, MD, FACP, Walter Reed National Military Medical Center, Bethesda, MD
Introduction: Coronary artery calcium scores (CAC) have been
linked to cardiovascular morbidity and mortality; guidelines
suggest their use in helping stratify intermediate risk patients. Additional studies with extended follow-up are needed
to better determine the prognostic value of coronary artery
calcium. We sought to verify the prognostic value of both normal and positive CAC scores in a large single centered cohort
with over ten year follow-up…
Link to full abstract: https://learning.usuhs.edu/x/wZvLJ4
BZ to you and your mentors from team cardiology!
This is a huge accomplishment as this is a highly competitive
competition with a huge number of resident submissions
(2,834). To be selected as one of the top 20 is tremendous
(and the $1000 JAG-approved check he receives from the ACP
is not bad either)!
WELL-DESERVED RECOGNITION
A Big Shout Out to LT Moon’s Mentors:
MAJ Joshua Mitchell, MD, FACP (PCSed from WRB, but now a
Cardiology fellow)
PULMONARY AND CRITICAL CARE
LCDR Joseph Zeman, MD, FACP (Pulmonary Critical Care Fellow)
Dr. Todd Villines, MD, FACP, FACC (Program Director, Cardiovascular Disease Fellowship)
LT Moon’s Profile Sketch:
Patrick is a second year medical resident in the National Capital Consortium program at Walter Reed National Military Medical Center. He received his medical degree from the Uniformed Services
University of the Health Sciences and graduated as a Lieutenant in
the Navy. His primary research focus is using mobile health for system improvement, and he served as the primary programmer for
Walter Reed’s Pulmonary Clinic Application, an iPad application to
help automate patient flow, assist the physician in documentation/
billing and gather research data. His clinical interests include Pulmonary/Critical Care and Cardiology, and he has presented six different
cases at national conferences as an Internal Medicine Resident. During his free time, Patrick enjoys spending time with his family.
4
Feb/Mar 2016
Congratulations LCDR Andy Philip
(Pulmonary and Critical Care
Medicine) for being elected a
Fellow in the American College
of Physicians (ACP) & for being
elected to fellowship to
American College of Chest
Physicians (ACCP).
Walter Reed DOM GME Snapshot
research and academic success
DERMATOLOGY
Walter Reed Dermatology Flexes
Its Muscle at the International Society of
Dermatopathology (ISDP) Joint Meeting.
WRB Dermatology Shows Its Strength at
the American Academy of Dermatology
Annual Meeting
Here is a list of Dermatology Residents who presented Poster
Presentations at the International Society of
Dermatopathology (ISDP), Meeting, March 2-3 2016.
CPT David Martell awarded the prestigious Fox Award
CPT Briana Barber
Poster Presentation Title: “Mobile Encapsulated Lipoma Sustained in Judo Sparring
Match”
CPT Casey Chern
Poster Presentation Title: “A Case of
Pilomatrixoma with Atypical Features”
CDR Michael Dent & LT John Roman
Poster Presentation Title: “Leukemia Cutis
with Blast Features”
CPT Tess Pollinger (Dermatology
Resident PGY-4)
CPT David W. Martell was
one of the winners of this
year’s prestigious Everett C.
Fox Memorial Award presented the most outstanding
papers in clinical and laboratory research March 6, during
the Resident and Fellows
symposium at the American
Board of Dermatology Annual
Conference at the Walter E.
Washington Convention Center in Washington DC.
Fox Award photo of Dr. Martell (2nd from left)
Click here to see the photo and write-up
To read CPT Martell’s abstract: https://learning.usuhs.edu/x/6lFu77
CPT Kara Hoverson
Poster Presentation Title: “Vision Loss with
Angioid Streaks” (Picture below)
CPT Christopher Lowe
Poster Presentation Title: “Bullous Lupus Erythematosus in a Dermatitis Herpetiformis Like Distribution”
CPT Tess Pollinger
Poster Presentation Title: “Difuse Epidermodysplasia verruciformis in
a Tranplant Patient with Intractable Pruritus” (See the Picture below)
CPT John W. Roman
Poster Presentation Title: “Carcinoma En Cuirasse: In a Woman with
Invasive Ductal Breast Carcinoma”
CPT Kara Hoverson (Dermatology
Resident PGY-2), presented her
poster at the ISDP
Walter Reed Dermatology Wins
Resident Jeopardy Championship!!!
Derm Residents, LT Shayna Rivard and
CPT Christopher Lowe, took over the
“Resident Jeopardy” competition at
American Academy of Dermatology’s
74th Annual Conference and brought
home the gold! This took place at the
Walter E. Washington Convention Center in Washington DC from March 4-8,
2016. Click here to read a full story and
interview
Shayna Rivard and Christopher Lowe beat out seven
other teams to win the “Resident Jeopardy” competition
at the annual AAD conference.
Abstract:
“Vision Loss with Angioid Streaks”
Kara Hoverson, MD, Nicholas
Logemann, DO, John Childs, MD Walter Reed National Military Medical
Center, Bethesda, MD
CPT Kara Hoverson (Dermatology
Resident PGY-2)
5
Feb/Mar 2016
Want to Share GME News and Highlights?
If you would like to contribute to the “GME newsletter,” please send your artwork, poetry, essays, research, publications, GME news or highlights, to
[email protected].
Walter Reed DOM GME Snapshot
research and academic success
2016 Research
Competition Finalists
2016 Research and Innovation Month
8th Annual National Capital Region Research Competition Finalists
CONGRATULATIOINS to the 2016 Research
Competition Finalists, CPT Christopher
Lowe (Dermatology), MAJ Heather Mascio
(Nephrology Staff), and CPT Eric Scofield
(Hem/Onc Fellow).
Job well done
CPT Stahlmann!
Click here to see Dr. Stahlmann’s PowerPoint presentation:
https://learning.usuhs.edu/x/Xn62vJ
Laura J. Gilbert a, Ping Li b,c, Clinton K.
Murray d, Heather C. Yun d, Deepak Aggarwal
b,c
, Amy C.Weintrob a,b,c,, David R. Tribble b,
on behalf of the Infectious Disease Clinical
Research ProgramTrauma Infectious Disease
Outcomes Study Group
a Walter Reed National Military Medical Center, Bethesda,
MD, USA
b Infectious Disease Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed
Services University of the Health Sciences, Bethesda, MD,
USA
c The Henry M. Jackson Foundation for the Advancement
of Military Medicine, Inc., Bethesda, MD USA
d San Antonio Military Medical Center, Joint Base San
Antonio, Fort Sam Houston, TX, USA
Diagnostic Microbiology and Infectious Disease
Volume 84, Issue 4, April 2016, Pages 358-360
CPT Charles Stahlmann
BAILEY K. ASHFORD (BKA) LABORATORY
FINALISTS
CPT Eric Scofield, MC: Up Regulation and
Targeting Of Cancer Testis Antigens in Leukemic Blasts Using
Epigenetic Therapy
6
Feb/Mar 2016
INTERNAL MEDICINE
“Multidrug-resistant gram-negative bacilli
colonization risk factors among trauma patients”
QUALITY IMPROVEMENT (QI)
MAJ Heather Mascio, MC: A QI project:
Improvement in Interdialytic Weight Gain in
the Walter Reed Hemodialysis Unit with
Individualized Adjustment of Dialysate Sodium Concentrations
The finalists will be presenting at the Poster Competition on 11 May 2016 or at the
Research Symposium I & II on 18-19 May
2016.
PUBLISHED
CPT Charles Stahlmann (Sleep Clinic) presented his research at the Maryland and DC
Thoracic Society Meeting on March 2nd,
2016.
CASE REPORTS INTERNS AND RESIDENT
CPT Christopher Lowe, MC: Primary Cutaneous Zygomycosis in an Extremely Preterm
Infant Successfully Treated With Liposomal
Amphotericin B
Here is a link to the complete list of finalists
for the 2016 8th Annual National Capital
Region Research
Competitions:
https://learning.usuhs.edu/x/vLWfCo
JUST
“Unity of Effort”
John P Murtha Cancer Center (MCC)
offers Lung Cancer Screening
Separately, to read about the John P. Murtha Cancer Center (MCC) lung cancer
screening program (in the Navy-wide medical service corps newsletter, “the Rudder”)
select:
https://learning.usuhs.edu/x/cj1UzI
Abstract
Prior studies have demonstrated high rates of
colonization and infection with multidrugresistant gram-negative bacilli (MDR-GNB) in
injured military personnel. Our analysis
shows that injuries inflicted during peak combat periods, massive blood transfusion requirement, and posttrauma cefazolin prophylaxis (additive effect with fluoroquinolones)
were risk factors for MDR-GNB colonization…
Here is a link to the publication:
https://learning.usuhs.edu/x/yAZq5z
Congratulations LT Laura Gilbert!!
It is outstanding that this is coming out in
print in April. Congratulations to you and
your mentors/collaborators at Walter Reed
Bethesda, USU IDCRP, the HMJ Foundation,
and SAMMC. This is important research that
is highly relevant to our Military Medicine
populations with broader applicability
worldwide.
Walter Reed DOM GME Snapshot
publications
Nephrology Fellowship Program
The
WRNMMC Nephrology Fellowship
Program is pleased to announce
that it will have four fellows starting in July 2016,
three Army and one Navy.
Also, here are some recent publications involving
our Nephrology Fellowship Graduates:
Dr. Moon, Dr. Mascio and Dr. Altenburg graduated fellowship in
2015. They completed a group quality improvement project during
their 2nd year of fellowship and published their results in November 2015 (citation #1)
“Implementing GFR Estimation Guidelines Using Cystatin C: A Quality Improvement Project.”
Little DJ, Mascio HM, Altenburg RJ, Moon DS, Deressa WT, Wong
S, Yuan CM.
Am J Kidney Dis. 2015 Nov 23. pii: S0272-6386(15)01320-7. doi:
10.1053/j.ajkd.2015.10.014.
[Epub ahead of print] No abstract available.
PMID: 26616337 [PubMed - as supplied by publisher]
Here are three publications in the last quarter by Nephrology Key
Clinical Faculty and Fellowship Graduates.
“Cost-Utility Analysis of Mycophenolate Mofetil versus Azathioprine Based Regimens for Maintenance Therapy of Proliferative
Lupus Nephritis.”
Nee R, Rivera I, Little DJ, Yuan CM, Abbott KC.
Int J Nephrol. 2015;2015:917567. doi: 10.1155/2015/917567. Epub
2015 Oct 27.
PMID: 26600951 [PubMed] Free PMC Article
“Impact of Poverty and Health Care Insurance on Arteriovenous
Fistula Use among Incident Hemodialysis Patients”
Nee R, Moon DS, Jindal RM, Hurst FP, Yuan CM, Agodoa LY, Abbott KC.
Am J Nephrol. 2015;42(4):328-36. doi: 10.1159/000441804. Epub
2015
Nov 17. PMID: 26569600 [PubMed - in process]
“Longitudinal Plasma Metanephrines Preceding Pheochromocytoma Diagnosis: A Retrospective Case-Control Serum Repository
Study.”
Olson SW, Yoon S, Baker T, Prince LK, Oliver D, Abbott KC.
Eur J Endocrinol. 2015 Dec 15. pii: EJE-15-0651. [Epub ahead of
print]
PMID: 26671972 [PubMed - as supplied by publisher]
7
Feb/Mar 2016
Also, MAJ Prince and Dr. Yuan, Nephrology PD and APD in collaboration with Mrs. Howle in the WRNMMC Simulation Center developed and tested a new simulation exercise to assess communication skills of nephrology fellows on counseling for renal replacement therapy and kidney biopsy. They presented the abstract as a
poster at the American Society of Nephrology Meeting in November 2015.
Prince L, Watson M, Howle A, Yuan C. “A Simulation Exercise to
Assess Renal Replacement Therapy and Kidney Biopsy Communication Skills. Presented at American Society of Nephrology Renal
Week, San Diego, CA, Nov 7, 2015."
Congratulations Team!
Lisa Prince
Lisa K. Prince, M.D.
MAJ(P), Medical Corps, U.S. Army
Program Director, Nephrology Fellowship
Nephrology Service, WRNMMC
Assistant Professor, Department of Medicine, USUHS
NEED A PROCEDURE COMPLETED?

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Thoracentesis
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Exercise Stress
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WANT TO HELP OUR HOUSESTAFF
BECOME MORE PROFICIENT?
Page IM CONSULT PAGER
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Connect with IM residents needing
various procedures listed above
when you don't have a rotating resident readily available (or fellow who
also needs the procedure).
Thanks in advance for thinking of
the residents.
You may be wondering about the illustration used for this advertisement…
from Hans von Gersdorff's Feldtbuch der Wundartzney (Strasburg, 1519)
Read more on page 3
Walter Reed DOM GME Snapshot
education, scholarship, outreach
NCC HEMATOLOGY/ONCOLOGY FELLOWSHIP
Dr. Roswarski presents poster at Forum in Texas
Hem/Onc fellow Joe Roswarski presented a poster at the
Immuno-Oncology Young Investigators' Forum in Houston
TX, Mar 9-11, sponsored by ARCoalition. The title is: “A
Phase I, Open-Label, MultipleAscending Dose Study to Assess the Safety and Tolerability of RRx-001 and Nivolumab in
Subjects With Advanced Solid Tumors or Lymphomas
(PRIMETIME) . “
Allergy/Immunology Service Offers Diagnostic Laboratory
Immunology Course
Held at Walter Reed Bethesda on 14-18 March, the Diagnostic Laboratory Immunology course is an annual week-long
course and was attended by eight GME trainees from the
Allergy/Immunology, Rheumatology, Hematology/
Oncology, and Infectious Disease fellowships (CPT Wayne
Bailey, CPT Jeannie Bay, LT Jeff Eickhoff, CPT Evelyn
Lomasney, CPT Jennifer Masel, CPT Joe Roswarski, CPT
Rodger Stitt, LCDR Karen Zeman). The course allowed
trainees to become familiar with laboratory assays and concepts that form the basis of many of the lab evaluations used
in patient care as well as in research. Those who attended
participated in hands-on laboratory exercises that covered a
wide range of techniques, from flow cytometry and enzymelinked immunosorbent (ELISA) assays, to immunoprecipitation reactions and western blots. A robust lecture schedule
was also offered and received strong support, with speakers
from WRNMMC, the Uniformed Services University, Department of Research Programs (DRP), the National Institutes of Health, Walter Reed Army Institute of Research
(WRAIR)/Navy Medical Research Center (NMRC), and
National Jewish Health. The course was also audited by several other GME trainees and staff, who were able to share in
the lectures that were offered.
Course director, LCDR Taylor Banks and Laboratory director, Dr. Yaling Zhou received strong support from COL
Peter Weina, CPT Franz Frye, the scientists at DRP, researchers at WRAIR/NMRC, the trainees' program directors,
and from the Education, Training, and Research directorate.
We hope to build on the course's success and open this opportunity to a larger number of interested GME and possibly
UME trainees in the future.
New Quality Improvement Course
Quality Rocks!
The Quality Rocks! course is a two-hour class that teaches the Institute for Healthcare Improvement’s Model for
Improvement. Internal Medicine house staff are wellfamiliar with this system; it’s what they use to do their
yearly QI projects, and it’s a great model for doing QI.
The course begins with a quick orientation to the Six
Aims of Healthcare (Can you name them??), which are
presented as a values check for any QI project. Whatever improvement we are undertaking should align with
one or more of the six aims. Then, students learn the
basic tools of QI, including the Aim Statement, stakeholder analysis, fishbone diagrams, flow charts, the
three measures (outcome, process and balancing), the
PDCA cycle and the Pareto chart. This section is a bit of a
whirlwind, covered in 40-45 minutes, and students are
directed to the IHI Open School and supplements in
their course booklet for additional content. Over a short
break, the students begin to craft Aim Statements and
stakeholder lists for their own projects, even if they are
just in the early stages. A guest speaker, often one of the
IM house staff, then shares his/her experience with a
recent QI project, reinforcing the Model for Improvement tools. Julia Cheringal, Ben Vipler, Adam Barelski,
Lee Jamison and Nick Fiacco have all filled this role and
brought a wealth of experience to the class. They’re
super! The final 20 minutes of the class has the learners
break into two groups and share their Aim Statements,
objectives and stakeholder lists with one another and
either Dr. Schexneider or the guest speaker for feedback, refinement and encouragement. I am always impressed with how easily the IM house staff step into the
role of teacher and facilitator to their peers, and I know
why. They’re a strong group across the board, and they
receive excellent instruction and guidance from Dr. Chin
Hee Kim, Dr. Joan Ritter and others in doing QI.
Thank you CAPT Schexneider for taking the lead in creating such a robust Quality Improvement Course, and to
all of the others who have also played a critical role in
making it so successful.
V/R,
Taylor Banks, MD
LCDR MC USN
Walter Reed National Military Medical Center Clinic Chief, WRNMMC
Allergy/Immunology Clinic Associate Program Director, NCC Allergy/Immunology
Fellowship Associate Program Director, NCC TY Internship
8
Feb/Mar 2016
Walter Reed DOM GME Snapshot
education, scholarship, outreach
PARTNERSHIPS
NCC Nephrology and the VA:
Walter Reed DOM, Uniformed Services University Department of
Medicine and Veteran’s Affairs partnerships: a very synergistic
relationship…
Qualitatively, both our Nation’s Veterans and DOM GME training
programs have dramatically benefited from VA resource sharing
arrangements through multiple venues.
Our inpatient ward, fellowship and MICU teams benefit from referral of these typically older and sicker patients from area VA Hospitals (i.e. DCVA, Martinsburg, WV) for specialized procedures in gastroenterology, pulmonology, cardiology and other medicine subspecialties. This has helped support a robust census on our five
Walter Reed inpatient medicine teams with commensurate increases in our ICUs. The net result is added medical training currency of
our active duty faculty providers and military GME trainees.
Additionally, the Walter Reed Bethesda IM Residency, which is the
largest resident complement GME training program in the MHS,
greatly benefits from our partnership with the DC Veteran’s Affairs
Hospital through our training agreements. At any given time, military resident teams (with Uniformed Services University medical
students) are covering two of the seven inpatient ward teams at
the DC VA. This amounts to two residents, four interns, and up to
six medical students at a time. Our residents greatly benefit from
this opportunity to learn from this Veteran patient population in
terms of case mix and complexity, while gaining a much greater
understanding of the continuum of care from the DoD to the VA
health care systems. The VA provides excellent inpatient faculty
who also train residents and medical students from Georgetown
University and George Washington University. Military residents
and students allow them to help meet their high demand for complex inpatient services. The arrangement is beneficial to Walter
Reed Bethesda, Uniformed Services University, the National Capital
Consortium and the VA, and is especially valuable to our veterans
who have answered the call.
These partnerships help a residency of our size train 1/3 of all Navy
Internists, more than 1/5 of all Army Internists, additionally preparing on average 10-12 interns for Fleet and Field service as General
Medical Officers per year. Our VA patients also help make possible
our DOM co-sponsorship of the joint Walter Reed Transitional Year
Internship Program, which is the largest in the MHS at 30 interns/
year, and prepares interns for both General Medical Officer assignments as well as future careers in a variety of clinical specialties.
This is in addition to the Unity of Effort advantages that we share
with the Uniformed Services University in helping to train their
clinical clerkship and advanced internship students in these
settings.
2) We currently rotate our first-year fellows to the Washington VA
for 1-2 months in order to gain exposure to a different socioeconomic mix for dialysis and hypertension patients.
JDO
James D. Oliver III, M.D., Ph.D.
Colonel, Medical Corps, U.S. Army
Chief, Nephrology Service, WRNMMC
Director and Associate Professor, Nephrology Division, USUHS
As further context, Dr. Pangaro, Chairman of Medicine at Uniformed Services University (USU) adds that the relationship between the department of medicine and the VA has become very
strong at the Undergraduate Medical Education level. Dean Kellermann of our med school is keenly interested in the VA-USU-WRB
connection.
USU medical students are present on the medicine wards and in
the outpatient clinics. CAPT Kyle Peterson of the USU medicine
department oversees our students' education there and he is part
of clinical care on the wards and in ID.
We have an active process of faculty appointments and review for
academic promotion. Most DC VA staff have primary academic
appointments at George Washington or Georgetown, but now several dozen now have USU faculty appointments at well.
Lou
Louis N. Pangaro, MD, MACP
COL (ret.) MC USA
Professor and Chairman
INTERNAL MEDICINE
Congratulations Dr. Julie Chen and LT Nick Fiacco on the recent
acceptance of your signature abstract, "'4+1' Ambulatory Block
Scheduling in Resident Continuity Clinic: Effects on Internal Medicine Resident Care Quality Measures," for inclusion in the Association of Program Directors in Internal Medicine (APDIM) Poster Reception for the 2016 APDIM Spring Meeting, to be held
April 19-20 in Las Vegas, NV.
Outstanding work Julie and Nick!
Nice to see data linking educational interventions to improvements in process measures for better patient outcomes – something the ACGME wants GME programs to be doing—very cool!
CAPT Shimeall
9
1) VA patients are currently seen at WRNMMC for pre- and posttransplant care. Also our trainees are often involved in the care of
neurosurgical patients who require dialysis.
Feb/Mar 2016
Walter Reed DOM GME Snapshot
education, scholarship, outreach
CPT Sarah Ordway Earns Poster of Distinction
S
arah Ordway's (Internal Medicine) research, "Factors Influencing Decisions for or Against a Career in Hepatology: A
Survey of Gastroenterology Fellows," was selected as a
Poster of Distinction for this year's Digestive Diseases Week
[to be held in May]. This is quite an honor and a testament to the
outstanding work Sarah has done! Kudos to Dr. Singla and Kwok
who mentored her on this project.
Congratulations Sarah! Thanks to Drs. Singla, Kwok and Young, as
well as the entire GI Department, for your continued outstanding
mentoring for resident scholarship.
"Poster of Distinction" is quite impressive, and the original research
is nice to see as well.
BZ Sarah!
Click here to link to CPT Ordway’s abstract
L
T Benjamin Vipler (Internal Medicine Chief Resident), and
CPT Adam Barelski (Internal Medicine Chief Resident), MAJ
Mike Cahill (Cardiology Resident) and LTC Brian Hemann
(Alumni), and COL Stephen Harrison (Gastroenterologist,
SAMMC).
Congratulations on being selected as new members of ΑΩΑ (AOA),
Uniformed Services University (USU) Gamma Chapter. “The applicants this year were extremely competitive and accomplished in
many areas. Amongst this high quality field you rose to the top
which is a testament to your achievement in alignment with the
values of AOA.”
AOA National is becoming known more of a lifetime service and
professional organization versus an academic honor.
Outstanding! Congratulations to all of you! Definitely a reflection
of all the hard work you have put in over the past year and your
futures as leaders in Academic Medicine.
http://www.usuaoa.org/
Feb/Mar 2016
T
he ACGME notified the Core IM Residency Program on
their continued accreditation without citations or areas for
concern. All 10 IM subspecialties, dermatology, and the
Transitional Year Internship program also received continued full accreditation from their respective Residency Review Committees under the ACGME. Outstanding work by our residents,
fellows, faculty and staff!!!
“Unity of Effort”
Second Look Weekend – A true Unity of Effort
Overview - USU Second Look, 18 March 2016
T
New Resident Members of ΑΩΑ
10
Good news!
he Second Look Weekend, held annually by the Uniformed
Services University of the Health Sciences, took place 1820 March, 2016. The Second Look Weekend is aimed at
prospective students who have been accepted to USU but
have not yet made their final decision regarding their medical education. The event is intended to highlight the advantages of pursuing a military medical education, offering prospective students the
opportunity to visit the USU campus and to see the world-class
medical facility they would be utilizing during their time at USU, as
well as to speak to USU Alumni regarding their experiences in military medicine and the opportunities available to military medical
practitioners. Feedback from Second Look participants is always
very positive, with students saying that the opportunity to see a
military medical center and to speak with Alumni has been pivotal
in their decision making regarding matriculation.
As part of Walter Reed National Military Medical Center’s commitment to the Unity of Effort with the Uniformed Services University,
the medical center supports the Second Look Weekend through a
visit on the first day of the weekend event, including a Leadership
Welcome and Briefing on Graduate Medical Education, coordinated
visits to clinical areas of interest, and strategic opportunities for
interaction between prospective USU students and USU Alumni
currently stationed at the medical center. As USU is key to military
medicine's ability support myriad medical requirements around the
globe, supporting the Unity of Effort between WRNMMC and USU is
a top priority for the Command.
This unparalleled event, scheduled to occur only once per year,
has been coordinated by Ms. Krysia Olas, Service Chief for Military
Health Diplomacy, for the past four years. Coordination of the
event requires the participation over 60 WRNMMC staff (including
more than 15 Alumni) and over 80 hours of advance planning,
trainings, and walk-throughs to execute.
Walter Reed DOM GME Snapshot
well-deserved recognition
Academic Awards –
Clerkship Curriculum, Class of 2017
Here is what a recent patient and staff had to say
about IM PGY2 Resident Dr. Ben Collen:
PATIENT QUOTE FROM “CENTER STAR”
F. Edward Hebert School of Medicine
– “America’s Medical School”
4 March 2016
Best students for the clerkship year (all Honors) were
recognized, and the students then took the time to recognize some faculty:
Walter Reed Bethesda was best "large teaching site"
out of roughly 20 teaching schools.
COL Bill Kelly won best Clerkship Director, which Bill
infers it to mean “Internal Medicine sites
(across the country) are #1. Of note the award has
been issued only for the past two years and Dr. Kelly/
IM won both times.
Ten exceptional attendings (also from across the country) were selected by the class of 2017 students for
recognition, including three DOM GME faculty – CAPT
Bill Shimeall, CDR Todd Gleeson, and LTC(P) Todd Villines.
To see the entire awards program:
https://learning.usuhs.edu/x/Sq2DzZ
A few of the many compliments a patient recently
made about Dr. Collen included how he has
“integrity,” and “builds trust & compassion.”
Dr. Shimeall,
I wanted to let you know that not only did
Dr. [Ben] Collen do an excellent job last month on the
Advanced Heart Failure service, he also got a “Center
Star” commendation by one of his patients.
I know I have told you in the past, but I again wanted to
reiterate what a pleasure it is to have your residents
rotate on our service. We look forward to continued
collaboration on medical education in years to come.
Mark R. Hofmeyer, MD, MS, FACC
Director of Medical Education - Advanced Heart Failure Program,
Associate Program Director - Advanced Heart Failure Fellowship
Assistant Professor of Medicine - Georgetown University
Advanced Heart Failure Therapies and Cardiac Transplantation
MedStar Heart and Vascular Institute - Washington Hospital Center
MHVI-CC (7)
Dr. Collen,
Recognizing Excellence
The following MC Officers (Army GME Faculty) were
selected to participate in the MHS Female Leadership
Course on 11-13 April 2016:
MAJ Mary Kwok- Heme/Onc, WRNMMC
MAJ Lisa Prince- Nephrology, WRNMMC
MAJ Maura Watson- Nephrology, WRNMMC
This is strong praise indeed. I am not sure
how long your rotation was but within a short
period of time you obviously impressed both
the leadership in the training program and
most important of all - your patient! The
qualities outlined by your patient on the Center Star are humbling "integrity, trust, compassion." Thank you for all that you do.
Proudly,
Dr. Nations
11
Feb/Mar 2016
Walter Reed DOM GME Snapshot
well-deserved recognition
check it out
New Resident Members
of Gold Humanism Society
We are excited to inform you that Dr. Brett Sadowski, Dr. Alison
Lane and Dr. Gilda Bobele have been selected as resident members of the Uniformed Services University Chapter of the Gold
Humanism Honor Society!
The GHHS was established by the Arnold P. Gold Foundation in
2002 to recognize individuals who are exemplars of humanistic
patient care and who are prepared to serve as role models,
mentors, and leaders in medicine.
http://humanism-in-medicine.org/ghhs/
Each year, up to 6 Residents are selected by 4th year Uniformed
Services University (USU) students. The resident nomination and
selection process is entirely student-driven, and his selection is a
direct result of the humanistic care USU students have regularly
observed them practicing and modeling.
Very respectfully,
Omojo O. Malu, 2d Lt, USAF, MSC
Air Force Medical Student, Class of 2016 F.
Edward Hébert School of Medicine – "America's Medical School"
Time Capsule
Every fall, the internal medicine chief residents lead program
overview sessions to internship applicants from USUHS and
around the country. This past fall, our current Navy Chief, LT
Ben Vipler noticed one of the Army HPSP applicants was from
his alma mater, the University of Miami Miller School of Medicine. At the end of the intro session, 2LT Mary Lan reminded
LT Vipler that she had actually met him before, when he hosted her at his home during her medical school interviews.
After much laughter and reminiscing about all the great
things "The U" had to offer during their medical school experiences, LT Vipler wished 2LT Lan luck.
About a month later, LT Vipler received an email from 2LT Lan
enquiring if he would like to contribute to the upcoming edition of Obliterants, the Journal of Humanities & Social Sciences in Medicine and Public Health at the University of Miami.
2LT Lan is current Editor in Chief of Obliterants and Dr. Gauri
Agarwal, one of LT Vipler's medical school mentors and deans
is Editorial Advisor. LT Vipler graciously accepted her invitation and his piece entitled "Time Capsule" was recently published in the Spring 2016 issue of Obliterants.
The full article can be found on page 18 at the following link:
https://issuu.com/obliterants/docs/oblit_spring_2016_pages
Uniformed Services University of the Health Sciences
4301 Jones Bridge Road
Bethesda, MD 20814
Radio Guest
As a guest on WTOP, Lt Col Todd Villines (Program Director,
Cardiovascular Disease Fellowship, Director, Cardiovascular
Research and Cardiac CT) talks about Heart failures’ warnings
for women: what to look for, and what to know.
Brett, Gilda, and Alison,
Congratulations on this tremendous honor! It is a testament to your patient-centeredness and dedication to
your patients, peers and trainees that is clearly evident to
your students and us every day. Thank you for everything that you do for our patients, program, facility and
the medical school. It is an honor to serve with you.
Click here to read the full story
I should also note that 3 of the 4 residents selected from
across the MHS were from Walter Reed Internal Medicine. IM Strong!
BZ!
12
Feb/Mar 2016
Walter Reed DOM GME Snapshot
hails, farewells and promotions
Department of Medicine Team,
Please join me in welcoming CAPT Timothy Whitman as the new Chief
of Infectious Diseases, and bidding a heartfelt adieu to CAPT Burgess!
C
APT Timothy Whitman is originally from Massachusetts
and attended Siena College in Albany NY for undergrad and
then New York College of Osteopathic Medicine on Long Island
NY for medical school. He did his internal medicine residency at the
National Naval Medical Center in Bethesda MD and then an Infectious Diseases Fellowship in the National Capitol Consortium in
Bethesda MD. During his Navy career, he has served as a general
medical officer with a Marine artillery battalion in Camp Lejeune
NC and later deployed to the US Military Hospital, Camp Arifjan
Kuwait as an internist/infectious diseases specialist. He is board
certified in internal medicine and infectious diseases and his research
interest is primarily in the prevention of skin and soft tissue infections in military recruits. He is widely published in the field of infectious diseases and is first author or co-author on 27 manuscripts
in peer reviewed journals. He is currently the chair of the infection
prevention and control committee and the infectious diseases fellowship director at Walter Reed Bethesda in addition to being the past
president of the Greater Washington Infectious Diseases Society.
He is married with three children.
From the Department of Medicine, I want to extend my congratulations and welcome. We look very forward to the further growth
and development of the Infectious Disease Service under the leadership of CAPT Whitman and welcome him to his new position.
C
ongratulations, Captain Whitman! The WRNMMC-B Infectious Diseases Service is indeed in exceptional hands.
It has been my very great privilege to have been afforded the opportunity to serve as ID Chief, and I'm honored to turn over the helm
to a master clinician and teacher and superlative officer. I look forward to continued work together with ID and DOM colleagues in
my new role as director of the multicenter Infectious Diseases Clinical Research Program based at USU.
V/r
Tim
T. H. Burgess, MD, MPH
Captain, Medical Corps, US Navy
Navy Medicine Specialty Leader for Infectious Diseases
Director, Infectious Diseases Clinical Research Program,
Department of Preventive Medicine and Biostatistics
Uniformed Services University School of Medicine
[email protected]
More on what CAPT Burgess is doing?
I additionally want to thank CAPT Timothy Burgess for his
leadership of the Infectious Disease Service of the last few
years. CAPT Burgess provided state of the art infectious disease
leadership and expertise from 1 September 2012 to 31 December
2015, culminating in Walter Reed National Military Medical Center
(WRNNMC) attaining full operating capability (FOC) for Ebola
Virus Disease (EVD) Preparedness on 01 January 2015. FOC status
was a matter of National Security as WRNMMC was designated the
Tier 1 Priority Medical Treatment Facility (MTF) for receipt of
suspected or confirmed persons with EVD during Operation United
Assistance. Officials at the highest echelons of the U.S. Government
looked to WRNMMC to safely provide excellent medical care to
service members exposed to Ebola Virus Disease while deployed to
Operation United Assistance. We have been privileged to have
CAPT Burgess lead the Infectious Diseases Service during these
times of change. We look forward to his further leadership in Infectious Diseases [in his new role at USUHS, as Director of DoD's
Infectious Diseases Clinical Research Program] and his continued
clinical presence here at Walter Reed Bethesda.
With deep respect,
Dr. Nations
Joel Anthony Nations MD, MBA, FACP, FCCP
Commander, Medical Corps, United States Navy
Chief of Medicine
Walter Reed National Military Medical Center, Bethesda MD
13
Feb/Mar 2016
CAPT Tim Burgess is now the “director of the DoD's Infectious
Diseases Clinical Research Program, IDCRP, which is a USUcentered, global collaborative research network active at 17 DoD
partner sites worldwide including WRNMMC. IDCRP is a joint
effort between USU, MTFs, DoD research commands (NMRC,
WRAIR, OCONUS labs) and surveillance activities (AFHSB/
GEIS), and the National Institute of Allergy and Infectious Diseases
(NIAID), chartered by the Assistant Secretary of Defense for Health
Affairs. IDCRP currently has 57 active multicenter observational
studies and randomized clinical trials investigating militarilyrelevant infectious disease threats in focus areas including acute
respiratory infections, HIV, trauma-associated infections, skin & soft
tissue infections, sexually transmitted infections, emerging pathogens and antimicrobial resistance. Of perhaps most interest to the
readers of the GME newsletter, a specific mission focus area for
IDCRP delineated in our Strategic Plan is supporting graduate
medical education in the MHS through involvement of trainees in
clinical research activities. We've supported residents' and fellows'
active participation, as well as that of GME faculty mentors, in several projects ranging from analysis of data from ongoing longitudinal studies to overseas clinical trials, leading to a number of trainee
presentations and publications.”
Tim
T. H. Burgess, MD, MPH
Walter Reed DOM GME Snapshot
Graduate Medical Education
DoM GME Shared Events & Deadlines
Department of Medicine
Walter Reed Bethesda
APRIL
JUNE
28 April, 2016:
IM Quality Improvement Review Conference: CPT Shannon Wood
1200-1300 in America Building Room 2525 B/C.
7 June, 2016
4th Annual Internal Medicine Residency Quality Improvement Poster Fair
We are excited to announce that RDML Lane will be one of the judges!!
29 April, 2016
Application deadline for 2016 Spring Research Summit
Link to Spring Research Summit: https://learning.usuhs.edu/x/krSG9o
If you are interested, please send the attached application and your slide
presentation to:
[email protected] no later
than 29 April, 2016. The subject line for your submission to the email above
should read: Last name, First name; 2016 Spring Research Summit. If you have
any questions, please send your inquiry to the above email address as well.
10-11 June, 2016
UVA GI conference
in Charlottesville, VA
Great opportunity to present posters and hear what others are doing around
the East Coast. Fellows/Residents interested in attending/submitting abstracts,
contact Course Director, Neeral Shah, Associate Professor, Gastroenterology
and Hepatology Associate Program Director, Internal Medicine Residency
MAY
3-4 May: Pre-Courses
5-7 May: Scientific Program, Clinical Skills
National ACP Internal Medicine 2016 Meeting
Center, Exhibit Hall, Walter E Washington Convention Center, Washington, D.C.
http://im2016.acponline.org/
04 May 2016
Aware for All
Location: Lobby of the America Building (Bldg. 19), Walter Reed National Military Medical Center
Time: 1100-1400
FLYER: https://learning.usuhs.edu/x/wPHe1K
18-19 MAY 2016
Research Symposium I and II
Memorial Auditorium, Building 2, 3rd floor
https://learning.usuhs.edu/x/vLWfCo
20 May
Organizational Day – Plan for normal morning schedules with light afternoon.
25 May
2016 Spring Research Summit
Location: Memorial Auditorium (Bldg. 2)
Time: 0800 – 1300 (time subject to change)
Link to Spring Research Summit: https://learning.usuhs.edu/x/krSG9o
26 May - Thursday at 0830
MD ACP Associates (Residents) meeting, Mulholland Mohler Residents
meeting
St. Agnes Hospital, 900 S. Caton Avenue, 21229 Main Entrance and Alagia Auditorium (So far Dr. Hays and Dr. Diemer have volunteered to serve as judges on
May 26th as well (Thanks Meredith and Gretta!).
For further information, you may email Maryellen Woodward, our Chapter Staff
person at [email protected]
27-29 JUN STOMP
for Simulated Training for Operations
Medical Providers for Interns
LONG-TERM PLANNING
October 26-30, 2016
IDSA meeting
The annual IDWeek meeting will take place in New Orleans, Louisiana.
Deadline for abstracts is 17 May.
See more at: http://www.idweek.org/
ON-GOING EVENTS
Third Thursday of Every Month
IM Quality Improvement Review Conference
We would like to invite everyone to our monthly Quality Improvement Review
Conferences (formerly Morbidity & Mortality). These generally occur on the
third Thursday of the month with the occasional exception. We had a great
discussion led by LT Ben Kurth on 18FEB and by CPT Alex Due on 17MAR on
various cognitive and systems errors that were encountered in two challenging
cases. All conferences are held at 1200-1300 in America Building Room 2525
B/C.
Every Friday
IM Grand Rounds schedule/speakers (2015-2016)
Dec schedule, Location: IM Noon Report Conference Room (America Building
2525 A-C) Please contact the Activity Director, MAJ Mary Kwok, MC, USA,
[email protected] for updates. https://learning.usuhs.edu/x/j9faq4
Every Friday
USUHS Department of Medicine Faculty Research Seminars
0900 – 1000 (usually Lecture Hall A, B, or C)
If you have any questions, contact Ms. Rhonda Stout at (301) 295-9602
Click here to view the complete Fall-Winter 2015 schedule
Various
Darnall Medical Library Workshops
In addition to the usual PubMed and citation management workshops, they will
also offer workshops on Time Saving Tips for Researchers, Systematic Reviews,
and Preparing Your Manuscript for Publication." Click on title above.
To share the incredible things our residents, fellows, administrators, and faculty are doing, contact
Sean Lynch, Editor, at [email protected], or (301) 319-4399
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Feb/Mar 2016
Walter Reed DOM GME Snapshot