AMSUS Student Webinar: What`s Up With (Air Force) Military

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AMSUS Student Webinar: What`s Up With (Air Force) Military
AMSUS Student Webinar:
What's Up With (Air Force) Military Residencies?
amsus.org
Air Force Personnel Center
Air Force GME
Update 2016
Michael A. Forgione MD, FACP, FIDSA
Colonel, USAF, MC
Chief, Physician Education
HQ AFPC/DP2NP
Overview

Background- USAF MC

AFPC/DP2NP- Physician Education Section

USAF GME Programs

HPERB

JSGMESB

ADSC

Pregnancy Policy and GME
Integrity - Service - Excellence
Active Duty USAF 2015

As of November 2015
 Total USAF Officers- 60,244
 AFMS Officers- 10,738
 AFMS MC- 3338
 Colonel 308
 Lt Col 662
 Major 1042
 Captain 1326
Integrity - Service - Excellence
Active Duty USAF 2015

As of November 2015
 Total USAF Officers- 60,244
 AFMS Officers- 10,738
 AFMS MC- 3338
 Colonel 308
 Lt Col 662
 Major 1042
 Captain 1326
Medical School
1104 HPSP
210 USUHS
USAF GME
859 AD Military
91 Civilian Sponsored Training
360 Deferred Civilian Training
34 Financial Assistance Program
Integrity - Service - Excellence
Active Duty USAF 2015

As of November 2015
 Total USAF Officers- 60,244
 AFMS Officers- 10,738
 AFMS MC- 3338
 Colonel 308
 Lt Col 662
 Major 1042
 Captain 1326
Medical School
1104 HPSP
MSC Officers
210 USUHS
USAF GME
 Summary:


2500 Staff Physicians
2500 In Training
859 AD Military
91 Civilian Sponsored Training
360 Deferred Civilian Training
34 Financial Assistance Program
Integrity - Service - Excellence
Integrity - Service - Excellence
7
Physician Career Management & Medical
Retention Standards Branch

Three Sections:
 Medical Retention Standards (Maj Valerie O’Brien)
 Physician Education (Col Michael Forgione)
 Physician Utilization (Col Steven Pflanz)

Physician Utilization:
 2.5K non-O-6 AD physicians, 27 core IDs, 106 AFSCs
 650 assignments/year
 Two DTs per year
 Schedule Aerospace Medicine Primary (AMP) Course
 Initial training for flight surgeons (750 enrollments/year)
 Critical shortages:
 Psychiatry (44P = 68%)
 Flight Medicine (48A = 84%, 48R = 70%)
Integrity - Service - Excellence
DP2NP/Physician Education
Section Personnel
GME Chief
Col Mike Forgione
DAS- Jun 2015
CME Program
B
Mr. Cal Baker GS11
DAS- Oct 2012
Deputy
A
Lt Col Roselia Labbe
DAS-2014
J-P
MSgt Ramayo McGriff
DAS- Nov 2014
Q-Z
Mr. Matt Kush GS9
DAS- 2004
C-I
TSgt Nada Larry
DAS- Apr 2014
Senior Program Manager
Mr David Zemkosky- Z
DAS- Jun 2015
Integrity - Service - Excellence
Physician Education (GME)

Subject Matter Experts on Medical Education for AFMS
 Interface with AFMS leadership/numerous civilian licensing,
accreditation and certification agencies related to med education

Health Professions Education Requirements Board (HPERB)
 Process in May of each year by which MC defines approved
training requirements (2015: 586 requests for 288 positions)

Joint Service GME Selection Board: Nov/Dec
 Selection and placement of all AF physicians in residency and
fellowship specialty training (623 applicants , 490 selects)

AF Surgeon General’s Physician CME Program
 Accredits Continuing Medical Education for all AF MTFs
 Accreditation with Commendation by national org (ACCME)
Integrity - Service - Excellence
Our GME Programs
Integrity - Service - Excellence
Military GME
 28 military GME sites (Air Force, Army, Navy)
 3,400 military docs in sponsored GME training
 >4000 total
 Comprises 30% of AD Medical Corps
 Together with VA, military GME accounts for
nearly 15% of all US physicians in training
 118,000 residents
Integrity - Service - Excellence
2015-16 Military Service GME
AIR FORCE
ARMY (2014)
NAVY
AD Military GME
859
1,355
AD Civ Spons
91
132
= Funded GME
= 950
= 1487
= 1055
AD Staff MC
2388
2913
2699
Funded GME
950
1487
1055
FGME + Staff
950 + 2388
1487 + 2913
1055 + 2699
Funded GME
29.2% end
strength
34% end
strength
28% end
strength
Integrity - Service - Excellence
12 AF GME Locations
Madigan Army Med Center
USAF-SAM
Offutt AFB
Wright-Patterson AFB
Travis AFB
National
Capital
Consortium
Scott AFB
Nellis AFB
NMC Portsmouth
Keesler AFB
ARMY
NAVY
USAF
SAUSHEC
Eglin AFB
Integrity - Service - Excellence
Air Force Directors of
Medical Education (DMEs)
Barbara B. Erickson, JD, MHA (Travis)
GME Office Phone- 707-423-7947
Col William Hannah (SAUSHEC)
GME Office Phone 210-916-0887
Col Christopher P. Paulson (Eglin)
GME Office Phone 850-883-8288
Col Gary Peitzmeier (Wright Pat)
Lt Col Roy Johnson- acting
GME Office Phone 937-257-8715
Col Kelly West (USAFSAM/Wright Pat)
GME Office Phone 937-938-2801
Lt Col Heather Gaddey (Offutt)
GME Office Phone 402-294-9270
Col Matthew Carroll (Keesler)
GME Office Phone 228-376-3082
Dr. Stephen Titus (Ft Belvoir)
GME Office Phone 571-231-3361
Stephanie L. Threats (Scott)
GME Office Phone 618-256-4287 ext 4407
Col Pamela Williams (Nellis)
GME Office Phone 702-653-3052
Integrity - Service - Excellence
USAF Graduate Medical Education Programs/Positions
SAUSHEC
ALLERGY & IMMUNOLOGY
ANESTHESIOLOGY
DERMATOLOGY
EMERGENCY MEDICINE
EMERGENCY MEDICINE EMS FELLOWSHIP
EMERGENCY MEDICINE ULTRASOUND FELLOWSHIP
INTERNAL MEDICINE
INTERNAL MEDICINE CARDIOLOGY FELLOWSHIP
INTERNAL MEDICINE ENDOCRINOLOGY FELLOWSHIP
INTERNAL MEDICINE GASTROENTEROLOGY FELLOWSHIP
INTERNAL MEDICINE HEMATOLOGY/ONCOLOGY
INTERNAL MEDICINE INFECTIOUS DISEASE FELLOWSHIP
INTERNAL MEDICINE NEPHROLOGY FELLOWSHIP
INTERNAL MEDICINE PULMONARY FELLOWSHIP
INTERNAL MEDICINE RHEUMATOLOGY FELLOWSHIP
NEUROLOGY
OB/GYN
OPHTHALMOLOGY
ORTHOPEDIC SURGERY
OTOLARYNGOLOGY
PAIN MEDICINE (MULTIDISCIPLINARY)
PATHOLOGY
PATHOLOGY CYTOPATHOLOGY FELLOWSHIP
PEDIATRICS
National Capital Consortium
FAMILY MEDICINE
FAMILY MEDICINE - SPORTS MEDICINE
OB/GYN
INTERNAL MEDICINE
PEDIATRICS
PEDIATRICS INFECTIOUS DISEASE
PREVENTIVE MEDICINE
SURGERY - GENERAL SURGERY
Wright-Patterson AFB
EMERGENCY MEDICINE
INTERNAL MEDICINE
OB/GYN
PEDIATRICS
PSYCHIATRY
SURGERY - GENERAL SURGERY
USAF-SAM
AEROSPACE MEDICINE
RAM/FAM (FAMILY MEDICINE)
PEDIATRICS ADOLESCENT MEDICINE
PEDIATRICS NEONATOLOGY
PSYCHIATRY
RADIOLOGY - DIAGNOSTIC RADIOLOGY
RADIOLOGY - MUSCULOSKELETAL
RADIOLOGY - NUCLEAR MEDICINE
SLEEP MEDICINE (MULTIDISCIPLINARY)
SURGERY - CRITICAL CARE / TRAUMA FELLOWSHIP
SURGERY - GENERAL SURGERY
TRANSITIONAL PROGRAM
UNDERSEA AND HYPERBARIC MEDICINE
UROLOGY
Keesler AFB
Travis AFB
FAMILY MEDICINE
INTERNAL MEDICINE
DIAGNOSTIC RADIOLOGY
SURGERY - GENERAL SURGERY
SURGERY - VASCULAR SURGERY
TRANSITIONAL PROGRAM
Nellis AFB
EMERGENCY MEDICINE
FAMILY MEDICINE
SURGERY - GENERAL SURGERY
Portsmouth NMC
OB/GYN
PEDIATRICS
Eglin AFB
FAMILY MEDICINE
Offutt AFB
FAMILY MEDICINE
INTERNAL MEDICINE
SURGERY - GENERAL SURGERY
Madigan AMC
PEDIATRICS DEVELOPMENTAL
FELLOWSHIP
Scott AFB
FAMILY MEDICINE
16
Military-Civilian Partnerships

Military Partnerships
 San Antonio Uniformed Services Health Education
Consortium (SAUSHEC)
 AF-Army Joint GME Platform
 36 GME programs

National Capital Consortium, Washington, DC
 TriService Joint GME Platform
 64 GME programs
Integrity - Service - Excellence
Military-Civilian Partnerships

Civilian Partnerships: Joint Mil-Civ GME Programs

Wright Patterson AFB/Wright State U, Dayton, OH

Nellis AFB/U of NV School of Med, Las Vegas, NV

Travis AFB/UC Davis

Offutt AFB/U of NE Med Center College of Med, Omaha, NE

SAUSHEC/UT Health Science Center of San Antonio

Scott AFB/St Louis School of Med

USAFSAM/Wright State U, Dayton, OH
Integrity - Service - Excellence
Our Leaders

GME faculty appointments at both military and civilian
institutions

Nationally recognized academicians/clinicians

Invited speakers to national/international medical
specialty meetings

Hold key US specialty organization leadership positions

Special Experience Identifier Program
 MF: “Clinical or Academic Master”
 ME: “Clinical or Academic Grand Master”
Integrity - Service - Excellence
Clerkship: Rules of Engagement

Administrative details
 Plan ahead- apply early

Professionalism
 Uniform
 Customs and Courtesies

Clinical performance

USMLE scores

Academic performance
Integrity - Service - Excellence
21
Clerkship: Make it Count!

Program Director
 Express interest

Interview

Show your strengths

Consultants
 Ask questions

Military specialty conference

National conferences

Begin to establish your network future sponsor/mentor
Integrity - Service - Excellence
22
Our GME Selection Process:
The JSGMESB
Integrity - Service - Excellence
Goals of the JSGMESB
1.
Meet the current and future requirements of the Air Force
Medical Service
Part 1- Health Professions Educational Requirements Board
(HPERB)
Part 2- Joint Service GME Selection Board (JSGMESB)
2.
Provide professional development opportunities for the
applicants
3.
Maintain the academic quality of our Air Force GME programs
through competitive process
Integrity - Service - Excellence
JSGMESB “Timeline”
Air Force
determines
GME need
Health Professions
Education
Requirement Board
HPERB
results
announced
February-March
April
May
HPERB
JSGMESB
Due dates
Joint Services
GME Selection
Board
Results
JSGMESB
1 July-31
August
Week of 28
November
Early
December
Interviews
supporting
documents
Number of “requirements” determined by need of the Air Force
Integrity - Service - Excellence
25
HPERB Request ProcessGenerates GME Requirements
1. Consultant
submits request
into HPERB
website
5. AFMOA
Product Line
Champion
receives request
4. MC Director
receives request
2. AFPC
Physician
Education Officer
receives
Consultant request
3. AFPC Physician
Education Branch
Chief receives
request
Integrity - Service - Excellence
CORPS
2014
2013
2012
2011
2010
2009
2008
Pr
e-S
ele
ct s
Ca
rry
-O
ve
Pr
rs
e-o
bl i
ga
Ne
ted
wS
To
ta r
tal
s
ts
To
tal
Pro
gra
m
AY2015
Projected Training Program
30
24
24
21
23
21
22
611
595
581
593
586
589
592
2015-2016 -
641
619
605
614
609
610
614
259
296
310
286
291
290
286
900
915
915
900
900
900
900
Source for Man Years > 900
1. Corps neutral set asides
2. Unused man yrs from
other Corps
3. Board Pres can fund
authorized unfunded (AU)
1 Yr GME positions that
will not impact next year’s
numbers
950 funded training positions
Integrity - Service - Excellence
2015 HPERB for 2016 Graduating Medical Students
AD Training Slots- 240
198 Categorical Residency Training Slots
4 Civilian-sponsored
38 PGY1-only Training Slots
Deferred Training Slots- 241
175 Categorical Slots
66 PGY1-only Training Slots
Integrity - Service - Excellence
JSGMESB
Residency Opportunities
•
Anesthesiology1,2
•
Ophthalmology1,2
•
Diagnostic Radiology1,2
•
Orthopaedic Surgery
•
Emergency Medicine
•
Otolaryngology
•
Family Medicine
•
Pathology
•
General Surgery2
•
Pediatrics
•
Internal Medicine2
•
Psychiatry
•
Neurology1
•
Radiation Oncology
•
Neurosurgery
•
Transitional Medicine
•
Obstetrics/Gynecology
•
Urology1
1.
2.
Pre-select: GME offer includes internship in transitional, IM (Neuro) or gen surg (Uro)
PGY2 select
Integrity - Service - Excellence
JSGMESB
Residency Opportunities
•
PGY-2 Only
•
•
•
•
Aerospace Medicine
(RAM)
Dermatology
Occupational Medicine
Preventive Medicine
•
Not Offered
•
Physical Medicine and
Rehab
Integrity - Service - Excellence
JSGMESB
Fellowship Opportunities
•
•
•
•
Anesthesia
•
Internal Medicine/Pediatrics
•
Cardiothoracic
•
Allergy/Immunology (IM/Peds)
•
Critical Care
•
Adolescent Medicine (Peds)
•
Pain
•
Cardiology (IM)
•
Regional
•
Critical Care (IM/Peds)
Derm Surgery
•
Developmental (Peds)
•
Endocrinology (IM)
•
Gastroenterology (IM)
Emergency Medicine
•
Critical Care
•
Geriatrics (IM)
•
EMS w/MPH
•
Infectious Disease (IM)
•
Toxicology
•
Neonatology (Peds)
•
Ultrasound
•
Nephrology (IM)
Family Medicine
•
Pulmonary/Critical Care (IM)
•
Rheumatology (IM)
•
Sleep Medicine (IM)
•
OB
•
Sports Medicine
Integrity - Service - Excellence
31
JSGMESB
Fellowship Opportunities
•
•
•
Neurology
•
Orthopedics
•
Neurophysiology
•
Sports Medicine
•
Neuro-Rehab
•
Adult Reconstruction
OB/GYN
•
Oncology
•
Maternal-Fetal
•
Otolaryngology Neurotology
•
Pathology
Neurosurgery
•
Spine
•
Peds
•
Trauma Critical Care
•
•
Cytology
•
Pediatric
•
Transfusion Medicine
Preventive Medicine
•
•
Ophthalmology
•
Health Informaticist with Masters
Psychiatry
•
Cornea/Refractive
•
Glaucoma
•
Child
•
Pediatric
•
Forensic
•
Traumatology
Integrity - Service - Excellence
32
JSGMESB
Fellowship Opportunities
•
•
•
•
Radiology
•
Surgery
•
Interventional
•
Research
•
Neuroradiology
•
Cardiothoracic
•
Nuclear Medicine
•
Colorectal
•
Pediatric
•
Oncology
•
Pediatric
•
Plastic
•
Thoracic
•
Trauma Critical Care
•
Vascular
RAM, Hyperbaric Medicine
Masters in Health
Professions Education
Masters in Clinical
Informatics
Integrity - Service - Excellence
33
The JSGMESB
5. JSGMESB
meets
Nov/Dec
4. Final
Documents
interviews &
choices
15 Oct 16
3.Intial Intent
application due
31 August 16
1. HPERB
Determines USAF
training
requirements
2. Application period
opens 1 July 16
MODS
Integrity - Service - Excellence
Guidelines of the JSGMESB
•
Competitive process
•
Fair process
•
Honest process
•
Confidentiality
•
All selections are made at the JSGMESB
•
Eventual product- best interests of the Air Force
Integrity - Service - Excellence
Application Trends- MODS
2015
2014
2013
2012
2011
2010
2009
2008
AF Applicants
623
621
535
544
525
518
542
555
Active Duty
234
206
175
196
186
198
229
220
141
131
114
119
126
126
150
140
Current PGY1 only
36
20
21
18
16
13
23
21
Current Residents
57
55
40
59
44
59
56
59
Medical Students
344
361
322
305
308
289
266
279
USUHS
56
50
52
53
51
49
50
50
HPSP
287
310
268
251
257
239
214
227
ROTC
1
2
2
1
0
1
2
2
45
53
38
43
28
28
45
55
11
16
16
9
5
8
20
22
FAP
3
0
2
1
3
4
3
7
Current PGY1 only
31
37
20
32
20
16
22
26
Staff Physicians
Deferred
Deferred Resident
(HPSP)
Integrity - Service - Excellence
2015 USAF JSGMESB Results
Select
Status
Choice
Number
Count
Select
1
390
Select
2
25
Select
3
9
Select
2
61
Select
All
490(5)
Non Select
Pre Select
2017
Break Down
First Choice
Specialty
Second Choice
Specialty
Non Match to
Second Choice
No Second Choice
Comments
Matched into first choice
Did not match first, got second
choice
Did not match first or second
choice, got PGY-1 only
Did not match first choice,
Selected PGY-1 only
(5 selected for Non-Traditional
Fellowships)
95(4)
1
32(2)
623(11)
Integrity - Service - Excellence
2015 Medical Students
Residency
Applicants
Selected
AD/CIV SP
/DEF
USMLE/
COMLEX
Step 1
USMLE/
COMLEX
Step2
Anesthesia
25
16 ( 64 %)
6/0/10
233 / 550
247 / 596
Dermatology
6
3
2/0/1
252/647
254/679
Emergency Medicine
67
38 ( 56 %)
18/0/20
240/ 555
257 / 582
Family Medicine
60
49 ( 88 %)
48/0/1
226/ 515
241/ 527
General Surgery
45
25 ( 55 %)
15/0/10
231/ 561
243 / 548
Vascular Surgery
2
2 ( 100 %)
1/0/1
Internal Medicine
38
35 (92 %)
35/0/0
236/ 518
244/ 552
Neurology
8
7 ( 87 %)
3/0/4
228/ 546
241/ 487
Neurosurgery
1
1 (100%)
0/0/1
OB/GYN
26
20 ( 77 %)
19/1/10
217/ 519
235/ 524
Ophthalmology
5
3 ( 60 %)
3/0/0
247
256
Orthopedics
27
15 ( 55 %)
3/2/10
243/ 692
253/ 637
Otolaryngology
9
7 ( 77 %)
2/2/3
239
240
Pathology
16
8 ( 50 %)
3/0/5
234
246
Pediatrics
51
44 ( 86 %)
26/0/18
242/ 503
253/ 539
Psychiatry
24
21 ( 87 %)
14/0/7
241/ 553
260/ 547
Radiology
15
12 ( 80 %)
7/0/5
239 / 556
248/ 508
I n t 7e g r i t y - S5 (e71r %)
v i c e -2/1/2
E x c e l l e 229/
n c 580
e
235/ 560
Urology
( 50 %)
39
How to be successful at the
JSGMESB

Timely communication with my office
 Keep us informed of phone number/email/address changes
 Websites provide information and deadlines, don’t hesitate to
contact us with questions

Medical school performance predicts future success!
 Perform your best on the Steps and rotations
 Dean’s letter defines where you rank in your medical school
class even if your school doesn’t rank.

Talk to the USAF Consultant for your specialty of interest about the
career field, practice opportunities, research, etc

Show the programs your best work ethic on clerkship rotations

Interview by phone at all the programs you do not rotate at

Consider a second choice specialty
Integrity - Service - Excellence
After the JSGMESB

Congratulations on your selection for training!

If selected to a PGY1 only year, you may reapply to the 2016
JSGMESB for further residency training
 Similar timelines as last year, but not officially approved yet
 Showing an excellent work ethic in your training and
seeking out the future specialty of choice mentorship can
help strengthen your application

If selected for a categorical residency, and you decide to resign
after your internship year
 FS/GMO for a 2 year tour before being allowed to reapply
for additional training

Please ensure your acceptance letter has been uploaded to
MODS so we can process you appropriately for you next stop
Integrity - Service - Excellence
44
Websites
Physician Education Websites

AFPC myPers:

https://mypers.af.mil/app/answers/detail/a_id/25393/

Military:
https://kx2.afms.mil/kj/kx4/AFPhysicianEducation/Pages/home.aspx

Public:
http://www.airforcemedicine.af.mil/About/Organizations/PhysicianEducation-Branch

MODShttps://education.mods.army.mil/MEDED/UserLogon/UserLogon.asp
Integrity - Service - Excellence
Air Force Personnel Center
Questions?
Integrity - Service - Excellence
46

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