NATIONAL NAVAL MEDICAL NATIONAL NAVAL MEDICAL CENTER CENTER INTERNAL MEDICINE INTERNAL MEDICINE RESIDENCY PROGRAMRESIDENCY PROGRAM

HistoryHistory

Original hospital dedicated Original hospital dedicated August 31, 1942August 31, 1942

Renovated hospital was dedicated Renovated hospital was dedicated November 21, 1980November 21, 1980

Plan for the new Walter Reed Plan for the new Walter Reed National Military Medical Center National Military Medical Center to be dedicated in September to be dedicated in September 2011.2011.

Patient PopulationPatient Population

Wounded WarriorsWounded Warriors RetiredRetired Veterans (VA rotation)Veterans (VA rotation) Active DutyActive Duty DependentsDependents Foreign military and dignitariesForeign military and dignitaries Members of CongressMembers of Congress The PresidentThe President

Walter Reed National Walter Reed National Military Medical CenterMilitary Medical Center Scheduled to be fully open September Scheduled to be fully open September

20112011 296 bed hospital, 50 ICU beds, 27 ER 296 bed hospital, 50 ICU beds, 27 ER

beds, 6 story outpatient building, beds, 6 story outpatient building, transplant servicestransplant services

Merger of Army and Navy Internal Merger of Army and Navy Internal Medicine Residency Programs by July Medicine Residency Programs by July 2011 (slots will remain Service-specific)2011 (slots will remain Service-specific)

2010-2011 2010-2011 Residency Program Residency Program

LeadershipLeadershipCDR William Shimeall, MC, USNCDR William Shimeall, MC, USN

Program DirectorProgram Director

LCDR Mark Corriere, MC, USNLCDR Mark Corriere, MC, USNAssociate Program DirectorAssociate Program Director

LT Rahim Remtulla, MC, USNLT Rahim Remtulla, MC, USNChief of ResidentsChief of Residents

Delilah RomanDelilah RomanProgram AdministratorProgram Administrator

Residency Program Residency Program StructureStructure

18-20 PGY-1’s18-20 PGY-1’s 18-20 total PGY 2’s and 3’s18-20 total PGY 2’s and 3’s 13 four week blocks13 four week blocks

Rotation and Faculty Rotation and Faculty AffiliationsAffiliations

Uniformed Services Uniformed Services UniversityUniversity USUHS faculty attend at NNMC NNMC is a core site for the MS3

Internal Medicine Clerkship Opportunity to teach medical

students– Wards– Intro to Clinical Medicine courses

Intern RotationsIntern Rotations

Ward Medicine NavyWard Medicine Navy Cardiology/CCUCardiology/CCU Inpatient OncologyInpatient Oncology ICU- Navy or ICU- Navy or

Virginia Hospital Virginia Hospital CenterCenter

ER Inova FairfaxER Inova Fairfax Consult MedicineConsult Medicine Night FloatNight Float

Psychiatry (2 weeks)Psychiatry (2 weeks) Ophthalmology (2 Ophthalmology (2

weeks)weeks) Gynecology (2 Gynecology (2

weeks)weeks) Musculoskeletal (4 Musculoskeletal (4

weeks)weeks) Neurology (2 weeks)Neurology (2 weeks) ElectiveElective

Medicine Specific Rotations GMO Preparatory and Medicine Complimentary Rotations

Sample Intern Sample Intern ScheduleSchedule

7/1 -7/26

7/27 -8/23

8/24 -9/20

9/21 -10/18

10/19 -11/15

11/16 -12/13

12/14 -12/22

12/23 -12/28

12/29 -1/3

1/4 -1/17

1/18 -2/14

2/15 -3/14

3/15 -4/11

4/12 -5/9

5/10 -6/6

6/7 -6/30

Andrews

Ward Onc Cards ER NF-Con Psy-Neu Onc off Ward Onc Ortho Elective Ward ICU AGYN-Oph

Con-NF

Crimm Ward ER Onc CardsGYN-Oph

NF-Con Psy-Neu off Cards Psy-Neu NF-Con ICU A Ward Elective Cards Ortho

DuRocher

NF-Con Elec Ward Neu-Psy Cards WardGYN-Oph

off WardGYN-Oph

ER Ortho Onc ICU-N Ward Ward

Dye Ward Con-NFOnc-Elec

Cards ER Ward ICU N ICU N off ICU N Ward Neu-Psy Ortho Oph-Gynonc-elec NF-Con

Enloe Onc OrthoGYN-Oph

Ward Elective Ward Cards Ward off Cards Neu-Psy Con-NF Ward ER Cards ICU N

Finny Cards ER Psy-Neu Con-NF Ortho Elective Ward Ward off Ward Cards Onc Con-NF Cards Oph-GynICU A

Ford Cards Psy-Neu ICU AGYN-Oph

Elec ER Ward off Ward Ward Ortho Onc Cards NF-Con Ward Onc

Gilson Elec Ward Cards Psy-Neu Onc Cards Ward off Ward Ward ER NF-ConGYN-Oph

Ward ICU N Ortho

Goodlow

ICU N Cards Ward Onc Ward Ward NF-Con off NF NF-Con Psy-NeuGYN-Oph

Elec Cards Ortho ER

Green,M

Ward ICU N Ward NF-Con ER Onc Elec off Ward ElecGYN-Oph

Cards Psy-Neu Ward Ortho Ward

Hwang Onc Oph-GynWard ER Cards Elective Con-NF off Ward Con-NF Cards Ortho ICU N Con-NF Neu-Psy WardKavanaugh, M

Lv-Con Ward Neu-Psy Ward Con-NF Elective ICU N off ICU N ICU N Ward Cards x x x x

Kumbalasiri

Ortho Elec NF-Con ICU N Onc Cards ER ER ER ER Ward ICU N Oph-GynWard Psy-Neu Ward

Kuschnerait

Con-NF Ward ER Onc Ward Ortho Ward Ward off Ward ICU N Ward CardsGYN-Oph

Elec Neu-Psy

Lewis Oph-GynNF-Con Ortho Ward Elective ICU A Neu-Psy NF off Neu-Psy Onc Ward ER Onc Onc CardsMackie con-elec Onc Con-NF Ward ICU-N Neu-Psy Cards Cards off Cards ER Ward Onc Ortho Con-NF Oph-GynMayr Neu-Psy Ward ICU N Ortho Elective ER Oph-GynICU N off Oph-GynOnc Ward NF-Con Onc NF-Con CardsMeagher

ICU A CardsWard-Onc

Ortho Ward Oph-GynOnc off ICU N Onc Con-NF ER Neu-Psy Ward Ward elec-onc

Wang x x x Consult WardGYN-Oph

Cards off Cards Cards Ward ICU N Ortho ERWard-Onc

onc-elec

7/1 -7/26

7/27 -8/23

8/24 -9/20

9/21 -10/18

10/19 -11/15

11/16 -12/13

12/14 -12/22

12/23 -12/28

12/29 -1/3

1/4 -1/17

1/18 -2/14

2/15 -3/14

3/15 -4/11

4/12 -5/9

5/10 -6/6

6/7 -6/30

Andrews

Ward Onc Cards ER NF-Con Psy-Neu Onc off Ward Onc Ortho Elective Ward ICU AGYN-Oph

Con-NF

Crimm Ward ER Onc CardsGYN-Oph

NF-Con Psy-Neu off Cards Psy-Neu NF-Con ICU A Ward Elective Cards Ortho

DuRocher

NF-Con Elec Ward Neu-Psy Cards WardGYN-Oph

off WardGYN-Oph

ER Ortho Onc ICU-N Ward Ward

Dye Ward Con-NFOnc-Elec

Cards ER Ward ICU N ICU N off ICU N Ward Neu-Psy Ortho Oph-Gynonc-elec NF-Con

Enloe Onc OrthoGYN-Oph

Ward Elective Ward Cards Ward off Cards Neu-Psy Con-NF Ward ER Cards ICU N

Finny Cards ER Psy-Neu Con-NF Ortho Elective Ward Ward off Ward Cards Onc Con-NF Cards Oph-GynICU A

Ford Cards Psy-Neu ICU AGYN-Oph

Elec ER Ward off Ward Ward Ortho Onc Cards NF-Con Ward Onc

Gilson Elec Ward Cards Psy-Neu Onc Cards Ward off Ward Ward ER NF-ConGYN-Oph

Ward ICU N Ortho

Goodlow

ICU N Cards Ward Onc Ward Ward NF-Con off NF NF-Con Psy-NeuGYN-Oph

Elec Cards Ortho ER

Green,M

Ward ICU N Ward NF-Con ER Onc Elec off Ward ElecGYN-Oph

Cards Psy-Neu Ward Ortho Ward

Hwang Onc Oph-GynWard ER Cards Elective Con-NF off Ward Con-NF Cards Ortho ICU N Con-NF Neu-Psy WardKavanaugh, M

Lv-Con Ward Neu-Psy Ward Con-NF Elective ICU N off ICU N ICU N Ward Cards x x x x

Kumbalasiri

Ortho Elec NF-Con ICU N Onc Cards ER ER ER ER Ward ICU N Oph-GynWard Psy-Neu Ward

Kuschnerait

Con-NF Ward ER Onc Ward Ortho Ward Ward off Ward ICU N Ward CardsGYN-Oph

Elec Neu-Psy

Lewis Oph-GynNF-Con Ortho Ward Elective ICU A Neu-Psy NF off Neu-Psy Onc Ward ER Onc Onc CardsMackie con-elec Onc Con-NF Ward ICU-N Neu-Psy Cards Cards off Cards ER Ward Onc Ortho Con-NF Oph-GynMayr Neu-Psy Ward ICU N Ortho Elective ER Oph-GynICU N off Oph-GynOnc Ward NF-Con Onc NF-Con CardsMeagher

ICU A CardsWard-Onc

Ortho Ward Oph-GynOnc off ICU N Onc Con-NF ER Neu-Psy Ward Ward elec-onc

Wang x x x Consult WardGYN-Oph

Cards off Cards Cards Ward ICU N Ortho ERWard-Onc

onc-elec

Daily ConferencesDaily Conferences

Morning Report 0730 Monday to Morning Report 0730 Monday to FridayFriday– Wednesday is Wednesday is Intern Morning ReportIntern Morning Report

Noon Conference lecture seriesNoon Conference lecture series– Presented by general internal Presented by general internal

medicine and subspecialty facultymedicine and subspecialty faculty

Periodic LecturesPeriodic Lectures

Monthly Practice Improvement Conference Monthly Practice Improvement Conference (M&M)(M&M)

Monthly Research SeminarsMonthly Research Seminars

Monthly Evidenced Based Medicine RoundsMonthly Evidenced Based Medicine Rounds– Focus on critically appraising medical literatureFocus on critically appraising medical literature

Monthly Journal ClubMonthly Journal Club

Weekly Grand RoundsWeekly Grand Rounds

Clinic Continuity Clinic Continuity ExperienceExperience One afternoon a week (except in One afternoon a week (except in

ICU or away rotations)ICU or away rotations)– Interns carry their own continuity Interns carry their own continuity

“panel” of 30-40 patients“panel” of 30-40 patients– 45 minute pre clinic didactic session 45 minute pre clinic didactic session

each week on core internal medicine each week on core internal medicine topicstopics

– Precepted by general internal Precepted by general internal medicine and subspecialty facultymedicine and subspecialty faculty

WardsWards

Four week blocksFour week blocks Take admissions q3 daysTake admissions q3 days No overnight callNo overnight call

– Covered by night floatCovered by night float Team structure includes attending, Team structure includes attending,

one R3 or R2, two interns, one one R3 or R2, two interns, one sub-intern, and one to two MS3’ssub-intern, and one to two MS3’s

Where do our Intern Where do our Intern Graduates go?Graduates go?2009 PGY-1 Graduates 2009 PGY-1 Graduates

Next AssignmentNext AssignmentUltimate Career GoalUltimate Career Goal

Internal Medicine Residency Internal Medicine Residency

Internal Medicine ResidencyInternal Medicine Residency

Internal Medicine Residency Internal Medicine Residency

Internal Medicine ResidencyInternal Medicine Residency

Internal Medicine ResidencyInternal Medicine Residency

Internal Medicine ResidencyInternal Medicine Residency

Internal Medicine ResidencyInternal Medicine Residency

Internal Medicine ResidencyInternal Medicine Residency

Internal Medicine ResidencyInternal Medicine Residency

Psychiatry ResidencyPsychiatry Residency Med/PsychMed/Psych

GMO- Gulfport, Mississippi. SeabeesGMO- Gulfport, Mississippi. Seabees NeurologyNeurology

GMO- Fort Meade, MarylandGMO- Fort Meade, Maryland Internal MedicineInternal Medicine

GMO- Camp Lejeune, Marine CorpsGMO- Camp Lejeune, Marine Corps Physical Medicine & RehabPhysical Medicine & Rehab

GMO- Hawaii. Marine CorpsGMO- Hawaii. Marine Corps UndecidedUndecided

GMO- Twenty Nine Palms, California. Marine GMO- Twenty Nine Palms, California. Marine CorpsCorps

DermatologyDermatology

GMO- Camp Lejeune, Marine CorpsGMO- Camp Lejeune, Marine Corps Internal MedicineInternal Medicine

GMO- Okinawa, Japan. Marine CorpsGMO- Okinawa, Japan. Marine Corps Internal MedicineInternal Medicine

Flight SurgeryFlight Surgery AnesthesiaAnesthesia

Flight SurgeryFlight Surgery UndecidedUndecided

Where do our Intern Where do our Intern Graduates go?Graduates go?2010 PGY-1 Graduates Next 2010 PGY-1 Graduates Next

AssignmentAssignmentUltimate Career Ultimate Career

GoalGoalInternal Medicine Residency Internal Medicine Residency

Internal Medicine ResidencyInternal Medicine Residency

Internal Medicine Residency Internal Medicine Residency

Internal Medicine ResidencyInternal Medicine Residency

Internal Medicine ResidencyInternal Medicine Residency

Internal Medicine ResidencyInternal Medicine Residency

Internal Medicine ResidencyInternal Medicine Residency

Emergency Medicine Residency- San AntonioEmergency Medicine Residency- San Antonio Emergency MedicineEmergency Medicine

Radiation Oncology Residency- DukeRadiation Oncology Residency- Duke Radiation OncologyRadiation Oncology

Flight SurgeryFlight Surgery UndecidedUndecided

Flight SurgeryFlight Surgery AnesthesiaAnesthesia

Flight SurgeryFlight Surgery Internal MedicineInternal Medicine

Undersea MedicineUndersea Medicine Emergency MedicineEmergency Medicine

Undersea MedicineUndersea Medicine RadiologyRadiology

GMO- Gulfport, Mississippi. SeabeesGMO- Gulfport, Mississippi. Seabees UndecidedUndecided

GMO- Okinawa, Marine Corps GMO- Okinawa, Marine Corps Emergency Medicine/Internal MedEmergency Medicine/Internal Med

GMO- Camp LeJeune, Marine CorpsGMO- Camp LeJeune, Marine Corps Emergency MedicineEmergency Medicine

Where do our Residency Program Where do our Residency Program Graduates go?Graduates go?

PGY- 3 PGY- 3 GraduatesGraduates

Next AssignmentNext Assignment

20102010 General Internal Medicine FellowshipGeneral Internal Medicine Fellowship

20102010 Hematology/Oncology FellowshipHematology/Oncology Fellowship

20102010 Cardiology FellowshipCardiology Fellowship

20102010 Naval Hospital Great LakesNaval Hospital Great Lakes

20102010 Naval Hospital Cherry PointNaval Hospital Cherry Point

20102010 Chief ResidentChief Resident

20102010 Nephrology FellowshipNephrology Fellowship

20102010 Naval Hospital LemooreNaval Hospital Lemoore

20102010 Pulmonary/Critical Care FellowshipPulmonary/Critical Care Fellowship

20092009 Naval Hospital LemooreNaval Hospital Lemoore

20092009 Naval Hospital YokosukaNaval Hospital Yokosuka

20092009 Pulmonary/Critical Care FellowshipPulmonary/Critical Care Fellowship

20092009 Naval Hospital CharlestonNaval Hospital Charleston

20092009 Office of Attending Physician to CongressOffice of Attending Physician to Congress

20092009 Cardiology FellowshipCardiology Fellowship

20092009 Naval Hospital BeufordNaval Hospital Beuford

20092009 Naval Hospital YokoskaNaval Hospital Yokoska

20092009 Operational Billet AfghanistanOperational Billet Afghanistan

20092009 Naval Hospital PensacolaNaval Hospital Pensacola

Fellowship Training at Fellowship Training at NNMC/USUHS/NCCNNMC/USUHS/NCC CardiologyCardiology GastroenterologGastroenterolog

yy PulmonaryPulmonary Critical CareCritical Care NephrologyNephrology General Internal General Internal

Medicine/MPHMedicine/MPH

EndocrinologyEndocrinology RheumatologyRheumatology HematologyHematology OncologyOncology Infectious DiseaseInfectious Disease Allergy/Allergy/

ImmunologyImmunology

Housestaff ResearchHousestaff Research

Potential to present at national Potential to present at national conferencesconferences

Dedicated research track for PGY 2 Dedicated research track for PGY 2 and 3 years for interested residentsand 3 years for interested residents

Affiliations with USUHS and NIH/NCIAffiliations with USUHS and NIH/NCI

Resident Research: Where our Resident Research: Where our residents have presented their residents have presented their research?research?

National American College of PhysiciansNational American College of Physicians Navy Chapter American College of Navy Chapter American College of

PhysiciansPhysicians D.C. Chapter American College of D.C. Chapter American College of

PhysiciansPhysicians Society of General Internal MedicineSociety of General Internal Medicine Chest ConferenceChest Conference Endocrine Society Endocrine Society Infectious Disease Society of AmericaInfectious Disease Society of America

Recent Faculty Recent Faculty PublicationsPublications New England New England

Journal of MedicineJournal of Medicine CardiologyCardiology Archives of Internal Archives of Internal

MedicineMedicine Emerging Emerging

Infectious DiseaseInfectious Disease American Journal of American Journal of

GastroenterologyGastroenterology

Annals of Internal Annals of Internal MedicineMedicine

Clinical Infectious Clinical Infectious DiseaseDisease

ThyroidThyroid American Journal American Journal

of Medicineof Medicine Journal of General Journal of General

Internal MedicineInternal Medicine

Graduate Board Pass Graduate Board Pass RatesRates

100% board pass rate for graduates of the NNMC Internal Medicine Residency for 2006, 2007, 2008 and 2009 40 out of 40 graduates certified by ABIM

Washington DC Washington DC Metropolitan AreaMetropolitan Area

MuseumsMuseums Wide range of dining optionsWide range of dining options Exciting nightlifeExciting nightlife Professional sports teamsProfessional sports teams Outdoor opportunitiesOutdoor opportunities National LandmarksNational Landmarks Excellent public transportationExcellent public transportation Easy access to NYC, Philadelphia, BostonEasy access to NYC, Philadelphia, Boston

Washington DC Washington DC Metropolitan AreaMetropolitan Area

Cost of LivingCost of Living

Wide range of Wide range of housing optionshousing options

Metro Check Metro Check ProgramProgram

Hospital is metro Hospital is metro accessible accessible (Medical Center (Medical Center Stop)Stop)

RankRank W/W/

depdepW/OW/O

depdep

O-3EO-3E $256$25622

$226$22655

O-3O-3NMCSDNMCSD

NMCPNMCP

$243$24333$2334$2334

$1755$1755

$214$21488$2085$2085

$1644$1644

O-4O-4 $271$27188

$233$23344

Questions?Questions?