February 2015, Issue 2 DOM GME Snapshot
With almost 19,000 active members from over 100 countries, the American College of
Chest Physicians (CHEST) is a global leader in medical education and clinical research. Over 5,000 attended the
CHEST 2014 international scientific meeting in Austin, TX. Several Walter Reed/Uniformed Services University Depart-ment of Medicine physicians significantly contributed to the success of that meeting by presenting their research and expertise in multiple sessions during the week, including: Fellows (Right, Clockwise) CPT Michal Sobieszczyk, LT Nikunj Bhatt, MAJ David Hostler, MAJ Tim Hauser, LCDR Joe Zeman. (not pictured: MAJ Brian Cohee, CPT Patrick Smith)
Residents (Bottom, Clockwise) - LT Ian Grasso, CPT Brian Foster, CPT Camellia Hernandez, LT Donovan Mabe, CPT Blair Glasgo, MAJ Ted Bridges.
Faculty (not pictured) - LTC John Sherner, CDR Anthony Na-tions, LCDR Scott Parrish, LCDR Andrew Philip, LTC Eric Os-born, MAJ Jordanna Hostler, LTC Aaron Holley, Dr. Andrei Khramtsov, Dr. Teotimo Andrada, Ms. Karen Sheikh, CDR
Saira Aslam, CAPT (ret) Angeline Lazarus, COL William Kelly (USU) and COL Lisa Moores (USU).
CHEST (ACCP) MEETING AWARDS: Representing Walter Reed NCC IM Resi-
dency, CPT Blair Glasgo, won 1st Place in the Resident Clinical Poster category.
Representing NCC Pulmonary/Critical
Care Fellowship, CPT Patrick Smith won
1st place in the Fellow Poster category.
COL William F. Kelly, MC, USA, FCCP, received the Distinguished Service Award for leading significant achievements and for donating time, leadership, and service to CHEST.
Photographer of the Year:
LCDR Andy Philip (Pulm/CC staff)
HIGHLIGHTS
American College of Chest Physicians (ACCP OCT 2014)
WALTER REED DOM GME Snapshot
Recap
A MONTHLY AND EVOLVING
SNAPSHOT OF GME NEWS & HIGHLIGHTS
February 2015, Issue 2 DOM GME Snapshot
Check It Out!
We are now able to use Google's analytics to display real-time analysis of resident/faculty research activities!!
Please visit: <http://tinyurl.com/residentresearchfacts>
You can see the raw data:
<http://tinyurl.com/IMResearchRecord>
Residents, at press-time
we have over
50 entries in
the database.
Please highlight
successes at:
http://tinyurl.com/ResidencyResearchRegistry
For CCC's, the best way
to use this data during
reviews is downloading as excel
spreadsheet from: http://tinyurl.com/IMResearchRecord
and then organizing is based on
your class etc. Hope this is helpful
to your mission.
THANKS to CPT Rohul Amin!!
RESEARCH & ACADEMIC SUCCESS
LT James Fisher (PGY2 IM Resident) and mentors MAJ Dustin Little (Nephrology Staff) and CPT Sarah Gordon (Nephrology Fellow) were selected to
present their abstract, "Recurrent Renal Infarction in an Otherwise Healthy Active Duty Male" at the National Kidney Foundation meeting March 25-29 in Texas.
Attention CCC chairs and PD's!! A new guidebook (Wahoo!!) has been developed to aid Clinical Competency
Committees (CCCs). The guidebook provides information regarding the purpose and structure of the CCC, how to prepare for and run a CCC meeting, and post-CCC meeting actions, as well as legal and other considerations. Also included is an annotated bibliography. The ACGME Clinical Competency Committees: A Guidebook for Programs can be found in the Milestones section of the website.
Of note, one of the authors, Dr. Eric Holmboe, is a retired Navy Internist and former
GIM Clinic Chief here, as well as a contributing instructor at the NCC Program Director Course held here every January. Dr. Padmore from MEDSTAR also helps teach the NCC course and is a frequent partner of the NCC. Its available on the web at the link below: <http://www.acgme.org/acgmeweb/tabid/430/ProgramandInstitutionalAccreditatio n/NextAccreditationSystem/Milestones.aspx>
MD ACP 2015 Please be sure to congratulate the Walter Reed Navy ‘Doctor's Dilemma’ (Medical Jeopardy) team - (side: left to right) coach
MAJ Joshua Mitchell, competitors LTs Benjamin Vipler, James Fisher, Benjamin Kurth, and Chris-ta Eickhoff - who came in 1st place at this year's competition at the Maryland ACP meeting.
The Navy team beat the best of Baltimore, with a 12-team field including Johns Hopkins and
Maryland, and the Army team - (bottom left: left to right) CPTs Sarah Ordway, Ryan Jones,
Adam Barelski, and Jennifer Masel - also played well, losing a tight first round to the eventual 2nd and 3rd place finishers. http://www.acponline.org/about_acp/chapters/md/dd_2015.htm
Adam, Mike and Allison, I extend my thanks for representing our specialty so well by coordinating the Resident/Student-focused "Iron Med" competition at the Maryland ACP. The interest and participation in the event was tremendous, and offered a nice complement to the outstanding Maryland ACP Chapter content... and hope that we can continue this excellent collaboration among our Chapters in seeking to promote our great specialty and inspire our 'replacements' in the future. Thanks to Maryellen Woodward, Dr. Steve Sisson and the MD Governor's Council for making this possible in the meeting as well. (William Shimeall, PD NCC - Internal Medicine)
(bottom right photo) Iron Med
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February 2015, Issue 2 DOM GME Snapshot
FOR YOUR EYES ONLY
Sakai
Have you presented a poster? Given a podium? Published in a peer-reviewed journal? Presenting at an upcoming meeting? Then share your outstanding work for all to see on the Residency Sakai
Research Page. Just click on the "Research" link on the Residency Sakai main page and fill in the details under the "Celebrate Successful Projects" link. This helps your peers see what you've done and promotes collaboration among peers and faculty alike.
If CPR doesn’t work, try biting — heartwarming video of a
monkey saving the life of a friend who had fallen unconscious after being electro-cuted at Kanpur train station in India: https://www.youtube.com/watch?v=YKpsQVgz0vM
WATCH AND LEARN
IM Meeting 2015
Congratulations to CPT Cynthia Philip (IM Intern) and ENS Chris Shank (USU Student and future IM Intern) (and thanks Nephro for mentors CPT Sarah Gordon and staff Dr. Dustin Little, and Dr. C. Yuan) for having been selected by the American College of Physicians Abstract Review judges for presentation as a poster finalist. Their poster, "A CASE OF SUPPLEMENT-ASSOCIATED ACIDEMIA AND ACUTE KIDNEY INJURY IN AN ACTIVE DUTY SOLDIER", will be judged on-site at the Internal Medicine Meeting 2015 in Boston.
Hats off to Dr. Gordon (with CPT Philip and ENS Shank as co-authors) submitted to the National Kidney Foundation national meeting a larger case series of similar patients we've seen (Renal failure soldiers taking NO Xplode), which was also accepted for presentation in March.
MORE ON SUPPLEMENTS
The use of per-formance-enhancing sup-plements in the US military in-
troduces real clinical risk to our servicemen and women and a le-gitimate threat to force health pro-tection. Many of these supplements are
marketed as performance-enhancing with-out a clinical benefit, therefore there is no direct Food and Drug Administration (FDA) oversight for this multi-billion dollar indus-try. Performance-enhancing supplements include over-the-counter multivitamins, single ingredient supplements including creatine and protein powders, pre-workout vasoactive substances as well as thermo-genic/fat-burners and anabolic agents.
Within the Department of Defense (DoD), clinicians and scientists are working togeth-er to tackle this growing problem. At the Uniformed Services University for Health
Sciences, Dr. Patricia Deuster is the director for the Center for Human and Military Performance (CHAMP), the DoD Center of Excellence
for integration, translation, & education of all topics related to human performance optimization & total force fitness.
CHAMP has developed the Human Performance Resource Center (HPRC, http://hprc-online.org) to provide
military service members and healthcare providers important information to best address the risks of supplement use.
To learn more about performance-enhancing supplement use, check
out the HPRC supplement pages, http://hprc-online.org/dietary-supplements/opss."
To report adverse effects and also querying their enormous database of reported effects from other sup-plements when you have concerns:
http://tinyurl.com/hprc-supplement-adverse-effect - The adverse event re-porting tab is on the right side.
Questions? Feel free to email her direct-
ly [email protected], or ,Charles Magee, MD, MPH, FACP, General Internist, and Assistant Professor of Medicine, at [email protected] or 301-295-0123 (office).
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February 2015, Issue 2 DOM GME Snapshot
QUALITY IMPROVEMENT / PATIENT SAFTEY
COMING
SOON
3rd Annual
Walter Reed
IM Residency
Quality
Improvement/
Patient Safety
Poster Fair
WHAT: Resident
teams will present
their year-long QI
projects
WHEN: May
2015—TBD
Attend to learn
about what our
residents have been
working on with
faculty mentors,
give feedback, and
improve your un-
derstanding of the
QI process.
2013—2014 Projects Team Alpha
Members: Andrew Biggs, Karen Zeman,
Christie Joya, Tyrone Robinson, Donovan Ma-
be, Lee Jamison, Emily Brown, Krystle Salazar
Title: “Pre-Appointment Questionnaires: Improving
Outpatient Patient and Physician Satisfaction”
Team Bravo
Members: Joe Roswarski, Marsha Johnson, Adam
Barelski, Akira Shishido, Ryan Jones, Laura Gilbert,
Serennah Harding, Daniel Hodge
Title: “Improving diabetes care in Bravo clinic
through implementation of ACC/AHA lipid guideline”
Team Charlie
Members: Nelani Pathirana, Dustin Albert, Jack Hut-
ter, Michael Dore, Monsur Ali, Oliver Chiong, Nicho-
las Fiacco
Title: “Implementation of mock codes into Internal
Medicine residency curriculum”
Team Delta
Members: Edward Bridges, Geoffrey Loh, Dorian
Anderson, Hector Medina, Matthew Biscotti, Allison
Bush, Diana Dougherty, Kayleen Elsbree
Title: “Improving Screening Rates for Hepatitis C
Virus:A Process-Improvement Exercise in an Internal
Medicine Home Team”
Team Echo
Members: Jackie Kircher, Kia Gallagher, Derek For-
sthoefel, Amy Puderbaugh, Shannon Wood, Richard
Plasse, Nicholas Pytel, Brett Sadowski, Robert Wauters
Title: “Vancomycin Adminstration and Serum Concen-
tration Monitoring: The Sequel”
Team Hotel Members: Anumeha Singh, Jennifer Masel, Brian Park,
Stacy Comer, Mark Pence, David Cook, Scott Snyder,
Andrew Spiro
Title: “Optimizing documentation of code status on the
inpatient medicine service”
Team Juliet
Members: Rohul Amin, James Nguyen, Stephen
Koplin, Michal Sobieszczyk, Blair Glasgo, Jeffrey
Eickhoff, Ryan Haley, Maryann Sullivan
Title: “Burnout Elimination Therapy To Enhance Re-
siliency (BETTER) Study”
Team Kilo Members: Chris Drinkwater, Camellia Hernandez,
Brian Foster, Gilda Bobele, Mark Hubbard, Matthew
Middendorf, Kenneth Motoyama
Title: “Implementation of a CCU Procedure Resident”
Team Lima
Members: Nicole Harrison, Julia Cheringal, Richele
Corrado, Benjamin Vipler, Christa Eickhoff, Melanie
Acevedo, Michael McMahon
Title: "Rethinking the Radiology Protocol: An Institu-
tion-Based Quality Improvement Project to Improve the
Ordering Process for Inpatient Radiology Studies"
im strong
im strong
im strong
im strong
DOM GME QI Review Conferences — Every 3rd Thursday of the Month
The Department of Internal Medicine held an outstanding Quality Improvement Review Conference (formerly known as Mor-bidity and Mortality Conference). The focus of this discussion was determining the potential cognitive and systems-based
errors made in our care. For this month’s case, we welcomed guests from Interventional Radiology and Pulmo-nary/Critical Care to comment on an insightful presentation by LT Donovan Mabe. The goals of the meeting was educa-
tional with generation of recommendations for improvement across the clinical spectrum. These recommendations will be sent to the Quality Management Committee and should generate action toward improvement in the suggested areas.
Than k you for Joining Us!!Than k you for Joining Us!!Than k you for Joining Us!!
Recap
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February 2015, Issue 2 DOM GME Snapshot
← Using the hint to the left, can you guess the Plenary speaker?
1st Annual Walter Reed
IM Research Symposium
We are excited to host a Symposium on March 12th at 11:30PM in the America Bldg, 2nd floor, room 2525 B/C. This provides a forum for IM residents to share active research projects and focus on the process of conducting research during residency. This year's guest speakers include:
COL Peter Weina, Chief, Dept. of Research Programs at WRNMMC
Panel Q & A session with success-ful resident research mentors in clinical and basic science areas
Subspecialty education coordina-tors to bring active and upcoming research projects where mentor-ship might be available for inter-ested residents.
The goal is to continue to foster world-class research at Walter Reed as a dis-tinguishing characteristic of this resi-dency program. We encourage all to come support resident research by attending this year's event. For any questions, the POC for this event is MAJ Charlie Magee ([email protected]). In April we are rolling out a new,
monthly resident research meeting, to be co-led by the residency research coordinators for each class and facilitat-ed by MAJ Charlie Magee. We invite all research-minded faculty to attend and support our resident researchers over the academic year by attending when possible. If you are a research-minded
faculty member and interested in providing short lectures or leading discussions on research topics, please email MAJ Charlie Magee ([email protected]). Name and specific dates and times TBD.
DOM
Annual
Retreat
Is being held Fri-day 13 March, 0800-1700 at USO NSA
Bethesda, Bldg 83. Open to all interested faculty, fellows and staff who work with IM Residents. Please clear with your Service if attending. Details to follow.
And we would like to thank Marla Redmond and her outstanding team of administrators for all of their behind-the-scenes work coordinating the logistics.
SNEAK PEAKS & NEW BEGINNINGS
THIS IS A HINT
CALLING ALL CARS, CALLING ALL CARS!!! Invitation to 1st Annual WR IM Resident Research Symposium (below)— Please extend this welcome to any Faculty (and Fel-lows) in your Services who are interested in providing mentorship or want to encourage research opportunities for residents. There will be an opportunity for your Service to showcase available research opportunities to our trainees. And please ensure that our Subspecialty Education Coordinators for the IM subs are up to date and that a backup has been identified.
Hail to the New Chief, Walter Reed Department of Medicine We are proud and excited to have Dr. Nations as our new Chief of Medicine. Anthony has been a
great leader, patient and staff advocate, clinician, and educator, and he will certainly put these
skills he has shown in the hospital, region, and national pulmonary communities to good use in
his new position. Some Quick Facts:
CDR Joel (Anthony) Nations, MD, MBA, FCCP
Born in Jackson, Mississippi and prior enlisted Navy
MD from University of Mississippi
Internship and Residency at NMC Portsmouth (separated by 3 year GMO tour)
Chief Resident at NMC Portsmouth
Fellowship in Pulmonary/Critical Care Medicine NCC/NNMC
Additional recent degrees: MA (Naval War College) and MBA (George Mason University)
Most recently served as Chief, Pulmonary Medicine, WRNMMC
Has won multiple teaching awards throughout residency, fellowship, and as faculty
Has over 8 peer-reviewed publications and multiple invited lectures and other presentations
Really looking forward to the Annual DOM Faculty Residency Retreat in March
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February 2015, Issue 2 DOM GME Snapshot
DOM GME SNAPSHOT P AGE 6
WELL-DESERVED RECOGNITION
ity I cannot recall such enthusiasm and genuine interest on the part of our students in completing this activity. Because of the outstanding volunteer participation of your resi-dents we were able to provide one faculty member for each group of four students giving them a high quality learning opportunity. The students cherished this opportunity to learn from and connect with their "near peers". The dedicated USU physiology faculty that stead-fastly help me teach this laboratory year in and year out were vocal in their admiration and appreciation of your residents support. To an individual they were superb. Thank you for allowing them to partici-pate in this event. I hope we can continue to work together in this regard in the future.
Respectfully, Brian E. Neubauer, MD, FACP Major, USAF, MC Assistant Professor of Medicine / Cardi-opulmonary-renal Module Director F. Edward Hebert School of Medicine - Uniformed Services University of the Health Sciences
OCEAN’S ELEVEN CAST: CPT Jed Mangal CPT Jennifer Masel CPT Stephen Savioli CPT Ryan Haley LT John Mattingly LT Meredith Lutz CPT Zachary Junga CPT Sarah Ordway LT Benjamin Vipler CPT Adam Barelski CPT Jack Hutter FAN MAIL NOT ACCEPTED AT THIS TIME.
Dr. Shimeall and Colleagues, I am writing to express my sincere appreciation and gratitude for the
expert teaching pro-
vided by 11 of your
residents… in the USUHS pre-clerkship cardio-vascular-pulmonary-renal module. For five solid hours...these residents helped our faculty provide the high-est quality instruction to 180 pre-clerkship medical students in work-ing through a practical experience exploring the electrocardiogram and phonocardiogram. And by helped I mean they were the stars of the show. In the two previous years that I have been responsible for this activ-
meaningful and substantive contribu-tions to our PI project. I hope to update you on our progress and look forward to continuing to work with your enthusiastic house-staff. Thank you! Very Respectfully, Taylor Taylor Banks, MD LCDR MC USN Allergy/Immunology Staff Physician, Walter Reed National Military Medical
“Allergy Antibiotic” Consult or-
der is now live in Essentris!!
If your patients are eligible for this PI project, please include the PCN/beta-lactam of interest in the "Comments"
CONGRATULATIONS!! CPT Rita Richardson (PGY2 in
the IM/Psych Resi-dency Program) has been “Nominated as a Star of Virginia
Hospital Center". She was nom-inated for "compassion, being straight forward and made dealing with father's death much easier" while serving as the resident in the VHC ICU over the holidays.
CAPT Shimeall, I wanted to recognize four of your house-staff for their willingness to vol-unteer as peer representatives to help their colleagues navigate our new Pen-icillin/Beta-Lactam PI Project.
CPT Jamison, CPT Bobele, and LT Salazar have already begun re-
viewing the project with the ward teams and have my thanks for their efforts. I would also like to specifically recog-
nize CPT Hyun (Robert) Park, who
is not only serving as a peer repre-sentative, but has been actively en-gaged in the development of the pro-
ject, collaborating with Drs. Ress-ner, Kim, Gada, and myself. He has been an active participant and made
February 2015, Issue 2 DOM GME Snapshot
DOM GME SNAPSHOT P AGE 7
Also here are the WINNERS: The "Tom Sellick" Best Mustache Award: Dr. Jace Mattingly The "John Waters" Creepiest Mustache Award: Dr. John Greenwald The "Joe Flacco" "I need a mustache so bad" Award: Dr. Michael Dore The "Miley Cyrus" Best Fake Mustache Award: Caelis and Sidera Mattingly (Jace's daughters, who had - as the award states - awesome fake mustaches!) Thanks to all who participated. Dr. Alexander Dew will be a shoe-in for
next January's new award: The "Mike Ditka" "Da Mustache" Award! Stay tuned...
In our first issue, we asked the DOM GME Community if they could
identify these four worthy contestants of the noble SCHNURRBART com-petition IM Residents and Faculty have proudly upheld for these many years.
Clockwise from the top left:
Dr. Ichee Frankenscratchme himself, the founding father of the long
and noble tradition, the discerning Dr. Blair Glasgo, the venerable Dr. Jack Hutter, and the esteemed Dr. Ben Vipler. The GME Community is
proud of your effervescent partaking in this tradition.
How Did It All Begin You Ask?
In the first issue, we also challenged our creative readers to finish the IM
folktale in 97 words or less. Here it is:
GUESS WHO
As the celebrated, medical legend goes, Long, long ago, before Blue Cross & Blue Shield, deep in
the bowels of the Middle Ages, Dr. Frankenscratchme was sitting on the latrine, and thought to
himself…”I think I’ll grow a mustache,” and there, the noble tradition began. Yes, hard to
believe, I know.
Discussing the Undiscussable With the Powerful: Why and How Faculty Must Learn to Counteract Organizational Silence Mary E. Dankoski, PhD, Janet Bickel, MA, and Maryellen E. Gusic, MD Abstract Dialogue is essential for transforming institutions into learning organizations, yet many well-known characteristics of academic health centers (AHCs) interfere with open discussion. Rigid hierarchies, intense competition for resources, and the power of peer review in advancement processes all hamper difficult conversations, thereby contributing to organizational silence, and at great cost to the insti-tution. Information necessary for critical decisions is not shared, individuals and the organization do not learn from mistakes, and di-verse perspectives from those with less power are not entertained, or worse, are suppressed. When leaders become more skilled at inviting multiple perspectives and faculty more adept at broaching difficult conversations with those in power, differences are more effectively addressed and conflicts resolved. In this article, the authors frame why this skill is an essential competency for faculty and leaders alike and provide the follow-ing recommendations to institutions for increasing capacity in this area: (1) develop leaders to counteract organizational silence, (2) develop faculty members’ skills in raising difficult issues with those in positions of power, and (3) train mentors to coach others in rais-ing difficult conversations. The vitality of AHCs requires that faculty and institutional leaders develop relational communication skills and partner in learning through challenging conversations.
http://journals.lww.com/academicmedicine/Abstract/2014/12000/Discussing_the_Undiscussable_With_the_Powerful__.17.aspx
SOMETHING TO CONSIDER
February 2015, Issue 2 DOM GME Snapshot
DOM GME SNAPSHOT P AGE 8
Your Fellows and House
Staff Read Snapshot
Post upcoming events, accomplish-ments, or projects here!! E-mail [email protected]
SNIPPETS. Please share any successes or
highlights we may have missed, or that you would
like included in the next issue. Help us by providing all of the key details or as you would like it to appear.
WE WANT YOU!!
Contact Us If You Must
Sean M. Lynch
Self-Declared Supreme Editor-in-Chief
Please use Subject Line: Snapshot
(301) 319-4399
And please share your ideas on how we
can improve the value of the newsletter
and the engagement of our readers.
We are also looking for
cartoonists, artists, po-
ets and writers (even if
you are only self-declared) Let us
know who you are.
Did someone say book CLUB?
BREAKING NEWS: THE HIGHEST U.S. FOOD
PANEL NOW SAYS IT IS
ok TO EAT EGGS!!
“I never know
how much of
what I say is
true”
Bette Midler
All are invited to join us for Board Review
Every Monday at 1600, and Friday at 0700 in Building 19, Shore Conference Room 1118
Much Gratitude to LT Donovan Mabe and the Chief Residents
for your hard work organizing the 46 hours of new video based board prep series!!
Link to the schedule: http://tinyurl.com/Video-Based-Board-Prep-Series
Leadership Book Club is successfully underway!
Thanks LT Cheringal for getting us started on JAN 27th,
discussing Part 1 of the book “Turn the Ship Around”, by
CAPT (ret) L. David Marquet. The next port of call will be
10 MARCH at noon in America rm 2525. We may be
hearing more for CAPT Marquet soon...
We need your help to share “...the many great things that our students, interns, residents, fellows
and faculty are doing within and outside the Command. The picture that emerges as you read through this issue is clear demonstration of excellence in clinical care, research, education and community service. It in part repre-sents the great things we can accomplish together. To build Departmental cohesion, we hope to see the many unreported accomplishments of all DOM GME training programs highlighted. This forum is FOR YOU! I will ask all Service Chief, fellowship Program Directors and all faculty to use future issue of this newsletter as the big board to spotlight your accomplishments as we bond together to achieve the Quadruple Aim of readiness, better care, better health and lower cost in our enterprise.”
V/R Sam O. Wanko, MD, FACP, CAPT(s) MC, USN, Hem/Onc Specialty Leader