March 2015 Walter Reed DOM GME Snapshot

Presidential Poster Winner

Amy Stratton, Manish Singla: Gas-

troesophageal reflux in a cohort of

morbidly obese patients before and

after sleeve gastrectomy

Crystale Cruz: Zieve's Syndrome:

Autoimmune Hemolytic Anemia Asso-

ciated With Alcoholic Liver Disease

and Hyperlipidemia

Scott Cunningham: The Use of

Bayesian Analysis to Predict Severe

Acute Pancreatitis in a Nationwide Mil-

itary Population

WALTER REED DOM GME Snapshot

highlights

A MONTHLY AND EVOLVING

SNAPSHOT OF GME NEWS & HIGHLIGHTS

CONGRATS!!

Manish Singla and Scott Cunning-

ham placed third in the nation in the

Jeopardy competition!!!

Plenary Presentation:

Manish Singla, Nisha Shah: Topo-

graphical Mapping in a Cohort of Pa-

tients with Gastric Intestinal Metaplasia

FELLOWS ABSTRACT WINNER

Poster Presentations:

Nisha Shah, Nicholas Fiacco: Suc-

cessful Treatment of Erythropoietic

Protoporphyria-Induced Liver Injury

With Pan-Hematin"

Nisha Shah, Thomas Mellor: Acal-

culous Cholecystitis Associated With

Acute Q Fever Infection

Amilcar Morales-Cardona: The Im-

pact of Eosinophilic Esophagitis on

Body Mass Index

FOUR IM RESIDENCY MEMBERS

WERE ACCEPTED TO PRESENT

AT ACG: LT Brett Sadowski (IM

PGY2 Resident), CPT Mark Pence

(IM PGY2 Resident), LT Tom Mel-

lor, (IM PGY1 Intern) and LT Nick

Fiacco (IM PGY2 Resident)

The American College of Gastroenterology's annual scientific meeting is the premier clinical Gas-

troenterology meeting in the United States. This year, over 5,000 attendees gathered in Philadelphia to learn about the current state of the art in digestive diseases and hepatology.

LT Nick Fiacco (IM PGY2 Resident) and LCDR Nisha Shah (GI Fellow)

LT Tom Mellor (IM PGY1 Intern) and LCDR Nisha Shah (GI Fellow)

Four IM Residency Members who were accepted to present at ACG

View current and past publications of Snapshot at tinyurl.com/domgmesnapshot

CHALKTALK pulmonaryfunctiontests http://youtu.be/g4j3nJKJQL8

kidneyphysiologyreview http://youtu.be/05RSNk29NK8

Got CHALKTALK? —contact William.Kelly@usuhs.edu

March 2015 Walter Reed DOM GME Snapshot

research and academic success

JUST PUBLISHED Images in Cardiovascular CT

M ultimodality imaging of multival-vular endocarditis after transcath-

eter aortic valve replacement Alison B. Lane MD, MS (department here)

Michael S. Cahill MD (Cardiology)

Andrew G. Letizia MD (Infectious Disease)

Joshua D. Hartzell MD (ID Faculty Mentor)

Todd C. Villines MD, FSCCT (Cardiology)

Published by Elsevier Inc. on behalf of Socie-ty of Cardiovascular Computed Tomography. most recent issue of JCCT (Vol 9, Issue 1, Pages 68-70).

P AGE 2

B arrett’s oesophagus length is established at the time of initial endoscopy and does not

change over time: results from a large multi-centre cohort LTC (P) Fouad J Moawad (GI Staff)

CDR Patrick E Young (GI Mentor)

CAPT (Ret) Brooks D Cash (Emeritus)

et., al. Downloaded from http://gut.bmj.com/ on March 2, 2015 Published by group.bmj.com Gut Online First, published on February 4, 2015 as 10.1136/gutjnl-2014-308552 Copyright Article author (or their employer) 2015. Produced by BMJ Publishing Group Ltd (& BSG) under licence.

R esults of a Formal Mentorship Program for Internal Medicine Residents: Can We

Facilitate Genuine Mentorship? Brian M. Cohee, MD

(Pulmonary/Critical Care Medicine Fellow)

Stephen A. Koplin, MD (Recent IM Residency Graduate)

William T. Shimeall, MD, MPH (IM Faculty Mentor)

Timothy M. Quast, MD (Former PCCM Staff)

Joshua D. Hartzell, MD (ID Faculty Mentor)

GI continues to make a signifi-cant contribution to the body of gastroenterology knowledge at a national level.

- CDR Bassett

COL (ret) Roy Wong, former Chief of Walter Reed Gastroenterology and an internationally recognized expert on esophageal diseases, explains the significance of MAJ Moawad and colleagues' work: "There have been 2 major questions concerning the pathophysiology of Barrett's esophagus. (1) How quickly does it occur? (2) Once one has BE, is there resolution of the Barrett's epithelium. Others have asked this question but there has not been a well-studied, large co-hort of BE patients followed over a period of time which has an-swered this question. Moawad et al. have answered this question fulfilling these criteria. They show that BE occurs rapidly and once the metaplastic epithelium has implanted within the esophageal mu-cosa, it stays put. GUT is also a very prestigious journal with very high impact factor - hence, very difficult to get an article accepted for pub-lication. BZ to Moawad and colleagues!"

The article in the Journal of Graduate Medi-cine Education documents the Walter Reed IM residency program's formal mentorship program and how it was able to increase high-quality mentoring relationships within the program through a facilitated mentor-mentee matching program. This work significantly adds to the current literature on improving mentorship in GME programs and would be a nice thing to add to the newsletter. CAPT Shimeall

Editorial

T wo Cheers for Milestones

Louis N. Pangaro, MD, MACP

http://www.jgme.org/doi/

pdf/10.4300/JGME-D-14-

00738.1

Letter to the Editor

I nfliximab-induced Anterior Uveitis in a Patient with Ulcerative Colitis

LCDR Manish B. Singla (GI Fellow)

LT Daniel K. Hodge (Resident)

LTC (P) Fouad J. Moawad (GI Staff Mentor) Journal of Crohn's and Colitis Advance Access published March 4, 2015 Journal of Crohn's and Colitis, 2015, 1–1 doi:10.1093/co-jcc/030

An insightful editorial dis-cussion of the ACGME Mile-stones

To view publications click on blue button or link: http://tinyurl.com/sharecontentsnapshot Click

To view publications click on blue button or link: http://tinyurl.com/sharecontentsnapshot

Click

March 2015 Walter Reed DOM GME Snapshot

P AGE 3

research and academic success

S trong Work!

Dr. Lauren Weber , Dr. Stephen Koplin and Dr. Barbara Cooper updated the ACP Smart Medicine online module entitled, “Pleurisy.” http://smartmedicine.acponline.org/content.aspx?gbosId=146

Internal Medicine Wins

USU award

for Best Medi-

cal Student

Clerkship. Thanks to IM

colleagues.

Leonard award winners for medical student teaching!!! Background: the Leonard Award recognizes outstanding skill and dedication in teaching and practicing internal medicine. Vital contribution to the success of the clinical training program in internal medicine. Recognized by students and peers alike. There are intern, resident, staff, and preceptor categories. James J. Leonard (1924-2005) was the founding chair of the USU Department of Medicine and was instrumental in establishing undergraduate clinical education at USU and graduate medical education programs at affiliated hospi-tals. Dr. Leonard's approach to medicine and his accessi-bility endeared him to students and colleagues. Fun fact: Dr. Leonard led the first morning report that Dr. Shimeall ever presented at when he was an intern at NNMC in 1995.

1st Annual WR IM Resident Research Symposium Kicked off new research support activities we are offering our residents to strengthen the culture of research within the program. The primary goal of the symposium was to highlight the process and celebrate successful IM resident research activities. The monthly resi-dent research meeting is designed to bring mentees/mentors and

other research-minded faculty to discuss and project ongoing research projects to completion. The 1st meeting will take place April 22nd, in the America Bldg, Room 2525 @ 1600. LT Donovan Mabe will be sharing his active research project. Bring your mentor/mentee and we’ll see you there! 48 Active/Upcoming Research Projects seeking Resident Support 2015 in 10 Departments

!!Coming Soon—Monthly Research Roundtable —Thank you for supporting our Residents!!

Thanks to everyone who at-

tended and contributed to the

success of the Symposium!

We appreciate all that you do

to support the residency and

in this way, we hope the resi-

dency can help support the

outstanding research that is

going on all around us here at

Walter Reed!

Best,

Charlie

Success

Great appreciation to the innovative force behind the momentum, MAJ Charlie Magee, Internal Medi-cine Residency Research Coordinator!! And special thanks to COL Pete Weina, , our Mentor panel, Dr. Moawad and Dr. Moratz , and the numerous Residency Subspecialty Education Coordinators, for rounding up all the research activities going on around us!

To learn more about research activities in the residency, please reach out to Charlie at (301)295-0123, or charles.magee@usuhs.edu

Left to Right: CDR Nations, MAJ Callendar, CPT Sobieszczyk, MAJ Kwok, LTC Van Echo, COL (Ret) Pangaro, COL (Ret) Hammer. Others recognized, but not pictured: John Massey GIMC, and Jason Blaylock, ID

March 2015 Walter Reed DOM GME Snapshot

P AGE 4

research and academic success

ReDefining COLLABORATION Research 101: A Guide to Successfully Completing Research at WRNMMC

Presented by the Departments of Research Programs, GME, and GIM Fellows

The presentations covered everything from developing re-search questions, to databases, literature reviews, to writing a protocol, to how to get published. his was an enormous team collaborative. We’d like to send out a special thanks to the presenters (right): The next iteration of Resident Research Day is schedule for 5 May. The goal of the course is to introduce residents to the principles needed to be successful at research. Please contact Dr. Hartzell to RSVP.

LTC Joshua D. Hartzell, MD, Assistant Chief, GME LCDR Joe Zeman, MD, PCCM Fellow LTC Ramey Wilson LCDR Mary Andrews, GIM Fellowship Sarah Cantrell, Darnall Medical Library COL Pete Weina CDR Janine Danko CDR Ruben Acosta Mary Kelleher

Success

14 programs received 'CONTINUING ACCREDITATION' status from their respective Residency Review Committee’s Annual Review process: 10 listed subspecialty fellowships (left) and Core IM residency (Target Self-study date re-mains May 2022) DOM also co-sponsors the TY Internship Program which received notification of continued accredita-tion Allergy has its own RRC and also received the same status (Target Self-study date Sep 2021) Core Derm residency and DermPath Fellowship have already received their letter describing

continued accreditation without citations or areas of concern (well-done!) Their target Self-study date remains May 2021. The IM/Psych program is recognized by the ACGME but not accredited by them. Accreditation is based on the parent programs' status.

Endo Rheum Nephro GI ID Cards Heme/Onc Pulm/CC Critical Care Sleep

C ONGRATULATIONS ON BECOMING

F INALISTS Intern Resident Student Case

Report Competition There were 70 abstracts submitted and 9 were selected as finalists, including two current IM interns:

CPT Steve Savioli, MD “Kikuchi Disease: A relieving diagnosis for a frightening presentation”

LT Tony Lewis, MD “Yellow Nail Syndrome”

Mark your calendars for their posters and presentations in the afternoon of 13 May (Building 9 lobby near the Wedge)

Robert A. Phillips Fellow/Staff Research Competition (RAP) This year the top 4 scores in each of the 6 categories have been selected for oral presentation at the Research Symposium on 18 and 19 May. A team of judges will score their oral presentation and select a winner. The winners will be announced on 19 May at 1500 in Memorial Auditori-um. BG Clark will present the winners with a certificate.

MAJ Dustin Little (Nephrology Faculty) (Predictors of non-adherence in kidney

transplant patients treated in a federal

universal healthcare system)

MAJ David Hostler,(Pulm/CC Fellow) (Feasibility of Intercostal Artery Doppler

Ultrasound Exam Prior to Thoracentesis)

LCDR Manish Singla, (GI Fellow) (Topographical Mapping in a Cohort of

Patients with Gastric Intestinal Metapla-

sia)

Bailey K. Ashford Clinical Competition

MAJ David Hostler, MD (same as above)

LCDR Manish Singla, MD (same as above)

Now that is something to crow about.

March 2015 Walter Reed DOM GME Snapshot

P AGE 5

well-deserved recognition

LCDR Casey Flanagan

Appointed Associate

Program Director for

the NCC Internal Medi-

cine Residency Pro-

gram!!

Casey is a wonderful fit for the resi-

dency program who I worked closely

with as an APD during his residency

and when he was the NCC-IM

(Bethesda) Chief Resident in 2007-

2008. He's gone on to great things in

cardiology and will maintain his im-

portant and complementary roles as

Medical Director, Heart Failure Clin-

ic, as well as Key Clinical Faculty and

Program Evaluation Committee Chair

for the NCC Cardiology Fellowship

Program.

- Bill Shimeall

Congratulations Marla

for being recognized as

Team Member of the

Week!!

Marla Redmond is a quiet force behind the

scenes for the Department of Medicine and

its GME programs. Since 2006 Marla and

her incredible team have supported the

Residents, Fellows, and Faculty in 2 resi-

dencies and 13 fellowships in countless

ways.

Thank you

for all you

do Mar-

la!!!

SAKAI Hits 199 Members! Become the 200th member today, and get a trip online http://tinyurl.com/IMaccountrequest

Please join me in wel-

coming LTC Aaron Hol-

ley as the new Chief of

Pulmonary Medicine!

LTC Holley attended Brandeis University and the Uniformed Services University (USUHS). He completed Internal Medicine internship and residency as well as Pulmo-nary and Critical Care Fellowship at the Walter Reed Army Medical Center. He has held leadership positions while deployed to Afghanistan as OIC of the ICU at Camp Dwyer as well as at WR-B as the Chief of Sleep Medicine from 2012 to 2015. For the past 2 months, he has also served as the acting Chief of Pulmonary Medicine. An avid researcher, he serves as the Princi-ple Investigator for 5 research protocols at WR-B. He is the author of over 33 peer

reviewed manuscripts, as well as numerous book chapters and abstracts. He was ad-vanced to Associate Professor at USUHS in 2014. He is a passionate leader who is widely respected and I am certain that he will lead the Pulmonary Service to new heights. From the Department of Medicine, I want to extend my congratulations and wel-come. We look very forward to the fur-ther growth and development of the Pul-monary Service under the leadership of LTC Holley and welcome him to his new position. With deep respect, Dr. Nations

LCDR Manish Singla

Elected to Fellowship in

the American College of

Physicians!!

Colleagues, Please join me in congratulating LCDR Man-ish Singla on his election to fellowship in the American College of Physicians. This is a major career milestone and reflects his dedication to excellence in medical practice and scholarship. BZ!

We would like to thank our col-

leagues in the ED, ICU (nurses/

physicians), ID, Cardiology, Neu-rology, and Infection Control for participating in our excellent Quality Improvement Review Con-ference on 19March15. Please join us monthly every third Thursday from Noon-time for our QIRC conferences.

Q I R C

March 2015 Walter Reed DOM GME Snapshot

DOM GME SNAPSHOT

well-deserved recognition

P AGE 6

Marla Redmond is a quiet force

behind the scenes for the Depart-

ment of Medicine and its GME

programs. Since 2006 Marla and

her incredible team have support-

ed the Residents, Fellows, and

Faculty in 2 residencies and 13

fellowships in countless ways.

Congratulations Marla!!

And Thank you for all you do!

FROM OUR PATIENTS

“(Dr.) Betteridge, Gastroenterology Clinic, is without

question awesome in terms of his professionalism as well as

his ability to communicate a plethora of information in re-

gards to IBS/Chronic disease. His manner was down to earth as the un-

explained side effects, supportive studies, diets and supportive dietary

products to relieve symptoms.

I felt reassured and much more relaxed

about continuing Remicade infusions

which I have been somewhat apprehen-

sive about with some of the warnings.

His resident was equally attentive in the

virtual evolution. Most of all, I sincerely

appreciated the extra time allotted to me

to alloy my concerns about (future) sur-

geries. “

BELOW—Nice com-

ments for staff from the

Heme-Onc Service

"I would like to tell you about

Ms. Erica West and the On-

cology team...Dr. [Mary] Kwok

(Staff), Dr. [Emily] McDuffee

(Fellow) Dr. [Darin] Yang (IM

Intern)... Thank you for the out-

standing care, for taking the time

to explain everything to me and

for answering all my questions. I

really appreciate everything and

am glad I am being followed by

your team. Thank you again for

the exceptional care!"

MAJ Betteridge

Strong

Work Strong

Work

C ONGRATULATIONS

Dr. Joshua Hartzell

Letter of Commendation,

Dr. Renee M. Mallory, In-

ternal Medicine Clinic,

WRNMMC

“...Three years ago, I received a

routine and pro-forma letter in-

forming me that my assigned

Medical Provider at WRNMMC

would be Dr. Renee M. Mallory

of the Internal Medicine Clinic.

Since that time, Dr. Mallory has

quietly and efficiently exhibited

the highest and most admirable

traits and qualities of military and

medical leadership, technical

competence, devotion to duty,

and pride in her work product. It

has been my observation, and

personal experience, that Dr.

Mallory works much longer

hours, and does a much better

job, day in and day out, than here

contemporaries and associates.

Characteristically, when my

(along with that of many others)

long-standing appointments with

her for 17 February 2015 was un-

avoidably canceled due to in-

clement weather, she immediate-

ly went to work to “find time” to

schedule make-up appointments,

in the immediate future, princi-

pally by extending the hours of

her “duty day.” To reiterate, Dr.

Mallory has been, and is, provid-

ing military medical care of a na-

ture, and in a manner, that ex-

ceeds the highest and most lauda-

tory criteria imaginable. In my

judgement, the Army would be

well advised to groom this truly

outstanding medical doctor for

positions at the highest levels of

the Medical Corps and the Army.

She is already performing at the

level of a very successful, and

respected, Colonel (0-6), in my

opinion.

Sincerely and respectfully yours,

Charlie Watkins

COL, USA, Ret.

The Order of Military Medical Merit is a unique, private organization founded by the Command-ing General of the U.S. Army Health Services Command in April 1982, to recognize excellence and promote fel-lowship and esprit de corps among Army Medical Department personnel. Membership in the Order Denotes distin-guished service, which is recognized by the senior leadership of the AMEDD.

March 2015 Walter Reed DOM GME Snapshot

DOM GME SNAPSHOT P AGE 7

quality improvement

NEED A PROCEDURE COMPLETED?

Lumbar Puncture Thoracentesis Paracentesis Arthrocentesis Exercise Stress

Test GXT

WANT TO HELP OUR HOUSESTAFF

BECOME MORE PROFICIENT? Page IM CONSULT PAGER

1062318

Connect with IM residents needing various procedures listed above when you don't have a rotating resi-dent readily available (or fellow who also needs the procedure). Thanks in advance for thinking of the residents.

Myths, exaggerations and uncomfortable truths

The real story behind Millennials in the work-place IBM Institute for Business Value By Carolyn Heller Baird, a Global Research Leader in the IBM Insti-tute for Business Value Executive summary Over the past few years, numerous reports have been published pre-dicting how Millennials (those aged 21–34) would revolutionize the workplace. All have one common feature: they assume that Millen-nials are somehow different from their predecessors. The fundamental distinction between Millennials and older employ-ees is their digital proficiency. Millennials are the first generation to grow up immersed in a digital world. Using mobile and social tech-nologies, immediately accessing data, ideas and inspiration and in-stantly communicating and collaborating is second nature for these digital natives...

To read the full Executive Summary and report, including 5 specific rec-ommendations for employers / man-agers for handling the challenges :(http://www-03.ibm.com/press/us/en/pressrelease/45904.wss)

something to consider

Career advice from Millennials for Millennials

“I’ve adopted my motto from

Amazon’s Jeff Bezos: Work hard,

have fun, make history.” Developer, IT, Spain

The retreat included 5 breakout discussion groups: Critical Care Medicine Inpatient Cardiology, Curriculum, PCMH—Ambulatory Medicine, Subspecialty Medicine, and Ward Medicine. Key Note Address delivered by CAPT-R Marquet author of Turn the Ship Around.. Thank you to all of our participants and wonderful administrative staff!

CAPT Shimeall, I want to thank you and your team for an outstanding Residency Retreat yesterday. The location, food, environment made for an excellent team-building event. Bring-ing in CAPT Marquet was really a game-changer. I have attended a lot of stand-downs. This was by far the most invigor-ating and thought-provoking event I have attended. I am intensely proud of what you and your team are doing! With deep respect, Anthony

MISSION Guide the next generation of mili-tary leaders in clinical care, re-search, and medical education, preparing you to meet tomorrow’s challenges in military and civilian healthcare RESIDENCY PILLARS Clinical care excellence—Quality and safety Scholarship—Research and collab-oration Education—Teaching and mentor-ship Leadership—Creating internists ready to lead change

ACKNOWLEDGEMENTS

WRNMMC Dept of Medicine and Medicine Directorate

USU Department of Medicine Regional military and civilian

partners Chief Residents and faculty

group leaders Fellows and residents who cov-

ered for us Fabulous Program Administra-

tors!: Marla Redmond, Sylvia Cook, Candice Bowman, Penny Sharps, Moszella Humphrey, Keisha White, Darie Allen

DOM Residency Retreat

March 2015 Walter Reed DOM GME Snapshot

DOM GME SNAPSHOT P AGE 8

Contact Us If You Must

Sean M. Lynch

Self-Declared Supreme Editor-in-Chief

Sean.M.Lynch36.CTR@mail.mil

(301) 319-4399

If you placed your accolade here, you’d be reading it now.

View current and past publications of Snapshot at http://tinyurl.com/domgmesnapshot

WHO WE ARE 74 Internal medicine residents

Army, Navy and USPHS Residents (AF incoming)

3 combined Medicine-Psychiatry (and growing)

DoM Residency co-sponsors 30 Transitional Interns

15 Dermatology Residents

12 Fellowships – 80+ Fellows

150+ high quality, invested clinical faculty

USU, VA, FB, WRAIR, FDA, NIH, BUMED, others

Virginia HC, Washington HC, INOVA Fairfax

Many Incredible administrators & clinical support staff

I n this month’s publication of Snapshot, we read about 2 Appointments, 14 GME programs receiving

continued accreditation, 3 Positive Patient Stories; 5 Publications; Research Conferences, re-occurring

quality improvement meetings, a couple of milestones, and many other highlights. And all of that was

from only a handful of our DOM GME Programs —Imagine all that we haven’t heard about?!

S o, please, help us tell your story by sharing news and information you are proud of.

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