Mission

To develop functionally independent and critically thinking physicians and Naval Officers capable of performing expert clinical care and thriving in military medicine.

Vision

To progressively develop the most interactive and sustainable academics of any program in the nation.

Aims

• Advance scholarly activity through quality improvement initiatives, case reports/series, and Institutional Review Board-approved longitudinal research projects.
• Continue to provide a top-tier 24-month military specific curriculum.
• Advance opportunities for subspeciality elective rotations at top-rated civilian facilities.
• Advance Quality Improvement opportunities by increasing access to high quality training in advanced topics such as Green Belt and by encouraging faculty mentorship of QI-based scholarly activity.

1. Morning report 7:30 - 8:15 a.m. Monday, Tuesday, Thursday and Friday (Follow up Friday)
2. Wednesday 7:30 - 8 a.m. Board Review
3. Monday 12 -1 p.m. Subspecialty Lecture
4. Wednesday 12 -1 p.m. Subspecialty Small Group Activities
5. Clinic Firm Week
   a. Wednesday 1:30 -3 p.m. Ultrasound Training
   b. Friday Academics 8:30 -11 (Journal Club, Hopkins PEAC module, 3rd year Best Clinical Practice)
   c. Friday 11 a.m. - 1:30 p.m. Monthly clinical simulation

Table Key:

• All rotations are at NMCP unless otherwise indicated
• Sentara = Sentara Norfolk General Hospital
• MV = Bon Secours Maryview Medical Center
• Rotations with a * mean 3 weeks on that rotation and a one-week continuity clinic (4 weeks total)

Medicine Elective Rotations at NMCP

• Cardiology
• Nephrology
• Gastroenterology
• Hematology/Oncology
• Infectious Diseases
• Allergy
• Endocrinology
• Neurology
• Pulmonary
• Research

Non-Medicine Elective Rotations at NMCP

• Anesthesia
• Pain Management
• Radiology
• Dermatology
• Orthopedics

Elective Rotations at Participating Sites

• Rheumatology (Sentara Care Plex)
• Intensive Care Unit (Riverside Regional Hospital)
• Palliative Care (Hampton Veteran’s Administration)
• Gastroenterology (Sentara Leigh)

Operationally Focused Elective Rotations

• Military Tropical Medicine (Offered through USUHS/NMLPDC)
• Shipboard Medicine, Flight Surgery, Undersea Medicine

Internal Medicine Residents participate in a 3+1 Rotation Schedule (three weeks of a rotation followed by one week of continuity clinic)

Ward Schedule

• Short Call:  6 a.m. -2 p.m.
• Long Call: 2 - 7 p.m. (admissions from 5:30 - 7 p.m. performed by night cross cover resident)
• Night shift cross covers: 5 p.m. - 6 a.m.
• Night admits and night interns: 7 p.m. - 6 a.m.

The NMCP IM Military Unique Curriculum, which includes military-specific topics, occurs quarterly during continuity clinic Journal Club. The last clinic block of each year is dedicated toward providing an understanding of the operational environment and the responsibilities of the Operational Medical Provider.

Small Group Topics

• Understand your Leave and Earnings Statement: Pays/Allowances/Allotments
• Thrift Savings Plan, Special Pays
• Writing Fitness Reports/ Enlisted Evaluations and awards
• Maintaining and updating your Officer Data Card
• Suicide Awareness in the Fleet
• Introduction to Surface Medical Capabilities

Tours

Based on Location with Proximity to the Fleet

• Amphibious Ships (LHD, LPD or LHA)
• Flight Surgery

Lectures

• Prolonged Field Care
• Introduction to Ship/Marine Corps (rotating this lecture every other year)
• Global Presence and Mission of Navy Medicine
• Outbreak Investigation
• Limited Duty/Medical Boards
• Trauma Experience at Camp Bastion
• USNS Comfort Experience
• Military Medicine in the Austere Environment
• Management of the Medical Department: Roles and Responsibilities of the OMO
• Independent Duty Corpsman training and certification
• Physical and Medical Standards for Enlistment and Commissioning
• Physical and Medical Standards for Special Duty: Flight, Dive, Special Operations, Submarines, Nuclear Field Duty
  

Activity/Procedural Skills

• How to run a drill:
  • Education on how to create a drill scenario, moulage, evaluation and feedback
  • Development of a Military Drill including evaluative rubric
  • Execution of the drill and feedback session
• Trauma and Prolonged Field Care simulation
• IV placement
• Airway management and intubation
• IO placement

Elective Rotations

• Electives available on Ships, Flight Surgery, Undersea Medical Officer

Required Rotations

See above box diagram of schedule Wards, ICU (PGY1 and PGY2), ICU (Sentara Norfolk General, PGY2 and 3), Maryview (hospitalist 3rd year), Geriatrics (3rd year), Continuity Medicine Clinic (3+1 model)

Required Academics

During Continuity Clinic Week: ultrasound (horizontal curriculum), simulation (monthly), journal club.

Monthly simulation Series (Executed on Fridays of the continuity clinic week)

Simulation is the heart of our didactics. Every month, there is a thought-based simulation related to high importance but often low occurrence diseases processes such as Tumor Lysis Syndrome, Massive Variceal Bleed, Thyroid Storm, Hospice Discussion, Bacterial Meningitis, Cardiopulmonary arrest, Transfusion Reactions, Hemolytic Anemia, Anticholinergic Toxicity, and more. These rare but critical presentations are both board relevant and clinically relevant for the internist to be able to rapidly identify and treat.

• Pre-simulation recorded lecture
• Execution of the case scenario simulation (Two groups of four)
• Procedural simulation (Central Line, Arterial Line, IV placement, LP, etc.)
• Post-simulation quiz
• Hear it, Do it, Review it. Make it Stick.

Our program utilizes a 3+1 curriculum with the focus of small unit leadership associated with the continuity clinic. Our 3rd year residents are our unit team leaders. Additionally, we utilize resident leaders on curriculum development and sustainment of programs such as the ultrasound curriculum where sessions are often resident led with faculty oversight.

Residents are required to complete a minimum of two scholarly projects for graduation. One of the projects must be as first author of an abstract for poster/podium presentation or of a published manuscript. The other project is the resident’s choice and can be any of the following: abstract for poster/podium presentation, presented quality improvement project, curriculum development lead, published case report/series, institutional review board (IRB)-approved research participant with staff, presented/published IRB exempt research, or another approved project. Residents can choose research as an elective to work on their projects. Resident projects this academic year have resulted in 13 presentations at national conferences, including:

• American College of Gastroenterology
• CHEST
• American College of Allergy Asthma and Immunology
• Society of Hospital Medicine
• American Academy of Allergy, Asthma, and Immunology

This academic year, our program also had 29 regional presentations, and publications in the Journal of Internal Medicine, CHEST, and American College of Gastroenterology Case Reports Journal.

Quality improvement education includes the completion of Quality Rocks Academics and an embedded project within each clinic firm, utilizing the A3 method. Each PGY-2 will lead clinic firms in QI with participation from PGY-1 and PGY-3 and complete the A3 steps. Projects are presented during morning report, and presentation at the command QI Symposium and other conferences is highly encouraged. Residents have started 9 new projects this year and continued 6 projects from last year. Our projects include:

• Improving interval DEXA scan times
• Clinic intake form to improve clinic efficiency.
• Colorectal Cancer Screening
• Hypertension in the Active-Duty population
• Continuity Clinic Week Ultrasound Curriculum
• Penicillin allergy de-labeling
• Positive blood cultures resulting in auto infectious disease consults.
• Notification of provider if lab cancels order due to it being incorrect.
• Women’s health day in clinic
• Nurse Driven Protocol expansion -- beyond UTI.
• Rapid Response Team
• Improving coding in clinic
• Standardizing hospital discharge process
• Review patients enrolled to coumadin clinic and indication for coumadin vs direct oral anticoagulants.

Our residents have participated in a variety of professional development opportunities tailored to align with their career goals. Our senior residents become Teaching Fellows with the USUHS. Each year multiple residents participate in obtaining their Lean Six Sigma Green Belt. Residents have obtained Instructor certifications in Advanced Life Support and Fundamental Critical Care Support.  Our residents also participate on many hospital- and GME-wide committees, including the Internal Medicine Education Committee, the Graduate Medical Education Committee, and the Internal Medicine Wellness Committee.

Additionally, our program places a major emphasis on faculty participation in the USUHS Faculty Development program.

Required Rotation Sites

• Sentara Norfolk General Hospital
• Bon Secours Maryview Medical Center

Elective Rotation Sites

• Riverside Regional Medical Center
• Sentara Leigh
• Hampton Veteran’s Administration

We are happy to accept 3rd and 4th year military medical student rotators on the Internal Medicine ward teams and inpatient/outpatient subspecialties. During the rotation, we also offer a procedural simulation rodeo for rotating medical students. To inquire about rotating, please contact usn.hampton-roads.navhospporsva.list.nmcp-dmsgmeinterview@health.mil.

Prospective applicants are encouraged to attend one of our scheduled program information and interview days. Requests for virtual interviews are also available upon request. Please reserve your spot by contacting us at the program email.

2024 In-Person Interview Available Dates

• July 19, 2024
• Aug. 16, 2024
• Sept. 6, 2024
• Sept. 13, 2024
• Oct. 4, 2024

Program graduates take the American Board of Internal Medicine (ABIM) exam. This exam is offered annually in August. To become fully board certified, applicants are eligible to take board certification exam 1 month following graduation. To be eligible to take specialty board exams, graduates must complete all pre-requisites required by the ABIM by August 31st. For further information, please see the ABIM website. IM Specialty board eligibility is from graduation up until seven years post completion of residency. Board examinations are completed post-residency.

• Residents have the opportunity to earn the Uniformed Services University of Health Sciences Teaching Fellow Designation.
• Residents are required to do a R2 Resident Lecture and R3 Grand Rounds. Residents are also required to perform a Resident Peer Review Conference (Formerly M&M).
• R1s are responsible for providing a small-group overview of a Johns Hopkins PEAC Module focusing on an ambulatory medicine topic during continuity clinic week.
• R2s are responsible for leading a small-group evidence-based journal club discussion during continuity clinic week.

• Several of our residents have become ALS and ATLS instructors and teach sections of the Fundamental Critical Care Support course.
• There are also opportunities for residents to take a leadership role in curriculum development such as developing cases for the Ultrasound Curriculum or the Diversity Equity and Inclusion Curriculum.

• Cardiology
• Infectious Diseases
• Hematology/Oncology
• Nephrology
• Neurology
• Allergy/Immunology
• Gastroenterology
• Pulmonary/Critical Care
• Medicine Critical Care
• ID/Critical Care
• Endocrinology

Our residents receive mentorship from 40+ Internal Medicine Faculty, including a group of core faculty. Each resident is assigned a faculty from the Clinical Competency Committee who regularly meets with residents to review their development. Our program has two Chiefs of Residents and three Associate Program Directors in addition to the Program Director to provide mentorship and support. We also have residents who participate as Peer Support residents for other trainees. Our residents also lead and teach third- and fourth-year medical students who rotate at NMCP.

We know residency is challenging. It has been described as “the nadir of personal wellness in a physician’s career” (Dennis Lefebvre, 2012), and at any given time up to 43% of residents will screen positive for depressive symptoms (Mata, et al, 2015). We know there are stressors in residency that can never be fully eliminated. We also know there are ways that we as a program can support you through this rigorous training and help you meet your full potential as a future Internist.
Some of our current Wellness Initiatives include:

• A dedicated Wellness Team run by residents with staff mentorship.
•  A 3+1 schedule that allows for a lighter clinic week between the rigors of inpatient rotations.
• One day, usually Friday, of each clinic week dedicated to academics without clinical responsibilities.
• Majority on-site rotations allowing for development of peer relationships.
• A GME area with personal desk space at every level of training.
• A year-long clinic firm “House Cup” competition and weekly morning report team competitions.
• Weekly resident sponsored "Happy Hours."
• Free coffee at Morning Report.
• Quarterly resident events, such as the “Best-Ball Golf Outing” and group fitness events.
• An annual resident retreat.
• Non-mandatory, resident run group therapy/debrief sessions.
• Access to many peer and mental health support programs.
• Resources to support your life outside of medicine, including an in-hospital gym, a vast array of local area events, including concerts, festivals, amusement parks, and state parks, and good local school systems for children.