Mission

The mission of the NMCP Transitional Year Residency is to prepare military physicians to practice independently as Operational Medical Officers (OMO) across all operational platforms and be adequately prepared to continue in post-graduate medical education (PGY-2+) in their chosen specialty upon graduation from the program.

Vision

Lead the way in creatively and effectively preparing our graduates to work as OMO and future residents in both civilian and military GME training programs.

Aims

1. Continue to strengthen our dedicated TY academics and didactics through continued, increased faculty presentations. Continue to develop our interns as “residents as teachers.”
2. Through operational medicine rotations, continue to expose our interns to operational medicine across all communities and operational platforms to help prepare them for future OMO tours.
3. Revamp our clinical rotation schedule to have “medicine track” and a “surgery track” in addition to our traditional transitional year track to better prepare our graduates for their eventual, desired residency and better align with the civilian model.

The TY program has specific, dedicated academic time every Thursday from 12 - 2 p.m. Additionally, TY interns are expected to go to their current clinical rotation’s dedicated academics while on that rotation.

Block Rotation Schedule KEY

The PGY-1 year consists of 13 four-week blocks.

Institution Site Key

• Inst. 1 = Naval Medical Center Portsmouth (ID 510314)
• Inst. 2 = Sentara Norfolk (ID 510276)
• Inst. 3 = Maryview Medical Center (ID 510480)

Superscript Key

• 1 IM Wards at Institution 1 is internal medicine inpatient wards.
• 2 CCS is Cardiac Care Service at Institution 1. Consists of 2 weeks of outpatient clinic-based cardiology and 2 weeks of inpatient cardiology consult service and inpatient cardiology.
• 3 OP Med/MRD is 2 weeks of operational medicine onboard ships or with flight squadrons or with the US Marines or dive/undersea medicine. As a military training program, we utilize unique opportunities with operational medicine to expose our interns to military unique situations and ambulatory medicine. MRD is the Medical Readiness Division, the second 2 weeks of the 4-week rotation, consisting of a combination of outpatient clinic medicine and administrative oversight of physician extenders onboard various operational platforms such as ships.
• 4 Psych/Gyn is 2 weeks of psychiatry and 2 weeks of gynecology. Psychiatry is a combination of outpatient clinic and inpatient/ER consult liaison service. Gynecology is a combination of outpatient women’s health clinic and inpatient obstetric care.

Elective rotations can consist of any of the below listed clinical rotations. One elective rotation can also be used to do dedicate research and/or process/quality improvement projects.

Naval Medical Center Portsmouth

• Anesthesia
• Pain Medicine
• Dermatology
• Otolaryngology
• Ophthalmology
• Neurology
• Neurosurgery
• Pathology
• Radiology
• Pediatrics (inpatient or outpatient to include subspecialties)
• Physical Medicine and Rehabilitation
• Occupational Health

Sentara Norfolk

• Emergency Medicine
• Trauma Surgery
• Pediatrics Emergency Medicine

Maryview Medical Center

• Emergency Medicine

**If research is used for an elective, then there is no inpatient or outpatient responsibilities. Residents can do research in the form of quality/process improvement projects, case reports, clinical series and/or IRB approved projects done in conjunction with other categorical training programs.

Transitional Internship does not have a specific, separate call schedule. The intern takes the same call as other interns on whatever clinical rotation they are currently on. For example, while on ICU, the intern takes call every 3 days like all other trainees currently on ICU.

Transitional Year Residents rotate through one or more of the following operational medicine communities:

• Flight Surgery
• Undersea Medicine
• Shipboard Medicine
• Fleet Marine Force

They work with current OMOs and experience what it is like to be an operational doctor attached to a squadron, ship, or battalion. We also have operational focused lectures throughout the year.

• Cardiology
• Internal Medicine
• Emergency Medicine
• Psychiatry
• OB/Gyn
• General Surgery
• Orthopedic Surgery
• Intensive Care Medicine
• Operational Medicine
• Family Medicine

Towards the end of the year, interns participate in STOMP (Simulation Training for Operational Medicine Providers), which uses a combination of simulations, scenarios, and standardized patients to ensure that they are competent in all core privileges for an operational medical officer. Certain rotations, such as orthopedic surgery and emergency medicine, utilize the simulation center and bioskills lab during their academic days and our interns fully participate in these activities during their time on these rotations.

The transitional internship has a monthly journal club where different leadership, wellness and resilience topics are discussed.

While there is no specific requirement for our Transitional Year Residents to do research, participation in research is heavily encouraged. One of the collateral duties available to TY Residents is a “research coordinator.” That TY Resident is responsible for gathering a database of current, ongoing research projects that different departments are doing that interns could participate in. There is also the possibility of having an elective rotation dedicated to research, but the TY Resident needs to have a well-developed research plan and product (journal paper, case report, conference poster presentation, etc.) that they will have at the end of their research elective. As part of the program orientation, we have representatives from the Clinical Investigations Department come and talk to the TY Residents to familiarize them to the research resources available at the command.

While there is no specific requirement for our TY Residents to participate in a quality improvement project, we do have collateral duties such as “QI/PI project coordinator” and “Quality Representative.” They are responsible for attending command/hospital-wide committee meetings where quality and process improvement projects and tasks are announced. They then communicate these to their fellow residents. They also help to connect interested interns with current, ongoing QI/PI projects to encourage maximum participation. There are also QI/PI lectures and training opportunities at the hospital that residents are highly encouraged to attend.

TY Residents participate in command and USUHS sponsored professional development activities and lectures.

• Naval Medical Readiness and Training Center Portsmouth
• Sentara Norfolk General Hospital
• Children’s Hospital of the King’s Daughters
• Bon Secours Maryview Hospital

Most of our rotations take place at the home institution of Naval Medical Readiness and Training Command Portsmouth and the outlying branch health clinics. There are elective rotation opportunities in trauma surgery (Sentara Norfolk General Hospital), pediatric emergency medicine (Children’s Hospital of the King’s Daughters) and emergency medicine (Bon Secours Maryview).

Interested applicants should contact the program via the program email to arrange an interview. In general, only applicants who are listing Transitional Year Internship as their first choice for PGY-1 training are required to interview with the program. If TY is your second choice or “back-up,” then you are more than welcome to interview with us, but it is not required.

No specialty board is available for this internship.

The TY Residents develop their skills as “residents as teachers” through the Thursday TY academics. Every TY Resident is required to prepare and present two didactic lectures (one required from a list of “core topics” and one elective topic of their choosing). Every TY Resident also presents one “My Mistakes” lecture in the model and spirit of a Mortality and Morbidity presentation. TY Residents are also encouraged to work with medical students who may be on clinical rotations with them throughout the year.

Our program is dependent upon the categorical training programs and departments for our faculty. Our faculty directly reflects the faculty of the other departments at the hospital.

Our program has a mentorship program where current TY Residents reach out to incoming program members to help them with their transition from civilian medical schools to military medicine. The TY Residents are here to answer any questions or concerns at a peer-to-peer level.

The TY Program has fall and spring offsite retreats, where we review and address any concerns trainees have about the program and clinical rotations, as well as going through intern feedback on the clinical rotations in detail. Part of the retreat is also morale building fun activities. We also have monthly offsite journal clubs. Intern holiday party, intern formal dining out and graduation party with hail and farewell.