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National Capital Consortium Dermatology Residency Program Director

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Here is the announcement/recruitment letter for the Program Director position for the NCC Dermatology Residency.

The memorandum to the Surgeons General requests the widest dissemination of the announcement to ensure that all physicians desiring an assignment as a Program Director have the opportunity to apply.

Also attached is the DoD Policy and Selection Criteria for GME Program Directors, as well as the ACGME requirements for this position.

Please ensure this message reaches all DoD physicians who may meet the criteria for GME Program Directors.

Please note: Applicants are required to submit a CV and Letter of Intent to apply for the position to me at Joel.M.Schofer.mil@mail.mil by COB 14 AUG 2020.

  • An applicant’s CV must include a section about faculty development activities that they have done.
  • An applicant’s CV must demonstrate at least 3 years of documented education and/or administrative experience, as well as ongoing clinical activity in the (sub)specialty for which they are applying.
  • An applicant’s CV must demonstrate current board certification in the (sub)specialty in which they are applying. Current medical licensure must also be documented on the CV.
  • An applicant’s CV must demonstrate current ongoing scholarly activity.
  • The Letter of intent must include the candidate’s level of commitment to GME and the Program Director position, including the number of years they are willing to serve, and that if selected, that they will accept the position.

If you have any questions, please feel free to contact Jerri Curtis, M.D. via e-mail at:

jerri dot curtis at usuhs dot edu

ASDHA July Message to the Military Health System Team

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The message can be viewed here in PDF form and cut/pasted below.

MHS Team:

July is Health Innovation Month in the Military Health System. Innovation drives how we meet many of the challenges that arise, and that’s especially the case in a crisis – when routine thinking doesn’t match the complexity, speed and urgency of the issues that confront us. Your ability to innovate is something that impresses me every day. Examples of innovative breakthroughs are occurring with vaccine development, testing and diagnostics, and preventative and rehabilitative care.

Two of the Department’s vaccine candidates have successfully advanced and are in the mix for vaccine development. Artificial Intelligence and Machine Learning-assisted efforts are helping to accelerate the process of discovering a new drug. This will help not only DoD, but potentially the Nation. The Department is also leveraging innovative research in anti-virals, anti- inflammatories, plasma products, and antibodies.

The Department’s sights are set on integrating emerging new technologies, like serology and point-of-care antigen tests, into the Department’s next testing strategy. We’re exploring alternative approaches like pooled testing, for which the Food and Drug Administration just issued an Emergency Use Authorization, allowing us potentially to accelerate our rate of screening and testing, while maintaining appropriate surveillance of COVID-19. In the meantime, MHS data are providing a common operating picture for commanders up and down the line, and are in alignment with the White House Coronavirus Task Force, through partnerships with the Department of Health and Human Services and the Food and Drug Administration. For instance, the Defense Health Agency, the military services, and the Uniformed Services University’s work on the Department’s first-ever COVID-19 patient registry is informing our medical research, clinical practice guidelines, and contributions to peer- reviewed journals, and are also being adopted as part of other policy and guidance products throughout the interagency. You can read more about our COVID-19 innovations at https://go.usa.gov/xfYGx.

Innovation is more than what takes place in a lab. I just returned from a visit to several sites in the Pacific Northwest and witnessed impressive examples of MHS innovation in action. At the 1SFG (Airborne) command at Joint Base Lewis-McChord, for example, the team is working hard on the Tactical Human Optimization Rapid Rehabilitation and Reconditioning THOR3 program, based on the training model used by professional athletics strength and condition coaches. They’re using this unconventional set of tools to build stronger, more resilient special operators who are less prone to injury and able to get back in the fight faster if injured. They’re laser-focus on reducing injuries associated with training. And they’re tackling the challenges with creative problem solving and new, cutting-edge resources.

Read more about the MHS’s COVID-19 innovations at https://go.usa.gov/xfYGx.

Some updates on current MHS issues:

MHSRS Canceled. Out of an abundance of caution about COVID spread, we canceled the Military Health System Research Symposium, our annual venue for showcasing cutting-edge, innovative research and development in military medicine. But the innovation continues, so we’re going to make sure the abstracts and success stories will not be lost. We’re creating a way to best share all of the important work that furthers the science and practice of military medicine, and tells the story of our innovative and caring enterprise.

DoD Testing Updates: DoD’s COVID-19 Diagnostic and Testing Team, led by the Defense Health Agency’s Maj Gen Lee E. Payne, continues to make measurable progress to screen, detect, and monitor risk through an integrated DoD-wide COVID-19 testing strategy. The Diagnostic and Testing Team works in several key areas. First, it ensures that the testing requirements are identified by the Services and Combatant Commands and that these requirements are supported by the Department’s laboratory and testing capabilities. Second, it ensures laboratories and testing sites have adequate supplies to execute testing. And third, it coordinates with the Joint Acquisition Task Force and HHS/FEMA to enhance the supply chain and acquire additional testing platforms and associated supplies.

The Secretary of Defense has prioritized the diagnostic and screening testing of the force in the following categories of units and commands: critical national capabilities, engaged field forces, forward deployed and redeployed forces and all other forces.

Since January, the Department has conducted more than 480,000 clinical and screening tests. Maj Gen Payne and his team have successfully set the framework for executing the Department’s tier-based testing program, increasing active-duty weekly testing fivefold in three months. DoD has expanded testing capacity from 15 to 125 laboratories conducting 60,000 tests per week, with the capability for up to 200,000 per week. In fact, in the last five weeks alone, we have doubled our testing rate, having now completed more than 466,000 tests. And the team continues to contribute to the military medical enterprise’s unparalleled expertise to inform Force Health Protection Guidance – with Supplement 11, for instance, centered on surveillance, screening and testing:

https://media.defense.gov/2020/Jun/12/2002315485/-1/-1/1/DOD-Guidance-for-COVID- 19-Surveillance-and-Screening-with-Testing.pdf.

Excellent job by Maj Gen Payne and his entire D&T CVTF team.

COVID-19 Convalescent Plasma Update: At the direction of Secretary Esper, we are about half way toward our goal of obtaining 10,000 units of convalescent plasma to help service members who are hit with COVID to recover more quickly, ultimately preserving our forces’ military readiness. We’re also able to use convalescent plasma to advance research against the virus.

The collected convalescent plasma is already making a difference. We’ve treated more than 50 patients, who have received more than 70 transfused units of plasma. And that’s just the beginning, in part because a lot of people recovered from COVID are rolling up their sleeves and donating their blood and their blood plasma to help others who may need it. Armed Service Blood Program Blood Donation Centers are contacting all beneficiaries who have tested positive for COVID-19 to let them know about how they can help the cause.

While plasma donations are completely voluntary, I was pleased to learn about Marines assigned to the Marine Corps Recruit Depot San Diego, who have tested positive for COVID-19, lining up to donate their plasma to help a fellow service member or military beneficiary. “It makes me feel good to be a part of the solution to this pandemic,” said Marine Corps Pfc. Xavier Flores, a recent donor. That’s the spirit that will get us through. Read more about this inspiring story here:

https://www.defense.gov/Explore/Features/Story/Article/2282184/marines-donate-plasma-in- fight-against-covid-19/

And at another stop while I was visiting Joint Base Lewis-McChord, it was inspiring to see the incredible blood center team in action for myself. I witnessed first-hand the kind of dedication we’re looking for on the plasma collection front. It was clear the team there understands that we need everyone eligible to donate. It could very possibly save a life. If you’ve been diagnosed with COVID-19, have fully recovered, and meet other eligibility requirements, or if you know someone who meets those requirements, please consider the importance of donating at an Armed Services Blood Program donor center. Learn more here: https://go.usa.gov/xfY7d.

Return to the Workplace: Throughout the MHS, we’re using a phased approach to return to more normal operations. Supervisors have the responsibility to carefully navigate through these stages with each employee, according to local conditions, health risk factors, and mission requirements. The Defense Health Agency recently released a Concept of Operations to guide resumption of full health care delivery operations, readiness support, enterprise threat reduction, and ongoing support for COVID-19 response efforts. Critical to our resumption of full health care operations will be risk mitigation practices and a deliberate focus on lessons learned. At every level of the MHS, thank you for finding the ways to best protect and care for our providers, patients, and the active force.

Resuming some travel, I was able to get out of Washington and to see some of the great work you all do every day to ensure our nation’s military medical readiness, support the warfighter, and care for the patient – and in the middle of an historic pandemic. My only thought was how proud I am to be a part of something so big and important to so many real people. Together, we are building an enterprise of dedication and innovation that is protecting our people, advancing readiness, and supporting the national COVID-19 response. Let’s continue to build on this success. Stay healthy and thank you for being a part of the fight.

Tom

NDAA 2020 Limits Promotion Opportunity to Max of 95%

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The Medical Corps has historically had a 100% promotion opportunity for O4/LCDR, but the 2020 NDAA limits promotion opportunities to 95%:

NDAA FY20 Section 503

I have no insight into why this change was made, and would only be guessing, so I won’t bother. How would this have affected our most recent FY20 board?

The FY20 O4 board had 253 LTs in-zone and a 100% promotion opportunity for O4, therefore they were allowed to pick 253 LTs total from those in-zone, below-zone, and above-zone. Here’s how it broke down:

Screen Shot 2020-07-30 at 12.04.45 PM

As you can see, they picked 253 (6 + 223 + 18).

If you apply a 95% promotion opportunity, they would have only been able to pick 240 (253 x 95%), so 13 people would have lost out.

Whether this will lead to less below-zone picks or what other effects it will have we’ll just have to see.

 

Finance Friday Articles

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Here are my favorites this week:

Almost Zero

How COVID-19 is forcing physicians to rethink the concept of job security

International stocks help diversify your portfolio

You Don’t Need Alpha

 

Here are the rest of the articles:

4 Things I’ve Learned Reading Medical Expert Witness Opinions

5 Ways to Protect Your Investment Portfolio in a Downturn

6 steps to selecting a target-date fund

7 Great First Steps in Real Estate Investing

15-Year or 30-Year Fixed Mortgage: Which Is Right for You?

AcreTrader Review: Invest in Non-Leveraged, Cash-Flowing Farmland

A Roth IRA For Every Baby in America

Asset Allocation (Part 1): The Security Bucket

A Year of Change for the TSP, Still More on the Way?

Being an Expert Witness: Why Starting Today Can Save Your Tomorrow

Best Time to Buy a Car & 8 Other Steps on How to Get the Best Deal on a Car

Chasing Markets Can Be a Poor Long-Term Investment Strategy

Cooking Up a Story About Robinhood Traders

Crash Test

Finding Your Ideal Retirement Location

Going Back to School? Here Are the 2020-21 GI Bill Rates

How I Found Financial Security in a Culture Obsessed with Consumerism

How Millennials Can Close the Generational Wealth Gap

How to Succeed at Private Real Estate Investing

Is It Wrong to Earn Less?

Just Another Day

MOAA Tax Update: The Status of 5 Key States

Patience is Virtue No One Has Time For Anymore

Pay off our mortgage or not? A glimpse into a couple’s final decision

Private School During the Pandemic: Visiting an Old Debate

Retirement plan down because of covid-19? Here’s why you still need stocks in your 401(k).

Say No to a Vacation Home

Should Retirees Adopt a Flexible Withdrawal Strategy?

Skewed Impression

Want a Strong Portfolio? Don’t Make These 7 Mistakes

What If We Get Inflation But Interest Rates Don’t Rise?

Why Is Gold Rising?

Would You Quit Your Job as a Lottery Winner?

COVID Grand Rounds Today at 1630 EST

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Sorry, but I just found out about this one, and it is today at 1630 EST. It is titled:

COVID-19 Therepeutics: “The 3-Legged Stool” Featuring Dr. Michael Joyner, of the Mayo Clinic

Details are in this PDF document.

Navy Announces New Mid-Career Officer Graduate Education Opportunity

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By MC1 Mark D. Faram, OPNAV N7 Public Affairs

Washington, DC (NNS) — The Navy is now calling for applications to a new graduate education program to be piloted this fall, with 80 officers expected to start low-residency opportunities offered by up to eight partner schools.

The Low-Residency Graduate Education Program (LGEP) is designed to provide due-course naval officers in paygrades O-2 to O-5 the chance to get a Navy-funded graduate degree in one of three disciplines — strategy, management or international relations.

The pilot program was announced last week in Naval Administrative Message (NAVADMIN) 204/20, which requests that applications be submitted by August 2.

“This initiative is the product of close collaboration between the Chief Learning Officer (CLO), N7, and the warfare communities,” said VADM Stuart Munsch, former Deputy Chief of Naval Operations for Warfighting Development and service-lead for naval education, whose office helped to champion the new program. “Once implemented, LGEP will give officers with compressed career paths an opportunity to pursue a graduate degree that fulfills education requirements for promotion and milestone screening and contributes directly to Navy warfighting advantage.”

The idea is to give officers on compressed career paths a flexible, Navy-funded option to earn graduate degrees which meet the O-7 promotion eligibility education requirement.

Each program is designed to be completed during a shore-duty tour. This means that selected officers will remain at their duty stations and complete most course work online or via telephone. Residency requirements are met through funded, monthly trips to campus.

The lineup of degree programs range in length from 10 to 24 months. Current partner institutions are Old Dominion University, William and Mary University, American University, Johns Hopkins University, UCLA, UCSD, University of Washington, and the Naval Postgraduate School.

In return for the service-funded education, selected officers agree to a continued service obligation of three years, which is served concurrently with any other service obligations they have.

The obligation, which is incurred whether or not the officer completes the degree, starts either on the date of program completion or, should the officer not complete the degree, the date of withdrawal from the program.

This year’s program is a test of concept, designed to gauge the effectiveness of low-residency education delivery models in netting officers required graduation education while also meeting the needs of the Navy for strategy-minded warriors.

If successful, the program could expand opportunities for up to 300 officers annually in future years.

The window for applications this year is open now and runs through August 2. A committee from the office of the CLO will review the applications; selectees will be announced by August 14.

Details on how to apply as well as Navy points of contact can be found in NAVADMIN 204/20, which is available for download here:

​LOW-RESIDENCY GRADUATE EDUCATION PROGRAM – NAVADMIN 204/20.

NOTE: Supplemental material advertised by the NAVADMIN message as available on the Internet (at http://www.navy.mil/local/clo) is not currently available due to technical difficulties. However, the NAVADMIN provides all information necessary for submitting an application to the program.

Get more information about the Navy from US Navy facebook or twitter.

For more news from Deputy Chief of Naval Operations for Warfighting Development (N7), visit www.navy.mil/local/OPNAVN7/.

SG’s Message – “Navy Medicine…Report to the Bridge!”

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Esteemed Colleagues,

“Anyone can hold the helm when the sea is calm. “ – Publilius Syrus.

For those of us who’ve had the privilege of getting underway in our great Navy can attest, the bridge attracts a lot of visitors when it is quiet at sea. It’s a much different scene however when situation get critical, as that is when the skilled, battle tested and steady hands are called to take over. But how did that “go to” team develop the proficiencies necessary to succeed in times of crisis? The answer can be found at the core of our Navy and Marine Corps team and the heart of what we do every day in Navy Medicine. It is the rare combination of being Brilliant on the Basics of our profession and at the same time, seeking those unique opportunities in our career to step out of our comfort zones, drawing confidence from our training, our mentors, our leaders and most importantly, ourselves to get the job done. Getting comfortable with being uncomfortable is a learned skill, and no one has set a better example of this principle in action than you…The amazing men and women of Navy Medicine.

We all have “comfort zones”; that behavioral space where our activities and behaviors fit a regular pattern. Routines can be stable and comforting, but they can also turn stale and confining over time. Doing something new and different helps stave off burnout and is good for our brains and bodies. Anyone who’s ever pushed themselves to get to the next level or accomplish something knows that when you really challenge yourself, you can achieve amazing results.

The idea of a comfort zone goes back to a classic experiment in psychology. In 1908, psychologists Robert Yerkes and John Dodson explained that a state of relative comfort created a steady level of performance. However, in order to maximize performance, one needs to reach a state where stress levels were slightly higher than normal. This space is called productive discomfort or optimal anxiety, and it exists just outside our comfort zone.

There are many examples of Navy Medicine personnel embracing the opportunity of operate outside their comfort zone to meet the challenge of the SARS-CoV-2 virus. For many it is overcoming the difficulties of continuing their demanding work remotely, without the proximate support of their co-workers. For others it is not just a change of venue, but of function. For example, our dental community, restricted from performing most of their operative procedures in order to limit spread of the virus, have contributed to the fight in ways they could not have imagined while they were in dental school. Here are just two of many examples:

  • LT Chris Wilde, NMRTC Yokosuka. A General Dentist, Chris stepped-up to orchestrate COVID-19 reporting for 223 commands across U.S. Forces Japan. He planned and executed multiple SWABEX evolutions and helped to test more than 6,000 people which prevented the spread a coronavirus outbreak on the base.
  • LCDR Geoffrey Ward, NMRTC San Diego. A prosthodontist, Geoff served as the command’s lead for COVID-19 operations and fleet testing. He helped to develop instructions for conducting drive-thru coronavirus testing, setting up tents for symptomatic and pre-operative testing, and co-authored standard operating procedures to provide consistent care and protect our Sailors and Marines.

One Navy Medicine’s willingness to move beyond our comfort zones remains a critical key to our success. Our ability to apply rapid-cycle feedback and lessons learned directly improves the quality, safety, and relevance in the care we provide.

For example, our experience in deploying Expeditionary Medical Facility (EMF)-Mike has taught us the value of smaller, rapid deployable units of highly skilled medical providers. This week 72 individuals attached to NMRTC Pensacola’s EMF-Lima (L) were sent to Texas as part of the newly established component platforms, the Acute Care Team (ACT) and Rapid Rural Response Teams (RRRT). The ACT is a 44-person team designed to support urban hospitals and RRRT’s are 7-person teams tailored to support patient surges. These Navy Medicine professionals are working on the front lines with the Federal Emergency Management Agency (FEMA) and local officials to serve as a relief valve for local hospital systems overburdened with COVID-19 cases. Rapidly and without hesitation they have selflessly stepped into the line of fire with local medical professionals to care for fellow Americans stricken by this relentless virus. In the coming weeks, we expect to provide additional aid to areas deeply impacted by the pandemic. Bravo Zulu to all who have and will answer this call. We are proud to call you our shipmates.

As our nation faces this generational crisis, it is OUR team that has been called to the bridge and I have never been more confident that the ship is in the best hands possible. Everyone who has stepped out of their comfort zone to respond to the pandemic understands the meaning of the quote: “a ship in a harbor is safe but that is not what ships are designed for”. Thank you for courageously sailing away from your personal safe harbor to strengthen our response to COVID-19.

You are making a positive difference in a world that has never needed you more.

SG

Bruce L. Gillingham, MD, CPE, FAOA

RADM, MC, USN

Surgeon General, U.S. Navy

Chief, Bureau of Medicine and Surgery

MOAA – NDAA Update: Where We’ve Been, Where We Are, and What’s Next

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Here’s a link to the article:

NDAA Update: Where We’ve Been, Where We Are, and What’s Next

Here’s the portion about military medicine:

Military Health Care

Despite the success of MOAA’s Virtual Storming the Hill, efforts to include a halt to military medical end strength cuts and the realignment of military treatment facilities (MTFs) in the NDAA remain at risk. While the House version has language supporting these provisions, the Senate version does not.

MOAA is pivoting its focus to the Senate to ensure the House provisions make it through conference. Contact your senator today to express your support for the House provisions.

Even though the Defense Health Agency has announced a delay to all MTF restructuring and billet cuts, we believe legislation is needed to not only slow the process but also bolster reporting requirements and oversight mechanisms at every possible juncture to ensure DHA conducts qualified analysis and planning for any patient care moved out of MTFs.