GME

Recording of MC Symposium Session Discussing GME and OMO

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Here’s a link to the video recording of this session:

Rescheduled Operational Medical Officer and GME Q&A Session – Friday at Noon Eastern

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The GME and OMO talk has now been rescheduled for 23 July at 1200 EST.  Please join us virtually at https://conference.apps.mil/webconf/uqg4sfys0bjzowjeyd9ir3ho0wrtuvn3 to have your questions answered regarding the new OMO instruction and GME Note that was just released.

The session will be recorded for asynchronous viewing and that link will be available following the session.  Please direct any questions to LCDR Jennifer Eng-Kulawy in the Corps Chief’s Office (contact in the global).

Tips to Get Selected for GME – A 2021 Update

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With the recent release of the 2021 GME note, I’d like to re-post an updated version of this post. I’ve participated in the last seven GME selection boards and would like to offer tips for people looking to match for GME in the future.  We’ll cover general tips and those specific for medical students and those returning from an operational tour:

General Tips

  • You can increase your score by having publications.  If you want to give yourself the best chance of maximizing your score, you need multiple peer-reviewed publications.  Any publications or scholarly activity have the chance to get you points, but having multiple peer-reviewed publications is the goal you should be trying to reach.
  • Be realistic about your chances of matching.  If you are applying to a competitive specialty and you’ve failed a board exam or had to repeat a year in medical school, you are probably not going to match in that specialty.  There are some specialties where you can overcome a major blight on your record, but there are some where you can’t.  If this is applicable to you, the residency director or specialty leader should be able to give you some idea of your chances.  Will they be honest and direct with you?  I’m not sure, but it can’t hurt to ask.
  • If you are having trouble matching in the Navy for GME, you may have a better chance as a civilian.  By the time you pay back your commitment to the Navy, you are a wiser, more mature applicant that some civilian residency programs might prefer over an inexperienced medical student.  You’ll also find some fairly patriotic residency programs, usually with faculty who are prior military, that may take you despite your academic struggles.

Tips for Medical Students

  • Do everything you can to do a rotation with the GME program you want to match at.  You want them to know who you are.
  • We have started our transition to straight-through GME, so you’ll notice that most specialties are considering applications from medical students for straight-through GME.  If you don’t want to do straight-through and only want to apply for internship, you can opt out on MODS.
  • When you are applying, make sure your 2nd choice is not a popular internship (Emergency Medicine, Orthopedics, etc.).  If you don’t match in your 1st choice and your 2nd choice is a popular internship, then it will likely have filled during the initial match.  This means you get put in the “intern scramble” and you’ll likely wind up in an internship you didn’t even list on your application.
  • Your backup plan if you don’t match should be an alternative program at the same site where you eventually want to match for residency.  For example, in my specialty (Emergency Medicine or EM) we only have residencies at NMCP and NMCSD.  If someone doesn’t match for an EM internship at NMCP or NMCSD, they will have a better chance of eventually matching for EM residency if they do an internship locally, like a transitional internship.  Internships at Walter Reed or any other hospital without an EM program are quality programs, but it is much easier to pledge the fraternity if you are physically present and can get to know people, attending conferences and journal clubs when you can.
  • You need to think about what you will do in your worst-case scenario, a 1-year civilian deferment for internship.  Many of the medical students I have interviewed did not have a plan if they got a 1-year deferment.  I think every medical student needs to pick a few civilian transitional year internships (or whatever internship they want) and apply to those just in case they get a 1-year deferment.  Per the BUMED note, this is required.  Most medical students do not grasp the concept that this could happen to them and have no plan to deal with it if it does.  It is an unlikely event, especially if you are a strong applicant, but it is something you need to think through.
  • Similarly, if your first choice specialty is offering civilian NADDS deferments, you need to apply to civilian residency programs.  This is also required, per the BUMED note.  You don’t want to find out that you were given a NADDS deferment but you didn’t apply for civilian residency programs.  This happens to people all the time.  Don’t be that student.

Tips for Applicants Returning from Operational Tours

  • You should show up whenever you can for conferences and journal clubs.  Again, you want them to know who you are and by attending these events when you can you demonstrate your commitment to the specialty and their program.
  • Always get a warfare device (if one is available) during your operational tour.  Not having it is a red flag.
  • Closely examine the GME note and by-site goals.  You’ll see that some specialties are offering full-time outservice (FTOS) or civilian deferment (RAD-to-NADDS).  If you are in one of these specialties, you need to consider applying for civilian residency programs.  If you are unsure, you should probably talk to the specialty leader for whatever specialty you are applying for.

Graduate Medical Education Note/Goals and Operational Community Info

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Here is the GME BUMED Note as well as the by site selection goals. Please disseminate far and wide!

Most importantly, just because there is not an initial training goal does not mean people should not apply. If an applicant wants to do something not on the initial goals, they should still apply. The world in March when we started this plan will be different than the one in November when we execute it.

Note that this is the beginning of our 5-year march to straight-through GME as most specialties will be offering some straight-through training opportunities to medical students.

Also, because medical students will be deciding whether or not they want to apply for straight-through training vs doing an internship and then an operational tour, we created this PDF guide to the various operational communities:

This content will eventually be on a public facing website, but that process has been slower than we’d like, so the PDF will serve as a bridge until the site is ready.

Tomorrow’s OMO/GME Talk Postponed Until GME Note Signed

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Unfortunately due to a delay in the release of the GME Note, we will have to reschedule the OMO/GME talk scheduled for tomorrow.  Information regarding the new date and time will be emailed out and posted to social media as soon as the GME Note is released.  Stay tuned for more information soon, and sorry about the delay, which we hope will be resolved very soon.

July’s Medical Corps Symposium Lecture – Operational Medical Officer and GME Q & A Session

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The next lecture series for the 2021 Continuous Medical Corps Symposium will be with CAPT Joel Schofer and CAPT William Beckman on the new Operational Medical Officer Instruction and Graduate Medical Education. There will be a short presentation followed by a question/answer session to try to answer questions regarding this new instruction and what to expect from GME.  Please join us on Friday 09 July at 1200 EST, https://conference.apps.mil/webconf/uqg4sfys0bjzowjeyd9ir3ho0wrtuvn3  

Please widely disseminate to your communities and if you have any questions, please feel free to contact me (contact in the global).

Very Respectfully,

Jennifer Eng-Kulawy, MD, FAAP

LCDR, MC, USN

Plans and Policy Officer

Office of the Medical Corps Chief

Throwback Thursday Classic Post – Authorship and Academic Careers in the Navy

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I recently gave a talk to the Emergency Medicine residents at NMC Portsmouth about authorship and academic careers in the Navy. Here is the outline of the talk and some tips…

Academic Career Options

There are a number of options for those who are interested in establishing an academic career in Navy Medicine. Here are the ones I know of:

  • Residency programs at a medical center – Serving as teaching faculty at a residency program at Walter Reed, San Diego, or Portsmouth.
  • Family Medicine (FM) teaching hospitals – Serving as faculty at the FM residency programs in Ft. Belvoir, Lejeune, Camp Pendleton, and Jacksonville. This opportunity is not just for FM physicians, but for Internists, Pediatricians, subspecialists, etc. as the FM programs need all of those people to support the education of their residents.
  • Japanese internships – Both Yokosuka and Okinawa have internships that are structured like Transitional Internships and allow Japanese physicians to learn how American medicine is conducted. Most graduates try to obtain letters of recommendation and apply for graduate medical education (GME) in the US. Taking a leadership role in these programs can prepare you to lead GME programs when you PCS back to the US.
  • Transitional internship programs – Leadership opportunities in Transitional Internships are open to just about every specialty, and many physicians have used Transitional Internship Program Director as the stepping stone to O6.
  • Uniformed Services University of the Health Sciences (USUHS) billets – Many specialties have billets at USUHS that allow you to take a leadership role in the departments and teach medical students.

Authorship Options

The opportunities to publish have increased dramatically during my 20 year career. For example, you’re reading this blog and that didn’t exist when I started. Here are the opportunities to publish that currently exist with some tips listed after each:

  • Apps – This is the only thing on this list I haven’t tried, but there are articles that explain how to do it and tell stories of physicians who made money doing it.
  • Blogs – This isn’t hard to do, so there’s nothing but time and effort preventing you from putting your opinion out there for others to read. Don’t underestimate how much time this takes, though, so know what you are getting into. I have literally spent thousands of hours on this blog.
  • Books and book chapters – I’ve published 4 books (you can see 3 of them on Amazon here) by working with my specialty society, so that is one opportunity to pursue when it comes to books. The easiest way to start writing books chapters is to find someone you know that is senior to you who already writes chapters and offer to be a co-author for the next edition. If you go to your department head/chair or residency director, they should be able to tell you who writes book chapters in the department.
  • Case reports – This is the entry path to publishing and where I made most of my initial academic bones. Frankly, publishing case reports gotten me a lot of my academic reputation, fitrep impact in block 41, and subsequent promotion to O4 and O5. Nowadays, there are a lot of journals and it is easier than ever to get something accepted, especially if you are open to publishing cases on blogs or in newsletters.
  • Humanities – Many journals regularly publish 1-2 page articles about the experience of being a physician, ethics, military medicine, and other related topics. A common way to get one of these published would be to deploy and then write a humanities piece while deployed or upon returning about your experience.
  • Newsletters – I wrote a personal finance column in one of our specialty society newsletters for 7 years. If you can get a regular gig like this, it will force you to write on a regular basis and really build your CV and academic reputation. Every specialty has newsletters and “throw away” journals that arrive in the mail. Contact the editors, offer to write something, and see if this is something you enjoy.
  • Podcasts – Similar to blogs, this is fairly easy to do with some free software (Audacity), a $50 USB microphone headset, a podcast host (I host on this blog’s WordPress site but here are other hosts out there), and the time to figure out how to post your content on the Apple store. Like blogging, it is very time consuming. Personally, it is not my favorite thing to do (which is why my podcast has lagged way behind) because I have zero interest in learning how to properly edit recordings, but there is nothing preventing you from getting your voice out there.
  • Research manuscripts – If you want to do research, you should start with the Institutional Review Board (IRB) that your command is subject to. There will be resources available to help you, but in my experience it is a pull system (you have to inquire and go get them) and they are not pushed to you. Typically, you’ll find grant writers, statisticians, and sources of money to do research. You’ll also find additional military rules and regulations heaped on top of all of the already existing IRB rules and regulations. This latter fact is what dissuaded me from doing a lot of research in my academic career.
  • Review articles – Most journals solicit authors to write review articles, so it is hard to get one accepted if it is unsolicited. That said, if you shorten it a bit by focusing on a more narrow topic and build it around a case presentation, you can get them accepted as case reports.

How to Build Your Academic Career in the Navy

What is the easiest way to build an academic career? It is simple but not easy. Not that many people follow through on it. Here are the steps:

  1. Obtain a USUHS faculty appointment – This blog post tells you how to do it.
  2. Progress toward promotion

This 2nd step is the step that most people fail to follow through on. They get appointed as an Assistant Professor, and then they stop working toward promotion to Associate Professor or full Professor.

In general, an Assistant Professor is a local/regional expert, an Associate Professor has established themself as a regional/national expert, and a full Professor has reached national or international acclaim. If you touch base with your USUHS department once a year and get their assessment about what steps you need to take to get promoted, you will be forcing yourself to progress in your academic career.

For example, I’m an Associate Professor of Military & Emergency Medicine and recently applied to be a full Professor. The feedback I was given was that I needed 3-4 more peer-reviewed publications as the first author. I may or may not choose to try and get them, but at least they gave me an honest assessment of what I needed to do. If you do this annually, you’ll get actionable feedback that you can address as you build your academic chops.

8 Minute Q&A Session with the Medical Corps Chief

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Watch the 8 minute video below to get RDML Hancock’s take on advice for a high school senior interested in Navy Medicine, billet divestitures, moonlighting while on TAD instead of leave, the definition of “critical wartime specialties,” straight-through GME training, and NDAA 2022.

NCC Pediatrics Residency Program Director

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Nominations are due to CAPT Anthony Keller (contact in the global) NLT 8 March 2021.  See the announcement and ACGME requirements for details:

NCC Child and Adolescent Psychiatry Fellowship Program Director

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Here is the announcement:

Here are the ACGME requirements:

Nominations are due to CAPT Anthony Keller (contact in the global) NLT 19 March 2021.