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Army Medical Education

Army Medical Education. Christine F. Lettieri, MD LTC (P), MC Deputy Director, Medical Education April 2014. Army Health Professions Scholarship Program. 152 medical schools ~280 graduates annually Provides 80% of active duty physicians Commissioned as 2LT in US Army Reserve (IRR)

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Army Medical Education

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  1. Army Medical Education Christine F. Lettieri, MD LTC (P), MC Deputy Director, Medical Education April 2014

  2. Army Health Professions Scholarship Program • 152 medical schools • ~280 graduates annually • Provides 80% of active duty physicians • Commissioned as 2LT in US Army Reserve (IRR) • 100% tuition paid • Required books and fees paid • Monthly stipend ($2,157/month) for 10.5 months each year • Military pay (about $6000) annually for 45 days Active Duty Training • Obligation is 1 year on active duty for each year of sponsorship in HPSP (2 years minimum) or 4 years if one opts to take Critical Skills Accession Bonus

  3. Army Graduate Medical Education • Largest program in the military: 1458 physicians • 1341 training in in-house programs; 117 in Army-sponsored civilian training; 28in educational delay • All Specialties • 10 training hospitals • 23 primary specialties; 70 residencies; 70 fellowships • Majority of Army physicians train in Army GME programs • 29-33% of active duty Medical Corps officers are in GME at any given time • All programs accredited by Accreditation Council for Graduate Medical Education • Average GME program cycle length > 6 years under NAS • No programs on probation • 94.4% first time board pass rate (civilian 85-89%)

  4. Medical Research • In addition to clinical research ongoing in our teaching hospitals, the Army conducts medical research at the following: • The U.S. Army Aeromedical Research Laboratory (USAARL), Fort Rucker, Alabama • U.S. Army Institute of Surgical Research (USAISR), Fort Sam Houston, Texas • U.S. Army Medical Research Institute of Chemical Defense (USAMRICD), Aberdeen Proving Ground, Maryland • U.S. Army Medical Research Institute of Infectious Diseases (USAMRIID), Fort Detrick, Maryland • U.S. Army Research Institute of Environmental Medicine (USARIEM), Natick, Massachusetts • Walter Reed Army Institute of Research (WRAIR), Forest Glen, Maryland • U.S. Army Dental Research Detachment • U.S. Army Medical Research Detachment • Armed Forces Research Institute of Medical Sciences-Thailand (AFRIMS) • U.S Army Medical Research Unit- Europe • U.S Army Medical Research Unit- Kenya

  5. Regional Medical CommandsTeaching Hospitals Walter Reed NMMC Womack AMC Ft. Belvoir Community Hospital Keller ACH (West Point) Eisenhower AMC Martin ACH Carl R. Darnall AMC Brooke AMC William Beaumont AMC Madigan AMC Tripler AMC

  6. Internal Medicine Family Medicine Emergency Medicine Pediatrics Obstetrics/Gynecology General Surgery Neurosurgery Orthopaedics Urology Otolaryngology Preventive Medicine*/ Occupational Medicine* Dermatology Radiology Radiation Oncology* Anesthesiology Aerospace Medicine* Neurology and Child Neurology Pathology Psychiatry Physical Medicine and Rehabilitation Ophthalmology Residencies * Specialty does not offer continuous contract; must reapply for PGY-2 year.

  7. ARMY FIRST YEAR GRADUATE MEDICAL EDUCATION: PGY-1 Programs for the 2014 Selection Board

  8. Active Duty for Training (ADTs) • Training programs located on website • 1st year - Basic Officer Leader Course (BOLC). If unable to attend then, need to complete before medical school graduation; BOLC should be completed prior to any clinical rotations • 2nd year - School ADT or rotation at Army community hospital • 3rd and 4th years - Clinical rotations at Army hospitals • Any year - Research rotation at Walter Reed Army Institute of Research, Institute of Surgical Research, Armed Forces Institute of Pathology, Uniformed Services University • Expectation to pass USMLE/COMLEX Parts I and II and CS/PE and attend BOLC prior to graduation

  9. Deadlines • USMLE Step 1/COMLEX Level 1 • Score due to HPSP office by September 15 • USMLE Step 2 CK/COMLEX Level 2 CE and ERAS application • Score and ERAS application due October 15 of 4th year • Step 2 CS/Level 2 PE • Result due February 15

  10. First Year Graduate Medical Education • Mandatory application/participation • All participants must apply for training in military residency programs. • GME beyond FYGME will always be in military programs or sponsored training (on active duty) in civilian programs. • Civilian deferral and participation in the NRMP will be limited and only if authorized by GME office to fill additional training requirements. • FYGME Letter of Instruction (LOI) and Fact Sheet released to 4th year students in July • Application via ERAS and HPSP/FYGME website: ***Potential for change this year with all applications done on Army Medical Education website- see LOI to confirm. • Army Match – computerized match similar to NRMP • Students declare specialty and rank all Armyprograms in that specialty • All programs will see all applicants who have identified them as a specialty of choice and will rank all applicants on their order of merit lists (OMLs). Programs are blinded to students’ rankings of programs. • Computer sorts and matches using student’s priority and program’s OML • Applicants not matching to their specialty of choice match to a transitional year position. Some unfilled positions may be available at post-match rebuttal board. • Class of 2014: 85% of applicants selected for desired specialty • Active duty service obligation/completion date may change depending on length of residency

  11. Emergency Medicine Family Medicine General Surgery Internal Medicine Neurology Neurosurgery OB-GYN Orthopaedics Otolaryngology Pathology Pediatrics Prelim Anesthesiology Prelim Dermatology Prelim Ophthalmology Prelim PM&R Prelim Radiation Oncology Prelim Radiology Psychiatry Urology PGY-1 Categorical Specialties

  12. Applications For PGY-1 Positions:Applicants Per Approved Positions

  13. Applications For PGY-1 Positions: Applicants Per Approved Positions (continued)

  14. Board Scores for Matched HPSP/USUHS Students(class of 2014)

  15. Board Scores for Matched HPSP/USUHS Students(class of 2014)

  16. Board Scores for Matched HPSP/USUHS Students(class of 2014)

  17. VA-DoD Training Opportunities • Intern year in Army program • Remainder of residency in VA-sponsored program • Radiology – Georgia Health Sciences University; UT San Antonio • Urology – UT San Antonio; Duke University • Neurosurgery* – University of Florida; UT San Antonio *Entirety of training in VA-sponsored program

  18. 2014 Army GMESB Selection Summary Report Fellowship Training Senior residents applying for fellowships do almost as well getting selected as staff physicians.

  19. FYGME RESIDENCY FELLOWSHIP Medical Corps Officer Career Progression YEARS 0 30 6 18 12 CPT MAJ COL LTC Rank BASIC CRS CPT CAREER CRS INTERMEDIATE LEVEL ED SENIOR SVC. COLLEGE Professional Military Education CBRNE, SHORT COURSES Additional Training EXECUTIVE SKILLS COURSE ADV. TRAUMA MANAGEMENT, ADV. TRAUMA LIFE SUPPORT, COMBAT CASUALTY MGT MPH MBA TWI ADVANCED SCIENCE DEGREE DEVELOPMENTAL & UTILIZATION ASSIGNMENTS Corps/MACOM Surgeon Commander Joint Assignments DCCS MECEN Staff Deputy Chief Dir Med Ed USUHS Faculty Department Chair Research Area Dir. BN/BDE/DIV Surgeon MEDCOM Staff DCCS MEDCEN Staff MEDDAC Staff Residency Director Product Line Mgr Division Chief Clinician Successful Completion of Fellowship TOE/TDA Physician Company Commander Clinic OIC Teaching Staff Research Assistant Clinician Successful Completion of Internship and Residency Utilization Tour Clinician Typical Assignments Self Development Continuing Medical Education / Board Recertification License by yr. 2 Board Certification Subspecialty Board Certification

  20. Army Medicine Serving the nation since 1775 China 1944 44th MASH, Korea 1954 Radiology residents 1968 Serving to Heal…Honored to Serve

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