Mission

The current NCC CCM Fellowship program aims to provide an outstanding clinical and educational experience in all aspects of critical care – to include but not limited to specialized critical care. Our mission is to produce clinical and academic leaders in our field with the goal of optimizing care for DOD beneficiaries.

Vision

Our goal is to develop you as a Physician and an Officer to best fit your career goals. If you are interested in Clinical Practice, Operational Medicine, Teaching/Academic Leadership, Command Leadership, Advanced Bronchoscopy or Research we will set you up with the mentors and connections in the Maryland/Virginia/DC area to achieve your long term career goals.

Aims

The NCC Critical Care fellowship aims to educate and mentor military physicians who will treat conditions of the respiratory system, especially of the lungs for military personnel, veterans and their dependents in an empathetic, intelligent and efficacious manner.

Our program participates in combined regional academics with our eight fellowship partners (to include John’s Hopkin’s, National Institute of Health, Georgetown University, University of Maryland and more). We start with a one month program of combined academics with the fellows from other programs to include ventilation lab, ultrasound simulation, intubation and chest tube practice to ensure that all fellows start their training with a baseline clinical and procedural skill level. We then move to weekly academics with 1-2 lectures given by a regional expert to all fellows in the DC Area in addition to a traditional case based lecture series.

13 four week blocks a year with a focus on critical care. The first year focuses on development and refinement of basic critical care skills and medicine, with the second year continuing to hone that skill set, while adding specialty care such as trauma, burn, ECMO, neuro, and other critical care subspecialities. Overall, our goal is 16-18 clinical critical care blocks over the two year program.

• Neuro, Cardiac, Burn, ECMO critical care specialties
• Interventional Pulmonary: Inova Fairfax
• Cardiac ICU: Inova Fairfax, Washington Hospital Center
• Trauma Airway Month: Baltimore Shock Trauma
• ECMO: Inova Fairfax, Washington Hospital Center
• Burn Center: Inova Fairfax
• Academic Teaching: Uniformed Services University of Health Sciences
• Executive Leadership: Walter Reed National Military Medical Center
• Research: Walter Reed National Military Medical Center

No call when not on a rotation, with all rotations honed to maximize learning. Since you have a supervisory role as a fellow and don’t write clinical notes, your inpatient call becomes very predictable shift work.

We have a Quarterly Officer Development Lecture series where we discuss clinical topics such as low-resource medicine or field trauma response exercises but also discuss non-clinical topics such as how to Set-up/Lead a Bronchoscopy suite or ICU. We also have an Executive Medicine Rotation for those interested in command leadership opportunities. Currently, Core Faculty include Walter Reed’s Medical Director for Healthcare Operations, Deputy Director for Medical Services, Chief of Medicine and Assistant Chief of Medicine.

Required Courses during the first year of fellowship include: 

• July: Summer Education Block (combined fellowship training as mentioned above)  
• August: Clinical Introduction to Walter Reed
• January: Winter Education Block

We have a two floor simulation center at Walter Reed and have access to a Ventilator Lab, Bronchoscopy and advanced Bronchoscopy simulators, Point of Care Ultrasound and Echocardiogram Simulations, and all Chest tube and Line set ups. We partake in monthly simulated patients for POCUS practice with two ARDMS Board Certified Ultrasound Pulmonologists. We also simulated complex clinical scenarios to include battlefield trauma quarterly.

We have a Quarterly Officer Development Lecture series where we discuss clinical topics such as low-resource medicine or field trauma response exercises but also discuss non-clinical topics such as how to Set-up/Lead an ICU. We also have an Executive Medicine Rotation for those interested in command leadership opportunities. Currently, Core Faculty include Walter Reed’s Medical Director for Healthcare Operations, Deputy Director for Medical Services, Chief of Medicine and Assistant Chief of Medicine.

We partner our Research Efforts with Dr. Steven Nathan at Inova Fairfax’s Advanced Lung Disease clinic and with the National Institute of Health Sciences. There are 4 Full Professors of Medicine and 6 Associate Professors of Medicine on the core faculty staff at Walter Reed. Although many fellows have had numerous publications upon graduation, requirements for graduation is one abstract presented at a National Conference (CHEST or ATS).

There is ample opportunity for quality improvement projects at Walter Reed both in the clinical and academic settings. Currently, the Chief Fellows have an ongoing Internal Medicine Rotation curriculum which they are using for all visiting GME.

We have a Quarterly Officer Development Lecture series where we discuss clinical topics such as low-resource medicine or field trauma response exercises but also discuss non-clinical topics such as how to Set-up/Lead a Bronchoscopy suite or ICU. We also have an Executive Medicine Rotation for those interested in command leadership opportunities. Currently, Core Faculty include Walter Reed’s Medical Director for Healthcare Operations, Deputy Director for Medical Services, Chief of Medicine and Assistant Chief of Medicine.

• Walter Reed National Military Medical Center
• National Institute of Health Sciences University of Maryland
• Baltimore Shock Trauma
• Georgetown University Medical Center
• Inova Fairfax
• Washington Hospital Center
• Suburban Medical Center

Medical Students

Medical students can rotate though the MICU, Inpatient consults service, and outpatient clinics as part of their sub-I rotations or as part of their core curriculum blocks. Medical students are given a comprehensive experience with patient encounters, bedside education, participating in our academic sessions, and informal didactics from one of our academic faculty members. Medical students are encouraged to participate in patient care and are often given opportunities to learn advanced pulmonary procedures to include bronchoscopy, chest tubes, vascular access, and thoracentesis. To schedule a rotation contact: dha.bethesda.Walter-Reed-Med-Ctr.mbx.gmerequests@health.mil

Residents

Residents rotate through the medical ICU as part of their core rotations and can rotate through the inpatient service as an elective. On the inpatient service, residents assist with the busy inpatient service and often perform pulmonary specific procedures to include thoracentesis, chest tube, intrapleural catheters, and bronchoscopy. Residents are considered an integral part of the inpatient service and are exposed to a wide variety of pulmonary diseases, procedures, and education.

Be yourself! Before interviewing for any position you should reflect on your career and life goals and decide what you want from a clinical and military perspective.

Program graduates take the American Board of Medicine Critical Care Medicine exam. This exam is offered annually. To become fully board certified, applicants are eligible to take board certification exam three months following graduation. To be eligible to take specialty board exams, graduates must complete all pre-requisites required by the Pulmonary and Critical Care Medicine by September 30th.

Fellows have the opportunity to formally teach medical students, residents and Physician and Nursing staff. Our fellows participate in the USUHS medical school pre-clinical teaching Cardio Pulmonary Renal block, to include helping with small groups, lectures and testing. Our fellows serve as procedural and ICU experts in training evolutions for incoming Interns, IM residents, deploying staff, and COVID-19 training modules. Our fellows also serve as faculty for the Limited Resource and Fundamentals of Critical Care Science faculty courses.

We utilize a Formal Mentorship program pairing fellows with like minded mentors designed around four career tracks:

1. Clinical/Interventional Pulmonary
2. Academic Leadership/GME
3. Command Leadership
4. Operational

Weekly Pickleball tournament after academics, Quarterly Program Parties, Monthly Outside of Hospital Journal Club.