Mission

The NCC PM&R Residency Program strives to provide training along a broad scope, ultimately producing military leaders in the field of rehabilitative medicine. Through partnerships with National Rehabilitation/ Georgetown, Sinai Hospital in Baltimore, INOVA Mt. Vernon in Fairfax, Children’s Hospital in D.C. and several other sites our residents receive training in a broad range of settings and patient populations.

Vision

To cultivate the future leaders of world-class rehabilitative care in the Military Health System via recruitment, retention, and cutting-edge research required to optimize operational readiness and restore function to the fighting force.

Aims

• Produce stellar Medical Corps Officers capable of providing exceptional Physiatric care to all military beneficiaries.
• Train individuals for expertise in the entire spectrum of PM&R with an emphasis on military-relevant capabilities to include but not limited to:
  • Combat Casualty Rehabilitation
  • Musculoskeletal Medicine to include Regenerative/ Orthobiologics
  • Traumatic Brain Injury (TBI)
  • Limb Loss Care and functional restoration
  • Point of Care Ultrasound
  • Pain Management with a focus on interventions/ non-pharmacologic approaches
  • Electrodiagnostic Medicine

All residents participate in weekly didactics for at least three hours on Wednesdays regardless of rotation. In addition, there are rotation-specific didactics that range from an additional 1-3 hours weekly. For instance, Electrodiagnostics has up to three hours weekly of protected didactic time. Outpatient clinic has at least two hours of didactics to include one hour weekly musculoskeletal Ultrasound training with expert faculty. Our program has weekly TBI didactics and monthly Peripheral Nerve Clinic educational sessions. In addition, we have quarterly State of the Science symposia with the University of Pittsburgh (Human Engineering Research Lab), annual Orthobiologic training with Sports Medicine, and a multitude of other learning opportunities.

• Outpatient clinics: General PM&R, MSK Ultrasound, TBI, Amputee - 6 months
• Interventional Pain Management - 1 month
• Inpatient Amputee Rehabilitation - 2 to 3 months
• Rheumatology - 1 month
• Sports: Naval Academy; Private outpatient Orthopedic Sports practice; Georgetown; Orthopedic Hand - 1 month
• Radiology: Musculoskeletal and Neuroradiology - 1 month
• Spinal Cord Injury: NRH - 3 months
• Stroke: INOVA Mt Vernon, Sinai  - 3-4 months
• Joint Replacement: Sinai - 1 month
• TBI: NRH - 3 months
• Electromyography - 6 months
• Elective - 1 month

All rotations at WRNMMC unless otherwise indicated.

Established agreements provide additional experiences in research, Pain, Sports, and Neuromuscular Medicine but elective rotations can be pursued in any area of PM&R.

In-house call is performed at NRH and Sinai while home-call is taken at Walter Reed.

The training program draws from a faculty and military community full of diverse experiences and backgrounds. PM&R topics such as function, impairment, and disability are synchronized with our mission of maintaining the fighting strength. Unique clinical experiences such Combat Casualty Rehabilitation, Amputee Care (Military Advanced Training Center), TBI (National Intrepid Center of Excellence), and the Peripheral Nerve Clinic (only such service in the MHS) ensure the highest level of care for our beneficiaries and training of our future Physiatrists.

Our simulation curriculum varies by year but has included hands-on Ultrasound (such as musculoskeletal and E-FAST). Opportunities to educate medical students during their musculoskeletal modules via the simulation center as well. We provide annual Mock Oral examinations for board preparation.

Professional Officer Development is provided during didactic training. Additionally, courses are available via the NCC such the Chief Resident and Transition to Practice courses.

Opportunities are robust and include integrated faculty and working relationships with MIRROR (Musculoskeletal Injury Rehabilitation Research for Operational Readiness) and CRSR (Centers for Rehabilitation Science and Research). Clinic coverage on Wednesday morning rotates, leaving dedicated time for research and mentorship. Additional time for research can be allocated during electives and clinical rotations on a case-by-case basis. While scholarly activity is required during residency, this can vary from an abstract presentation at a conference to peer-reviewed publications depending upon the goals of the trainee.

Quality Improvement projects are performed at a group level to ensure all trainees have exposure to this critical area. In addition, didactic time is dedicated to understanding the basics of Quality Improvement (QI) / Process Improvement (PI). Trainees have the opportunity to become more involved in a QI project, which can subsequently count towards future American Board of PMR certification (this is a staff requirement but can be completed during residency).

Trainees meet with teaching faculty mentors at least twice per year, but often more frequently. Mentorship is tailored towards the goals of the residents and includes research, leadership, and clinical skills development.

• Walter Reed National Military Medical Center
• U.S. Naval Academy
• Private Outpatient Orthopaedic Sports Medicine Practice
• National Rehabilitation Hospital
• INOVA Mt. Vernon
• Mount Sinai

Our program offers rotations to residents interested in applying to PM&R. Rotations are typically four weeks (one block) long and include clinic, procedures, and didactic opportunities. Students interested in rotating with our program should contact dha.ncr.walter-reed-med-ctr.list.ncc-pmr@health.mil.

Most medical students interview with faculty including the Program Director during their MS4 rotation, but virtual interviews can be arranged as needed. Most applicants for the PGY-2 positions interview with the Program Director and Specialty leader, but this guidance may vary based upon the selection board. In-person and virtual interviews are equally weighted as per Joint GME Selection Board guidelines.

The majority of program graduates take the American Board of PMR (ABPMR) or American Osteopathic College of Physical Medicine and Rehabilitation (AOCPMR). This exam is offered annually. To become fully board certified, applicants are eligible to take board certification exam following graduation (ABPMR Part I is typically administered in August following graduation). To be eligible to take specialty board exams, graduates must complete all pre-requisites required by the ABPMR by August (exact date may vary).

USUHS offers teaching opportunities (resident education of medical students) throughout the academic year, to include Ultrasound, Musculoskeletal Medicine, Pain Medicine, and ethics. Residents have the opportunity to educate their colleagues and junior resident during the academic year. It is common for motivated residents to serve as teaching faculty at both local and national conference workshops.

We strive to support any additional opportunities identified outside of the residency.

• Sports Medicine
• Pain Medicine
• Brain Injury Medicine
• Amputee Care
• Electrodiagnostic Medicine
• Musculoskeletal Ultrasound

As above, residents meet with teaching faculty regularly for mentorship. In addition, there are Specialty Leaders for each service as well as other military faculty that provide mentorship on a regular basis.

We have an established resident wellness retreat as well as regular social events organized by our Chief resident and wellness/ social chairs. Our curriculum includes topics such as finance, nutrition, and physical fitness. There is dedicated time on Wednesdays to ensure residents have time to take care of themselves and their families.