National Capital Consortium Program

Program Overview and Philosophy

The National Capital Consortium Internal Medicine/Psychiatry Residency Program offers a distinctive and rigorous training experience at the Walter Reed National Military Medical Center in Bethesda, MD. This five-year residency program, accredited by the Accreditation Council for Graduate Medical Education (ACGME), is specifically designed to prepare residents to become board-certified in both internal medicine and psychiatry. It uniquely serves as the sole program of its type within the Department of Defense, highlighting its importance in developing skilled physicians adept at managing a wide range of health conditions in military settings.1 The program aims to provide comprehensive training that integrates the principles of internal medicine with the insights of psychiatry, resulting in well-rounded physicians equipped to address the multifaceted needs of their patients.

Curriculum and Rotations

The program's curriculum is thoughtfully structured over five years, offering a balance between internal medicine and psychiatry disciplines.1 Residents undertake rotations in various high-volume, high-acuity settings that include both inpatient and outpatient environments. Key rotation sites include the DC Veterans' Affairs Medical Center, Washington Hospital Center, and Children's National Medical Center.1

Internal Medicine Rotations

• Ward Medicine: Residents manage a spectrum of acute medical conditions, gaining firsthand experience in patient care dynamics.1
• Medical Intensive Care Unit (MICU): Training in critical care management and emergency interventions.
• Inpatient Cardiology: Focused on the diagnosis and treatment of cardiovascular diseases.
• Night Float: Emphasizes continuity of care and acute management skills during overnight hospital coverage.

Psychiatry Rotations

• Inpatient and Outpatient Psychiatry: Comprehensive exposure to mental health care, covering diagnosis, patient management, and therapeutic interventions.
• Emergency Psychiatry Consultations: Training on immediate assessment and treatment planning for psychiatric emergencies.

The scheduling format for internal medicine rotations involves a six-day workweek followed by one day off, while psychiatry rotations typically encompass a five-day workweek with two days off, ensuring ample rotation-specific learning alongside rest and recuperation.1

Training Sites and Facilities

Residents gain hands-on experience at several key institutions, ensuring exposure to diverse patient populations and a breadth of clinical conditions. Training takes place at:

• Walter Reed National Military Medical Center: The primary site, offering a comprehensive mix of medical and psychiatric care services.1,3
• DC Veterans' Affairs Medical Center: High-volume facility focusing on veterans' healthcare.
• Washington Hospital Center and Virginia Hospital Center: Facilities that bridge civilian and military healthcare environments.
• INOVA Fairfax and Northern Virginia Mental Health Institute: Key partners in achieving diverse psychiatric experience.
• Children's National Medical Center: Provides pediatric rotations in both medicine and psychiatry.

The consortium fosters an environment rich in scholarly activities, enhanced by affiliations with prominent research institutions.1

Research Opportunities

Research constitutes a pivotal aspect of the residency experience, with residents encouraged to engage in a variety of scholarly activities. Opportunities are provided at the Walter Reed Army Institute of Research, the Uniformed Services University of the Health Sciences, and the National Intrepid Center of Excellence. Areas of research include:

• Curriculum Development: Engaging in the creation and refinement of educational content.
• Case Reports and Book Chapters: Contributing to academic literature.
• Quality Improvement Projects: Initiatives aimed at enhancing patient care and clinical practices.
• Clinical Research: Opportunities to participate in studies that may have significant implications for both military and civilian medical practices.1

Unique Program Features

The program integrates military-specific curricula, allowing residents to enhance their skills beyond traditional medical education. Opportunities are available for participation in military schools such as Air Assault and Airborne courses.1 Additionally, residents partake in the Advanced Trauma Life Support and Combat Casualty Care Course, crucial for developing military decision-making and leadership capabilities.

Resident Wellness and Support

Resident wellness is strategically supported through initiatives focusing on workload management, recognition, and fairness. This includes:

• Recognition Through Military Awards: Encouraging and acknowledging outstanding performance.
• Social Events and Fitness Challenges: Promoting a healthy work-life balance.
• Mentorship and Coaching: Offering guidance and development in leadership and professional growth.2

Support structures are critically embedded within the program, ensuring residents receive the necessary mentorship and coaching throughout their training.

Overall, the National Capital Consortium Internal Medicine/Psychiatry Residency Program offers a robust, comprehensive training experience designed to cultivate highly competent physicians with dual expertise in internal medicine and psychiatry, while also providing a nurturing and supportive environment for residents to thrive in their medical careers.1