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Governor's Newsletter, Summer 2002

Capt. Angeline A. Lazarus, MD, FACP
Governor, U.S. Navy Chapter

Governor's Message

I am delighted to share the exciting news that our own, former Governor of the Navy Chapter, Capt (Ret) John Mitas, FACP has been chosen as the Chief Operating Officer of ACP-ASIM. The first Annual Meeting of the Navy Chapter was held during his term of governorship and he was instrumental in making our Chapter strong and vibrant.

The Board of Governors' Meeting was held April 8-10, 2002 and the Annual Meeting was from April 11-14, 2002. There were over 5000 attendees at the Annual Session. There was a good representation from the Navy. There were many resolutions that were passed and approved by the Board of Governors. I would like to share two of them with you:

1. Recertification - The ACP-ASIM Board of Governor's meeting held April 8-10, 2002 in Philadelphia was a highly productive one. The governors recommended a set of specific negotiating points for the ABIM regarding recertification in Internal Medicine and subspecialty. These will be presented to the ABIM by College leadership. ACP-ASIM has been working very diligently with ABIM in changing some of the requirements of Continuous Professional Development (CPD). It has always been the ACP-ASIM position to support a well designed and executed recertification process. Using the negotiating points in an atmosphere of cooperation with the ABIM, internists and sub-specialists will hopefully see substantive improvement in the recertification process, hopefully in the near future. Many of the concerns raised by the internists regarding the recertification process were carefully considered. The ACP-ASIM in collaboration with ABIM will continue to explore pathways for recertification. Finally, the ACP-ASIM Education Committee presented a series of draft documents that enunciated principles guiding the relationship of education and evaluation to development and maintenance of competence, as well as working definitions of medical education, evaluation, and practice performance measurement. Clear definition of principles and terms should also help as discussions continue with the ABIM.

2. ACP-ASIM Name Change - It was agreed upon when ACP and ASIM merged some years ago, that after a specified period of time the name of the organization might be shortened. That time has come and the ACP-ASIM governing boards have been studying how best to proceed. At this point, it looks like we may soon be once again the American College of Physicians. The merger with the name ACP-ASIM began when I started my term as the governor. The merger between ACP and ASIM has been very successful. ACP-ASIM has been a very capable and powerful advocacy organization for our membership while at the same time preserving a set of professional values based on the primacy of the patient and the value of life long professional development and learning. There has been some concern about omitting reference to internal medicine in the name, but the long tradition of the American College of Physicians and the respect the organization has garnered were felt to be overriding considerations when this was discussed in the Board of Governors meeting.

Congratulations

Our Chapter received the Chapter Excellence Award. Our Chapter has received this award annually since the inception of the award a few years back. This award is given to chapters who excel in the performance of chapter activities. Congratulations to our Associates who had poster presentation at the Annual Meeting:

Naval Medical Center, San Diego:

  • "Learning curve in the comparison of esophageal biopsy forceps," Paul Uday, MD

Naval Medical Center, Portsmouth:

  • "Does a Pre-printed reminder aid in documentation of using herbal products?" H. Ventura, MD

  • "Acute renal failure due to ephedra-containing dietary supplements," May-DePaola, MD

National Naval Medical Center, Bethesda, MD:

  • "Musculoskeletal examination skills at varying levels of training: A retrospective comparison of scores on two OSCE scenarios using standardized patients," Robert Browning, MD

  • "First report of myocardial infarction secondary to an ephedrine propranolol adverse drug interaction," Robert Browning, MD

  • "Kaposi's Sarcoma in the setting of HAART," Mark Corriere, MD

  • "Effect of lipid-lowering agents on dyslipedemia in HIV-infected patients receiving high active antiretroviral therapy (HAART)," Kevin Dorrance

  • "Evaluation of an internship program to prepare graduates for general medical officer tours," Gautam Nayak, MD

Congratulations to the Medical dilemma (Medical jeopardy) team from San Diego. They missed the winning position in the round by just a few points. The team was represented by LT Greg Francisco, LT Jarrod Holmes, LT William Shields. They performed in an outstanding manner.

Fellowships advancements

The following individuals took the ACP-ASIM Fellowship oath during the 2002 Annual Session:
Capt. Margaret Calloway
CAPT. Al Drake
Dr. Wesley Emmons

Dr. Steven Sheris
CAPT. Sybil Tasker

Associates Corner

LT Dan Seidensticker, LT,MC, Chief of Residents at Naval Medical Center, Portsmouth

"Associates Corner" reflects the activities of the Associates as well as the activities of the internal medicine training program and the internal medicine service.

  • We completed the RRC site review in late March. LT Dan Rakowski, Resident Physician of the quarter (hospital wide).

ACP-ASIM Presentations—

  • LT Brenda Depaola and LT Heather Ventura presented posters in April at the 2002 Annual Meeting in Philadelphia.
  • LT Heath Morgan and LT April Truett were chosen as the Finalists at the Virginia Chapter Associates Day competition, and were selected for presentation at Virginia Annual Meeting in May 2002.

Other Scholarly Achievements—

  • LT Fred Yeo prepared an abstract accepted for publication in the Journal of American Society of Nephrology.
  • LT Brenda Depaola prepared an abstract accepted for presentation at the National Kidney Foundation Scientific Session.

March 2002 Hospital Research Competition—

  • CDR Treyce Knee, Best Oral Presentation, Outcomes Research
  • LT James Witkowski, Best Poster presentation, Case Vignette
  • LT Heath Morgan, Presenter
  • LT Wendy Mahone, Presenter
  • LT Ebonee Davis, Presenter

Volunteerism Activities—

There has been a significant increase in participation at the Chesapeake Care Clinic due to the efforts of LT Pam Krahl, one of the Chapter's PGY-2's.

Department Recognitions—

CAPT Bart Gumpert, FACP, named Service Line Leader for Adult Medical Care Services.
CDR Chris Culp, FACP, named President of ECOMS (Executive Committee of the Medical Staff.).
CDR Treyce Knee, FACP, elected Representative Fleet and Family Medicine for ECOMS.
LT Meg Oberman, Associate, selected as Internal Medicine Intern Advisor.
LT Dan Rakowski, Associate, selected to be Chief of Residents at the Naval Medical Center in San Diego.

Residency Program Update LCDR

A.F. Shwayhat, MC USNR, Chief of Residents, 2002-2003

1. The Navy Medical Center, San Diego, Department of Internal Medicine Residency Program is closing the 2001-2002 academic year stronger than ever with 12 graduating residents-7 matching for fellowship training in cardiology, gastroenterology, allergy, pulmonary/critical care, and rheumatology-and 4 taking orders to duty stations in Camp Lejeune, Camp Pendleton, the Naval Operational Medicine Institute, and the Naval Hospital in Guantanamo Bay, Cuba. All the graduating residents completed their training on time and are currently preparing for their board certification exam this August.

2. A highlight of the New Year was the selection of the winners of the residency program Jeopardy Competition receiving full funding to attend the National Jeopardy Competition at the ACP-ASIM Annual Session in Philadelphia this year. LT Greg Francisco, LT Jarrod Holmes, LT William Shields delivered a strong showing and placed second in their round. Meanwhile, LT Uday Paul, who won the Navy Regiona research competition in Portsmouth, presented his research on endoscopy biopsy forceps at the Annual Meeting.

3. While the residents are preparing for boards, fellowships and new duty stations, the staff and administrators are preparing for the arrival of 19 new interns and 11 new residents in the internal medicine program. Eight of the residents are completing operational tours and are arriving in July and August and 3 have been selected to enter residency directly from internship. While the selected interns beginning residency bring familiarity with the program to the new year the operational physicians bring leadership skills and knowledge of where "the rubber meets the road" in the Navy. We are all looking forward to working with each of them in the 2002-2003 academic year.

Medical Student Council of ACP

Congratulations to ENS. Steve Bernick who as a representative of the Department of Defense was elected to serve on the ACP-ASIM Medical Student Council. I want to share with you Steven J. Bernick ENS, MC, USNR's personal statement, which is as follows:

The submarine slipped silently through the darkness, barely visible above the surface of the frigid northern Pacific waters. Key members of the crew frantically scrambled along the deck to retrieve the only functioning communications buoy before it was irreparably damaged by the 25-foot swells. As the ship's rescue swimmer and emergency medic, I knew that if anyone lost his footing on the rain-slicked surface of the submarine and was tossed overboard, I would have to take immediate action to affect a rescue. I also knew the chances of survival would be very slim.

Had I been asked when I was 14 years old what I was going to do with my life, I would have replied that I'd be a vocalist. I'd already recorded two solo gospel music albums and, following the loss of my parents when I was ten years old, I found myself touring the U.S. performing at revivals and in churches. As the only one of four siblings to graduate from high school, I never really considered the possibility of acquiring a college education. Instead, I decided to enlist in the U.S. Navy's nuclear power training program.

The Navy taught me to excel in and out of the classroom. I began enrolling in classes at every available opportunity, often taking coursework with me while deployed. I volunteered my spare time to helping children, drawing upon my experiences at an orphanage as a young teen. I qualified as a rescue swimmer and emergency medic, and volunteered at a local hospital during off-duty hours. When my enlistment expired, I chose to give up a high paying job for the life of a student. Sacrifices would certainly be required, but I never questioned the decision. I knew I was doing the right thing.

Now I have come full circle. I am back in the Navy wearing an officer's gold, and I am living my dream. I have endeavored to set the example for others to follow. I have taken great care to fulfill my obligations to my service, my family and myself. Serving as the student Commanding Officer for the Navy has provided me with the perfect vehicle to do this. In addition, serving as an Academic Officer for the Biostatistics and Epidemiology courses has allowed me to pursue my interest in Public Health.

I had the opportunity to meet CAPT Angeline A. Lazarus at an ACP-ASIM introductory seminar last year, where I volunteered to serve on her Advisory Council. While my activities in that capacity have been limited, I am hoping to broaden their scope in the immediate future. Serving as the Military Liaison to the Council of Student Members (CSM) of the ACP-ASIM would allow me to not only further explore this interest, but would also provide me with the opportunity to participate in and have an impact upon the medical community to which I now proudly belong. My strong leadership skills and great pride in my school, my uniform, and my country will reflect highly upon those whom I represent. In this capacity, I will do my utmost to ensure that all relevant issues are addressed with speed and diligence.

Medicine, like military service, means many things to many people. For me, they share the common bond of opportunity. This position represents a fine example of such opportunity and, if selected, I will ensure that its inherent honor, value, and integrity are maintained.

From the Specialty Leader of Internal Medicine…

Chris Culp, CDR. MC, USN

2002 has been another in a now long series of years marked by challenging detailing in the face of a relative shortage of Internists and marked shortages of certain of our subspecialties. Currently, the community is roughly at end strength, but a large number of Internists not doing clinical Internal Medicine, increased fellowship training opportunity, and a slight increase in the number of IM billets mean that there will be gaps across the community. Summer 2003 will see opportunities for tours in Rota, Naples, Sigonella, Japan, and most CONUS hospitals. Additionally, Congress, CBRF (the chemical, biologic, and radioactive response force), fleet surgical teams, and several LHA/LHD platforms (SMO jobs and CATF Surgeon jobs) and will present opportunities to do some out of the ordinary things unavailable to our colleagues at the HMO.

To match you to these opportunities, we have a new detailer in Commander Charlie Hames. CDR Hames returned from a 3-year tour in Rota to relieve CDR Mallack in May. His web page contains information on long-range billet availability as well as hot fills.

We are currently seeing shortages in the sub-specialty communities as large numbers of NADDS trained specialists retire. NADDS was used in part to reduce active duty numbers during the draw down a decade ago, and the pipeline for fellowship training was markedly reduced after this as the subspecialty numbers rose and total end strength fell. We are now at the point of needing to again increase fellowship opportunity. The next few GMESB cycles look to be promising for General Internists wishing to pursue further training in areas of shortage. The IM subspecialty leaders (names and contact information) are the best source of information on individual community needs and opportunities.

Finally, I cannot emphasize enough the value of our chapter meeting as a community town meeting. This is where the Navy community of Internists gathers, networks, teaches and learns. October's San Diego meeting looks to be outstanding. Generalist, specialist, big command, little command, it doesn't matter - Be There!

Attention, Attention

10th Regional Meeting of the ACP-ASIM Navy Chapter - "America's Finest City," San Diego, California will be the site of the 2002 U.S. Navy Region Scientific Meeting. The meeting will be held at the Horton Grand Hotel located in downtown San Diego between the dates of Thursday, October 10th thru Friday, October 12th. The pre-session for chief residents and program directors will be held on Thursday, October 10th prior to the beginning of the main conference. The ACP-ASIM's Navy Chapter meeting is one of traditional forums to present resident related research. Residents will present both oral vignettes and poster presentations.

In conjunction with the scientific presentations, the theme of this year's symposium will be "Disaster and Humanitarian Medicine." Internationally recognized speakers will be representing various aspects of military, humanitarian, and disaster medicine- Dr. Eric Noji, Senior Medical Advisor, Office of Homeland Security, Executive Office of the President of the United States; Dr. Francesco Della Corte, Director European Master's Program in Disaster Medicine; Dr. Jennifer Leaning, Professor of International Health, Director of the Program on Humanitarian Crises and Human Rights, FXB Center for Health and Human Rights, Harvard School of Public Health; Dr. Skip Burkle, Senior Scholar & Scientist, The Center For International Emergency, Disaster & Refugee Studies, Schools of Medicine and Hygiene & Public Health, The Johns Hopkins Medical Institutions; and Dr. Rick Jolly, British Royal Navy, Medical Commander during the Falklands War. Additionally, this year's program will also highlight sub-specialty review sessions where "landmark studies" will be reviewed to help both the general practitioner as well as the specialist to practice current trends in the evolving field of internal medicine.

The mixture of topics and speakers should provide for a provocative, diverse, and informative meeting to all registrants regardless of their level of training. The culmination of the event will be an awards dinner to be held at the "University Club." This banquet hall sits atop the Copley Symphony Hall and has an unparalleled view of San Diego's Skyline. The menu and ambiance are equivalent to comparable "5 Star" restaurants found in Southern California.