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U.S. Army Governor's Newsletter October 2020

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COL Cristin A. Mount, MD, FACP, ACP Governor

 


TriService ACP Meeting Highlights

Hello US Army ACP Chapter Members!

What a whirlwind few weeks it has been for the Chapter. In case you missed it, we hosted our first Tri-Service Chapter meeting in nearly a decade and, to up the level of difficulty, we did it over Zoom. I can't say enough how proud I am of our planning committee and all of the faculty who jumped through hoops, learned out to pre-record voice over power point, navigated technical difficulties and came together to put on one of the best meetings we've had in a very long time. Each year, the quality of the content and the breadth, depth and scope of what we bring to this meeting improves and despite the virtual setting, this year was no exception. While we all missed the opportunity to get together and catch up in person, I'm glad we had the opportunity to try a virtual presence – we were able to register over 600 members and at least one chapter member was able to attend the meeting on a deployment. Look for some component of future meetings to remain accessible through a virtual platform.

Pre-recorded meeting content, including all of the abstracts submitted for competition and the open poster session, is available for meeting registrants here for the next 6 months. You will also find CME and MOC submission here and an opportunity (through the CME/MOC form) to give us feedback on the meeting.

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Highlights: The meeting kicked off with a perspective on military medicine's role in pandemics, taking us all the way back to the plague, with CAPT Ryan Maves. CAPT Maves is an ID/Critical Care physician at NMCSD and included a fitting tribute to our current contributions in providing medical support to COVID-19 missions. COL Patricia Short gave a much-needed update on the latest evidence impacting Peri-Operative Medicine. We had plenty of operationally-relevant plenaries with Sleep Medicine and its importance to the warfighter (MAJ Jennifer Creamer), Trauma Care for Internists Across the Continuum from LCDR Nicolas Rohrhoff and Updates in Operational Medicine from COL Ramey Wilson. We brought back Thieves' Market, run by Dr. Alex Schafir with a “Chat Assist” from Dr. David Scrase (the originator of Theives' Market). This dynamic duo brings Thieves' Market to the National ACP meeting and it was great fun to have them at our meeting with three military-relevant cases. We had an excellent Faculty Development plenary from COL Jessica Bunin on Mentorship Challenges, thanks go out to the USUHS Faculty Development Program for continuing to offer high-level content to our meeting.

 

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Not to be outdone, we presented our breakout coordinators with a challenge: cut your time in half, incorporate residents and fellows and throw a few of your own plenaries in there. They all rose to the challenge with full slates on the latest and greatest in Nephrology, GI, Pulm/CCM, General Internal Medicine, Endo, Rheumatology, Cardiology, Heme/Onc, ID and a special, very well attended breakout on Women in Medicine.

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Consultants and Specialty Leaders joined us for individual service Townhalls and, of course, we had amazing resident, fellow and early career physician abstract competitions. While we did not to Doctors' Dilemma concurrently with this meeting, the Chapters are hard at work building a virtual Doctors' Dilemma competition to take place on Zoom in early November – concluding with a “Military Bowl” where the Army, Navy and Air Force Champion Teams will face off against each other.

Finally – we issued a Social Media (#SoMe) challenge during the meeting to live-Tweet and post about the meeting using #TriserviceACP, #IMProud, and #MilMed. Tagging the Army Chapter account @army_acp and Navy Chapter account @AcpNavy. It was great to see all of the positivity, cheering, sharing and support come through. If you want to keep building our presence on social media, please reach out to me and I'll link you up with our Communications Chair, CPT Kimberly Fabyan.

Before I list the winners of our Chapter Awards and Abstract Competitions, I want to acknowledge the group hard at work behind the scenes of the TriService Chapter Meeting:

PLANNING COMMITTEE

MAJ Kelly Chohonis
Capt Matthew Bezzant
CPT Kimberly Fabyan
LTC Robert Walter
LTC Tatjana Calvano
MAJ John Hunninghake
LCDR Robert Olejnik
Maj Derek Smith
CDR Mark Tschanz
COL (Ret) Matthew Carroll
COL Cristin Mount

ACP STAFF MEMBERS

Judy Spahr
Nicole Turkowski
Nicole Poponi
Keirston Scott
Julia Baldini
Noreen Duffey

BREAKOUT COORDINATORS

MAJ Noah Hall
Maj Samuel Owen
LTC Sky Graybill
Maj Jeffrey Colburn
MAJ Heather Pomerantz
Maj David Lindholm
MAJ Nikhil Huprikar
Maj Jess Anderson
CPT Peter Mattingly
Maj Asha De
MAJ Rachel Robbins
LTC Ian Rivera
LtCol Jesse Wickham
MAJ Brian Pomerantz
CDR Lauren Weber
LTC Robert Setlik

ABSTRACT COMPETITION JUDGES

LCDR Caitlin Cruz
LCDR Jason Weiner
LCDR Anthony Choi
Dr. Dora Stadler
Dr. Alison Colantino
MAJ Zorana Mrsic
MAJ Garrett Britton
MAJ Timothy Hunter
MAJ Mary Truitt
COL Kevin Chung
COL Joshua Hawley-Molloy
Dr. Pat Danaher
Col Michael Forgione
Dr. Rechell Rodriguez
Dr. William Hannah
Dr. Helen Hootsman
Dr. David Gremillion
Dr. Matt Dolan
Dr. Jay Higgs
Dr. Paul Hemmer

Chapter Awards

COL Robert H. Moser Award: MAJ Nupur Garg
Master Teacher Award: COL Patricia Short, FACP
William Crosby Superiority in Research Award: LTC Christopher Colombo, FACP
Excellence in Operational Medicine Award: MAJ Michal Sobieszczyk
MTF Teachers of the Year:
MAJ Kelly Chohonis, DDEAMC
MAJ Maurice Khayat, MAMC
LTC Robert Walter, SAUSHEC
CPT David B. Zusin, TAMC
LTC Maura Watson, WRNMMC
CPT John M. Bustos, WBAMC
Greg Agryros Outstanding Achievement Award: 2LT Zachary A. Haynes
Resident Podium Research Competition Winner: CPT Lisa Conte, WRNMMC, “Recognizing Gender Parity in Military Medicine: An Analysis of Plenary Speakers and Awardees at Military ACP Chapter Meetings”
Resident Clinical Vignette Competition Winner: CPT Robert Spiller, MAMC, “Urea(lly) Got Me”
Resident Quality Improvement/Patient Safety Winner: CPT Ariana Ramirez, MAMC, “Retrospective Review of a Novel Virtual Medical Soldier Readiness Processing (SRP) Process in Response to the COVID-19 Pandemic
Fellow Podium Research Competition Winner: CPT Trevor Wellington, SAUSHEC, “The Burden of Arboviral Infection in the Military Heath System, 2011-2019”
Early Career Physician Quality Improvement/Patient Safety Winner: CPT Joshua Boster, SAUSHEC, “Competency Using Simulation Based Medical Education”
Early Career Physician Clinical Vignette Winner: Dr. Daniel Miles, TAMC, “Unique presentation of calciphylaxis as a new heel lesion”

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CALL FOR APPLICATIONS FOR NATIONAL COUNCILS

I have just finished work for the National ACP as a Chair of one of the Board of Governors' Reference Committees. In that position, I facilitated discussion on resolutions brought forward to the Board of Governors from membership, worked with my Reference Committee to dive into those discussions and create a consent calendar for the Board of Governors' Approval and then take the live (virtual) discussion and meld that into a report to the Executive Committee of the Board of Governors and the Board of Regents. One of the things that stood out most to me was the amazing work of the National Councils of Early Career Physicians (CECP), Resident and Fellow Members (CRFM) and Student Members (CSM) in the resolutions they brought forward. They tacked topics such as medical student mental health, processes for protecting house-staff during residency program closures, advocating for workplace violence protection for healthcare workers and advocating for assistance with public loan service forgiveness programs to name a few. If you are interested in a position on the National CECP, CRFM, or CSM, follow this link for information – applications are due no later than 1 November. The Army Chapter has a long history of members sitting on these national councils – it is a great way to get involved with our professional organization!

Council of Medical Students

Council of Resident and Fellow Members

Council of Early Career Physicians

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ARMY COUNCIL OF RESIDENT AND FELLOW MEMBERS

Speaking of fantastic involvement in a professional organization, our own, newly-launched, Council of Resident and Fellow Members (CRFM) is equally active and working hard to bring great resources to our resident and fellow members. They are initiating a virtual Grand Rounds Series which will kick-off over Zoom in mid-December. The first speaker will be Dr. Erica Johnson, Assistant Professor of Medicine, Division of Infectious Diseases at Johns Hopkins University and the Program Director for Johns Hopkins Bayview Internal Medicine Residency Program. She will be discussing Structural Competency, which is the ability of health care providers and trainees to appreciate how what they encounter in clinical scenarios is influenced by upstream social determinants of health. Look for information on how to join via Zoom in a future Chapter Email and via our social media accounts.

In addition to organizing National Grand Rounds, the CRFM is working on a Day of Service Activity which can be done by individuals or groups wherever you are. More details to come.

Finally, because they have an incredible amount of enthusiasm, I've asked the CRFM to assist us with putting together the virtual Doctors' Dilemma competition. As noted in the Meeting Highlights above, we will be doing the competition over Zoom with the 6 Army IM Residency Programs competing in two games (3 teams each), followed the next day by a “Military Bowl” where I have no doubt they will come out victorious over our sister services. The winning team in the Army Chapter Doctors' Dilemma will represent us in the National Doctors' Dilemma Competition which will be held virtually this spring. A huge thank you to Dr. William Kelly, USUHS, for offering his virtual quiz game services – he runs a similar program for the American College of Chest Physicians. Catch his #ThoracicThursday case series on Twitter too!

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GOVERNOR’S COUNCIL POSITIONS

We are looking to fill the following positions on the Governor's Council:

Assistant Treasurer: Work with the Henry Jackson Foundation and current Treasurer, COL Jess Edison, to manage Chapter funds with the National ACP, set the Chapter budget and look for opportunities to build our strategic reserves.

Student Representative: We are interested in growing our Student member programming. We are looking for a Medical Student Representative (HPSP or USUHS) to serve a two-year term and work with the conference planning committee on student programming.

Membership Chair: Recently vacated, the Membership Chair is an important position on the Governor's Council. Very often, opportunities arise to grow our membership. Growth in membership ensures that we're giving Army Internists and IM Subspecialists the opportunity to remain connected with the Army community and benefit from resources available through ACP membership. The Membership Chair will work directly with the Governor on outreach and retention efforts and will work with the Credentials Chair on identifying members for FACP, MACP and National ACP Awards.

If you are interested in any of the vacant positions noted above, or THINK you might be interested, please contact me

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MEMBER RESPONSE TO COVID-19

Military Internists and Internal Medicine Subspecialists continue to deploy in support of the COVID-19 response. No Internists are better prepared take on the mission of caring for patients during a chronic mass medical casualty situation than military Internists! Please find below some pictures from Army Chapter members who have recently completed missions in support of COVID-19 operations.

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LTC Dave Hostler (PCCM), MAJ Kate Haney (IM) and MAJ Evelyn Lomasney (Allergy/Immunology) deployed to the Rio Grande Valley to support Army COVID Operations in McAllen TX as part of UAMTF-16.

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They rapidly assessed the situation and formed a hospital within a hospital, calling themselves the SW-AMC where they provided non-stop care for hundreds of critically-ill COVID-19 patients.

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LTC Dave Hostler (PCCM) and LTC John Thurlow (Nephrologist). Their take-away message from this experience is that Army Medicine must continue to reinforce “substitutability training” because military Internists will be called upon to respond to medical missions that don't mimic their routine daily practice in our MTFs and MEDDACs.

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CPT Kylie Casey (FNP, USAR), CPT Mary Saleeby (IM), MAJ Megan Mahowald (FM) and MAJ Leslie Jette-Kelly (PCCM), served with the 1st BDE, 627th Field Hospital. CPT Cameron Ryan (IM), CPT Trevor Lutz (IM) and CPT Tyler Paul (IM), also of the 627th Field Hospital deployed to five different civilian hospitals in San Antonio. While Army units fell in on civilian hospitals, Brooke Army Medical Center took primary responsibility for receiving trauma patients, augmenting their usual contribution to Level I trauma support for San Antonio, and also served as an ECMO referral center for patients from as far away as McAllen, TX

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CPTs Ryan, Lutz and Paul

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MAJ Michal Sobieszczyk rounds in the ICU at Brooke Army Medical Center

As we move into an anticipated surge of COVID cases in the fall, please continue to send me your pictures, stories and lessons learned. What are you doing differently in your practice due to COVID-19? If you are a member of the USAR or NG, how has your COVID response impacted your usual practice?

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