Mission

To develop competent, board eligible anesthesiologists that are experts at mitigating risk and crisis response in austere and resource rich environments.

Vision

To be a leader in anesthesia training in the Military Health System. To build a community of expert anesthesiologists working together to provide the best care in a dynamic health care environment.

Aims

• To develop a core competency of proficiency in the perioperative, critical care and pain management of a wide range of patients (neonate to geriatric) in numerous anesthesia subspecialties and in diverse settings.
• To acquire medical knowledge that facilitates successful completions of parts I and II of the American Board of Anesthesiology certification examinations.
• To develop adequate technical skill and judgment to practice anesthesia competently. This includes performing at least the minimum number of procedures required for board certification and demonstrating adequate skill level when performing these procedures to the faculty.
• To develop a pattern of practice-based, life-long learning facilitating the maintenance of competency in the specialty of Anesthesiology.
• To acquire communication skills facilitating interaction with patients, families and other health professionals. This also includes developing verbal presentation skills required to pass the oral board examination of the American Board of Anesthesiology.
• To foster professionalism in all aspects of resident behavior.
• To develop the skills required to function as an anesthesiologist in both the military and civilian medical systems.

The didactic curriculum is designed in a way that organizes the anesthesia curriculum by topic. Each topic is introduced to highlight the basic knowledge within that topic and then further expand throughout the month to more advanced academic and clinical concepts. The modules are each approximately one month long and include the following categories (Main Operating Room, Pharmacology, Cardiac, Pulmonology, Obstetric Anesthesia, Neuro-Anesthesia, Math, Ethics, Trauma, Pediatrics, Renal Physiology, Acute and Chronic Pain, Endocrinology, Gastrointestinal/Hepatic, Hematology, Ear Nose and Throat, and other).

The blocks are centered around the Morgan and Mikhail’s Clinical Anesthesiology book chapters that correspond to each topic. The residents read these chapters on their own for each block. The blocks start with Pass Machine® videos to introduce basic concepts in each category. These basic concepts are reinforced and expanded upon with staff anesthesiologist lectures, problem-based learning discussions, oral board preparation, and journal club discussions. The academic schedule has the following op-tempo:

After every resident has completed the required number of anesthesia rotations as per ACGME, electives are offered to obtain additional experience in:

• Regional Anesthesia at Inova Fair Oaks
• Thoracic Anesthesia at the National Institutes of Health
• Cardiac Anesthesia at Sinai of Baltimore or Virginia Hospital Center
• Non-Operating Room Anesthesia with Kaiser Permanente

The call schedule is dependent upon the rotation. General OR Anesthesia and Advanced Clinical Anesthesia rotations have overnight call four to six days a month. Call averages every 4th night on Obstetrics and Surgical Intensive Care Units. Call ranges from every four to six days at Children’s National Medical Center and Washington Hospital Center Cardiac. Rotations at Johns Hopkins, National Institutes of Health, Virginia Hospital Center, Inova Fairfax, Inova Fair Oaks, Sinai of Baltimore, and Kaiser are no call rotations.

The residency providers quarterly military specific guidance for officership, leadership, and service specific mentoring opportunities. In addition to these opportunities, the simulation and point of care ultrasound curriculum in conjunction with academic training and lectures touch on the necessity and reality of providing anesthesia in austere locations as would be expected for the deployed anesthesiologist.

The WRNMMC NCC Anesthesiology Residency provides a robust simulation experience focusing on fundamentals of clinical decision making in high-risk scenarios and anesthesia emergencies. The Walter Reed Simulation Center is accredited by the Society for Simulation in Healthcare and is staffed by full time simulation operators in which high fidelity mannequins are utilized in an operating room environment. The simulation curriculum is level of training year specific scenarios which have been built to enhance the development of the anesthesia trainee over the course of their residency to become more comfortable managing significant anesthesia emergencies. The scenarios built for the simulation curriculum also incorporates material specific to preparation of the anesthesia trainee to the ABA Applied Examination to meet the content outline of this exam.

The residency providers quarterly military specific guidance for officership, leadership, and service specific mentoring opportunities.

Each resident is expected to produce an academic work that is shared beyond the Department of Anesthesiology at Walter Reed National Military Medical Center and the Uniformed Services University.

Examples of work that will meet this expectation are:

• First author on a scientific, quality, or clinical report poster at a regional or national meeting
• First author for an abstract presented at a national meeting
• First or second author on a publication in a peer reviewed journal
• A podium presentation lasting 30 minutes or more at a regional, military, or national meeting

Residents have presented at many conferences to include American Society of Anesthesiology, Uniformed Services Society of Anesthesia, American Society of Regional Anesthesia, International Anesthesia Research Society, and Military Health System Research Symposium.

All residents are expected to complete a quality or process improvement project during the period of their training. Quality and process improvement concepts are taught throughout the residency. Quality improvement projects range in size and duration but the completion of at least one Plan-Do-Study-Act cycle complete with a write-up is required.

Professional development entails lectures, small group sessions and individual development throughout the residency and expand outside the department with opportunities to serve on local, regional, or national committees.

Walter Reed National Military Medical Center is the primary institution with greater than 50% of the clinical experience at Walter Reed.

Other participation sites include:

• Washington Hospital Center
• Children’s National Medical Center
• Johns Hopkins University
• Inova Fair Oaks Hospital
• Inova Fairfax Hospital
• National Institutes of Health
• Sinai of Baltimore
• Virginia Hospital Center
• Kaiser Tyson’s Surgery Center

An in-person rotation is not required for applicants but is recommended - it is the best opportunity for you to get to know our program and for us to get to know you. Please contact the GME Medical Student Coordinator at dha.ncr.walter-reed-med-ctr.list.ncc-anes@health.mil to schedule a clerkship. Rotations are most commonly funded with Active Duty for Training orders but can be done unfunded as well. June–August are the busiest times for clerkships, and we are limited to the number of students we can accept per period, so please coordinate the rotation as early as possible. A Memorandum of Understanding may need to be set up between WRNMMC and your school in order for you to obtain credit, if there is not already one in place.

Interviews will be scheduled on a first-come, first-served basis. Interviews generally occur in July and August but can occur as early as May and as late as October. The program can be flexible depending on unique circumstances, but interviews should be complete before the beginning of October (generally interview forms must be submitted around 15 October). For the interview, the candidates should reach out to the anesthesia residency distribution email to schedule.

For the interview itself, it is important to be yourself! We want to get to know the applicant personally to find out if they would be a good fit within the residency and within the culture of the program. We will ask some standardized questions and would like to hear about each applicant’s background and interest in the program. There will be an opportunity to ask questions about the program as well.

Program graduates obtain board certification through the American Board of Anesthesiologists. Residents are required to pass the Basic Exam at the end of their PGY2 year in order to graduate. Upon completion of residency, graduates take the Advanced Exam in July or December after the completion of residency and the Applied Examination consisting of The Standard Oral Examination and the Objective Structured Clinical Examination the calendar year after graduation. The Basic and Advanced exams are offered bi-annually. The Applied Exam is offered six weeks a calendar year spread between March and October.

Residents participate in clinical and didactic teaching throughout residency to include medical students and junior residents. Each PGY4 is assigned two to four teaching weeks to facilitate the weekly didactic schedule of the residents.

Beyond teaching students on anesthesia and surgical intensive care unit rotations, anesthesia residents are given the opportunity to teach USUHS students as well as interns preparing for General Medical Officer tours airway management and vascular access labs.

Walter Reed has faculty consisting of active duty and civilian physicians with subspecialty training in all anesthesia subspecialty categories to include:

• Critical Care
• Cardiac
• Regional and acute pain
• Chronic pain
• Pediatrics
• Obstetrics

The anesthesia residency provides mentors for both clinical and military professional development throughout the residency.

The anesthesia residency works to promote well-being through strong community development. This occurs through scheduled off-sites every three months, at residency retreats every February, and other resident driven group activities such as running the Army 10-Miler.