Mission

Through a diverse and inclusive environment, the Adolescent Medicine Fellowship fosters the professional and personal development of fellows and faculty that ignites a desire for learning, dedication to serving, and the commitment to bettering the health and well-being of our patients.

Vision

Train the next generation of adolescent medicine and military physician leaders ready for service anytime, anywhere.

Aims

Our program is dedicated to ensuring our graduates are committed to excellence in teaching and learning, discovery and scholarship, service and leadership, and improving the health and well-being for all. We will accomplish this by:

• Providing a diverse, well-rounded educational and clinical experience encompassing the full scope of adolescent and young adult care.
• Developing lifelong learners engaged in addressing healthcare equity and quality through innovative scholarship actions.
• Cultivating educators skilled in the nuances of teaching and mentoring others in a variety of environments.
• Developing military physician leaders who demonstrate personal accountability and resilience, collegiality and teamwork, and ensure the highest ethical and professional standards in all situations.
• Producing military medical officers ready to take on the mission of advisor, planner and supervisor in their staff positions.

Our didactics are comprised of biweekly sessions:

• Wednesday from 9 – 11 a.m. focused on board review and preparation.
• Friday from 9 – 10:30 a.m. focused on a variety of topics from journal club, research/quality improvement, leadership/professionalism, teaching, military unique topics, and our mentorship curriculum.
• Once a month, one of our didactic days is focused on well-being which may involve a community service project, team building activity, or personal well-being day.

Through BAMC, SAUSHEC, or the Department of Pediatrics, we participate in Grand Rounds, Diversity/Equity/Inclusion (DEI) focused lectures, and multidisciplinary conferences.

• Over the course of three years of training, fellows will rotate through 16 rotation blocks.
• Six of the blocks will occur every year - Clinic, School Based Health Clinic, WHASC Consult Service, Juvenile Detention Center Clinic, Women’s Health Clinic and Multi-D rotation that includes four interdisciplinary clinics.
• Fellows will have one continuity clinic per week on non-Adolescent Clinic months.
• 10 blocks will be based on PGY level and build in complexity each year.

Depending on the interest of the fellow, we have room in our rotation schedule to establish a local rotation based on the interest of the fellow.

Two fellows will cover the inpatient service consult pager each month. Each fellow will cover 2 of the 4 weeks (usually every other week) allowing for one day off in seven averaged over the month. Fellows cover the inpatient consult service 3 to 4 times a year with staff covering any remainder months (depends on the number of fellows in training).  All call is at home call.

The field of Adolescent Medicine is uniquely suited to train physician in care of the active duty servicemember. Our scope of care allows us to focus not only on preventive health issues, but also on areas which can have a significant impact on soldier readiness. This is namely addressed through our contraceptive clinics caring for menstrual related issues and prevention of unplanned pregnancies, preventive health screens through our sexually transmitted infections (STI) walk in service, full scope of transgender care, and care of sexual assault victims. Through these clinical experiences, our fellows become comfortable with the not only the medical requirements to ensure a medically ready force, but also the administrate and policy aspects that may impede readiness.

We incorporate military unique topics within our didactic schedule every quarter. This provides a forum to address instruction on such items as temporary and permanent profiles, medical evaluation boards, Officer Evaluation Report (Army)/Officer Performance Report (OPR), award writing, understanding the physician role in the deployed environment or in a military treatment facility (MTF) setting. All PGY6 fellows will attend the Critical Skills Expandatory Course.

The fellowship can support fellows request to support military humanitarian missions or attend short 1-to-3-week military training courses such as Tactical Combat Casualty Care Course (TCCC), Tropical Medicine Course, or Clinic Leadership courses.

• Root Cause Analysis training course (RCAW3)
• Critical Skills for Expeditionary Medicine (CSEM)
• Basic Life Support (BLS)
• Pediatric Advanced Life Support (PALS)

We are not a procedurally heavy training program, therefore we primarily utilize direct observation type experiences built into our education program.

We offer a pelvic simulation model that we use to teach residents, who are on their Adolescent Medicine block rotation on how to perform pelvic exams and pap smears. Fellows or faculty lead this training session.

Our leadership curriculum utilizes several avenues through didactics and practical experience to develop fellows understanding and personal competence in leader positions.

Didactics (1 session quarterly)

Fellows have been introduced to leadership curriculum as residents, which covers basic core topics. We aim to address next-level issues from a military or medical leader perspective. We tailor our curriculum to be beneficial for military or clinical leadership experiences. Specific subjects include ethics in leadership, gender-based differences, transitioning between leadership styles, and military vs medical vs Clinical (admin) leadership roles.

Clinical leadership responsibilities

• Fellows will be able to practice within and lead multi-disciplinary teams throughout training.
• Fellows will have hands on experience through their assignment as the lead clinic preceptor for a half day of clinic. They will be responsible for managing patient flow for the entire clinic, troubleshooting a variety of clinic administrative situations and supporting and answering any nursing questions.

Educational leadership

• In the second half of the PGY4 year, fellows will begin precepting residents and medical students. They will be responsible for mentoring, educating, and providing feedback to junior trainees as they see patients.
• In their PGY6 year, fellows will be responsible for managing the program’s annual didactic schedule, which involves establishing the intent & design of the lecture schedule and arranging speakers for one academic year.
• Fellows will be responsible for directing and guiding their research and quality improvement teams.

The American Board of Pediatrics (ABP) requires all fellows (pediatrics trained) to have one year of their training dedicated to research and must complete a research project to be eligible for the Adolescent Medicine boards. Internal medicine and Family medicine-trained fellows do not have a research requirement to qualify for Adolescent Medicine boards. The program will support them during their training if they wish to complete a project.

Research projects must be submitted to the BAMC Institutional Review Board (IRB) for approval. We require our pediatrics-trained fellows to submit their research projects to a conference or for publication before graduation. Submissions do not have to be accepted for presentation or publication before graduation. Fellows will identify faculty as part of their Scholarly Oversight Committee (SOC). The SOC is responsible for supporting and guiding the fellow through their project until completion.

There are many opportunities to collaborate with other services for research or quality improvement projects. The program has a premade list of completed and potential project ideas to assist fellows with initiating their projects. All fellows will attend a research symposium during orientation month and are supported in attending the numerous additional research and quality improvement training opportunities. We incorporate funding for each fellow to present a project annually in our budget.

Regardless of residency training background, all fellows will complete a quality improvement (QI) project by graduation. There are several institutional-level training courses in QI the fellowship requires fellows to attend to support their efforts in completing their QI project. The program has a project idea list to assist fellows and faculty in getting started on a project. Additionally, we have incorporated time in our didactic schedule for biannual reviews of all quality improvement projects to provide ongoing support and guidance. All fellows will identify a faculty member as a mentor to guide them on their projects. There are many opportunities to submit completed projects for presentation at local, regional, or national conferences.

There are numerous opportunities for fellows to become involved within SAUSHEC or national professional organizations. We highly encourage and support fellows becoming part of one of the many SAUSHEC Subcommittees during their training. In addition, through the American Academy of Pediatrics (AAP) or Society for Adolescent Health and Medicine (SAHM), there are many opportunities to participate as a fellow representative or to serve on a committee. Many conferences also provide opportunities to be poster or abstract reviewers for their respective conferences.

• Brooke Army Medical Center
• Wilford Hall Ambulatory Surgical Center
• University of Texas Health Science Center
• Eating Recovery Center San Antonio
• United States Air Force Academy

We welcome fourth-year medical students and residents from Pediatrics, Internal Medicine and Family Medicine who are interested in an elective rotation in adolescent medicine.

• Rotations can be 2 to 4 weeks in length.
• Trainees will spend most of their time in the Adolescent Clinic where they will actively evaluate patients under the supervision of a faculty or fellow.
• Depending on space availability, trainees will be assigned to a variety of our subspeciality clinics where they may shadow or actively see patients. This would include our School Based Health Clinic, Active-duty Transgender Care Clinic, one of our Women’s Health Clinic, Interdisciplinary Obesity Medication Management Clinic, Outpatient Consult Service.
• Trainees will participate in our Wednesday morning didactics.
• Trainees will also participate in our Monday and Thursday afternoon resident didactics series.

To schedule a rotation, e-mail: usarmy.jbsa.medcom-bamc.mbx.saushec-clerkship@health.mil.

For additional info, or if there is no response from the above e-mail, contact: dha.jbsa.brooke-amc.list.saushec-peds@health.mil.

Interested applicants should contact the program to schedule an in-person or virtual interview. The benefit of in-person interviews allows the applicant to spend a full day with the fellowship, participate in our educational program, meet with staff and fellows, and participate in a formal interview. For applicants who interview virtually, separate from the formal virtual interview we arrange a virtual meet-and-greet with current fellows as a forum for asking additional questions about our learning environment and culture of the program.

If you would like to schedule an interview with our program, please contact: dha.jbsa.brooke-amc.list.saushec-adolmed@health.mil. 

Program graduates take the Adolescent Medicine Specialty Board. This exam is offered every 2 years. Applicants are eligible to take the board certifying exam within seven years following graduation. All pre-requisites required must be completed by October 31st of the exam year.

To be eligible to take specialty board exams, graduates must complete all pre-requisites required by their respective board (American Board of Pediatrics, American Board of Internal Medicine, and the American Board of Family Medicine). Pre-requisites for eligibility are described on the links below:

• https://www.abp.org/content/adolescent-medicine-certification
• https://www.abim.org/certification/policies/internal-medicine-subspecialty-policies/adolescent-medicine/
• https://www.theabfm.org/added-qualifications/adolescent-medicine

We have numerous opportunities for fellows to develop their skills as an educator. Under the program, fellows will deliver journal club and board review didactics. Additionally, we support six residency programs in delivering their annual lectures on adolescent medicine-specified topics. Built into our resident adolescent medicine month rotation are specific didactic sessions on core adolescent medicine topics, which fellows and faculty are responsible for delivering. Fellows will work directly with resident and student rotators as clinic preceptors, providing teaching and feedback. Our fellows also will provide Grand Rounds lectures through a variety of programs for in-person or virtual audiences. Lastly, we encourage fellows to create and develop educational workshops to submit for presentation at national conferences.

Obesity Medication Management Certification

• All fellows are required to choose and monthly meet with a mentor (or faculty advisor).
• Fellows are not limited to just one mentor but are encouraged to consider that different aspects of their career path may need more than one person in this role.

Mentorship Curriculum:

• Provides dedicated time monthly with staff of the fellows choosing to develop a deeper understanding of the field of adolescent medicine and the role of the military physician
• Each month will cover a different topic such as career planning, educator development, performance mentorship, and longitudinal case review
• Each topic has resource and tools available to encourage a robust discussion

• Incorporated into our didactic schedule as a monthly offsite activity aimed at team building, community volunteer service, or an individual “Wellness day”.
• Fellows have opportunity to be involved in SAUSHEC or BAMC level wellness activities such as Peer Support.
• Organized offsite activities are held outside of normal duty hours for fellowship and clinic staff to get together in a social outing.