Mission

The mission of the Transitional Year Residency Program at NMCSD is to develop the natural curiosity in every TY resident, instill the courage to advocate for their patients and themselves, and provide the tools to make an impact where they go.

Vision

Training tomorrow’s global leaders, today.

Aims

• Provide a comprehensive and well-balanced program of graduate medical education in multiple clinical disciplines to facilitate the choice of and the preparation for a specific specialty, as well as to prepare for operational military medical tours.
• Commit to physician wellness through faculty mentoring, active participation, and focused use of abundant resources.
• Promote individual development as leaders and as teachers by providing opportunities to serve as leaders and teachers throughout the hospital.
• Effectively utilize simulation to gain experience and competency in essential medical procedures.
• Develop a culture of commitment to patient safety and quality improvement through the instruction of skills, tools and attitudes necessary for these key components of medicine reinforced by active individual participation.
• To understand that physicians must take an active role in multidisciplinary teams to advocate for safe and effective patient care.
• Use a structured mentorship program to facilitate development of leadership skills and assist in the identification of and steps towards individualized career goals.
• Continue to support resident opportunities to complete research and other scholarly activity to foster their intellectual curiosity and enhance the future of medicine.

TY residents attend mandatory weekly didactics that focus on medical topics relevant to general and operational medicine as well as professional development. Simulation sessions covering commonly encountered scenarios as well as rare but critical clinical skills are scheduled throughout the year. All TY residents present once during the academic year on a clinical error encountered on rotation and a summary of “lessons learned.” Quarterly journal clubs and quality improvement project opportunities supplement the curriculum.

TY residents may select three 4-week elective rotation.  All elective rotations are performed at NMCSD unless otherwise specified.

• Anesthesia
• Dermatology
• General Surgery
• Interventional Radiology
• Neurology
• Ophthalmology
• Otolaryngology
• Orthopedic Surgery
• Pathology
• Plastic Surgery
• PM&R
• Radiology (diagnostic)
• Radiation-Oncology
• Research
• Teaching Elective (longitudinal)
• Flight Surgery elective - Marine Corps Air Station Miramar
• Basic Underwater and Demolition/SEAL Team (BUD/S) elective - Naval Amphibious Base Coronado
• Fleet Marine Force elective - Marine Corps Recruit Depot

1. Each 24-hour Business Day will be divided into day and night duty with an AM and PM sign out/patient transition of care session.
2. The MHS GENESIS Rounds List will be used as the primary written/electronic reference while performing this TOC.
3. The off-going Intern and/or Intermediate resident is required to update and print a copy of the MHS GENESIS Rounds List for the entire call team prior to morning signout.
4. The IPASS communication format will be utilized for all written and verbal TOC.
5. Faculty on call will be available for supervision/mentorship during the morning sign out, rounds, and transitions of care.
6. The morning sign-out rounds/transition of care sessions must occur before the overnight duty Intern and/or Intermediate Resident reaches duty hour limitations as per ACGME guidelines.

• Combat Casualty Care Course (C4) in San Antonio, Texas or completion of Tactical Combat Care Course (TCCC) and Advanced Trama Life Support (ATLS) at NMCSD
• General Medical Officer (GMO) didactics
• Operational Medicine electives

• All TY residents are required to maintain Basic Life Support (BLS) and Advanced Life Support (ALS) or Advanced Cardiac Life Support (ACLS) certification throughout the training year.
• TY residents who receive follow-on orders to operational units or overseas assignments will also be required to complete either the Combat Casualty Care Course (C4) in San Antonio, Texas or the Advanced Trauma Life Support (ATLS) and Tactical Combat Care Course (TCCC) course at NMCSD. 

Each year, the TY program coordinates a variety of SIM sessions to improve critical skills. An example of these skill sessions is provided but is subject to change each academic year.

• Sessions1: ACLS codes, crash carts, IV, IO
• Session 2: Trauma Codes, Airway management, Chest Tubes, Needle Decompression
• Session 3: OB/GYN and ENT skills
• Session 4: RRT Training
• Session 5: Intro to US, E-FAST, Cardiac US
• Session 6: Suturing Workshop and Dermatology Skills
• Session 7: Critical Care and Neurology skills
• Session 8: Ophthalmology
• Session 9: Splinting

Research Medicine is a 4-week elective rotation that TY residents may select. This rotation is beneficial to residents going into a variety of different specialties and aimed at providing those residents the skills and knowledge needed to understand the process of research within the military treatment facility. The goal of the resident research program is for the resident physician to gain a greater understanding of the scientific method and the acquisition of new knowledge through a mentored research experience. Residents must submit a one-page proposal which highlights the title, mentor, hypothesis, specific aims and a brief summary of the methods to be used. Upon completion of the rotation, the TY resident will submit a summary of the work completed during the rotation as well plans for submission of the project as a presentation or publication. Opportunities to present research include at academics within the department as well as the annual NMCSD Academic Research Competition.

TY residents are encouraged to participate in QI projects throughout the year. Past QI projects have included: Benefits of the fundamentals of critical care course, A Guide to CHCS for New PGY-1s, Improving DKA protocol, optimizing nursing to intern communications, stroke process improvement, and an analysis of NMCSD’s readmission rates. Results from these projects were presented at the annual NMCSD Continuous Process Improvement (CPI) Fair.

Class Officer positions:

• TY Class President
• TY Class Vice president
• TY Treasurer & Journal Club Coordinator
• TY Simulation Coordinator
• TY PS/QI Representative
• TY Wellness Chair
• TY Mentorship Coordinator
• TY Public Relations Officer

• Naval Hospital Camp Pendleton
• Naval Branch Medical Clinics at Kearny Mesa, Liberty Station, Marine Corps Recruit Depot, and Basic Underwater and Demolition/SEAL (BUD/S) team training
• Rady Children's Hospital of San Diego
• Scripps Memorial Hospital
• Scripps Mercy Hospital
• University of California San Diego (UCSD) Medical Center

Medical students do not rotate within the TY program. 

Please visit our Medical Student Rotation informational page to see a listing of available medical student rotations offered at NMCSD.

Interested individual are invited to interview with the TY Program although it is not a requirement. Interviews may be performed in person or remotely and will be conducted with TY Academic Chief, followed by the Program Director. To schedule an interview, please email the program at: dha.san-diego.San-Diego-NMC.list.nmcsd-ty@health.mil.

Program participants must take COMLEX Level 3 or USMLE STEP 3 during the academic year. All TY PGY-1 residents must register for the appropriate examination by 1 December of each academic year and have completed the examination by 31 December. This timeline ensures adequate time for processing examination results prior to applying for your individual unrestricted state medical licensure.

The TY Teaching Elective course is a year-long, longitudinal non-clinical elective with a dedicated four week block for NMCSD house staff. TY residents complete a minimum of six learning activities throughout the academic year, meet with an assigned preceptor periodically, use the 4-week block to construct their educator’s portfolio, catch up on assignments, and updating their teaching philosophy. This rotation is beneficial to residents interested in improving their knowledge in health professions education. The goal of the rotation is for the resident physician to learn about different aspects of teaching, implement them in an authentic environment, and start an educator’s portfolio. It is our intention that this early career introduction will instill confidence in teaching, motivation for continued innovation, and a lifelong interest in medical education.

TY Residents are encouraged to actively engage in teaching rotating medical students, hospital corpsman, and each other on rotations.

Our TY Leadership specialize in radiology, neurology, and ophthalmology. In addition, TY residents interact with many faculty members in a broad range of specialties during rotations.

TY mentorship program: Incoming Transitional Year residents are matched with current TY residents to allow for a smooth transition between medical school to their first academic training year at NMCSD.

Wellness Coordinator Chair

Coordinates wellness activities and group activities throughout the year for the intern class.

Wellness Committee

This is a GME-wide committee that creates programming throughout the year, as well as responds to resident concerns.

TY T-group

This is an hour-long session led by one of the psychiatry senior residents aimed at talking through some of the challenges interns may face during internship and providing constructive solutions. Interns receive protected time to attend, though attendance is optional.