Mission

The mission of the Internal Medicine residency at WBAMC is to train exceptional internists who are prepared for a career in general internal medicine. By focusing on this simple goal, our residents also depart our program as competitive fellowship applicants and ready to be leaders in Army Medicine. We achieve out mission by placing equal emphasis on clinical reasoning and the science of medicine, military relevant procedural skills, and compassionate, empathetic care. We offer opportunities for research as well as in the areas of quality improvement and patient safety. We also offer opportunities for residents interested in operational medicine through our relationship with Fort Bliss: Home of the 1st Armored Division!

Vision

To train excellent internists with a community focus who are committed to contributing the Military Health System as clinician-leaders.

Aims

Care to Community

Graduates from training program are prepared to practice general internal medicine in any environment. Residents will gain patient-based educational experience that emphasizes diseases and problems common in internal medicine. Should they choose to pursue fellowship or other forms of additional training, our residents will be poised to do so.

Clinical Excellence

Our mission is to train superb internists able to pursue careers in clinical practice, academic medicine, research, or administration. Internal medicine trainees will have ample experience in inpatient and outpatient medicine where they will learn to practice safely and reliably.

Improvement

The practice of medicine is changing - dramatically. While the doctor / patient relationship is still paramount to providing effective, patient-centered care, there is a growing need to recognize, appreciate, and help mold the systems and environments in which we practice. This requires new graduates to have a firm command of systems of care, quality and process improvement, and transitions of care. Our internal medicine program and faculty foster a culture of innovation and safe, high-quality patient care with an emphasis on the constant pursuit of both self and institutional improvement. Resting on one’s laurels is not going to cut it in our program!

Medical Education

Many of our internal medicine residency graduates go on to pursue careers in medical education. We believe the rich academic environment, coaching, and diverse mentorship aid residents in their career decision-making process. The emphasis that internal medicine faculty place on education is exceptional and includes strong involvement at both the medical student and resident level. Internal Medicine residents receive training on improving their teaching skills and providing feedback. In addition, residents are also taught by leaders in medical education, policy, and accreditation, which allows them to learn the “language” and national trends in medical education.

The program hosts a daily hour-long noon conference in the main conference room in hospital. This conference schedule provides a wide range of topics including case presentations, journal club, clinical reasoning conference, subspecialty updates, Morbidity and Mortality (M&M), and other unique presentations on topics in medicine and on social determinants of health. We also have dedicated academics for our ambulatory clinic rotators and hospital-wide medicine grand rounds every Friday.

The internal medicine residency at WBAMC uses a 4+1 academic schedule in which trainees are scheduled in alternating 4-week rotations of varying types followed by 1-week blocks of ambulatory time. There is progressively more elective time added to the schedule as the trainee moves to PGY2 and PGY3 years. Leave is authorized to be taken during elective and research. Every 4-week rotation ends in a golden weekend (Sat and Sun off) prior to the start of the clinic week. There is progressively more elective time added to the schedule as the trainee advances . A general outline of the three-year curriculum follows:

Elective rotations are subject to availability. Options include: 

• Cardiology
• Gastroenterology
• Geriatrics 
• Hematology/Oncology Clinic
• Infectious Disease Clinic
• Medical Intensive Care Unit
• Medical Officer on Duty
• Nephrology
• Night Medical Officer on Duty
• Neurology
• Pulmonology
• Nuclear Medicine/Radiology
• Research
• Rheumatology
• Ultrasound

All rotations are organized on day/night shifts of 12 hours or less in length. Required rotations (e.g. ward medicine, medicine intensive care unit, cardiac care unit, night float) consist of six days of duty and one scheduled day off per week. Clinic weeks, elective, research, and most other rotations consist of five days of duty and two days off per week.

Graduates of our program will be prepared to begin the practice of general internal medicine in any environment which of course includes the unique opportunities presented by the United States military. We have a diverse group of trainees that provide peer-to-peer education. We enrich our program with education that often underlines military relevance.

Graduates from our program will serve a diverse group of active-duty service members, dependents, and retirees in addition to potentially treating foreign nationals and citizens of foreign countries. Residents will gain patient-based educational experience that emphasizes the knowledge and skills needed to manage such a variety of patients with both acute and chronic diseases common in internal medicine irrespective of the setting.

All residents are required to maintain Basic Life Support (BLS) and Advance Life Support (ALS) certification throughout residency. These courses are available at WBAMC by Education Dept. Army interns/residents complete Combat Care Casualty Course (C4) training prior to graduation.

Procedural skill training, including common internal medicine procedures such as:

• Central line placement
• Arterial line placement
• Thoracentesis
• Paracentesis
• Chest tube placement
• Lumbar puncture
• Arthrocentesis

The program provides a robust opportunity to develop leadership skills throughout residency training. These opportunities range from formal lectures to small group discussions to experiential learning. Opportunities start from the first day of training. Increasing levels of responsibility are placed on our trainees in a progressive nature over the 36 months of residency. Some examples include:

• Opportunity to lead ward or Intensive Care Unit (ICU) team on a regular basis
• Opportunity to lead residency committees
• Opportunity to serve teaching medical students on team
• Quality improvement projects
• Scholarly projects

The Resident Research Coordinator(s) is/are staff members with research expertise, dedicated to coordinating and optimizing research amongst our residents. They provide expertise and mentorship in project concept, design, statistical analysis, presentation, and publications. The coordinator helps in preparation of abstracts and presentations for the Army American College of Physicians (ACP), Far West Texas ACP Clinical Vignette competition, Texas ACP, and WBAMC Research Day. He or she also promotes publications to include the El Paso Physician, Military Medicine, and other peer-reviewed journals. Finally, they are responsible for tracking resident research activity.

Modern health care institutions are complex adaptive systems. Our program strives to provide highly reliable, safe, and effective care for all our patients while providing high quality medical education for all learners that train in our institution. We practice a continuous quality improvement lifecycle to meet these goals and we aim to instill these habits in our trainees. The program has a monthly Morbidity and Mortality Conference in a multi-disciplinary setting to review complex inpatient and outpatient cases for areas of improvement. The discussion is focused on systems-related, provider-related, and patient-related factors that contribute to patient outcomes. We emphasize the importance of a team-based, comprehensive approach to patient care.

Our Internal Medicine Program believes that it is a physician’s duty to advance our profession through scholarship of discovery, integration, application, engagement, and teaching. To that end, the program strives to ensure that each graduate possesses basic knowledge, skills, and experiences in research and scholarly endeavors. Furthermore, the program aims to provide a rich array of opportunities and mentorship to participate in research projects specialties and in medical education and quality improvement.

• Texas Tech University Health Science Center (TTUHSC) – Permian Basin in Odessa, Texas, Geriatric Rotation which is required rotation for PGY-2 or PGY-3.
• El Paso Veterans Affairs Health Care System in El Paso, Texas. One 4-week rotation in VA Primary Care Clinic during PGY-2 and PGY-3 years to improve care to our Veterans.
• Texas Tech University Health Science Center in El Paso, Texas. Opportunity for residents to work in the ICU, Neurology. Residents also have a rotation in Level 1 Trauma Center and provides experience in how civilian hospitals are run.

Our program offers rotations to fourth year medical students interested in applying to internal medicine and is a core clerkship site for third year Uniformed Services University students. Other third year medical students rotations are on a space available basis.

Students interested in arranging a rotation should start by reviewing the Medical Student Guidance from William Beaumont Army Medical Center. 

Rotations opportunities include: 

• Medical Student (MS) 4th Year
  • Medical Intensive Care Unit
  • Cardiac Care Unit (CCU)
  • Hematology/Oncology Clinic
  • Pulmonary Clinic
  • Gastroenterology Clinic
  • Cardiology Consult Service / Clinic
  • Infectious Diseases Consult Service / Clinic
  • Nephrology Consult Service / Clinic
  • Rheumatology Clinic
  • Endocrinology Clinic

• MS 3rd Year
  • Core clerkship site for Uniformed Services University of the Health Sciences F. Edward Hebert School of Medicine
  • Space available rotations for other MS3 students

Military MODS will open in August for medical students to put their application in military data base. We will attempt to coordinate face to face interviews with any applicants able to come visit us or those who are scheduled to rotate with us. We also offer virtual interviews. We require a current CV and Personal Statement prior to interview. All military interviews must be completed before middle of October. Interviews are coordinated/scheduled by our program coordinator.

VA Civilian Stipend PGY-1 Intern applicants must apply through Electronic Residency Application Service (ERAS) for our VA program. You must be a US citizen (by birth or naturalization) tin order to apply for this VA -sponsored position. ERAS opens in July for applicants. The WBAMC Internal Medicine Training Program will interview selected applicants from early December through February. These interviews are also scheduled thorough Internal Medicine Residency Coordinator.

Program graduates take the American Board of Internal Medicine (ABIM) Certifying Examination. This exam is offered annually in August. All Internal Medicine physicians who have met the standards for Board Certification in general internal medicine are considered Board Eligible for a period of seven years. During this period of board eligibility, the candidate may apply for the certifying examination in internal medicine. To be eligible to take this exam, graduates must complete all pre-requisites required by the American Board of Internal Medicine by August 31st. For more details, please visit the American Board of Internal Medicine website.

Teaching is considered a core competency for trainees in our program. Trainees have opportunities to practice and hone their skills as educators from the outset of training in both formal and informal settings. Some examples of teaching opportunities available to all trainees in our program include:

• Interns and residents teach third- and fourth-year medical students on hospital medicine, ICU and elective rotations throughout the academic year.
• Residents participate in teaching interns in both the inpatient and ambulatory setting throughout the academic year.
• Residents can design and deliver other educational sessions in lecture or small group format throughout the academic year.

Faculty supporting the Internal Medicine Residency program have a wide range of subspecialty representation, including:

• Cardiology
• Endocrinology
• Gastroenterology
• Hematology and Oncology
• Infectious Diseases
• Interventional Cardiology
• Nephrology
• Pulmonary and Critical Care
• Rheumatology
• Sleep Medicine

Our program matches trainees with mentors. We attempt to do this based on the resident’s interests and background. Residents are free to choose additional mentors on their own. Assigned faculty mentors meet with their resident mentees at least twice per year. The goals of our mentorship program are to help the mentee address their personal, military, and civilian professional (clinical) goals including a review of relevant career pathways within the military, the trainee’s curriculum vitae and individualized learning plan.

Our program takes resident well-being and work-life balance seriously. Our schedule is structured to balance the provision of robust clinical training with reasonable time away from the workplace. Residents receive one day off in every seven days on inpatient rotations (e.g. hospital medicine, CCU, ICU) and two days off in seven on outpatient and elective rotations. The program and institution have a rich array of resources available for trainees to help support their health and wellness including a peer support program, behavioral health resources, financial planning resources, chaplain services, and military and family life counseling.