New military residencies?

[FizbanZymogen]

So it looks like Gates is still planning on closing Walter Reed in 2011 as per this article....(no big surprise)

http://news.yahoo.com/s/ap/20070503/ap_on_go_ca_st_pe/walter_reed

This will be the year I graduate from USUHS and so I am wondering, what will happen to all those residents and residencies that Walter Reed currently houses. Will they move these positions to Ft. Belvoir and NNMC or will they try to open more Army slots at the other "big four" bases? Any ideas?

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[NavyFP]

Most of the WRAMC/NNMC programs are joint programs. There is no expected loss of slots. While the size of NNMC is expected to increase, I would expect there to be some rotations down at Belvior.

 

[DCM]

So it looks like Gates is still planning on closing Walter Reed in 2011 as per this article....(no big surprise)QUOTE]

They are not really "closing" Walter Reed. They are merging NNMC and Walter Reed. As above, many of the services here are complementary already. For example, peds inpatient is at WR, peds outpatient is at NNMC. I think the name of the new merged hospital in bethesda is going to be Walter Reed. It may be better for GME if they do make it a big academic center like they say they want to.

 

[FizbanZymogen]

thanks everyone for helping to clear this up.

 

[mitchconnie]

Most of the WRAMC/NNMC programs are joint programs. There is no expected loss of slots.

I don't know how the rotations will be restructured, but it's still a long way off before the facility actually shuts down, so they have plenty of time to figure that out.

I don’t doubt that some residency programs are well-integrated and the transition will be minimally disruptive, but some are not, and the residents are in for a rough ride. Program directors seem to be parroting the party line of “nothing will change,” but this is just magical thinking. For instance, separate general surgery programs at NNMC and WRAMC train a total of seven categorical residents per year, and residents are already hurting for caseload at the home institutions. A combined surgical residency with seven residents per year would be one of the largest in the country, and it’s unrealistic to think that the RRC will approve such a large program at an institution with only 300 inpatient beds (I’m guessing at the size of the new Walter Reed National Naval Medcal Center at Bethesda). Just by way of comparison, Johns Hopkins trains 6 residents per year. The NCA will clearly be forced to cut back the number of surgery trainees or risk their accreditation.

The Wilford Hall/BAMC surgery residency merger in San Antonio is being handled much better. There is already a concrete plan in place for reorganization and a preliminary RRC site visit for the combined program. They will start matching next year for the combined program with half the number of residents that trained at the separate programs. NCA program directors need to act NOW, since residents who match in surgery next Dec. will not finish training until 2013

I feel that the BRAC offers the opportunity to completely restructure and improve residency training for some of the surgical specialties in the NCA. Unfortunately, it seems as though many program directors simply want to maintain the status quo as long as possible and protect their fiefdoms. The people that get burned are the residents. While I hate to be so pessimistic about my own department, my recommendation is to avoid surgical training in the NCA for the next 5-7 years.

 

[Dr. Dukes]

A combined surgical residency with seven residents per year would be one of the largest in the country, and it’s unrealistic to think that the RRC will approve such a large program at an institution with only 300 inpatient beds (I’m guessing at the size of the new Walter Reed National Naval Medcal Center at Bethesda).

When I was at USUHS for my interview (fall 06) they mentioned that the new hospital was supposed to be ~1,000 beds. I found that hard to believe, just cause thats the size of MGH, so I got home and searched online. I found several articles talking about the process (Washington Post/Time/CNN type articles) that all quoted the same figure. I'm not sure if the budget for the new building has been set in stone (and therefore they "know" how big it will be), but I would bet on a hospital much closer to 1,000 than 300 beds.

 

[mitchconnie]

Walter Reed now tops out at a little over 200 staffed inpatient beds. We start getting nastygrams about discharging patients when it gets any higher. 280 is supposed to be the absolute max., but it doesn't seem like the nursing is ever there to support it. I do not not believe Bethesda is any larger, and it's probably a little smaller. Plus, a large amount of the capacity of WRAMC is scheduled to move to Ft. Belvoir. That's why I guessed 300.

The number of beds which we might theoretically be able to cram into the building is irrelevant, since the census is never anywhere near that, and the current staffing levels cannot possibly support it. I have no idea where that 1000-bed figure comes from--it sounds totally made up. I do hear high figures like that thrown around as some kind of hypothetical "surge capacity" since in the past WRAMC and Bethesda did have that many beds in the building.

But the idea that the the new medical center will have four times the capacity of the current WRAMC is laughable. I've been in some planning meetings about the merger, which are already extremely precise about the planned increase in hospital space and staff. The total space alotments and staffing levels are WAY less than the sum total of the two institutions.