NCC Pediatrics Residency @ Walter Reed Bethesda
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Military Unique Curriculum for Pediatricians

Graduates of the NCC Pediatrics Residency practice pediatrics in settings that the vast majority of graduates of civilian training programs will never experience. They include remote clinics without nearby subspecialist support, overseas clinics and hospitals in foreign lands, in areas devastated by humanitarian crises and natural disasters, and in combat environments.

Our faculty of uniformed and civilian physicians, nurses, and other medical professionals have over 1200 years of combined experience taking care of children of military personnel, children affected by humanitarian crises, and Soldiers, Marines, Sailors, Airmen, and Guardians. They have practiced in small clinics home and abroad, at referral hospitals, and in deployed medical facilities of all sizes. The Military-Unique Curriculum, detailed below by the ACGME competencies, draws on our faculty's experience to prepare pediatricians who can successfully care for children and succeed in any environment in which they serve.

Patient Care

  • Care for the military child and family, including managing stressors of parent military deployment and frequent moves
  • Care for patients while providing humanitarian assistance or disaster relief in resource limited environments or developing countries
  • Stabilization and aeromedical and ground evacuation of critically ill newborns and children
  • Care for soldiers, prisoners of war, civilian casualties as a general medical officer to include initial interpretation of acute radiographs; electrocardiogram (ECG) interpretation; management of infected ingrown toenails; perform initial and emergency management of musculoskeletal injuries pending transfer; gynecologic examinations; emergency resuscitation and stabilization of adults to include intubation and ventilation, chest tubes and emergency drug administration; triage and manage mass casualty situations; supervise and conduct soldier readiness processing; and plan and conduct air-medical evacuation with a flight surgeon

Medical Knowledge

  • Asynchronous and synchronous virtual health management by email, telephone, and video platforms
  • Neonatal Intensive Care Unit (NICU) training to prepare graduates to resuscitate, stabilize, and transport preterm infants while practicing in remote locations
  • Pediatric Advanced Life Support (PALS) certification
  • STABLE Course Certification (acronym stands for six assessment and care modules relating to the stabilization of neonates Sugar, Temperature, Airway, Blood pressure, Lab work, and Emotional support)
  • Military Medical Humanitarian Assistance Course
  • Chemical, Biological, Radiological, Nuclear and Enhanced Conventional Weapons (CBRNE) training
  • Deployment and International Health Short Course (optional)
  • Global Medicine Course (optional)
  • Tropical Medicine Program (optional)
  • Military Professional Education (Captain's Career Course, Intermediate Level Education, Basic Readiness Officer Course)
  • Medical Threat Assessments intended to limit impact of Disease and Non-battle injuries (DNBI) and battle injuries on combat effectiveness
  • Understanding duties of a battalion brigade surgeon (Army), Flight Surgeon (Air Force/Space Force), or General Medical Officer, Dive Officer, or Flight Surgeon (Navy/Marines)
  • Professional Filler System (PROFIS) or service equivalent; and requirements for authorizing medical profiles
  • Combat Casualty Care (Combat Casualty Care Course, Combat Trauma Course, Advanced Trauma Life Support) - required for all graduates

Professionalism

  • Maintaining Physical Fitness as a role model to patients and colleagues
  • Military customs, courtesy, and traditions
  • Officership and Leadership

Interpersonal and Communication Skills

  • Learning each Service's language and customs
  • Communications within the chain of command
  • Military mentoring
  • Learning to communicate effectively with medical providers in other countries upon whom military pediatricians rely upon for continuity of care or complementary care

Practice-Based Learning & Improvement

  • Basic Certificate in Quality and Patient Safety (Institue for Healthcare Improvement)
  • Instructor Certification in the Pediatric Advanced Life Support (PALS) for overseeing and training providers at assigned duty stations
  • Instructor Certification in the Neonatal Resuscitation Program (NRP) for overseeing and training pediatric providers at assigned duty stations
  • Instructor Certification in the STABLE Course for overseeing and training pediatric providers at assigned duty stations
  • Evaluation systems to include Officer Evaluation Reports (OER), Fitness Reports (FITREP), Officer Performance Reports (OPR) and civilian employee evaluation systems (DPMAP)
  • After action reports and lessons learned analyses
  • Writing awards

Systems-based Practice

  • Patient Centered Medical Home (PCMH)
  • Military Healthcare Insurance Systems: Tricare and the Extended Care Health Option (ECHO) supplemental program
  • Exceptional Family Member Program (EFMP)
  • Facility with Electronic Medical Record systems and Tools
  • Armed Forces Health Longitudinal Technology Application (AHLTA - legacy system) and MHS GENESIS - the largest world-wide networked EHRs
  • Essentris - legacy inpatient EMR
  • Composite Health Care System (CHCS) - legacy system
  • Joint Legacy Viewer (JLV) - connection between legacy inpatient & outpatient EHRs
  • Electronic dictation systems (Dragon Speak, As-U-Type, etc)
  • Management of Electronic communication with patient or family (RelayHealth)
  • MHS Clinic Management Course (required for all graduates)
      Defense Medical Human Resources System-internet (DMHRSi)
      Quality Assurance/Improvement projects within the Military Healthcare System access to care requirements
      Joint Outpatient Experience Survey (JOES)
      Relative Value Unit (RVU) calculation
      Full Time Equivalent (FTE) calculation
      Managing temporary duty (TAD/TDY) funds
      Staffing models
      Clinic schedule templates
  • Disaster preparedness planning
  • Active duty service member chain of command
  • Hospital and Post/Base Command Structures
  • Family Advocacy Program (FAP); Family Advocacy Program Case Review Committee; Family Advocacy Coordinating Committee; Military Fatality Review Committee Community support programs to include Family Readiness Groups (FRG); Army Community Services (Programs for Primary Prevention); New Parent Support Program (NPSP); School Based Mental Health (SBMH); Family Assistance for Maintaining Excellence (FAME); and Child and Family Assistance Center (CAFAC); Families Overcoming Under Stress (FOCUS); Child, Youth & School Services (CYSS); Special Needs Accommodation Process (SNAP) multidisciplinary team

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