Raising Expectations in Military Medical Education

Lauren Cyran
Health.mil

March 31, 2010 - Many military medical professionals are trained in the civilian sector prior to serving, but Uniformed Services University of the Health Sciences (USU) in Bethesda, Md. offers individuals, both with and without prior military service, the opportunity to study medicine. The USU provides a unique approach to medical training, allowing its students to combine their passions for serving people and their nation.

“We are developing future physician leaders who can perform in austere environments and under complex circumstances,” said retired Navy Capt. Larry W. Laughlin, M.D., Ph.D., dean of the F. Edward Hébert School of Medicine at USU. “We need to ensure that our students, when they complete their education and hit the battlefields and military treatment facilities, are prepared to lead and be mentors, both in their military roles and as physicians. They may find themselves, right off the bat, in situations where their leadership will be called upon to make critical decisions that will save lives.”

Beyond the traditionally-required elements of an accredited medical school, USU’s curriculum incorporates 500 hours of military-specific education and training that emphasizes trauma and emergency medicine, infectious disease and parasitology, preventive medicine, the humanities and behavioral sciences and the principles of leadership and teamwork. USU students also benefit from alternative opportunities, including a four-week segment with an operational military unit, where their focus is not on medicine but on learning about military operations. Such trainings are especially important for those students who enter USU as a civilian, then go on to fulfill their military commitment upon graduation.

While USU stands prepared to offer these many different approaches to medical teaching, students and instructors alike take many different career paths before walking through the USU gates.

Laughlin was nearing completion of his own medical degree at the St. Louis University School of Medicine when he was drafted in 1971. Following a residency in Internal Medicine and a fellowship in Infectious Diseases at the Harvard Medical Service, Boston City Hospital, he reported to National Naval Medical Center for active duty as a Lieutenant in the U.S. Navy.

Throughout the next 13 years, Laughlin’s Navy medical career afforded him the opportunity to study and practice medicine throughout the world before returning to the U.S. as USU’s director, Division of Tropical Public Health, Department of Preventive Medicine and Biometrics.

Later, he took over as chair of the entire department. Laughlin has served as the dean of USU’s Medical School since 2002.

USU graduates are considered the preferred health care providers for troops since they are exposed to, and have familiarity with, military settings and protocols.

“These practitioners already bought into military medicine as a concept so they know protocols, behaviors, strengths and weaknesses,” said Laughlin. Graduates also have greater opportunities to live overseas and practice medicine in developing countries with access to DoD and State Department resources and laboratories.

Understanding the intricacies of military medicine, however, does not require that one enter straight into medicine, as Laughlin did. Army Lt. Col. Rebecca Yurek, a Family Nurse Practitioner student in USU’s Graduate School of Nursing, started her military career in law enforcement before she decided to pursue medicine.

Throughout her education at a civilian nursing school, Yurek served as a combat medic in the Reserves before joining the Nurse Corps upon graduation. As a combat medic, she was exposed to military medicine before coming to USU, while still working and studying in the civilian sector.

She has thoroughly enjoyed the ability to serve in a variety of roles spanning the world since that time, from being a critical care nurse at Fort Lewis, Wash., to an ICU nurse and commander for a company of 400 nurses, doctors and technicians at Fort Bliss, Texas, to the head nurse of cardiology in Germany, to New York City where she recruited medical students to USU.

“My biggest exposure to other [medical] schools was in recruiting. The best thing about USU is the [student-to-student and student-to-faculty] camaraderie, because at a lot of other schools, you are a number or just a face, especially in the big schools,” she said. “[At USU] everyone serves the same common purpose, it’s more than just caring for those in harm’s way, it’s the ability to serve service members, veterans, families, retirees and to respond to disasters. I think it’s that link to the flag and to Uncle Sam, responding around the world and knowing you make a difference. You feel it in your heart and soul.”

Yurek completed a six-month tour in Iraq as an ICU nurse before she applied to USU’s two-year family nurse practitioner program, which she expects to graduate from next year. She looks forward to interacting with her patients and teaching them prevention and health promotion in addition to the opportunity to train and develop younger nurses and staff. It is clear that among USU’s greatest strength is its ability to blend medical procedure and military need. As it develops military medical professionals to serve wherever the nation needs them, USU also emphasizes a research-intensive curriculum, giving students the chance to learn from dynamic leaders in their field and contribute to the advancement of medicine. “After working with wounded Soldiers and veterans, or even just those who are sick, you know what they’ve been through and that they’ve served their country, so you feel like you give more back than in civilian [medicine],” Yurek said. “Many medical advances have roots in military medicine. USU has been my best assignment yet; I’m excited to be here and to be a great nurse when I leave.”