Military Medical University Dispenses Medical Education, Much More

By Donna Miles
American Forces Press Service

May 20, 2008 - Navy Ens. Sandra McLaughlin could have gone to medical school anywhere, all expenses paid. But after a year at Yale University's School of Medicine, she felt she wasn't in the best place to prepare for a career treating combat casualties. "It didn't really feel like a good fit," said McLaughlin, reflecting on a climate that, after the initial post-9/11 surge of patriotism, "isn't always favorable to the military."

With fellow U.S. Naval Academy graduates serving in harm's way, McLaughlin said, she felt committed to becoming the best military doctor possible. So she transferred to an institution dedicated to training military doctors, graduate nurses and other specialized health care professionals for the unique challenges of military medicine: the Uniformed Services University of the Health Sciences.

The university also trains medical professionals for the Public Health Service, many who go on to serve with the Indian Health Service.

McLaughlin was among 157 doctors, 25 nurses and more than 60 Ph.D.-trained medical professionals to graduate over the weekend at USUHS, on the grounds of the National Naval Medical Center here. After receiving her medical degree and a promotion to lieutenant, McLaughlin is off to an internship at Naval Medical Center Portsmouth, Va., before joining the fleet.

"This is a full-package program," she said of the USUHS curriculum, which blends a traditional medical education with operational military training.

Students at the school get all the academics and hands-on training offered at any other accredited medical school, but also something more, explained Dr. Charles Rice, university president. They're trained to be military officers and leaders, able to provide top-notch medical care in difficult or austere conditions.

"The school of medicine trains its students to become the finest physicians in the largest, most sophisticated hospitals in the military health care system," said Dr. Larry Laughlin, dean of the university's F. Edward Hebert School of Medicine. "But what makes us unique is that we also train our students to be able to practice good medicine in bad places. And that's what sets us apart."

The curriculum emphasizes subjects just touched on at many medical schools: prevention, combat resuscitation, global infectious disease, humanitarian assistance and medical response to weapons of mass destruction. "We amplify this, because it's something we believe our graduates will have to deal with," Laughlin said.

Two major field training exercises at Fort Indiantown Gap, Pa., expose students to realistic combat scenarios and "give them a sense of the complexities of war and practicing medicine under those circumstances," he said.

Lectures by uniformed medical professionals who have served in combat or supported humanitarian assistance missions offer students unique insights. "We get the experience of our senior medical officers and nonmedical officers about what they went through, the challenges they faced, and how they dealt with them," said Army Capt. Massimo Federico, valedictorian of the school's 2008 graduating class.

"It adds another dimension to our training, because we all know that we will be participating in something like that at some point in the future," said Federico, who spent nine years as an Army medical evacuation pilot before coming to USUHS. "That's why we're here training to be physicians."

Carol Scheman, USUHS vice president, said she found something distinctive here that's simply not found at other medical institutions. "There's a real sense of mission here that sets the students apart," she said. "What's evident here that these students are committed to something larger than themselves."

Also unique to USUHS is a sense of teamwork not necessarily found at other medical schools. Air Force Capt. Brent Feldt, a member of the Class of 2008, said he picked up on the difference quickly when he began interviewing at medical schools.

"At other schools, you got more of a sense that people were looking out for themselves," said Feldt, a former Air Force communications officer. "But here, students are really motivated to help each other out and help each other succeed. That's because we know we will be working together for a long time."

"Our students know and understand from day one that they will be practicing and working together for probably the next 25 years," Laughlin said. "That changes the attitude of interaction. They become more of a team. Early on, they begin to depend on one other rather than competing in traditional ways. They are bonded."

The training emphasizes that doctors are part of a full military medical team. Medical and graduate nursing students work side by side during medical exercises. Medical students realize the skills and experience nurses bring to the table "and come to value that very quickly," Rice said.

"It's a team concept, and that's what's important about this university," said Army Col. Bruce Schoneboom, acting dean of USUHS' Graduate School of Nursing. "We have doctors and nurses training together, and it is that team that will be out there in the operational setting."

Clinical rotations at major Army, Navy and Air Force medical centers during students' third and fourth years of study provide prime training in how the medical team treats servicemembers, particularly those wounded in combat.

"Their experience here prepares them well so there are few surprises for them when they get out to their operational assignments," Rice said.

"We've been working with those patients, so we'll be able to bring more compassion and understanding to the wounded warriors," McLaughlin said. "The training we received here will help us to be more competent."

Meanwhile, the regular exposure to wounded troops provides a regular reminder of the important calling graduates will face. "One walk through Walter Reed [Army Medical Center] will send the message home pretty quickly," Federico said.

"It's impossible to walk through Walter Reed without seeing what guys are dealing with coming back from Afghanistan and Iraq," he said. "To see that on a daily basis while you're learning your trade of medicine, it certainly gives you motivation to get up early and work hard and do a good job and serve them the best you can."

It's not a job just anyone can do. Only one of every 12 applicants gets admitted to USUHS, and only after a rigorous interview process by military physicians, Laughlin said.

"You have to be bright and have the potential to be successful in your studies," he said. "But we also look for resilience, the capacity to survive and thrive in the type of medicine that we practice. We also look for elements of leadership, because that's valuable to our type of medicine."

Rice said he hears it time and again: Line commanders say they find leadership skills in USUHS graduates that they don't find elsewhere.

"They can spot one of our graduates in very short order for the ability to quickly figure out what assets they have available, how to organize them and then how to deploy them," he said. "That's a skill set that's enormously valuable in an operational setting, and our graduates are used to doing that."

Navy Lt. Sarah Harnett, a new USUHS graduate headed to the Indian Health Service, called leadership the most important thing she learned at the university. "It's not just about being doctors and not just about learning medical information," she said. "It's about being a leader. ... And as important as being a leader is, it's also when to be a follower and how to follow appropriately and how to know where you are and what you need to be doing at any particular time to get the team where it needs to be.

"If more civilian doctors had that lesson," she said, "it would be better for all patients."