MEDCOM Updates
Christopher A. Dillon MD
COL, MC
Accessions/Recruiting Liaison to OTSG
1
Current Issues in Medical Education
• Increase in Medical School Enrollment
 AAMC reports nearly 30% from 2002
 80% of MD schools
 75% initiatives encouraging primary care
• 112th Congress Deficit Reduction
 60% reduction ($3.9B) in Medicare payments
to teaching hospitals
 ACGME concerned re: # trainees & education
2
Current Issues in Medical Education
• Control Act of 2011
 Eliminates interest subsidies on Stafford Loans
– Graduate & Professional Students begin July 1, 2012
– Still have access to same amount of loans ($40,500
for medical students)
– Since unsubsidized, estimates increase loan costs by
$10,000-$20,000 per student
• Physician Salaries
 https://www.aamc.org/download/48732/data/compensation.pdf
3
Current Issues in Medical Education
• National Match
 2014- MD applicants will equal positions
offered
– GME slots up 6%/5 yrs but applicants up 9.5%/5 yrs
– Only 52% of civilians got 1st choice
 14,000 non-U.S. senior applicants
 Match will be more competitive (>900 U.S.
senior medical students didn’t match last year)
• Military Match
 Smaller, better chance to match 1st or 2nd
4
GRADUATE MEDICAL
EDUCATION STATS
• Number, specialty distribution, subspecialty options programmed
to meet the needs of the Army.
- 137 Programs 72 residencies, 59 fellowships, 6 transitional
internships).
- 22 Specialties.
- 11 Teaching hospitals.
- 57% of programs with 5 yr. accreditation; 20% with 4 yr.
accreditation (3.95 yr is civilian average; Army average 4.3 yrs).
• Majority of Army physicians in GME train in in-house programs.
- 1466 in training (1355 in-house programs and 111 Army
sponsored civilian training). 30 in educational delay/FAP.
- Comprises 31% of active duty Medical Corps end strength.
• 93% first time board pass rate.
5
Army GME Success Stories
• Brooke AMC and Walter Reed AMC General Surgery
 Two of only 10 surgery programs in the country (250 programs total)
to have a 100% first time pass rate on both written and oral boards
over the last 5 years
• Emergency Medicine
 Residents at Darnall ACH, Brooke AMC and Madigan AMC have
scored in the top 10 nationwide on the annual EM in-service exam
for the past 11 years
• Internal Medicine
 WRAMC IM residents (13) achieved a 100% pass rate on the 2007
ABIM certification exam. The national average for first-time takers
between 2002 and 2006 is 91%. The Walter Reed average for
first-time takers for the past 10 years is 98%.
• Ophthalmology
 The Army had the first residency program in the US to get the virtual
reality ophthalmic surgical simulator. 100% of our ophthalmology
residency programs are sim-inclusive.
6
Medical Research
•
The U.S. Army Aeromedical Research Laboratory (USAARL), Fort
Rucker, Alabama
•
U.S. Army Institute of Surgical Research (USAISR), Fort Sam Houston,
Texas
•
U.S. Army Medical Research Institute of Chemical Defense
(USAMRICD), Aberdeen Proving Ground, Maryland
•
U.S. Army Medical Research Institute of Infectious Diseases
(USAMRIID), Fort Detrick, Maryland
•
U.S. Army Research Institute of Environmental Medicine (USARIEM),
Natick, Massachusetts
•
Walter Reed Army Institute of Research (WRAIR), Forest Glen,
Maryland
 U.S. Army Dental Research Detachment
 U.S. Army Medical Research Detachment
 Armed Forces Research Institute of Medical Sciences-Thailand (AFRIMS)
 U.S Army Medical Research Unit- Europe
 U.S Army Medical Research Unit- Kenya
7
Regional Medical Commands
Teaching Hospitals
Walter Reed AMC
Eisenhower AMC
William Beaumont AMC
Womack AMC
Martin ACH
Madigan AMC
DeWitt ACH
Darnall AMC
Tripler AMC
Keller ACH (West Point)
Brooke AMC
8
ARMY FIRST YEAR GRADUATE MEDICAL EDUCATION
(FYGME) PROGRAMS - (PGY-1)
SPECIALT Y
SAUSHEC
Emergency Medicine
X
Family Medicine
General Surgery
X
GS Neurosurgery
GS Urology
X
Internal Medicine
X
Neurology
Child Neurology
OB-GYN
X
Orthopaedics
X
Otolaryngology
X
Pathology
X
Pediatrics
X
Psychiatry
Psychiatry/Internal Medicine
T ransitional
X
Prelim Aerospace Medicine
Prelim Anesthesiology
X
Prelim Dermatology
X
Prelim Ophthalmology
X
Prelim Physical Medicine
Prelim Preventive Medicine
Prelim Radiation Oncology
Prelim Radiology(DIAG)
X
EAMC
X
X
MAMC
X
X
X
T AMC
NCC
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
WBAMC
WAMC
X
DARNALL
X
X
MART IN VA-DoD
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
SAUSHEC –Brooke Army Medical Center, Fort Sam Houston, T X/Wilford Hall Medical Center, Lackland AFB, T X/University of T exas, San Antonio, T X
NCC –Walter Reed Army Medical Center, Washington, DC/DeWitt Army Community Hospital, Fort Belvoir, VA
National Naval Medical Center, Bethesda, MD/Malcolm Grow Medical Center, Andrews AFB, MD/USUHS
9
Residencies
•
•
•
•
•
•
•
•
•
•
•
Internal Medicine
Family Medicine
Emergency Medicine
Pediatrics
Obstetrics/Gynecology
General Surgery*
Neurosurgery
Orthopaedics
Urology
Otolaryngology
Preventive Medicine/
Occupational Medicine*
•
•
•
•
•
•
•
•
•
Dermatology
Radiology
Radiation Oncology
Anesthesiology
Aerospace Medicine*
Neurology and Child Neuro
Pathology
Psychiatry
Physical Medicine and
Rehabilitation
• Ophthalmology
* Specialty does not offer continuous contract; must reapply for PGY-2 year.
10
PGY-1 Categorical Specialties
• Emergency
Medicine
•
•
•
•
•
Family Medicine
General Surgery
Internal Medicine
Neurology
•
•
•
•
•
•
OB-GYN
Orthopaedics
Otolaryngology
Pathology
Pediatrics
Psychiatry
Neurosurgery
11
Designated Preliminary/Pre-Select Specialties
• General Surgery*
o Urology
• Transitional Year
 Undesignated
 Designated
o Aerospace Medicine*
o Anesthesiology
o Dermatology
o Ophthalmology
o Physical Medicine
o Preventive Medicine/Occupational Medicine*
o Radiation Oncology
o Radiology (Diagnostic)
* Specialty does not offer continuous contract; must reapply for PGY-2 year.
12
Applications For FYGME
Applicants Per Approved Positions
SPECIALTY (#slots 2011)
2006 2007 2008 2009 2010
2011
Emergency Medicine (28)
1.25
1.23
1.63
1.15
1.14
1.36
Family Medicine (44)
1.09
0.80
0.58
0.56
0.88
1.07
General Surgery (26)
1.29
1.10
0.92
1.65
1.84
1.65
GS Neurosurgery (3)
0.50
1.00
1.00
7.00
1.50
1.33
GS Urology (7)
1.57
1.00
1.17
1.57
0.57
0.71
Internal Medicine (58)
0.84
1.06
0.75
0.65
0.71
0.66
Neurology (6)
1.20
0.60
0.33
1.20
0.50
0.83
Child Neurology (1)
0.00
0.00
0.00
0.00
0.00
1.00
OB-GYN (17)
1.53
1.13
1.20
1.20
0.59
0.83
Orthopaedics (19)
1.36
1.95
1.84
1.47
0.89
1.21
Otolaryngology (7)
1.28
4.00
1.14
1.00
1.71
1.33
Pathology (6)
1.16
0.50
1.17
1.00
1.00
1.17
Pediatrics (26)
1.20
0.88
0.92
0.62
0.62
0.92
Psychiatry (15)
0.83
1.07
0.64
0.71
0.87
0.88
13
Applications For FYGME (continued)
Applicants Per Approved Positions
SPECIALTY (#slots 2011)
2006 2007 2008 2009 2010 2011
Psychiatry/Internal Medicine
(0)
0.50
1.50
0.50
1.50
2.00
0.00
Transitional (15)
0.27
0.06
0.20
0.13
0.13
0.13
Prelim Aerospace Medicine (1)
0.50
0.50
0.00
0.00
1.00
0.00
Prelim Anesthesiology (12)
1.33
1.42
1.25
1.50
0.83
1.25
Prelim Dermatology (7)
1.62
1.29
0.57
1.29
1.29
0.71
Prelim Ophthalmology (7)
1.42
1.14
0.72
1.57
0.86
0.43
Prelim Physical Medicine (3)
1.66
2.00
3.33
1.00
1.33
2.00
Prelim Preventive Medicine (2)
0.25
0.67
0.75
0.50
0.50
1.00
Prelim Radiation Oncology (1)
2.00
0.00
2.00
1.00
0.00
1.00
Prelim Radiology (Diag) (15)
1.25
1.00
1.67
1.00
0.87
0.87
14
VA-DoD Training Opportunities
• Intern year in Army program
• Remainder of residency in VAsponsored program
 Radiology – Medical College of Georgia;
UT San Antonio
 Urology – UT San Antonio; Duke University
 Neurosurgery* – University of Florida; UT
San Antonio
*Entirety of training in VA-sponsored program
15
2010 Army GMESB Selection Summary Report
Fellowship Training
Selects
Inservice
Military
Selects
Deferred
Selects
Civilian
Sponsored
Total
Applicants
Inservice
Select
Rate
Overall
Select
Rate
Total
Selects
NonSelects
Utilization/
Field
46
0
26
72
23
95
48%
76%
Interns
0
0
0
0
0
0
0%
0%
Current
Deferred
1
0
0
1
6
7
14%
14%
Current
Residents
30
0
29
59
57
116
26%
51%
Civilian
1
0
0
1
2
3
33%
33%
Totals
78
0
55
133
88
221
35%
60%
Female
19
0
10
29
22
51
37%
57%
Minorities
21
0
12
33
26
59
36%
56%
Totals
40
0
22
62
48
110
36%
56%
16
Fellowships 2012
Aerospace Med
Hyperbaric Med
CIV
1
Anesthesiology
Acute Pain/Regional Anesth
NCC
1
Critical Care Anesth
NCC
1
Pain Management
NCC
2
Pediatric Anesth
CIV
1
Dermatology
Dermatologic Surgery
CIV
1
Emergency Med
Wilderness Med
MAMC
1
Emergency Med Cardiology
CIV
1
Emergency Med Services
SAUSHEC
1
Emergency Toxicology
CIV
1
Pediatric Emergency Med
CIV
1
Sports Med
CIV
1
Ultrasound
SAUSHEC/MAMC/Darnell
3
Faculty Development
MAMC
3
GI/Colonoscopy
MAMC
1
Hospitalist
CIV
1
OB/GYN
Darnall/CIV
2
Sports Med
NCC/CIV
3
General Surgery
Plastic Surgery
CIV
2
Other Surgery
Advanced Laproscopy
CIV
3
Trauma/Critical Care Surgery
SAUSHEC/CIV
2
Family Medicine
17
Fellowships 2012
Internal Medicine
Neurology
OB/GYN
Ophthalmology
Cardiology
SAUSHEC(2)/NCC(3)
5
Cards Interventional
CIV
1
Critical Care Med
SAUSHEC
1
Endocrinology
NCC
1
Gastroenterology
SAUSHEC(3)/NCC(2)
5
GI Invasive Endoscopy
CIV
1
General Internal Med
WBAMC
1
Hematology/Oncology
SAUSHEC(1)/NCC(2)
3
Infectious Diseases
SAUSHEC(2)/NCC(1)
3
Nephrology
NCC
1
Pulmonary/CCM
SAUSHEC(1)/NCC(2)
3
Rheumatology
NCC
1
Child Neurology
NCC
1
Clinical Neurophysiology
NCC
1
Headache Medicine
CIV
1
Neuro Critical Care
CIV
1
Maternal and Fetal Medicine
MAMC/CIV
2
Gyn Minimally Invasive Surgery
NCC
1
Reproductive Endocrinology
NCC/CIV
2
Glaucoma
CIV
1
Ophthalmic Pathology
CIV
1
Retinal Surgery
CIV
2
18
Fellowships 2012
Orthopedics
Otolaryngology
Pathology
Pediatrics
Childrens Ortho
CIV
1
Feagin Sports Med
Keller
2
Hand Surgery
NCC
2
Orthopedic Trauma
CIV
2
Shoulder Surgery
CIV
1
Spine Surgery
CIV
2
Total Joint/Recnstructive Surg
CIV
1
Facial/Plastic/Reconstruct Surg
CIV
1
Head and Neck Surgery
CIV
2
Pediatric Otolaryngology
CIV
1
Sleep Med and Surgery
CIV
1
Clinical Molecular Genetics
CIV
1
Forensic Pathology
AFIP
1
Neuro Pathology
CIV
1
Pathology Infomatics
CIV
1
Developmental Peds
MAMC
2
Neonatology
SAUSHEC(1)/NCC(1)
2
Pediatric Cardiology
CIV
1
Pediatric Endocrinology
NCC(1)/CIV(1)
2
Pediatric Gastroenterology
NCC
1
Pediatric Infectious Diseases
NCC
1
Pediatric Pulmonary
CIV
1
19
Fellowships 2012
Physical Medicine
Pain Management
NCC
2
Prevent/Public Health
Medical Toxicology
CIV
1
Occupational Medicine
NCC
2
Preventive Medicine
NCC
1
Addiction Psychiatry
TAMC
1
Child/Adolescent Psych
TAMC(3)/NCC(3)
6
Forensic Psychiatry
NCC
1
Preventive Psychiatry
NCC
1
Psychosomatic/Geriatric Psych
NCC
1
Musculoskeletal Imaging
CIV
3
Neuroradiology
CIV
1
Trauma Radiology
SAUSHEC
1
Vascular/Interventional Rad
CIV
1
Stone/Laproscopy Disease
CIV
1
Trauma/Reconstructive Uro
CIV
1
Adolescent Medicine
SAUSHEC
1
Allergy
NCC
3
Clinical Pharmacology
WRAIR
2
Clinical Research
SAUSHEC
2
Critical Care Ultrasound
SAUSHEC
1
Geriatric Medicine
MAMC
2
Medical Genetics
CIV
1
Nuclear Medicine
NCC
2
Sleep Disorders
SAUSHEC(3)/NCC(2)
5
Psychiatry
Radiology
Urology
Specialty Immaterial
20
Fellowships 2012
Degree Programs
Epidemiology
USUHS
1
Medical Information Systems
MAMC
1
147
Leadership Develop.
Health Care Admin
CIV
2
Health Care Admin-Baylor
CIV
2
21
HPSP
•
•
80% of all active duty physicians
•
Available to: physicians, dentists,
veterinarians, clinical psychologists,
pharmacists and optometrists
•
Reasons to take scholarship
Full assistance (tuition, books, equipment and
monthly stipend of $2,088)
 Debt free after med school (avg. debt is $160,000)
 GME opportunities and subspecialty training
 Unlimited practice opportunites in
22
Reasons to Apply for HPSP
•
Debt free after Medical school+ $20k bonus
 Median education debt is $160,000
•
Outstanding GME opportunities in Army
programs and subspecialty training
•
Unlimited practice opportunities in academic,
operational, clinical medicine and research
•
Excellent benefits while on AD and
retirement*
•
Selfless service
23
HPSP
HPSP MODEL
Scholarship Length
YEAR
OUTPUT
1 YR
2 YR
3 YR
4 YR
11
12
13
14
15
MAX
10
0
30
255
INPUT
295
2010
232
283
324
300
255
TOTAL
1162
5
0
30
255
INPUT
290
2011
283
329
300
285
255
TOTAL
1169
0
0
20
255
INPUT
275
2012
329
300
285
275
255
TOTAL
1115
0
0
20
255
INPUT
275
2013
300
285
275
275
255
TOTAL
1090
0
0
20
255
INPUT
275
2014
285
275
275
275
255
TOTAL
1080
0
0
20
255
INPUT
275
2015
275
275
275
275
255
TOTAL
1080
0
0
20
255
INPUT
275
2016
275
275
275
275
255
TOTAL
1080
0
0
20
255
INPUT
275
2017
275
275
275
275
255
TOTAL
1080
0
0
20
255
INPUT
275
2018
275
275
275
275
255
TOTAL
1080
0
0
20
255
INPUT
275
2019
275
275
275
275
255
TOTAL
1080
0
0
20
255
INPUT
275
2020
275
275
275
275
255
TOTAL
1080
24
HPSP Changes
•
MAC (Minimal Acceptance Criteria):
 GPA >/= 3.2 undergrad
 MCATs >/= 24 with no score <8
•
AAC (Automatic Acceptance Criteria):
 NO LONGER
•
Average MCAT for HPSP matriculants is 29.3
and average GPA is 3.62
•
Waivers: 103 requests, 19 approved
 Virtually all approved were for combined programs
25
More HPSP Notes
• Residency Competition for Army will
peak in 2012-2013
• Most scholarships are 4 years
 3-year scholarships mostly rollovers
• HPSP students expected to take BOLC
after 1st year medical school
 2nd year prepare for part 1 of boards
 3rd and 4th years to ADT at Army hospitals
26
HPSP Plan of Attack
• New Approach
 USAREC and MEDCOM working
together
 Adjustments in requirements
 Improvement in Quality
27
Attrition Rates
Year
Overall
Academic
2007
5.4%
1.7%
2008
4.6%
3.3%
2009
6.4%
4.7%
2010
4.0%
3.1%
2011
3.2%
1.2%
National
4.0%
1.4%
28
HPSP Plan
•
Target:
 Undergraduate universities
 Universities with large number of medical school matriculants
 Universities with large number of matriculants to out-of-state
and private medical schools
 Pre-health clubs, Medical Honor societies, advisors & ROTC
 Target financial aid advisors at medical schools and staff with
access to accepted students
•
Provide SME at all events involving at least major
universities (Top 65)
•
Provide regular training to recruiters from GME and
deliver readily available POC
•
Provide visibility to leaders and AARs
29
STATE
University
Location
Top MD
Top DO
AL
Oakwood College
Huntsville
AZ
U. of Arizona
Tucson
Arizona State U.
Tempe
UCLA
Los Angeles
UC Berkeley
Berkeley
UC San Diego
La Jolla
UC Irvine
Irvine
UC Davis
Davis
Stanford
Stanford
U. of Southern Calif.
Los Angeles
CO
U. of Colorado Boulder
Boulder
CT
Yale
New Haven
DC
Howard U.
Wash DC
FL
U. of Florida
Gainesville
U. of Miami
Coral Gables
u. OF South Florida
Tampa
Florida State U.
Tallahassee
U. of Central Florida
Orlando
Florida International U.
Miami
U. of Georgia
Athens
Emory U.
Atlanta
Spelman College
Atlanta
Morehouse College
Atlanta
X
Georgia State U.
Atlanta
X
U. of Illinois Champaign
Champaign
Afr. Am.
CA
GA
IL
Hispanic
Asian
LEGEND
Top 10
Next 11-20
Next 21-30
Next 31-40
Next 41-47
30
STATE University
Location
Top MD
Top DO
Afr. Am.
Hispanic Asian
Northwestern U.
Evanston
U. of Illinois Chicago
Chicago
Loyola U Chicago
Chicago
U. of Notre Dame
Notre Dame
LEGEND
Indiana U.
Bloomington
Top 10
Louisana State U.
Baton Rouge
Next 21-30
Xavier U.
New Orleans
Next 31-40
Harvard U.
Cambridge
Boston U.
Boston
Johns Hopkins U.
Baltimore
U. of Maryland College Park
College Park
U. of Michigan Ann Arbor
Ann Arbor
Michigan State U.
Lansing
MN
U. of Minnesota
Mineapolis
MO
Washington U.
St. Louis
NC
Duke U.
Durham
U. of North Carolina
Chapel Hill
NJ
Rutgers U.
New Brunswick
NM
U. of New Mexico
Albuquerque
NY
Cornell U.
Ithaca
New York U.
New York
Columbia U.
New York
Stony Brook U.
Stony Brook
IN
Next 11-20
LA
Next 41-47
MA
MD
MI
31
STATE University
LEGEND
Top 10
Next 11-20
Next 21-30
Next 31-40
Next 41-47
Location
OH
Ohio State U.
Columbus
OK
U. of Oklahoma
Norman
PA
Penn State U.
University Park
U. of Penn
Philadelphia
RI
Brown U.
Providence
TN
Vanderbilt U.
Nashville
TX
U. of Texas Austin
Austin
Baylor U.
Waco
U. of Texas Pan American
Edinburg
Texas A&M
College Station
U. of Texas San Antonio
San Antonio
UT
BYU
Provo
VA
U. of Virginia
Charlottesville
Hampton U.
Hampton
Virginia Polytech
Blacksburg
WA
U. of Washington
Seattle
WI
U. of Wisconsin Madison
Madison
PR
U. of Puerto Rico-Rio Pedras
Rio Pedras
U. of Puerto Rico-Mayaguez
Mayaguez
U. of Toronto
Toronto
Can.
Top MD
Top DO
Afr. Am.
Hispanic Asian
32
Army Unique
Medical Professional Career Tracks
•
•
•
Clinical
Academic
Research
Same for
Civilian
and
Army**
•Operational
•Multiple Levels of Hooah!
•Command – Leadership
•Corporate Level Management
33
Life Cycle Model Is:
•
Integration of Professional Medical Education and
Professional Military Education as the three pillars of
leader development:
-Military training/GME
-Self development
-Operational assignments
•
Designed to provide guidelines for completion of
courses, career integration at specific ranks and career
points
•
http://www.army.mil/usapa/epubs/xml_pubs/p600_4/he
ad.xml
34
Medical Corps Officer Career Progression
YEARS
0
Rank
6
CPT
BOLC
Professional
Military Education
Additional
Training
CCC
FYGME
MAJ
COL
LTC
INTERMEDIATE LEVEL ED
RESIDENCY
30
18
12
SENIOR SVC. COLLEGE
FELLOWSHIP
CBRNE SHORT COURSES
EXECUTIVE SKILLS COURSE
ADV. TRAUMA MANAGEMENT, ADV. TRAUMA LIFE SUPPORT, COMBAT CASUALTY MGT
MPH
MBA
TWI
ADVANCED SCIENCE DEGREE
DEVELOPMENTAL & UTILIZATION ASSIGNMENTS
Typical
Assignments
Successful
Completion of
Internship and
Residency
Utilization Tour
Clinician
Self Development
Successful
Completion of
Fellowship
TOE/TDA Physician
Company Commander
Clinic OIC
Teaching Staff
Research Assistant
Clinician
BN/BDE/DIV
Surgeon
MEDCOM Staff
DCCS
MEDCEN Staff
MEDDAC Staff
Residency Director
Product Line Mgr
Division Chief
Clinician
Corps/MACOM
Surgeon
Commander
Joint Assignments
DCCS
MECEN Staff
Deputy Chief
Dir Med Ed
USUHS Faculty
Department Chair
Research Area Dir.
Continuing Medical Education / Board Recertification
License by yr. 2
Board Certification
Subspecialty Board Certification
35
Leadership Opportunities
•
•
An Army Officer
Training and mentoring junior soldiers/physicians in your
specialty.
• Opportunities to lead sooner than civilian practices
• Your professional recommendations are more valued, and
you have the autonomy within your practice without thirdparty interference
•
Full-spectrum of leadership opportunities from
service/department chief to Surgeon General
36
The “Right” Career?
•
•
•
•
4300 career “rabbit paths”
Clinical competence is paramount
Meet the requirements
Stack the deck in your chosen path
–
–
–
–
Assignments
Schools
“A” designator
OER Support Forms
• Understand the consequences and accept
responsibility
Retention
• MC Retention Issues
 Deployment / Family
 Length of deployment
– Down to 4.5 months for physicians
 AHLTA/admin issues
• Initial ADSO Retention FY11=70%
 FY10 = 63%
 FY09 = 59%
 57% - 65% over the past 5 years
• Continuation rate beyond initial ADSO > 90%
38
OEF/OIF: Rapid Integration of
Lessons Learned
•
Force Health Protection
 Behavioral Health
– Interventions to Enhance Psychological Resilience and Prevent Psychiatric
Casualties.
– Pentagon Post-Disaster Health Assessment
– PTSD
 Immunizations
– Vaccine Healthcare Centers Network (VHC)
– Myocarditis and Oral Vaccine with Smallpox Vaccine
•
Battlefield Medicine
 Training of Medics: 91W
 Use of Blood Transfusions, Whole Blood, Factor VII
 Hemostasis: Tourniquets and HemCon Bandages
 Pain Control & Regional Anesthesia: pain pumps
•
Home Station/Garrison Care
 Amputee Care & Rehabilitation: Intrepid Center
 Deployment Health Practice Guideline
 Community Based Warrior Transition Unit: CBWTU
 Traumatic Brain Injury (TBI)
39
Battlefield Survival
• Forward
surgical/resuscitation
capabilities
• Advanced evacuation
capabilities
• Body Armor
• Advanced surgical
techniques
• Advances in antibiotic tx
Transforming for Success
Survivability (%)
100
90
93
87.1
80
78.2
70
70.7
76
60
50
40
30
20
10
0
WW II
WWII
Korea
ODS
Vietnam
SOMALIA
OEF
OEF
Survivability = 100% - (KIA% + DOW%)
OIF
OIF
41
41
Army Medicine
Serving the nation since 1775
China 1944
44th MASH, Korea
1954
Radiology residents
1968
42
The Army’s Home for Health…
Saving Lives and Fostering Healthy
and Resilient People
~ Partnerships Built on Trust
43