West Point for Doctors: The Uniformed Services University of the Health Sciences

By J.R. Wilson

The Uniformed Services University of the Health Sciences (USUHS), founded in September 1972 by an act of Congress, is a unique and critical, yet comparatively little known, component of the U.S. military. Located on 100 acres of wooded land on the grounds of the National Naval Medical Center, 3 miles from Washington, D.C., and across the street from the National Institutes of Health, it is the premier medical education and research center for all the U.S. armed services.

“We’re unique in many ways, as far as being a medical school,” USUHS President Dr. Richard W. Thomas told Veterans Affairs and Military Medicine Outlook. “Having a university focused on developing military physicians – a West Point for doctors – has proven its value over the years, providing a steady stream of high-quality physicians for the armed services. We were established as a medical school and grew into a university, which is the opposite of how most evolve. We recently created a College of Health Sciences that, for the first time, allows us to award undergraduate degrees.

“I didn’t graduate from this university and was on active duty before I went to med school. Even when I was on active duty, I wasn’t familiar with what the university did. USUHS is the foundation for a lot of capabilities, and the advantage we bring is resident capabilities the services can reach back to and take advantage of. We are supporting the services so they can accomplish their mission by ensuring the medical readiness of our forces. We don’t want to be the best med school in the country you’ve never heard of; we’re becoming more well known for what we do, which is a positive trend.”

The Uniformed Services University of the Health Sciences (USUHS) located in Bethesda, Maryland, is the premier medical education and research center for the U.S. armed forces.

About 60 percent of the university’s students have had no prior medical training. With a better than 95 percent graduation rate, USUHS provides from 15 to 18 percent of new military doctors each year. As they become more senior, that grows to about 25 percent of all active-duty doctors and 35 percent of senior physicians in key billets, influencing medical operations as well as policy. Currently, one service surgeon general, two deputy surgeon generals, the Joint Staff Surgeon, and a number of command surgeons are USUHS graduates.

“Our strategic plan comprises three domains. The first is education and training, the second is research, and the third is leadership development. What makes us unique from other medical schools is we are focused on leadership development. I want military health care facilities, not just doctors and nurses who happen to wear a uniform,” Thomas said, adding that plan and the university’s structure have proven invaluable in dealing with COVID-19, which he believes will have a long-lasting impact on USUHS and its graduates.

“One of the advantages we have in the military, since the foundation of military medicine in 1775, is catching and learning from experience so we can improve. We have a mandate to improve the medical health of the force, and to do that we have to look at where we’re coming from. When this [COVID-19] happened, we pulled the after-action reports on what happened with previous outbreaks, such as H1N1. But this one is unique, so we are in the process of adapting to meet those challenges. This is about force medical readiness, and we want to make sure we can optimize our medical response so we can minimize the impact on the force.”

First-year medical students at USUHS’s F. Edward Hébert School of Medicine receive more than 140 pounds of books each inside the school’s anatomy lab in August 2016. USUHS educates, trains, and prepares uniformed services health professionals, officers, and leaders to directly support the Military Health System, U.S. national security and national defense strategies, and the readiness of the armed forces.

Since its first graduating class of 29 doctors 40 years ago, USUHS has produced more than 5,000 doctors, 70 dentists, 660 nurses, and 1,300 biomedical sciences medical research doctors. It has continuously expanded and now houses four schools, 13 research centers, and the Armed Forces Radiobiology Research Institute (AFRRI), the nation’s research and response facility for radiation-related events.

Reflecting on that anniversary, Thomas cited the value the doctors and nurses who have graduated from USUHS have added to both military and overall national medical care.

“If you look at the value proposition of the university and our alumni, we have folks who have gone on to serve only in the federal systems – military and otherwise – but others have taken their talents to the civilian medical care community,” he noted. “Most of our students came from the health professions scholarship side, so we got a predictably high-quality product who have had a tendency to serve longer than the average medical professional coming in from other sources.”

The F. Edward Hébert School of Medicine, the original medical school, offers doctorate degrees in medicine, doctorate and master’s degrees in public health and related disciplines, doctorate degrees in medical and clinical psychology, and interdisciplinary PhD degrees in three military-relevant areas of science: molecular and cell biology, neuroscience, and emerging infectious diseases. The school supports 19 departments and 13 centers, programs, and initiatives. At present, 687 students are enrolled.

The Daniel K. Inouye Graduate School of Nursing, with 179 current students, offers a PhD in Nursing Science, Doctor of Nursing Practice (DNP) in Nurse Anesthesia, Family Nurse Practitioner, Women’s Health Nurse Practitioner, and Psychiatric Mental Health Nurse Practitioner. It also offers a Master of Science in Nursing (MSN) and a Doctor of Nursing Practice in Adult-Gerontology Clinical Nurse Specialist.

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The Postgraduate Dental College incorporates more than 29 programs from Army, Navy, and Air Force dental schools. It offers its current enrollment of 242 students a master’s degree in Oral Biology and unique research opportunities.

The recently established College of Allied Health Sciences awards transferable college credits that can lead to undergraduate degrees for corpsmen and medics completing one of four military medical training programs at the Department of Defense’s (DOD’s) joint Medical Education and Training Campus (METC). It has 170 students enrolled in 2020.

Under a program begun five years ago and graduating its first students this year, enlisted personnel wanting to become military physicians can attend a two-year postgraduate pre-med program. Graduates of the Enlisted to Medical Degree Preparatory Program (EMDP2) can apply to any medical school in the country, including USUHS, where they are promoted to junior grade officers. On graduating from USUHS with their MDs, they become O-3s (Army or Air Force captains or equivalent Navy lieutenants).

Retired U.S. Public Health Service Rear Adm. (Dr.) Kenneth Moritsugu, a member of the Uniformed Services University of the Health Sciences board of regents, watches as students in the medical laboratory technologist (MLT) training program at the Medical Education and Training Campus in San Antonio, Texas, practice blood draw skills. The MLT program is one of several programs that are eligible for college credit under USUHS’s College of Allied Health Sciences.

“There is a lot of interest in growing this program, because we have a lot of enlisted members interested in becoming military doctors. It originally was established due to interest from senior members of the services,” Thomas noted. “The program has been highly successful and has been expanded each year. The class that came in this year is about 30. We’ll have to make some major investments to expand our footprint here for that, but you’re getting experienced military personnel from all work areas.

“Following World War II, the military saw a need to develop and retain highly qualified doctors, so they established the Military Graduate Medical Education Program. About 40 percent of all military graduates from that program go through here. As we look at a shortage of civilian doctors, it is more essential than ever that the military maintain these graduate medical programs to ensure a pipeline for high-quality physicians.”

Army Sgt. 1st Class Joshua Richter listens to a lecture at George Mason University-Prince William Campus, Manassas, Virginia, as a student in the Uniformed Services University of the Health Sciences’ Enlisted to Medical Degree Preparatory Program in 2014. Richter was among the first 10 enlisted members accepted into the program, which has expanded each year since it began.

The university’s 13 centers enable faculty and students to collaborate with leading experts from around the nation to push the boundaries across a wide range of biomedical sciences to advance and shape military medicine and world health. The USUHS centers are the:

• Center for Deployment Psychology

• Center for Global Health Engagement

• Center for Neuroscience and Regenerative Medicine

• Center for Rehabilitation Sciences Research

• Center for the Study of Traumatic Stress

• Consortium for Health and Military Performance

• Defense and Veterans Center for Integrative Pain Management

• Infectious Disease Clinical Research Program

• Murtha Cancer Center Research Program

• National Center for Disaster Medicine and Public Health

• Surgical Critical Care Initiative

• Tri-Service Center for Oral Health Studies

• Center for Health Professions Education

“Right now, we’re in the top 10 percent in the nation in medical research dollars – medical rehabilitation, human optimization, suicidality, and other areas – in response to areas that have been identified to us by the services,” Thomas said. “The foresight of some of our founders has helped us facilitate medical research, giving us a unique statutory ability to shorten key research in areas important to the services and our service members.

“We continue to do that research, in partnership with non-federal agencies, as DOD’s foundation for health care education and research. The university exists to support the services, not only training and graduating health care professionals, but also through our ongoing research efforts.”

USUHS has come a long way since its first three years, when its classrooms, laboratories, and offices were housed on the third floor of a small office building in downtown Bethesda, Maryland, above a drug store and a bank.

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“We’re a moderately sized university. We are looking seriously at growing from our current class size of about 170 to up to 200 per class; beyond that, we would have to do some significant new construction,” Thomas said. “But we have been asked to grow. We have more than 3,000 applicants for each new class, so we can be highly selective, giving us very high-quality students. If we don’t take someone, we work closely with the services to make sure they are linked up with the right folks to talk about health professionals scholarships.

“We have more than 730 foreign and domestic active patents from our research side and a large number of partnerships with other nations. When we do our field training exercises, we invite students from other nations to come in and train with our students; we always get more applicants than we can handle. That is consistent with the joint, interagency, intergovernmental, and multinational [JIIM] environment.”

As might be expected, with its heavy emphasis on biomedical research, USUHS is heavily involved in – and affected by – the COVID-19 pandemic.

Cmdr. Kevin Michel, a certified registered nurse anesthetist at Naval Hospital Jacksonville, who earned a Master of Science in Nursing degree from USUHS, prepares anesthesia in the main operating room. USUHS provides high quality health care professionals it graduates into military medicine.

“We have been significantly impacted. As a federal agency, we’re following the guidance given us by DOD, so we’re going to distance learning, which isn’t a big jump because we’ve used that already, and it is a great opportunity to enhance that capability,” Thomas said.

“DOD also turned to us immediately on the research side, and our IDCRP [Infectious Disease Clinical Research Program], which is heavily involved in helping manage COVID-19 in select military centers across the nation, putting us at the leading edge of research on the virus. Some of our experts in public health and occupational medicine are working to refine the clinical practice guidelines on how to handle patients infected with the virus.”

Looking to the future, Thomas is confident USUHS will continue to provide the highest quality of new doctors and nurses it graduates into military medicine and in its contributions to the nation’s warfighters.

First-year USUHS medical students at the F. Edward Hébert School of Medicine participate in the Advanced Combat Medical Experience (ACME) training exercise at USUHS. ACME is designed to test medical students’ knowledge in a simulated combat situation, and volunteer role players wearing latex cut suits that simulate battle injuries allow medical students to apply simulated medical interventions such as hemorrhage control, IV insertions, and tracheostomies. USUHS ensures its graduates can provide care whether in a hospital or on a battlefield.

“I think we’ll continue to grow and evolve as we’ve done over the 45 years since our founding. The Institute for Defense Analyses just did a study I commissioned looking at the cost and value of the university. Since its founding, the USUHS has evolved into a critical capability for DOD and the nation, and I think we will continue on that path. It is mandatory for the force medical readiness to maintain a cadre of top-level medical professionals. There is a shortage of civilian doctors in the U.S. and there is some talk about us growing to take in more students, such as increasing our capacity to educate more nurses,” he said.

“The reason the U.S. can deploy forces around the globe, in austere environments, and fight and win is because we have a medical force that can deploy side by side with them. The university provides the environment to not only establish centers of excellence, but to maintain and sustain that capability, always there for the services to reach back and tap into … so we can help them react and adapt for the readiness of the force. We are both an academic and a military organization – academic is the noun, but military is the modifier.”