The Uniformed Services The Uniformed Services UniversityUniversity

of the Health Sciences: of the Health Sciences: A Unique Resource A Unique Resource

AMMA/Joint Health Command SymposiumAMMA/Joint Health Command SymposiumCanberraCanberra

30 October 201030 October 2010

Uniformed Services University of the Health Sciences

Uniformed Services University Uniformed Services University of the Health Sciencesof the Health Sciences

USU is a joint service institution: Army, Navy, Air Force and U.S. Public Health Service• F. Edward Hébert School of Medicine

• Undergraduate – M.D.• Graduate programs in the biomedical sciences• Graduate medical education (within NCA)

• Graduate School of Nursing• Advanced practice degrees (M.S.N)• Doctoral degree (Ph.D.)

• Postgraduate Dental CollegeMaster of Science degrees (M.S.)

• Armed Forces Radiobiology Research Institute• U.S. Military Cancer Institute• Continuing Health Education Programs

USU is a joint service institution: USU is a joint service institution: Army, Navy, Air Force and U.S. Public Health ServiceArmy, Navy, Air Force and U.S. Public Health Service•• F. Edward F. Edward HHéébertbert School of MedicineSchool of Medicine

•• Undergraduate Undergraduate –– M.D.M.D.•• Graduate programs in the biomedical sciencesGraduate programs in the biomedical sciences•• Graduate medical education (within NCA)Graduate medical education (within NCA)

•• Graduate School of NursingGraduate School of Nursing•• Advanced practice degrees (M.S.N)Advanced practice degrees (M.S.N)•• Doctoral degree (Ph.D.) Doctoral degree (Ph.D.)

•• Postgraduate Dental CollegePostgraduate Dental CollegeMaster of Science degrees (M.S.)Master of Science degrees (M.S.)

•• Armed Forces Radiobiology Research InstituteArmed Forces Radiobiology Research Institute•• U.S. Military Cancer InstituteU.S. Military Cancer Institute•• Continuing Health Education ProgramsContinuing Health Education Programs

History of USUHistory of USUHistory of USU

• USU was chartered in 1972 by an act of

Congress, as envisioned by Congressman F.

Edward Hébert (D-LA)

• The medical school opened in 1976; the

Graduate School of Nursing was added in

1993. The Postgraduate Dental College was

added in 2010

• USU is the nation’s military and public

health services academy, with the mission

that includes the accession of fully qualified

officers into the medical, dental,nursing

and medical service corps of the uniformed

services

• Officers provide much of the senior

leadership of the uniformed services health

activities

•• USU was chartered in 1972 by an act of USU was chartered in 1972 by an act of

Congress, as envisioned by Congressman F. Congress, as envisioned by Congressman F.

Edward Edward HHéébertbert (D(D--LA)LA)

•• The medical school opened in 1976; the The medical school opened in 1976; the

Graduate School of Nursing was added in Graduate School of Nursing was added in

1993. The Postgraduate Dental College was 1993. The Postgraduate Dental College was

added in 2010added in 2010

•• USU is the nationUSU is the nation’’s military and public s military and public

health services academy, with the mission health services academy, with the mission

that includes the accession of fully qualified that includes the accession of fully qualified

officers into the medical, officers into the medical, dental,nursingdental,nursing

and medical service corps of the uniformed and medical service corps of the uniformed

servicesservices

•• Officers provide much of the senior Officers provide much of the senior

leadership of the uniformed services health leadership of the uniformed services health

activitiesactivities

F. Edward Hébert School of MedicineF. Edward F. Edward HHéébertbert School of MedicineSchool of Medicine

• Average entry age is 24-25• 3:1 male to female ratio• 165-180 students per class• Nearly 50% prior service• Rank: O-1• Military unique curriculum• Army - 37%• Navy - 30%• Air Force - 30%• Public Health Service - 3%

•• Average entry age is 24Average entry age is 24--2525•• 3:1 male to female ratio3:1 male to female ratio•• 165165--180 students per class180 students per class•• Nearly 50% prior serviceNearly 50% prior service•• Rank: ORank: O--11•• Military unique curriculumMilitary unique curriculum•• Army Army -- 37%37%•• Navy Navy -- 30%30%•• Air Force Air Force -- 30%30%•• Public Health Service Public Health Service -- 3%3%

Medical students come to USU with widely diverse backgrounds:Medical students come to USU with widely diverse backgrounds:

•• From undergraduate university, no prior From undergraduate university, no prior military affiliationmilitary affiliation

•• ROTCROTC

•• Service AcademiesService Academies

•• Prior service enlistedPrior service enlisted

•• Prior service officerPrior service officer

•• Medic/corpsman, submariner, MP, Medic/corpsman, submariner, MP, musician, aviator, secondmusician, aviator, second--generation USU students, etc.generation USU students, etc.

Includes:

•Combat field resuscitation (cognitive)

•Blast injury

•High velocity GSW injury

•Field exercisesOperations Kerkesner/Bushmaster (practical labs)

Includes: Includes:

••Combat field resuscitation Combat field resuscitation (cognitive)(cognitive)

••Blast injuryBlast injury

••High velocity GSW injuryHigh velocity GSW injury

••Field exercisesField exercisesOperations Operations KerkesnerKerkesner//Bushmaster Bushmaster (practical labs)(practical labs)

Military Unique CurriculumMilitary Unique CurriculumMilitary Unique Curriculum

• Global infectious disease

• WMD/Disaster and humanitarian assistance

• Medical ethics in war

• Preventive Medicine

• Aviation/aerospace medicine

• Hypo-/Hyperbaric medicine

•• Global infectious diseaseGlobal infectious disease

•• WMD/Disaster and WMD/Disaster and humanitarian assistancehumanitarian assistance

•• Medical ethics in warMedical ethics in war

•• Preventive MedicinePreventive Medicine

•• Aviation/aerospace Aviation/aerospace medicinemedicine

•• HypoHypo--/Hyperbaric /Hyperbaric medicinemedicine

Unique aspects of Preventive Medicine curriculum:

In addition to the epidemiology and biostatistics that are taught in most schools, USU provides:

• Preventive services delivery in medical care setting – including oral health

• Extensive 2nd year course in parasitology that includes laboratory diagnosis of parasitic diseases

• 3rd-4th year intersession course on health services

• Introduction to operational field preventive medicine is included in Kerkesner by Department of Military and Emergency Medicine

• 4th year electives in tropical medicine, during which students have structured learning experiences at overseas sites in Africa, South America, or Southeast Asia.

Unique aspects of Preventive Medicine curriculum:Unique aspects of Preventive Medicine curriculum:

In addition to the epidemiology and biostatistics that are In addition to the epidemiology and biostatistics that are taught in most schools, USU provides: taught in most schools, USU provides:

•• Preventive services delivery in medical care setting Preventive services delivery in medical care setting –– including oral healthincluding oral health

•• Extensive 2Extensive 2ndnd year course in year course in parasitologyparasitology that includes laboratory diagnosis that includes laboratory diagnosis of parasitic diseasesof parasitic diseases

•• 3rd3rd--4th year intersession course on health services4th year intersession course on health services

•• Introduction to operational field preventive medicine is inIntroduction to operational field preventive medicine is included cluded in in KerkesnerKerkesner by Department of Military and Emergency Medicineby Department of Military and Emergency Medicine

•• 4th year electives in tropical medicine, during which stude4th year electives in tropical medicine, during which students nts have structured learning experiences at overseas sites inhave structured learning experiences at overseas sites in Africa, Africa, South America, or Southeast Asia.South America, or Southeast Asia.

Graduate Education Programs in the Biomedical SciencesGraduate Education Programs in the Biomedical SciencesGraduate Education Programs in the Biomedical Sciences

Research Degree Programs:

Interdisciplinary Ph.D. Programs

•Emerging Infectious Diseases

•Molecular and Cell Biology

•Neuroscience

Department-based Ph.D. Programs

•Clinical and Medical Psychology

•Environmental Health Sciences

•Medical Zoology

Doctor of Public Health

Physician Scientist (MD-Ph.D.)

Research Degree Programs:Research Degree Programs:

Interdisciplinary Ph.D. ProgramsInterdisciplinary Ph.D. Programs

••Emerging Infectious DiseasesEmerging Infectious Diseases

••Molecular and Cell BiologyMolecular and Cell Biology

••NeuroscienceNeuroscience

DepartmentDepartment--based Ph.D. Programsbased Ph.D. Programs

••Clinical and Medical PsychologyClinical and Medical Psychology

••Environmental Health SciencesEnvironmental Health Sciences

••Medical ZoologyMedical Zoology

Doctor of Public HealthDoctor of Public Health

Physician Scientist (MDPhysician Scientist (MD--Ph.DPh.D.).)

Master of Public Health

Master of Science in Public Health

Master of Tropical Medicine &

Hygiene

Master of Military Medical History

Master of Healthcare Administration and Policy

Master of Public HealthMaster of Public Health

Master of Science in Public HealthMaster of Science in Public Health

Master of Tropical Medicine & Master of Tropical Medicine &

HygieneHygiene

Master of Military Medical HistoryMaster of Military Medical History

Master of Healthcare Master of Healthcare Administration and PolicyAdministration and Policy

Federal Civilian and Career Officer programs:Federal Civilian and Career Officer programs:Federal Civilian and Career Officer programs:

• Master of Healthcare Administration and Policy

- Focused on political and economic dimensions of health policy

- Focused on issues involving cost, quality and access in the administration of healthcare services

- One year didactic; one year practical experience- DoD Military Health System- Veterans Administration headquarters- Agency for Healthcare Research and Quality- National Institutes of Health- TRICARE Management Activity- USAID/U.S. State Department- Logistics Management Institute- Defense Health Board

•• Master of Healthcare Administration and PolicyMaster of Healthcare Administration and Policy

-- Focused on political and economic dimensions of health policyFocused on political and economic dimensions of health policy

-- Focused on issues involving cost, quality and access in the Focused on issues involving cost, quality and access in the administration of healthcare services administration of healthcare services

-- One year didactic; one year practical experienceOne year didactic; one year practical experience-- DoDDoD Military Health SystemMilitary Health System-- Veterans Administration headquartersVeterans Administration headquarters-- Agency for Healthcare Research and QualityAgency for Healthcare Research and Quality-- National Institutes of HealthNational Institutes of Health-- TRICARE Management ActivityTRICARE Management Activity-- USAID/U.S. State DepartmentUSAID/U.S. State Department-- Logistics Management InstituteLogistics Management Institute-- Defense Health BoardDefense Health Board

Graduate School of NursingGraduate School of NursingGraduate School of Nursing

• Established by Congress in 1993, the Graduate School of Nursing’s mission is to educate advanced practice nurses

• Uniformed service members; Average Rank: O-3

• Federal service civilians enrolled in Ph.D. program

•• Established by Congress in 1993, Established by Congress in 1993, the Graduate School of Nursingthe Graduate School of Nursing’’s s mission is to educate advanced mission is to educate advanced practice nursespractice nurses

•• Uniformed service members; Uniformed service members; Average Rank: OAverage Rank: O--33

•• Federal service civilians enrolled in Federal service civilians enrolled in Ph.D. programPh.D. program

GSN Unique ContributionsGSN Unique ContributionsGSN Unique Contributions

• Nurse Anesthesia program – Rated among the top 5 in the country

by U.S. News & World Report

• Family Nurse Practitioner program

• Psychiatric Mental Health Nurse

Practitioner program

• Perioperative Clinical Nurse Specialist

program

• Ph.D. in Nursing Science program

•• Nurse Anesthesia program Nurse Anesthesia program –– Rated among the top 5 in the country Rated among the top 5 in the country

by by U.S. News & World Report U.S. News & World Report

•• Family Nurse Practitioner programFamily Nurse Practitioner program

•• Psychiatric Mental Health Nurse Psychiatric Mental Health Nurse

Practitioner programPractitioner program

•• PerioperativePerioperative Clinical Nurse Specialist Clinical Nurse Specialist

programprogram

•• Ph.D. in Nursing Science programPh.D. in Nursing Science program

College of Post-Graduate Dental Studies

• USAF Comprehensive Dentistry Residency Program

• Navy Post-graduate Dental School• Army: under review• Master of Science in Oral Health

• As of May 2010, USU has awarded more than 4,500 medical degrees,

1,100 masters and doctoral degrees in the biomedical sciences, and

470 nursing science degrees

•• As of May 2010, USU has awarded more than As of May 2010, USU has awarded more than 4,500 4,500 medical degrees, medical degrees,

1,1001,100 masters and doctoral degrees in the biomedical sciences, and masters and doctoral degrees in the biomedical sciences, and

470470 nursing science degreesnursing science degrees

Research and ConsultationResearch and Consultation

Armed Forces Radiobiology Armed Forces Radiobiology Research InstituteResearch Institute

•• Established 1960Established 1960•• Mission: provide expertise and Mission: provide expertise and

operational support in a radiation or operational support in a radiation or nuclear eventnuclear event

•• Research program: develop effective and Research program: develop effective and safe countermeasuressafe countermeasures

•• TRIGA, CobaltTRIGA, Cobalt6060, LINAC, LINAC•• Became part of USU in 2004Became part of USU in 2004

Graduate Education Programs in the Biomedical SciencesGraduate Education Programs in the Biomedical SciencesGraduate Education Programs in the Biomedical Sciences

Research Degree Programs:

Interdisciplinary PhD Programs

•Emerging Infectious Diseases

•Molecular and Cell Biology

•Neuroscience

Department-based PhD Programs

•Clinical and Medical Psychology

•Environmental Health Sciences

•Medical Zoology

Doctor of Public Health

Physician Scientist (MD-PhD)

Post-doctoral Fellowships

Research Degree Programs:Research Degree Programs:

Interdisciplinary PhD Programs

•Emerging Infectious Diseases

•Molecular and Cell Biology

•Neuroscience

Department-based PhD Programs

•Clinical and Medical Psychology

•Environmental Health Sciences

•Medical Zoology

Doctor of Public Health

Physician Scientist (MD-PhD)

Post-doctoral Fellowships

Center for Disaster and Humanitarian Assistance Medicine

Center for Disaster and Center for Disaster and Humanitarian Assistance MedicineHumanitarian Assistance Medicine

A USU-based center under Department of Military and Emergency Medicine.

Mission : to advance the understanding and delivery of disaster medical care and humanitarian assistance worldwide.

Uniquely positioned academic center actively developing relationships between governmental agencies, non- governmental agencies, and private volunteer organizations to improve relief efforts.

A USUA USU--based center under Department of based center under Department of Military and Emergency Medicine.Military and Emergency Medicine.

Mission : to advance the understanding Mission : to advance the understanding and delivery of disaster medical care and and delivery of disaster medical care and humanitarian assistance worldwide. humanitarian assistance worldwide.

Uniquely positioned academic center Uniquely positioned academic center actively developing relationships between actively developing relationships between governmental agencies, nongovernmental agencies, non-- governmental agencies, and private governmental agencies, and private volunteer organizations to improve relief volunteer organizations to improve relief efforts.efforts.

Recent ExperienceRecent Experience• Hurricane Katrina• Banda Aceh, Indonesia• Afghanistan and Iraq• Pakistan• Haiti

• Hurricane Katrina• Banda Aceh, Indonesia• Afghanistan and Iraq• Pakistan• Haiti

Center for Neuroscience and Regenerative Medicine

Center for Neuroscience Center for Neuroscience and Regenerative Medicineand Regenerative Medicine

Congress directed CNRM to study combat casualties cared for at WRAMC and NNMC using advanced neuroimaging technology at the NIH Clinical Center

Congress directed CNRM to study combat casualties Congress directed CNRM to study combat casualties cared for at WRAMC and NNMC using advanced cared for at WRAMC and NNMC using advanced neuroimagingneuroimaging technology at the NIH Clinical Centertechnology at the NIH Clinical Center

Unprecedented collaboration among USU, NIH (particularly NIMH, NINDS), WRAMC, and other federal agencies

Focused on TBI and PTS:Identifying pathophysiologyDeveloping modelsUnderstanding plasticityExploring regenerative approachesEnhancing rehabilitation

Unprecedented collaboration among USU, Unprecedented collaboration among USU, NIH (particularly NIMH, NINDS), WRAMC, NIH (particularly NIMH, NINDS), WRAMC, and other federal agenciesand other federal agencies

Focused on TBI and PTS:Focused on TBI and PTS:Identifying Identifying pathophysiologypathophysiologyDeveloping modelsDeveloping modelsUnderstanding plasticityUnderstanding plasticityExploring regenerative approachesExploring regenerative approachesEnhancing rehabilitationEnhancing rehabilitation

Center for the Study of Traumatic StressCenter for the Study of Traumatic Stress•• Research, education, consultation and training Research, education, consultation and training

•• Preparing for/responding to the Preparing for/responding to the psychological effects and health psychological effects and health consequences of traumatic events consequences of traumatic events

•• Natural disasters (hurricanes, floods Natural disasters (hurricanes, floods and tsunami) and tsunami)

•• HumanHuman--made disasters (motor vehicle made disasters (motor vehicle and plane crashes, war, terrorism and and plane crashes, war, terrorism and bioterrorism) bioterrorism)

•• Studies of genetic vulnerability to stress, Studies of genetic vulnerability to stress, individual and community responses to individual and community responses to

terrorism terrorism

•• Policy recommendations to help our nation and Policy recommendations to help our nation and its military and civilian populations its military and civilian populations

Center for Deployment PsychologyCenter for Deployment Psychology

•• Training Training

•• SupportSupport

•• ProgramsPrograms

•• ProgressProgress

Infectious Diseases Clinical Research Program (IDCRP)Infectious Diseases Clinical Research Program (IDCRP)

Interagency Agreement in 2006Interagency Agreement in 2006

National Institute of Allergy and Infectious Disease (NIAID)/National Institute of Allergy and Infectious Disease (NIAID)/Uniformed Services UniversityUniformed Services University

Objectives:Objectives:Establish and support a Establish and support a DoDDoD infectious disease clinical research networkinfectious disease clinical research network

Develop a portfolio of protocols focused on militarily relevantDevelop a portfolio of protocols focused on militarily relevant infectious infectious disease problemsdisease problems

Research program synergized with:Research program synergized with:other other DoDDoD clinical and research partnersclinical and research partnersthe civilian research community including federal partners, the civilian research community including federal partners, academia and industry.academia and industry.

Establish a network Infectious Disease IRB (Institutional ReviewEstablish a network Infectious Disease IRB (Institutional Review Board) that Board) that streamlines the approval process for multicenter projectsstreamlines the approval process for multicenter projects

One IRB review and one Headquarters reviewOne IRB review and one Headquarters reviewTwo years in the making Two years in the making –– first meeting in June 08first meeting in June 08

IDCRP Clinical Research NetworkIDCRP Clinical Research Network

Tripler Army Medical Center,

Honolulu, HI

Naval Medical Center &

Naval Health Research Center

San Diego, CA

Data Analysis Center

University of Minnesota

IDCRP headquarters at USU, National Naval Medical Center,

Walter Reed Army Medical Center, Walter Reed Army Institute of Research,

Naval Medical Research Center, Military HIV Research Program

Naval Medical CenterPortsmouth, VA

Eisenhower Army Medical CenterFt. Gordon, GA

Naval Medical Research Center Detachment

Lima, Peru

U.S. Army Medical Research UnitNairobi, Kenya

Naval Medical Research Unit 2

Jakarta, Indonesia

Naval Medical Research Unit 3

Cairo, Egypt

Landstuhl Regional Medical CenterGermany

WHMC/SAMMC BAMC/SAMMC

USAISRUAFSAM

San Antonio, TX

IDCRP Project CollaborationsIDCRP Project Collaborations

DoDDoD GEIS GEIS –– Global Emerging Infections Surveillance SystemGlobal Emerging Infections Surveillance System

WRAIR WRAIR –– Walter Reed Army Institute of ResearchWalter Reed Army Institute of Research

NMRC NMRC –– Naval Medical Research Center Naval Medical Research Center

VRC VRC –– Vaccine Research Center of NIAIDVaccine Research Center of NIAID

DoDDoD Overseas Medical Research Labs Overseas Medical Research Labs

USAMRIID USAMRIID –– US Army Medical Research Institute for Infectious Diseases US Army Medical Research Institute for Infectious Diseases

NHRC NHRC –– Naval Health Research Center Naval Health Research Center

USAFSAM USAFSAM –– US Air Force School of Aerospace Medicine US Air Force School of Aerospace Medicine

CDC CDC -- Centers for Disease Control and PreventionCenters for Disease Control and Prevention

UT Health Science Center San AntonioUT Health Science Center San Antonio

INSIGHT INSIGHT -- International Network for Strategic Initiatives in Global HIV TInternational Network for Strategic Initiatives in Global HIV Trials rials

CHAVI CHAVI –– Center for HIV/AIDS Vaccine Immunology at Duke UniversityCenter for HIV/AIDS Vaccine Immunology at Duke University

KEMRI KEMRI –– Kenya Medical Research Institute Kenya Medical Research Institute KerichoKericho, Kenya, Kenya

MakerereMakerere University, Kampala, UgandaUniversity, Kampala, Uganda

NabiNabi PharmaceuticalsPharmaceuticals

Lessons LearnedLessons Learned

“My education at USU came back in a flash when I was placed in an environment where the culture and environment were not optimal.”

Captain David Lane USU Alum

“My education at USU came back in a flash when I was placed in an environment where the culture and environment were not optimal.”

Captain David Lane USU Alum

The Military/PHS ConnectionThe Military/PHS Connection

• Military assets • Rapid deployability• Logistics• Communications• Security• Heavy lift• Engineering capability

• PHS assets• Public health, population health focus• Interaction with civilian authorities• Sustainability

• Military assets • Rapid deployability• Logistics• Communications• Security• Heavy lift• Engineering capability

• PHS assets• Public health, population health focus• Interaction with civilian authorities• Sustainability

Walter ReedWalter Reed NationalNational

Military Medical Center Military Medical Center

““The prototype 21The prototype 21stst century academic medical center.century academic medical center.””

-- Harvey Fineberg, M.D., Ph.D.Harvey Fineberg, M.D., Ph.D.President, Institute of MePresident, Institute of Medicinedicine

Walter Reed Army Medical Center

Building #2 RenewalBuilding #2 Renewal

•• Heaton Pavilion (Building 2): 1.3 million square foot hospital cHeaton Pavilion (Building 2): 1.3 million square foot hospital completed ompleted in 1977 (2.4 million square feet including interstitial floors)in 1977 (2.4 million square feet including interstitial floors)

•• Facility is over 30 years oldFacility is over 30 years old

•• Cost of hospital renovation/renewal estimated at $550M (2002)Cost of hospital renovation/renewal estimated at $550M (2002)

•• Renewal/Renovation would require 12Renewal/Renovation would require 12--15 years to execute construction 15 years to execute construction while maintaining operability of hospitalwhile maintaining operability of hospital

•• Periodic disruptions to service throughout project lifecycle as Periodic disruptions to service throughout project lifecycle as medical medical functions rotate through transitional locations required to vacafunctions rotate through transitional locations required to vacate space te space during phased constructionduring phased construction

National Naval Medical Center

15 September 201115 September 2011……

USU AlumniUSU Alumni

USU Alumni Selected for Flag RankUSU Alumni Selected for Flag Rank

USU Alumni in ActionUSU Alumni in Action

• Lisa Peterson• U.S. Navy Lieutenant and flight surgeon• Banda Aceh Tsunami response on

aircraft carrier U.S.S. Abraham Lincoln • Provided anti-malarial treatment and

other preventive measures, along with emergent services

• Carrier and crew took on unaccustomed roles, including water desalination, repair of facilities for health care and water purification, and support of other relief operations

• Lisa Peterson• U.S. Navy Lieutenant and flight surgeon• Banda Aceh Tsunami response on

aircraft carrier U.S.S. Abraham Lincoln• Provided anti-malarial treatment and

other preventive measures, along with emergent services

• Carrier and crew took on unaccustomed roles, including water desalination, repair of facilities for health care and water purification, and support of other relief operations

USU Alumni in ActionUSU Alumni in Action• Various grads supported:

• U.S.S. Comfort, Bataan and Iwo Jima during Hurricane Katrina response efforts in Mississippi and Louisiana

• On-ground and air rescue support following earthquakes in Pakistan and Central Java

• Various grads supported:• U.S.S. Comfort, Bataan and Iwo Jima during

Hurricane Katrina response efforts in Mississippi and Louisiana

• On-ground and air rescue support following earthquakes in Pakistan and Central Java

USU AlumniUSU Alumni

USU Alumni have become integral to operational medicine USU Alumni have become integral to operational medicine

and have played significant roles across the federal health and have played significant roles across the federal health

system since the first class graduated in 1980system since the first class graduated in 1980