My Army Experience - Florida State University College of Medicine

My Army Experience
Christopher A. Dillon MD
COL, MC, USA
Physician Recruiting/Accessions
Liaison
[email protected]
Too Much Background…
• Rural farm in
Oregon
• Middle class family
• UCLA
undergraduate
• U. of Cincinnati
College of
Medicine
It was 1985…
• University Cincinnati College of Medicine
• Applied for HPSP Scholarships
• Chose Army because > # choices
– Hospitals
– Clinics
– Residencies/fellowships
Army Health Professions Scholarship
Program
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158 medical schools
 ~240 graduates annually
 Provides 80% of active duty physicians
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Commissioned as 2LT in US Army Reserve (IRR)
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Obligation is 1 year on active duty for each year of sponsorship
in HPSP (2 years minimum)
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ARMY has HPSP for doctors, dentists, veterinarians,
optometrists and psychologists
100% tuition paid
Required books and fees paid
Monthly stipend (>$2,000./month) for 10.5 months each year
Military pay (about $5500.) annually for 45 days Active Duty
Training
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Officer Basic Course 1985
• Summer 1985: 6
week ADT/OBC
• Discovered the
sameness of
HPSP Docs
• Two Groups
– Smart Middle Class
Folks
– Hard charging
Military Types
Post-Graduate Training
• Combined MedPeds
– El Paso Texas
• Adolescent
Medicine
Fellowship
– El Paso Texas
Tripler Army Medical Center
Honolulu Hawaii
Naval Medical Center San Diego
San Antonio Texas
Brooke Army Medical Center
Unique Medical Care
• Humanitarian
Missions
– Philippines 2000
– Honduras 2002
• Navy Cruises
• Backfills– Korea 1995, numerous
other CONUS bases
• IRAQ: OIF 3 2004
• Afghanistan: 2009
Tiger Cruise
Operation Balikitans 2000
Operation Balikitans 2000
Operation Balikitans 2000
Operation Balikitans 2000
Honduras 2001
Honduras 2001
Honduras 2001
You see a Lot of This…
And This
Camp Junction City
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Bad time to have to go…
Treatment Bay
Imbedded Reporters
Air Evac
Driving a Tank!
Afghanistan
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Circle of Trust
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Kandahar NATO Hospital
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Egyptian Hospital
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Army Medicine
ARMY MEDICAL
DEPARTMENT
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State of the Art Equipment
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Largest Health
Advanced Technologies
World Renowned Research
and Development
Network in the World
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TYPICAL DAY IN THE ARMY
MEDICAL DEPARTMENT
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63 Births
361 Admissions
1,308 Beds occupied
2,148 Veterinary outpatient visits
5,420 Immunizations
6,340 Radiology procedures
28,863 Dental procedures
37,102 Clinic visits
52,479 Laboratory procedures
81,984 Pharmacy procedures
$22.4 Million-worth of food inspected
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GRADUATE MEDICAL EDUCATION STATS
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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).
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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.
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93% first time board pass rate.
Army Residencies
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Internal Medicine (151)
Family Medicine (140)
Emergency Medicine (78)
Pediatrics (75)
Obstetrics/Gynecology (80)
General Surgery (123)
Neurosurgery (3)
Orthopaedics (112)
Urology (32)
Otolaryngology (37)
Preventive Medicine (26)
Occupational Medicine (26)
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Dermatology (38)
Radiology (104)
Radiation Oncology (13)
Anesthesiology (55)
Aerospace Medicine (13)
Neurology/Child Neuro (16)
Pathology (34)
Psychiatry (64)
Psych/IM, Psych/FM (10)
Physical Medicine and
Rehabilitation (13)
Ophthalmology (34)
ARMY MEDICAL FACILITIES
• 8 Medical Centers
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Walter Reed, Washington DC
Madigan, Fort Lewis, WA
Brooke, Fort Sam Houston, TX
Womack, Fort Bragg, NC
William Beaumont, Fort Bliss, TX
Dwight D. Eisenhower, Fort Gordon, GA
Landstuhl, Landstuhl Germany
Tripler, Honolulu, HI
• 19 Community Hospitals
• 65 Medical Clinics
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
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DoD Research
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DoD R&D
– $82.4 Billion
• Mostly for Tanks, planes, ships &
missiles
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DoD Science & Technology
– Program Fund 6
– $14.3 billion annually
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DoD Medical R&D
– $1.1 billion
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DoD DHP (P8) Research
– $0.9 billion
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Army Controls
Lion’s Share
Medical
Research
Budget
P6 Medical R&D
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U.S. Army Medical Research
and Material Command
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U.S. Army Aeromedical Research Laboratory (USAARL)
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U.S. Army Institute of Surgical Research (USAISR)
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Fort Detrick, Maryland
U.S. Army Research Institute of Environmental Medicine (USARIEM)
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Aberdeen Proving Ground, Maryland
U.S. Army Medical Research Institute of Infectious Diseases (USAMRIID)
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Fort Sam Houston, Texas
U.S. Army Medical Research Institute of Chemical Defense (USAMRICD)
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Fort Rucker, Alabama
Natick, Massachusetts
Walter Reed Army Institute of Research (WRAIR)
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Forest Glen, Maryland
Medical Research Detachments
• CONUS
– US Army Center for Environmental Health Research (USACEHR)
– US Army Dental Research Detachment (USADRD)
– US Army Medical Research Detachment (USAMRD)
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Overseas
– Armed Forces Research Institute of Medical Sciences – Thailand
(AFRIMS)
– US Army Medical Research Unit – Europe (USAMRU-E)
– US Army Medical Research Unit – Kenya (USAMRU-K)
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Research Centers of Interest
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Battlefield Health and Trauma, San Antonio, TX
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Infectious Disease, Bethesda, MD
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Aerospace Medicine, Dayton, OH
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Biological Defense, Fort Detrick, MD
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Chemical Defense, APG-EA, MD
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Regulated Medical Product Development and Acquisition (e.g.,
vaccines) , Ft Detrick, MD
Armed Forces Institute
of Regenerative Medicine (AFRIM)
• Established by the DoD in 2008
– Managed and funded by DoD with additional funding
from NIH, VHA and local Public and private sectors.
• Mission: Developing new products and therapies
to treat severe injuries suffered by U.S. service
members
• Multi-institutional, interdisciplinary networks of
scientists designed to accelerate the delivery of
regenerative medicine therapies
AFRIM Research
• Face and Hand Transplant with bone-marrow induced
immunotolerance to minimize the immunosuppression and
reduce side effects
• Muscle Tissue Regeneration via biological scaffolding
composed of extracellular matrix and autologous fat injections
to reduce and repair scars
• Treatment of partial thickness burns using autologus spray on
skin
• Skin graft stretching for coverage of large areas of scarring
• Bone scaffolding for craniofacial regeneration
• Allogenic human dermal fibroblasts for remodeling scars
Combat Casualty Care Research Program (CCCRP)
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Hemorrhage control products
Advanced, noninvasive physiologic sensors
– detecting wounding events
– Support remote triage
Blood product technology development
Prevention and treatment of dental & OMF disease/wounds
Orthopedic surgical techniques, equipment, and implants
Neuroprotective strategies for brain and spinal cord injuries
Diagnostics and decision support for combat medics
Intravenous / intraosseous fluid technology and application
Military Operational
Medicine Research Program
(MOMRP)
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Biomedical solutions to protect and enhance soldier performance
Human physiology
Bioenergetics (human metabolic and physiologic responses to operational and
occupational stressors)
Injury Biodynamics including human-machine interactions and their impacts on
bone, muscle, and other tissues
Neuropsychology (neuropsychiatric stressors and cognitive performance)
Psychophysics focuses on human visual and auditory performance capabilities,
and non-ionizing directed energy bioeffects
Force Health Protection ( health risk mitigation)
Environmental exposures to toxic materials
Health damaging behaviors (i.e. alcohol abuse prevention / treatment)
Battlefield Survival
• Forward Medical Care
– Combat Medics
• CAT Tourniquet
• Combat Gauze
– Surgical Teams
• Advanced evacuation
capabilities
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Battlefield Survival
• Soldier Protection
– Body Armor/Fire Resistant
Clothing
– Armored vehicles/Fire
Resistant
• Advanced surgical
techniques
• Advances in antibiotic tx
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Transforming for Success
Survivability (%)
WWII
Korea
Viet Nam
OEF
Survivability = 100% ‐ (KIA% + DOW%)
OIF
Recent Initiatives
• Centers of Excellence
for Psychological
Health & Traumatic
Brain Injury
• Armed Forces
Institute of
Regenerative
Medicine
Army Research Institute
for the Behavioral and Social
Sciences
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Lead laboratory for manpower, personnel and training systems.
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Mission: maximize Army effectiveness through research and development
in the acquisition, training, development, utilization and retention of soldiers.
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ARI has five core competencies:
 Quality Personnel Science and Technology
 Leadership Science and Technology
 Training Science and Technology
 Attitude and Opinion Surveys
 Occupational Analysis
Telemedicine and Technology Research Center
(TATRC)
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TATRC is predominant DoD research entity for developing advanced
medical technologies
TATRC areas of interest:
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Medical Robotics
Health Information Technologies
Medical Imaging
Computational Biology
Biomonitoring
Simulation and Training Technology
Neuroscience
Chronic Disease Management
Regenerative Medicine
Nano-Medicine
Biomaterials
Medical Logistics
Advanced Prosthetics Human Performance
Cons of Army Medicine
• The War
• Fear of the Unknown
– Army Culture
– Army Lingo
– Army People
• Uniform
PROs of Army Medicine
• Training choices
• FAMILY
• Business hassles
reduced
• Competitive pay and
benefits packages
• Network of friends/docs
• Leadership opportunites
• Travel
• Serve the service
members