For Yolanda Figueroa, it was an unforgettable experience. Wearins: combat fatigues and clutching an M-16 rifle, the 28-year-old from Torrance. California, was crawling through a clearing, keeping her head low, and staying as close to the ground as she could.
"There was tiring all around us, and we had to focus on what we needed to do," she says, remembering how her adrenaline How surged and ebbed repeatedly during her time in the field. "It was very intense, but very valuable as well."
Ms. Figueroa wasn't undergoing recruit training at Parris Island or Fort Bragg. She's a medical student-at the Uniformed Services University of the Health Sciences, or USUHS. a combination medical school and research center that has become the military's "West Point for doctors." And to Figueroa, an ensign in the Navy medical corps, the utilities were almost as familiar as a lab coat.
While USUHS" four-year curriculum for physicians provides the same array of anatomy, biochemistry, and physiology courses that civilian medical schools offer, it's clearly geared toward turning out career medical officers for the armed forces. Besides the two-week summer field exercises in which Ms. Figueroa participated, there are special classes in military organization, history, and structure. And medical courses cover such subjects as combat trauma, aviation and undersea medicine, infectious and tropical diseases, and anthrax and radiological poisoning, situations that civilian physicians rarely see. In all. the military-related training adds some 700 hours to the normal fouryear medical school curriculum.
Surprisingly, USU. as the school has begun calling itself, is one of the military's best-kept secrets. Few outside the armed services' own medical corps have even heard of it. The four-building, brick-and-concrete complex, located on a nine-acre tract on the sprawling National Naval Medical Center campus in Bethesda, Maryland, isn't even visible from the street; a small grecn-and-white sign near the entrance to the naval hospital grounds is the only hint of its presence.
Yet USU is rapidly becoming the mainstay of the armed services' efforts to train and retain career physicians-much the way service academies at Annapolis. West Point, anil Colorado Springs do in the case of vvarfighters. The university turns out aboul 170 doctors a year-about 18 percent of the new physicians entering the military. USU graduates currently make up about a quarter of the military's total complement of physicians, and in more senior ranks the proportion is even higher: some 70 percent of USL' alumni stay in the service for their full careers.
Medical officers say going through USU gives incoming military doctors a head start over graduates of civilian medical schools who join one of the services-by acquainting its students with the culture and procedures of the military, from battlefield medicine to the operation of hospital ships and field hospitals.
USU Grads More Military
"There's an unbelievable difference between civilian-trained physicians and USU graduates." says Army Major General Elder Granger, a University of Arkansas med school alumnus who commanded the 44th Medical Task Force in Iraq from November 2004 through October 2005. "USU graduates tend to be better critical thinkers and more adaptive to leadership jobs than those from civilian schools." General Granger says. "They're head-andshoulders above the others. You can tell they've grown up in the system."
Kudos for USU outside the military are less effusive. Partly because of its special nature, the university is consistently absent from lists of the nation's top medical schools, such as U.S. News & World Report's annual ratings. But it's fully accredited-by the nationally recognized Liaison Committee for Medical Education and by the Middle States Commission on Higher Education-and among those familiar with its programs, it has a reputation for maintaining consistently high quality.
"It's a respected institution-1 think you would regard its graduates as solid candidates for a job at a civilian hospital," says Dr. Steven Simon, a faculty member at the Harvard University Medical School. At the same time, he adds. USU isn't well known outside military circles. "The people who apply there are pretty well committed to a military career." he says.
That's slill a long way Io have come in the three decades that USU has been in existence. Established by Congress in 1972. the school began taking students in 1976 and graduated its first class tour years later. Besides the medical school. USU maintains a graduate school of nursing, and offers master's degrees and doctorates in biomedical sciences and public health. It also trains physicians for the commissioned officer corps of the Public Health Service. It maintains special centers for radiobiology and cancer, which carry on joint research programs with the National Institutes of Health and other government and private institutions. And it provides continuing education for a wide variety of healthcare professionals. Its research programs have spawned 284 patents.
Prior military service isn't a prerequisite. Many of the school's 700 students come from civilian backgrounds, and chose USU mainly because they were intent on military careers. But a substantial number have come from active-duty units, sometimes with surprising backgrounds. The list includes aviators, submariners, and even some special forces personnel. Some are graduates of the service academies. Indeed, the military has quietly begun pitching the school to cadets and midshipmen who look as though they might make good physicians.
Former Navy lieutenant Ted Utz. a 29-year-old Cornell graduate, had completed his training as a submariner and finished a three-year tour on the USS Columbus (SSN-762) when he decided to go into medicine and apply to USU. Now a first-year medical student, he had to take a demotion to eiisimi to make the transfer. He won't be an 0-3 again until lie earns his M.D. Even so. he asserts, the switch was worth it. "I like the trouble-shooting aspect of medicine." he says. "There's a parallel with engineering, but we're doing body engineering instead."
Army second Lieutenant Kohul Amin. 26. is a former Marine Corps sergeant who decided on a career in medicine alter he was discharged. He chose the Army when lie was accepted to USU-rather than go into the Navy, which provides physicians tor the Marine Corps-because. he says, the Army's medical corps "is gigantic" and "you can suh-specialize and become involved in more research projects."
Multi-service Environment a Boon
Both school officials and students view the multi-service environment as a big plus for their careers. With many military medical facilities already run jointly by the Army. Navy and Air Force-and even more "jointness" likely in future conflicts-making contacts with dozens of your counterparts in other services while you're still in ined school makes for smoother cooperation after you've been assigned to field posts. Lieutenant Amin says. Graduates also learn a lot about each others' services.
"Our students learn in a multi-service environment-one that emphasizes and capitalizes on the strengths of each service," says retired Navy Medieal Corps Captain Charles L. Rice, the school's current president.
The simulated gunfire exercise that sent Ensign Figueroa crawling across the clearing last June was part of a two-phase set of summer Held tours-the counterpart of the Naval Academy's summer midshipmen cruises-held at Fort Indiuntown Gap. a 17,000-acre Army hase and National Guard training c e n t e r n e a r Harrisburg, Pennsylvania.
The training sessions are strictly for first- and fourth-year medical students. The neucomers are divided into two groups. One group, outfitted in utilities and flak jackets, spends a week undergoing basic military training, learning how to function in combat conditions, fire M-16s and M-9 pistols, engage in hand-tohand combat, and use a compass. The students also spend time acting as corpsmen and combat medics, learning, for example, how to crawl to a wounded soldier, administer intravenous treatment, and call for a medevac helicopter, all while under fire. They also practice rappelling off a 50-foot wall.
While that's going on, the second group, smeared with Hollywood-style makeup that realistically portrays various kinds of casualties, serves as mock patients for the fourth-year students, who spend the training period setting up and operating military Held aid-stations and Held hospitals under simulated combat conditions. For these soon-to-graduate students, the goal is mainly to hone their leadership skills, school officials say. At the end of one week, the two groups ni newcomers switch assignments.
Right after their stints at Indiantown Gap. firstyear students spend a week assigned to line units so they can get a better appreciation of how military personnel work and live while they're deployed. This past year. Ensign Figueroa, now a secondyear medical student, was with the Marine Coips helicopter squadron that serves the White House. "It's a chance to see what the environment is like in an operational unit," she says, "-what the real Marines do and how they work together."
Not everyone is impressed with the military side of things. "By my Marine Corps measuring-stick, not a lot of military stuff goes on at USU, but compared to what students at civilian medical schools get it's quite a hit." says lieutenant Amin. the former Marine sergeant. But Ensign Michael Cunningham, a 28-year-old Naval Academy graduate from San Antonio who made lieutenant before applying to USLI. says the field training was "an unbelievable experience" and "more rewarding" than his summer cruises during his Academy days. "I didn't really sec the big picture back then." he says.
Military Obligation Sizable
Whatever a student's background, graduating from USU usually means a full career in military medicine. No matter where they came from, with prior military experience or not. graduates must agree in advance to spend seven years on active duty as military physicians-and that's after they complete their four years of medical school. a year of internship, and between two and eight years as medical residents. For someone who entered USU at. say. age 22, that means finishing up your military obligation at age 36 to 40-late enough to make staying in for the full 20 years a sensible option.
The school has had a difficult history. In the late 1970s. then-President Jimmy Carter tried to shut it down entirely, insisting it was an unnecessary luxury in the midst of a wide selection of civilian medical schools. And its traditionally low profile has gained only limited political support for the institution.
Yet the likelihood is that LISLI will he expanding-if only hecause the military's needs are growing. The school is expected to become part of the new National Military Medical Center that will he formed when Walter Reed Army Medical Center in Washington. D.C'.. moves over to the National Naval Medical Center in Bethesda during the next several years. Indeed. LJSLJ already is putting up a Ilfill building in Bethesda to provide new quarters for its graduate school of nursing.
By then. Ensign Figueroa. who will become an M.D. in the class of 2009. will be ready to join the Fleet-or a joint-services medical facility-and become one of USD's growing cadre of alumni in the military medical corps.
"The thing I kept hearing over and over before coming here was that physicians coming from LJSU were ready to hit the ground running when they got out." she says. For that, those rappelling skills may come in handy.
Mr. Pine, a former naval officer, is a veteran journalist who has worked as a Washington correspondent for the Baltimore Sun, Washington Post. Wall Street Journal, and his Angeles Times. He was Pniceedings 2006 Co-Author of the Year.