Clemente Fuentes Maj Roselyn W
is a Flight Surgeon, Medical Director at Flight and Operational Medicine Clinic, Eglin Air Force Base in Florida.
Fed Pract. 2021 Oct;38(10):474-482. doi: 10.12788/fp.0192.
The current operational tempo and transitions in the structure of the military health system demands a renewed commitment to operational medicine readiness. There is an official mandate as well as the practical necessity to increase operational readiness within the medical corps. There is also a need to continue the scholarly evaluation of military medicine through research to ensure the progression of evidence-based medical care for the war fighter. Military graduate medical education (GME) has been threatened by budget cuts and lack of understanding of its value. This article reviews the literature on operational medicine curriculums and makes recommendations to restructure current military medicine training to produce operationally prepared clinicians who are informed in operationally focused research principles.
During early medical training operational curriculum cements military identity, fosters military leadership skills, provides practice of scenarios unique to military medicine, and connects learners to experienced mentors. There have been several versions of curriculum development in various GME programs observed from a literature search; however, the curriculum overall is fragmented and there is no universal implementation. Studies have shown that deliberately mapped longitudinal curriculums can be well integrated into a existing medical curriculum. Multiple studies also suggest that military GME is a large component of the production of operational-themed medical research and is vital for continued advancements. Value-based analysis performed by multiple sources have found that the initial increased cost of a military medical school education and GME becomes cost-effective based on increased retention, deployments, and filling of leadership billets.
Access to existing operational training structures that have well-established programs should be increased, and individual GME program curriculums should be modeled on those that have shown proven success with a focus on operational training, leadership, and research.
当前军事卫生系统的行动节奏和结构转型要求重新致力于作战医学准备。在医疗部队内部，既有官方指令，也有提高作战准备的实际必要性。还需要通过研究继续对军事医学进行学术评估，以确保为作战人员提供循证医疗的发展。军事毕业后医学教育（GME）受到预算削减和对其价值缺乏理解的威胁。本文回顾了关于作战医学课程的文献，并提出建议，以重组当前的军事医学培训，培养具备作战准备、熟悉以作战为重点的研究原则的临床医生。
在早期医学培训中，作战课程巩固军事身份，培养军事领导技能，提供军事医学特有的场景实践，并将学习者与经验丰富的导师联系起来。通过文献检索发现，各种GME项目中有多个版本的课程开发；然而，总体课程是零散的，没有普遍实施。研究表明，精心规划的纵向课程可以很好地融入现有的医学课程。多项研究还表明，军事GME是作战主题医学研究产出的重要组成部分，对持续进步至关重要。多个来源进行的基于价值的分析发现，军事医学院教育和GME最初增加的成本，基于留用率提高、部署增加和领导职位的填补，变得具有成本效益。
应增加对现有拥有成熟项目的作战训练结构的利用，个别GME项目的课程应以那些已证明成功的项目为蓝本，重点关注作战训练、领导力和研究。
