Lieutenant General R. Scott Dingle, the U.S. Army Surgeon General and Commanding General of the U.S. Army Medical Command, visited Vanderbilt University Medical Center last week to observe the ongoing military-civilian partnerships which strengthen the Army’s medical readiness.
He told Medical Center leadership he was so impressed with what he saw he hopes to expand the involvement of other military medical personnel at VUMC to include enlisted combat medics.
“To the entire Vanderbilt team, just simply one word, ‘Wow,’” Dingle said. “My staff has been telling me for a while, ‘You have to get to Vanderbilt.’ Now I understand why I needed to get to Vanderbilt, because what you’re doing for the United States Army is generating, what we call in the military, readiness for our nation’s heroes.”
Dingle, the most senior officer of the U.S. Army Medical Command, and other military medical leaders met with Medical Center leaders and toured clinical sites at Vanderbilt University Hospital, where military medical personnel work alongside their civilian medical counterparts. Dingle quizzed service members working in the hospital’s Emergency Department, operating rooms and in the Trauma Intensive Care Unit about how the partnerships were benefiting them.
The embedded military medical personnel reported that they were routinely caring for patients with serious trauma and were able to practice the critical skills they would need when caring for wounded soldiers during a deployment.
“What Vanderbilt is doing, which is why this program is so important, is that you are giving the United States Army Medical team — from the combat medic who has to stop the bleeding, to the surgical team, to the doctors, to the nurses and everyone that comes to the program — the acuity to save lives,” Dingle said.
“So, I say thank you on behalf of the 120,000 that are in Army Medicine. Thank you for what may seem so little here at Vanderbilt, but what is huge to our nation, the readiness of our Army.”
In 2021, VUMC became an official site of the U.S. Army Military-Civilian Trauma Team Training (AMCT3), formalizing a longstanding relationship between the two entities. The AMCT3 program delivers medical training to military medical personnel serving on forward resuscitative surgical teams by assigning them to civilian, Level 1-verified trauma centers. VUMC is one of eight civilian medical centers in the nation now participating in the program.
In addition to serving as an AMCT3 site, VUMC serves as a site for Strategic Medical Asset Readiness Training (SMART) for Army Medicine. This program brings combat medics, licensed practical nurses, operating room technologists and other specialists essential to the medical care of soldiers in the field to a high-volume civilian trauma hospital for two to three weeks. SMART allows them to complete much of their annual medical skills competency requirements and helps prepare them to provide life-saving medical care during combat operations.
Through coordination with the Vanderbilt Military Affairs Committee (VMAC) and VUMC’s Trauma Outreach team, Medical Center faculty also give lectures and provide hands-on training on trauma-related topics to military personnel at nearby Fort Campbell, Kentucky.
Command Sergeant Major Diamond D. Hough made the case to VUMC leadership that enlisted combat medics would benefit from more time embedded with civilian medical teams.
“When our continuum of care starts, most of the time it starts at the point of injury,” Hough said. “That enlisted tech is at the point of injury, most often with no other provider with them. With all the great things Vanderbilt is doing, I’m going to ask for a little bit more, that we’d be able to get our enlisted technicians in here to practice medicine with the rest of the team. We don’t always get the acuities we need at our own facilities, so these types of partnerships are huge for us.”
Vanderbilt has had a long history of military-civilian partnerships that date back to World War I, according to Bradley Dennis, MD, associate professor of Surgery in the Division of Trauma and Surgical Critical Care and VMAC chair.
“Our experience has been that these relationships are mutually beneficial,” he said. “In the current era, we’re able to provide meaningful skill sustainment training so our military medical corps are ready and capable to take care of combat-wounded soldiers when they deploy,” Dennis said. “On the receiving end at Vanderbilt, we benefit from the expertise, education and training of our military partners as the military certainly has cutting-edge trauma research as well as other areas of medical advancements. We’ve been able to sustain these partnerships throughout the decades, and we look forward to continuing that for many, many years to come.”
Army Maj. Joshua Smith, an active-duty trauma surgeon, came to VUMC in 2019 for a Trauma and Surgical Critical Care Fellowship after his residency at Madigan Army Medical Center. Smith, who is also an assistant professor of Surgery in the Section of Surgical Sciences, then joined the AMCT3 program in August 2021.
He told the group he would admit approximately one or two ICU patients a month and two trauma cases a month while he was at Madigan, compared to an average of one ICU admission per shift and four or more trauma admissions per shift at VUMC.
“The volume and acuity are significantly more, and the types of patients I see at VUMC directly prepare me to take care of America’s wounded warriors on the battlefield,” Smith said.
“I’m going to go out the door (for a deployment) in a month, and I know that no matter what happens, I am prepared.”