Proceedings 15th conference on Military Medicine Uniformed Services University of the Health Science

Military Medicine, Apr 2002

EXECUTIVE SUMMARY

The Uniformed Services University of the Health Sciences (USHUS) is proud to offer this report of the 15th Conference on Military Medicine, "A Challenge to Readiness: Maintaining Currency in Military Medical Education." These proceedings serve as a record of the Service's Surgeons General nominees' contributions toward predicting the changes that will affect military medical practice over the next twenty to thirty years and of their recommendations regarding the changes needed in military health care education to prepare today's students to practice in the future.

The Uniformed Services University, as the nation's preeminent center of military medical education, is committed to ensuring that its students are prepared to practice in our rapidly changing world. To this end, Dr. Val Hemming, Dean of the School of Medicine (SOM), directed that this conference be conducted and its proceedings be published. The specific focus of this conference was to identify the anticipated changes in military health care practice and the new educational objectives needed to properly prepare military health care practitioners for the next twenty to thirty years. Changes in both the content and structure of medical education and military medical education within the SOM are already underway.

Process

Experts in military and contingency medicine contributed their expertise, experience, knowledge, opinions, predictions and, most importantly, their recommendations for the planning and implementation of military medical education and training by the Department of Defense in the next twenty to thirty years. The conference began with a plenary session in which selected experts reviewed current military medicine educational and training programs and offered their "best guess" predictions in four principal topic areas:1 new technologies, both medical and non-medical, that are likely to significantly influence the practice of military medicine over the next twenty to thirty years;2 changes in the Services' missions and doctrines that will affect future health care delivery and the practice of military medicine;3 emerging threats -new emerging or re-emerging diseases, and new weapons or new weapon technologies;4 changes in ethics, mores, and societal expectations that will affect the future practice of military medicine.

The opening plenary session, which was designed to "set the stage," provided background information and defined the "deliverables" for each of the working panels. Presenters included: (1) Rear Admiral (Ret.) William Rowley, MD, a prominent futurist, speaking on '"The Potential Future"; (2) Colonel (Ret.) Craig H. Llewellyn, MD, M.P.H., M.S., Professor and former Chair of the Department of Military and Emergency Medicine, USUHS, speaking on "Military Medicine: Yesterday, Today, and Tomorrow"; (3) David P. Stevens, MD, Vice President for Medical School Standards and Assessment, Association of American Medical Colleges (AAMC), speaking on "Educating Physicians for Unpredictable Change"; (4) and Rear Admiral Richard A. Mayo, USN, Director, J4-MRD, speaking on "Joint Vision 2020." Each of the individual Services' medical departments also provided overview briefings.

In the following three days, each of the four working panels developed and presented to the Dean of the USUHS SOM their predictions for how medical practice will change, and recommendations for educational objectives that, if met, would prepare today's students for medical practice in the next twenty to thirty years. The complete list of these predictions and recommendations is provided in the full text. A consolidated summary of these predictions and recommendations follows.

While no one can predict the future with any degree of certainty, there are aspects of the future that can be reasonably determined and, because human nature remains fairly constant, there are some things that will remain unchanged regardless of how technology evolves. Although there has been unprecedented change in the technology of war, most of the issues related to the delivery of medicine in war remain unchanged; therefore, most of the current military medicine educational objectives will remain relevant for the foreseeable future.

Working Panel Core Concepts

The following core concepts emerged from the working panels:

(1) Technology, by itself, is not nearly as significant a factor in altering the practice of medicine in general, and military medicine specifically, as is the way technology is integrated into a new way of doing business.

(2) Information technology and the Internet will fundamentally shift the relationship between physician and patient. The role of physician will increasingly shift from that of impersonal expert who is assumed to know best, to that of listener, teacher, and guide working with the patient to achieve health goals set out by the patient. Physicians and other health care providers will have to be able to interpret medical information and help patients weigh decisions regarding risks and benefits.