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Medical Colleges Pledge to Improve Training for Care of Military and Veterans

By U.S. Medicine

By Sandra Basu

WASHINGTON — Servicemembers who suffer from PTSD or other medical problems often seek treatment outside the military and veterans’ healthcare systems when they return from deployment. Civilian providers do not always have the expertise to provide optimal care, however.

Now, some 130 medical schools have pledged to do something to remedy that problem.

As part of first lady Michelle Obama’s “Joining Forces” initiative, the Association of American Medical Colleges (AAMC) and the American Association of Colleges of Osteopathic Medicine (AACOM) agreed last month to “create a new generation of doctors, medical schools and research facilities that will make sure our military veterans and their families receive the care worthy of their service.”

First Lady Michelle Obama shakes hands with veterans and medical personnel during a recent Joining Forces event at Virginia Commonwealth University AAMC-Medical Center in Richmond, Va. Mrs. Obama announced a major commitment by the country’s top medical colleges and universities to create a new generation of doctors, medical schools, and research facilities to ensure that veterans, service men and women receive the medical care that they deserve. (Official White House Photo by Chuck Kennedy)

“We’ve seen from prior wars that as many as 60% of veterans with PTSD sought help outside of the VA system,” Obama said at an event last month. “And of our Iraq and Afghanistan veterans who have returned home, only about half have sought any type of care through the VA system at all. So what this tells us is that we have to meet our veterans and military families where they live. We have to engage all of this country’s doctors, nurses, healthcare providers on the variety of health issues these families face, especially on issues of mental health.”

Training Doctors

According to the White House, PTSD and TBI have affected about 1 in 6 veterans. It is not that medical schools do not currently address these issues but that they probably are not taught “with the emphasis needed,” to address needs of military troops, John Prescott, MD, chief academic officer for the AAMC, told U.S. Medicine.

As part of their commitment, participating medical schools affiliated with AAMC and AACOM were asked to sign a pledge, which Prescott called, “doable, but also a stretch.” The pledge states that the participating schools commit to:

  • Enrich the medical education curriculum to ensure future physicians are equipped to treat the unique needs of the military;
  • Disseminate the most up-to-date information on conditions such as PTSD and TBI;
  •  Expand the body of knowledge available about the health and wellness of veterans through new research and clinical trials; and
  •  Collaborate with other institutions, agencies and healthcare providers to deliver the best care possible. 
First lady Michelle Obama speaks about the White House’s “Joining Forces” military family support campaign to a crowd of National Guard and local families in Columbus, Ohio, last year.

As part of the initiative, a Joining Forces iCollaborative Collection was established on the AAMC website to include education units developed by the Uniformed Services University of the Health Sciences and others institutions and make them available to be freely shared with medical schools and physicians.

“We have posted well over 45 separate pieces of information we have collected from DoD, VA and from others on tried-and-true education material that we can get out to medical schools and to practicing physicians,” Prescott said. “We wanted to make sure that those [clinicians] who are in communities that are not near an academic medical center would have a free and open resource to tap into.”

Stephen C. Shannon, DO, president and chief executive of AACOM, told U.S. Medicine that the efforts to enhance medical education and research will be critical in meeting the needs of veterans and their families. Educating medical students, even on simple steps such as reminding them to ask patients if they have a military history, can help them better care for patients, he explained.

Many osteopathic colleges are ideally located in rural and underserved areas where many veterans reside, he explained. AACOM will help its member colleges incorporate targeted PTSD, TBI and depression treatment training throughout their curricula.

“We need to have our medical students, our residents-in-training, fellows-in-training and practicing physicians aware of the disorders like PTSD and TBI and the other psychosocial

dimensions of military service,” he said. “A way to coordinate this is through the quality of the educational experience.”

For Johns Hopkins University School of Medicine, joining the initiative was a very good fit, according to Steve Steffensen, MD, a neurologist and board member of the Military and Veterans Health Institute at the Maryland university.

In the past year, he said Johns Hopkins had established the Military and Veterans Health Institute, which he said aligns with the purpose of the Joining Forces effort, adding, “the whole purpose of this institute is to align clinical, research and educational opportunities toward the military.”

Steffensen recently separated from the military and said he understands the challenges that troops face when they have conditions such as PTSD and TBI and return to their home community where their provider may not have the expertise to address those issues.

The goals of the Joining Forces initiative will help the participating medical schools better educate students about optimal treatment for military-related conditions.

“I am excited to see where this will go,” he said. “There was a lot of excitement at the announcement. How often do you see this group of people, over 100 universities, come together under one cause like this?”

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