Uniformed Services University: Educating Healthcare Professionals for Military Service

The Uniformed Services University (USU) is a unique institution dedicated to training healthcare professionals for service in the U.S. uniformed services and the federal government. Distinct from traditional civilian medical schools, USU provides a comprehensive education tailored to the specific challenges and demands of military medicine. This article delves into the history, structure, programs, and impact of this vital institution.

Overview

The Uniformed Services University of the Health Sciences (USU) stands as the nation’s only federal health sciences university. It is similar to a federal service academy, such as the United States Military Academy, Naval Academy, Air Force Academy, United States Merchant Marine Academy, and United States Coast Guard Academy, and the Senior Military Colleges, such as National War College or Dwight D. Eisenhower School for National Security and Resource Strategy. Established by Congress on September 21, 1972, USU's mission is to educate, train, and comprehensively prepare uniformed services health professionals to support the American Warfighter. USU is a Defense Department agency.

History and Establishment

The concept of a federally run medical school gained traction following World War II when the discharge of physicians from military service created a void in the Military Health System. Congressman F. Edward Hébert of Louisiana heavily championed a "West Point for doctors," advocating tirelessly for a military medical school. Secretary of Defense Melvin Laird recognized the potential of such an institution as an adjunct to military scholarship programs, leading to increased support from congressional leaders.

Founding members ensured that USU would be a center of academic and scientific excellence, with competitive selection processes for students and faculty. The curriculum would be grounded in educational and scientific rigor, fostering collegiality, peer review, and high standards of medical professionalism. The university's Board of Regents, consisting of 15 members appointed by the President of the United States, served as an advisory committee.

Dr. Anthony Curreri was selected as the first president of the university on Jan. Curreri and staff began supporting the vision, but in humble surroundings. They occupied the third floor of a small office building in downtown Bethesda, Maryland. Curreri would often jest that a bank and drugstore were fitting companions for an up and coming medical school. In 1973, the Board of Regents appointed a site selection committee to survey various tracts by ground and helicopter transportation, and USU's permanent home now spans 100 acres of wooded land on the grounds of the Naval Support Activity Bethesda.

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USU graduated its first class in 1980.

Campus and Location

The university's main campus is located in Bethesda, Maryland, on the military installation of Naval Support Activity Bethesda (NSAB). USU shares NSAB with the Walter Reed National Military Medical Center and is located along Maryland Route 355, across from the National Institutes of Health.

Colleges and Schools

USU encompasses several colleges and schools, each dedicated to specific areas of health sciences education:

F. Edward Hébert School of Medicine

The medical college is named after Louisiana Congressman F. Edward Hébert of the House of Representatives (1941-1977). With an average enrollment of approximately 170 students per class, the F. Edward Hébert School of Medicine is located in Bethesda, Maryland on the military installation of Naval Support Activity Bethesda (NSAB), sharing NSAB with the Walter Reed National Military Medical Center. Typically, the first-year class is composed of 63 Army students, 51 Air Force students, 51 Navy students, and two Public Health Service students. The Class of 2010 increased the Public Health Service student number to six.

Curriculum

The curriculum at the School of Medicine begins with 1.5 years of basic sciences organized into organ-system based modules called "Molecules to Military Medicine". Additional courses include Parasitology, Combat Medical Skills, Military Medical History, Officer Professional Development, Military Applied Physiology, Epidemiology, and several other courses. The clerkship year begins in January of the second year, and is followed by the USMLE Step 1. After Step 1, students participate in an integrated advanced didactic module, "Bench to Bedside and Beyond", and then begin fourth year clerkships/subinternships.

The USU was founded with a curriculum designed to advance health and science education for students as they prepare for the challenges of military medicine. In 2012, the school revamped its curriculum using a systems-based model adopted by many other medical schools. The current coursework design is called “Molecules to Military Medicine.” This curriculum connects basic and clinical sciences to military leadership and training over a four-year period. After 18 months of on-campus academics, students also benefit from clerkships that begin after the first 16 months of instruction, which help strengthen their knowledge and leadership skills in actual hospital settings.

MD/PhD Program

Students can indicate their intent to apply for the MD/PhD program on the USU secondary application and complete the graduate school application. Applicants not selected for the graduate school are still eligible for acceptance into the medical school. The combined MD/PhD program requires the same military commitment as the school of medicine. Three MD/PhD degrees are currently offered; neuroscience (NES), molecular and cell biology (MCB), and emerging infectious diseases (EID). Students remain civilian until graduate school requirements are completed.

Unique Aspects

USU School of Medicine students are all active-duty uniformed officers during their schooling and receive pay and benefits at the grade of O-1 (second lieutenant for the Army and Air Force and ensign for the Navy and Public Health Service) - unless the student was prior service at a higher rank then that student will wear the O-1 rank but be paid at their previous pay grade. When the school was first formed, the United States Congress weighed whether to make each student a cadet or midshipman (like the military service academies) or to give students full active-duty officer status and promotion benefits. A compromise was reached whereby medical students were commissioned as O-1 grade officers, were not promoted while enrolled in the School of Medicine, and do not receive time in grade or time in service while enrolled in USU. However, this status puts USU Medical Students in a unique position; unlike the Graduate School of Nursing and other programs, School of Medicine students are barred from promotion. Additionally, prior-service commissioned officers must accept a demotion to O-1 in order to matriculate. Upon graduation, when these officers are promoted to O-3, half of the time spent in prior active duty service is then added to their time-in-service (TIS)/time-in-grade (TIG) and used toward promotion to the rank of major or lieutenant commander (O-4).

Admission and Financials

Students attending this institution receive free tuition, as well as reimbursement for all fees. They also receive salaries and benefits as junior officers.

No prior military service is required for admission to USU's medical school. Students pay no tuition or fees and receive the full salary and benefits of a uniformed military officer throughout their time at the university. In return, all military students incur an active duty commitment proportionate to their time at USU.

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Service Commitment

Upon graduation, medical students are promoted to the grade of O-3, (captain for the Army and Air Force, lieutenant for the Navy and Public Health Service), and are expected to serve at least seven years after residency on active duty and six years in the inactive ready reserve. After USU students finish their residency, they serve on active duty for seven years. Your specific role will depend on your training and the Military's needs. Another option for fulfilling your service commitment involves becoming a general medical officer (GMO) after you receive your license. In this position, your role would be similar to that of a general medical practitioner, except you are attached to a specific unit, air wing, ship or submarine.

Daniel K. Inouye Graduate School of Nursing

The Graduate School of Nursing students are all active duty uniformed military nurses or nurses in federal civilian service. The Graduate School of Nursing offers two Advanced Practice Degrees: a Master of Science in Nursing (MSN), and a Doctor of Nursing Practice (DNP) degree in five different APRN specialty options: Family Nurse Practitioner, Certified Registered Nurse Anesthesia, Adult Gerontology Clinical Nurse Specialist, Psychiatric Mental Health Nurse Practitioner, Women's Health Nurse Practitioner, as well as a Ph.D. The Graduate School of Nursing offers a Master of Science in Nursing degree programs in nurse anesthesia, family nurse practitioner, perioperative clinical nursing, Psychiatric Mental Health Nurse Practitioner, and full- and part-time programs for a Ph.D. The Masters of Nursing Science and Doctor of Nursing Practice degrees at USU are accredited by the Commission on Collegiate Nursing Education, and The Nurse Anesthesia Program is fully accredited by the Council on Accreditation of Nurse Anesthesia Educational Programs (COA).

Postgraduate Dental College

The postgraduate dental college offers a Master of Science in Oral Biology degree to students enrolled in selected graduate dental education programs of the Army, Air Force, and Navy. The Post Graduate Dental College (PDC) is a degree-granting institution for active-duty personnel enrolled in branch-specific dental programs.

College of Allied Health Sciences (CAHS)

The College of Allied Health Sciences (CAHS) is the newest college, established in 2017. The College of Allied Health Sciences was established in 2017, responding to the National Defense Authorization Act which modified USU's authorities to include undergraduate and other medical education and training programs. These programs ensure military medicine remains on the cutting edge of providing a “Ready Medical Force” to support the American Warfighter and the Department of Defense (DoD) community around the world. Currently, the CAHS supports Army, Navy and Air Force Medical Enlisted Services across a wide range of education and training requirements. Current enrolment across the programs exceeds 7,000 students per year. Only students enrolled in specific Military Occupational Specialty (MOS) / Navy Enlisted Code (NEC) / Air Force Specialty Code (AFSC) / Additional Skill Identifier (ASI) training programs of the Services are eligible for enrollment. Depending on specifics of the respective program, the Servicemember is enrolled into either an Associate of Science Health Science (ASHS) or Bachelor of Science Health Science (BSHS) program. The technical training received by the Servicemember constitutes the discipline with the majority of General Education required for the respective degree coming via transfer credit.

Graduate Programs

The graduate programs in biomedical sciences and public health in the School of Medicine are open to civilian and military applicants. Civilian students may apply to most of these programs. The faculty is composed of a mix of military and civilian professors. There is no tuition, stipends are guaranteed for three years, and no military service is required after graduation for civilian PhD students. USU currently offers the Ph.D. There are military students in the graduate programs, most notably the public health and tropical medicine programs and clinical psychology program. Students in the School of Medicine graduate programs are a mix of both civilians and uniformed officers of various ranks. They also pay no tuition or fees. Civilian students may receive stipends and uniformed graduate students continue to receive their active-duty pay and benefits while attending school at USU. USU’s Hebert School of Medicine also has graduate degree programs in the biomedical sciences and public health. They include doctoral programs in emerging infectious diseases, neuroscience, molecular and cell biology, medical psychology, clinical psychology, health professions education, environmental health sciences, and medical zoology. Students enrolled in USU’s graduate programs remain on active duty and maintain their rank and pay throughout their enrollment. As with all of USU’s educational programs, tuition is waived. An additional service commitment is incurred after successful completion of the program.

Enlisted to Medical Degree Preparatory Program (EMDP2)

The Enlisted to Medical Degree Preparatory Program (EMDP2) program is a two-year, full-time education program for enlisted members of the military to prepare for medical school applications. It is intended for motivated service members who show academic promise and whose experiences and goals align with the mission of their military services and the F. EMDP2 includes premedical coursework, Medical College Admissions Test (MCAT) preparation, clinical experience, mentoring, and pre-health career advising. EMDP2's current civilian partner institution, George Mason University (GMU), provides the coursework, MCAT preparation courses, and pre-health advising on a contract basis. These services are currently provided at GMU's Science and Technology Campus (Manassas, VA) in an exclusive cohort structure. The two-year program is a partnership of USU, the Army, the Navy, the Air Force, the Marine Corps and the George Mason University-Prince William Campus in Manassas, Virginia.

The EMDP2's first year is designed to prepare students from any academic and career background to take the MCAT exam. The curriculum starts with fundamental coursework and expands into a full pre-medical curriculum. Students typically take the MCAT and begin medical school applications near the end of EMDP2 year one. The EMDP2's second year is designed to expand the student's understanding of medical and biological concepts. Coursework covers anatomy, microbiology, neurology, genetics, etc., to ensure EMDP2 students are well-prepared to matriculate into medical school. After completing the second year, gaining acceptance into a medical school, and fulfilling requirements for commissioning, students will have successfully completed the EMDP2.

Accreditation

June 22, 2023To acknowledge receipt of the self-study report. To note the on-site evaluation visit by the Commission's representatives to the main campus at 4301 Jones Bridge Road, Bethesda, MD 20814 on March 26-29, 2023. To note the following branch campuses were visited: (1) 2450 Pepperrell Street Lackland Air Force Base, San Antonio, TX 78236, and (2) 3176 CPL Johnson Road, Bldg. 1291, JBSA-Fort Sam Houston, TX 78234. To note the following additional locations were visited: (1) 2817 Reilly Road, Stop B, Ft Bragg, NC 28310; and (2) 3630 Stanley Road, San Antonio, TX 78234. To reaffirm accreditation. To request a supplemental information report, due March 1, providing further evidence of (1) adequate fiscal and human resources, including physical and technical infrastructure, to support operations (Standard VI) and (2) comprehensive planning for facilities, infrastructure and technology that include consideration of sustainability and deferred maintenance (Standard VI). To note that Recommendation Responses in conjunction with the Annual Institutional Update (AIU) are no longer required. The next evaluation visit is scheduled for 2030-2031.March 9, 2023To acknowledge receipt of the supplemental information report. The next evaluation visit is scheduled for 2022-2023.December 2, 2022Staff acted on behalf of the Commission to request a supplemental information report due January 9, providing information on enrollment by educational program in accordance with federal regulation 34 CFR § 602.19 (d) (Accreditation Review Cycle and Monitoring Policy and Procedures).

Impact and Notable Alumni

Approximately 80 percent of military physicians reaching 20 or more years of military service are graduates of USU. A majority of medical corps leadership positions are occupied by graduates of USU.

Adv. Thomas W. Joseph Caravalho, Jr. - physician, Joint Staff surgeon, the chief medical advisor to the Chairman of the Joint Chiefs of Staff. He currently serves as the CEO and President of the Henry M. C. Katalin Karikó - Nobel Prize Winner in Physiology or Medicine 2023.

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