- The Washington Times - Sunday, December 19, 2004

Where the troops go, so go the doctors. Along with nurses and medics, they are the lifesaving arm of the American military.

Among them are graduates of the Bethesda-based Uniformed Services University of the Health Sciences, a top-notch medical training facility under the Department of Defense. They also are a breed apart from most physicians turned out at civilian medical schools.

Their training is longer — it includes compulsory studies of leadership and tropical medicine, as well as emergency medicine and field exercises. Graduates’ professional duties can be more rigorous because many eventually are deployed to battlefield sites. “Good medicine in bad places” is a school slogan.

The outlook of USUHS students generally differs from that of civilian medical students, as well. They are older on average. Half have had military experience. Teamwork is the rule — an attitude summed up by Ensign Tim Bruehwiler, 30, of Ridgefield, N.J., and Gaithersburg, a former Navy submarine officer.

“I like working in a team environment and supporting my country. I really felt the calling to help my fellow man,” he says. “And just like the Naval Academy makes good officers, USUHS makes the best doctors for the military. … Some medical schools are highly competitive with one another. Here, I don’t feel competition between students. I feel my class of ‘08 works well helping each other — in studying materials for exams, for instance. We’re only as good as the slowest man.”

Second-year student Ensign Erin McKenzie, 24, of Pittsburgh and Bethesda, a graduate of the Naval Academy, agrees. She picked USUHS over three civilian medical schools that had accepted her.

About half of USUHS students are women, a higher percentage than that found at most medical schools. Only about 160 out of a total 1,800 applicants gain admission each year. (The drop-out rate over all four years is about 3 percent.) Five hundred candidates are interviewed to ascertain their motivation for pursuing medicine and their understanding of military culture.

Two slots are taken — and paid for — by the U.S. Public Health Service’s uniformed corps, which is under the Department of Health and Human Services, hence the university’s awkward but carefully crafted name.

The school’s motto, reasonably enough, is “Learning to care for those in harm’s way.” Research, continuing education and graduate-degree programs are offered in related fields, including nursing, much of it done off site.

USUHS’ operating budget is $84 million, with a great percentage of faculty — a 60-40 split between civilian and military members — listed off campus, in military-base hospitals and elsewhere. Of the nearly 4,000 physician alumni, more than 90 percent are on active duty in the armed forces or Public Health Service. A commitment of seven years is required beyond graduation.

“It’s a noncompetitive atmosphere and very helpful. The Naval Academy was very competitive, and so was high school, and I didn’t want to be competitive anymore,” Miss McKenzie says. Such an attitude is common sense, she admits, because “every one in your class is going to be taking care of your family members eventually. Military professionals see military docs.”

Asked to name some of the 32-year-old school’s outstanding graduates, Dr. Larry W. Laughlin, a retired Navy captain who is the medical school’s dean and the university’s acting president, says, “We don’t think in terms of who is a star and who is not.” Pressed, he named a graduate who served as President Clinton’s military physician and another acclaimed for research on effective body armor, both women.

A physician’s ego gets “transferred to a sense of mission,” concurs Dr. Laughlin, 59, whose own mission long ago was electing to study internal medicine and infectious disease — very useful in military circles — as a way of fulfilling a draft commitment.

“People kind of know what they will be doing in the next 10 or 20 years when they graduate,” he says. “They are part of this big team. They are going to be working all over the world — up here at Walter Reed, or wherever. That is the essence of what sets us apart. When we plop you down in Iraq or someplace, that is normal business, as far as we are concerned.”

And who ever heard of being paid to go to a medical school — as much as $40,000 a year — and having future income determined by rank rather than by the earning capacity of one’s specialty?

Students pay for their own housing and live off campus, which is in four buff-red buildings on the grounds of the National Navy Medical Center. Everyone wears a service uniform to class and for official inspections and appearances. Medical students are identified by a single gold bar. Students who don’t come from a military background receive an officer’s rank upon entrance.

The medical school, which began life above a People’s drugstore, is named for the late Rep. F. Edward Hebert of Louisiana, who led the effort to establish the institution.

Various moves have been made through the years to end the school’s existence, based on analyses comparing the school’s costs with those at civilian schools. Supporters say the school justifies itself in its ability to train doctors in matters unique to military life and wins the loyalty of most graduates who elect to stay on past the seven years.

Dr. Laughlin ruefully acknowledges the truth of the words on the back of some USUHS T-shirts — “The best medical school you’ve never heard of” — but he also says he doesn’t fully understand why because “we try to advertise as much as possible.” One common misconception, he says, is “that because we are part of DOD, that bazillions of dollars in research that DOD gets comes here.”

The school competes for grants like any other university, he says.

Still, there is no mistaking that this is a military place, a base camp in a way. The uniforms and inspections only enhance the loyalty of someone such as California-born 2nd Lt. Mike Simpson, 40, a third-year student headed for a career in emergency medicine with 20 years’ Army service behind him.

“I enjoy the military lifestyle and like working with people who are professional and always want to be at the top of their game,” he says. “I was out three years and didn’t like what I saw in the civilian sector. Everyone is out of uniform, and no one is in charge.”

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