A Smattering of Opportunities in Military Medical Research
By 2LT Ryan Leone
Interested in research on topics of relevance to military and emergency medicine? Check out this non-exhaustive, brief summary of several leading DoD research commands, organizations, and programs that may enable you to engage in research on a part-time or full-time basis:
(1) U.S. Army Medical Research and Development Command (USAMRDC)
This command manages research across five primary program areas - the Military Infectious Diseases Research Program, the Combat Casualty Care Research Program, the DoD Blast Injury Research Program Coordinating Office, the Military Operational Medicine Research Program, and the Medical Chemical Biological Defense Research Program. It also has oversight of several subordinate commands including the U.S. Army Institute of Surgical Research (USAISR), which is located next to Brooke Army Medical Center and focuses on “Optimizing Combat Casualty Care” with five primary divisions of work - (1) Blood & Shock Resuscitation, (2) Hemorrhage & Vascular Dysfunction, (3) Organ Support & Automation Technologies, (4) Wound Progression & Infection, and (5) Pain & Sensory Trauma Care. It also has a leading Burn Center. Other USAMRDC institutes of interest to EM students, residents, and attendings include the U.S. Army Institute of Environmental Medicine, with divisions focused on (1) Military Nutrition, (2) Military Performance, and (3) Thermal and Mountain Medicine and a separate Female Warfighter Research Directorate. These join other facilities that work on chemical and biological threats, like the U.S. Army Medical Research Institute of Chemical Defense that targets toxin and nerve agent countermeasures among other areas, and the U.S. Army Medical Research Institute of Infectious Diseases that looks at bacterial and viral diseases, diagnostics, and treatments. Additional research on infectious diseases occurs through the Walter Reed Army Institute of Research (WRAIR), which also focuses on psychiatry and neuroscience, and at its global research sites that extend from Joint Base Lewis-McChord to Thailand (Bangkok), Kenya (Nairobi), and Georgia (Tbilisi). From a technology perspective, USAMRD has oversight of groups like the U.S. Army Telemedicine & Advanced Technology Research Center (TATRC) which conducts research on technological innovations in medical support alongside the U.S. Army Medical Research Acquisition Activity (USAMRAA) that deals with contracting and the U.S. Army Medical Materiel Development Activity (USAMMDA) that develops and tests medical products across a variety of use cases. Many opportunities for part-time collaborations or full-time posts exist within these organizations.
(2) U.S. Naval Medical Research Command (NMRC)
This command has oversight of numerous research and development (R&D) commands, including the Naval Health Research Center (NHRC) in San Diego which focuses on (1) Military Population Health, (2) Operational Readiness, and (3) Operational Infectious Diseases. It also includes Naval Medical Research Unit (NAMRU) - San Antonio (NAMRU_SA) which targets (1) Directed Energy Health Effects, (2) Combat Casualty care & Operational Medicine, and (3) Craniofacial Health & Restorative medicine. Additional domestic entities include NAMRU-Dayton (NAMRU-D) at Wright-Patterson Air Force Base in Dayton, OH and Naval Submarine Medical Research Laboratory (NSMRL) at Naval Base New London in Groton, CT. International research sites include (1) NAMRU-INDO-PACIFIC (NAMRU-IP) with locations from Vietnam (Hanoi) to Thailand (Bangkok), Malaysia (Kuala Lumpur), and Singapore, (2) NAMRU-EURAFCENT with locations from Accra, Ghana to Cairo, Egypt and Camp Lemonnier, Djibouti, and (3) NAMRU-South (NAMRU-S) with locations across Honduras (Comayagua), Peru (Iquitos and Callao). These facilities cover topics ranging from environmental health to infectious disease, behavioral science, and combat casualty care. Many opportunities for part-time collaborations or full-time posts exist within these organizations.
(3) Air Force Research Laboratory (AFRL)’s 711th Human Performance Wing (HPW) and 59th Medical Wing (MDW)’s Chief Scientist’s Office
The AFRL has many subordinate entities, including the 711th HPW, which itself has a Human Effectiveness Directorate with three divisions spread across Wright-Patterson Air Force Base in Dayton, OH and Joint Base San Antonio in San Antonio, TX. These divisions are (1) Warfighter Interactions & Readiness Division (RHW), (2) Air and Space Biosciences Division (RHB), and (3) Bioeffects Division (RHD). Separately, the 59th MDW’s Chief Scientist’s Office, Science and Technology (59 MDW/ST) conducts clinical and translational research to support health and science needs with sub-programs like the Joint Austere Medicine Research Portfolio, including the En-Route Care Research Center and the Frontline Illness, Exposure & Recovery Care Efforts (FIERCE). The 711th HPW and 59th MDW also collaborate directly on initiatives, including those focused on outer space like the Clinical and Operational Space Medicine Innovation Consortium (COSMIC). Many opportunities for part-time collaborations or full-time posts exist across these organizations.
(4) Congressionally Directed Medical Research Program (CDMRP)
Technically aligned to USAMRDC, this institution has been around since it was Congressionally appropriated in 1992. Since then, it has allocated nearly $20 billion to research programs that range from burn care, traumatic brain injuries, and chronic pain to work on rarer conditions like glioblastoma, neurofibromatosis, and scleroderma. Those with interest may get involved by submitting their own work for funding, joining teams with existing grant support, or becoming either peer reviewers - those with expertise in specific topics- or consumer reviewers - those who can speak to the end-user experience, such as providers and patients - who evaluate submissions.
This organization, physically located within the USAISR but reporting up to the Defense Health Agency, has focused on reducing mortality and morbidity for two decades. In its current form, the JTS works to support combatant commands with trauma system planning and execution, capture data on DoD trauma-related injuries in its Department of Defense Trauma Registry (DoDTR), and conduct research based on that data and other sources that supports performance improvement through evidence-based Clinical Practice Guidelines. Many students, postgraduates, and Active Duty Service Members are involved in publishing research based on data in the JTTR. Additionally, those with certain areas of expertise may contribute to Clinical Practice Guidelines that are periodically updated to reflect the most up-to-date knowledge in each area of focus.
This center, based out of Fort Moore’s Martin Army Community Hospital, focuses on how to prevent and treat heat casualties. The 2022 article here discusses more about the center’s development and work until that point in time, and a recap of the 8th Annual Heat Forum can be found here. Collaborative research opportunities may exist.
(7) Defense Health Agency (DHA)’s Research and Engineering (R&E) Directorate
DHA R&E oversees many aspects of military research, including the Military Health System Research Branch, as well as the National Museum of Health and Medicine (which accepts volunteers to serve as docents) and the many Centers of Excellence (CoE). These CoEs include the Extremity Trauma and Amputation CoE, the Hearing CoE, the Psychological Health CoE, the Traumatic Brain Injury CoE, and the Vision CoE - each of which focus on research and clinical guidelines for care. Interested individuals should reach out to contacts to inquire about opportunities
(8) Uniformed Services University of the Health Sciences (USU)
As the country’s sole federal health professions university, USU not only trains students, but also conducts research at its ~20 academic centers. These include the Armed Forces Radiobiology Research Institute, the Center for Global Health Engagement, the Center for the Study of Traumatic Stress, and many others. Unique institutions housed at USU also include the National Center for Disaster Medicine and Public Health, which has created a Visiting Scholar program. Interested individuals may engage directly with centers or scholars to find projects and may also engage by applying to become faculty members.
(9) Clinician Scientist Opportunity Network (CSION)
This unique two-year, additional-duty program aims to teach clinicians about conducting research that aligns with DoD priorities. It exists across services and corps, and it does not come with a service obligation. More about the program’s development can be read in the article here, and the primary link above includes contact information and additional context.
(10) Defense Advanced Research Projects Agency (DARPA)
While DARPA does not conduct research itself, it is responsible for investing funds into research programs that have high-priority, futuristic objectives and managing their progress. Its past successes include supporting the development of the internet, GPS, drones, voice recognition, and mRNA vaccines. Most of its medically relevant programs exist in the Biological Technologies Office (BTO), though some also sit within the Defense Sciences Office (DSO). The Service Chiefs Fellows Program is an excellent way to get involved with DARPA for a 3-month period of time, and DARPA has created program manager spots for military physicians in the past, along with inviting some to serve as expert consultants on specific topics.