The 16-Year Optimization of a Military-Civilian Collaboration: the University of Alabama at Birmingham Model

Introduction: At the University of Alabama at Birmingham (UAB), a multi-tiered military-civilian collaboration has flourished since 2006. We aimed to outline this model to facilitate its replication nationally. Methods: We performed a comprehensive review of the partnership between UAB, the United States Air Force Special Operations Command (AFSOC), and the Department of Defense (DoD) reviewing key documents and conducting interviews with providers. Results: Six core programs exist targeting training, clinical proficiency, and research. Training: 1) The Special Operations Center for Medical Integration and Development trains over 200 medics yearly. 2) UAB trains one integrated military Surgery resident yearly with two additional civilian-sponsored military residents currently in Emergency Medicine. 3) UAB’s Surgical Critical Care Fellowship has one National Guard member with two incoming Active-Duty and two prior service members in August 2022. Clinical Proficiency: 4) UAB hosts four AFSOC Special Operations Surgical Teams composed of General Surgeons, Anesthesiologists, Certified Registered Nurse Anesthetists, Surgical Technicians, Emergency Physicians, Critical Care Registered Nurses, and Respiratory Therapists totaling twenty-four embedded Active-Duty Healthcare Professionals. 5) Additionally, one Active-Duty Trauma Critical Care Surgeon is embedded at UAB. Research: 6) UAB’s Division of Trauma and Acute Care Surgery currently has ten DoD-funded research projects totaling $6,411,247, and seven research projects with military relevance totaling $9,118,723. Conclusion: The partnership between UAB and various elements within the DoD illustrates a comprehensive approach to military-civilian collaboration. Replicating components of this model nationally may aid in the development of a truly integrated trauma system best prepared for the challenges of the future.