Military-civilian partnerships on the west coast: Differing models producing combat-ready trauma teams

Military-civilian partnerships have emerged as essential platforms for preparing military trauma surgeons and health care teams for deployment. These programs, many of which were developed following congressional initiatives to enhance military trauma readiness, address the critical issue of sustaining trauma skills during peacetime avoiding a phenomenon known as the "Walker Dip," when skills and proficiency in treating battlefield injuries decline during peacetime after periods of intense conflict. They also provide military surgeons and other providers with training in research methodology and trauma systems management, skills that are difficult to obtain solely within the military structure. This article examines three distinct military-civilian partnership models based on West Coast trauma centers: Oregon Health & Science University (affiliated with the US Army), Los Angeles General Medical Center (affiliated with the US Navy), and UC Davis Medical Center (affiliated with the US Air Force). These programs provide critical trauma exposure while fostering advanced academic and leadership skills. The Joint Trauma System, with its focus on data-driven improvements in trauma care, has further shaped these programs. By comparing these models, we identify their strengths, deficits, and strategies for enhancing training effectiveness. The conclusion highlights the uniqueness of each site and affirms that there are multiple successful approaches to fostering military readiness.