ADDITIONAL TRAINING FOR PHYSICIAN ASSISTANTS

Additional Training for Physician Assistants Chapter 9 ADDITIONAL TRAINING FOR PHYSICIAN ASSISTANTS Sharon Rosser, PA-C, DScPAS-EM; Amelia Duran-Stanton, PA-C, PhD, DScPAS-CO; John Detro, PA-C, MPAS, MEd; Amy Jackson, PA-C, MPAS; and Luis Vidal, PA-C, MPAS Introduction As Army Medicine pursues its journey of becoming a system for health, fostering the principles of a high-reliability organization, physician assistants (PAs) more than ever are paramount in achieving this ambitious goal. Army Medicine s DSc programs are integral to achieving success in the system-for-health mission, and the pursuit of doctoral-level education by the best and the brightest PAs is vital in positively impacting the care of soldiers and their families. This chapter describes the role of the graduate education manager (GEM), the postprofessional education opportunities, and additional medical and leadership courses available to the military physician assistant. The table attached at the end of the chapter provides additional operational, medical, predeployment, and leadership training resources available to the PA. Graduate Education Manager The GEM, a position assigned either to the Army Medical Department Center and School Health Readiness Center of Excellence (AMEDDC&S HRCoE) Graduate School or to San Antonio Military Medical Center, is responsible for coordinating all postgraduate education for Army PAs funded through the long-term healthcare education and training (LTHET) programs. These programs include the Doctor of Science in Physician Assistant Studies (DScPAS) programs, as well as PhDs in epidemiology or education; MS degrees in occupational health, 103

US Army Physician Assistant Handbook education, or informatics; Master of Healthcare Administration/ Business (MHA/MBA) degrees; training with industry (TWI) programs; and the military Emergency Medicine/Critical Care Ultrasound Fellowship. The GEM must not only manage the education occurring today but also envision future needs, and facilitate collaboration within the PA, Army Medical Specialist (SP) Corps, and Army Medical Corps (MC) community to support development of future training to fulfill anticipated capability gaps. 1 The GEM regularly interacts with postgraduate program managers, the Professional Education and Training Department (PETD), which is under the Department of Training and Academic Affairs, AMEDDC&S HRCoE, the SP corps-specific branch proponency officer, the PA consultant to the Army surgeon general, and the SP Corps PA branch chief. He or she occasionally interacts with the SP Corps chief. The GEM develops short- and long-term goals for Army PA education and staffs these goals within the branch leadership to the SP Corps PA branch chief for approval. 1 The GEM is a member of the SP Corps Graduate Education Committee and works closely with the committee and SP Corps leadership to develop, refine, and review postgraduate education and postprofessional short courses. The collaborative relationship between the GEM and the postgraduate program managers results in a consolidated effort in advising PA and SP Corps leadership on the current and future needs for LTHET (Figure 9-1). When assigned directly to San Antonio Military Medical Center, the GEM spends half their time in clinical work and half on GEM duties. 1 Whether assigned to AMEDDC&S HRCoE or to the SAMMC, the GEM must maintain clinically proficiency as a specialty-trained PA to keep up with current medical trends and sustain rapport with individual program managers and students. Duty Descriptions Serves as conduit between postgraduate PA programs, AMEDDC&S HRCoE Graduate School, PETD, and SP Corps leadership on matters Figure 9-1 (right). The graduate education manager s relationship with physician assistant postgraduate education programs and US Army Specialist Corps leadership. AOC: area of concentration; PA: physician assistant 104

Additional Training for Physician Assistants AOC Chief PA Consultant Graduate Education Manager School of Choice Programs DSc Program Managers Ultrasound Fellowship Training with Industry (TWI) Occupational Health PhD Education / Public Health Baylor Healthcare Administration MHA/MBA Emergency Medicine Clinical Orthopedics General Surgery Sites: 1. San Antonio Military Medical Center 2. Madigan Army Medical Center 3. Carl Darnall Army Medical Center 4. William Beaumont Army Medical Center Site Faculty: 1. Program Director 2. Assistant Program Director 3. Research Director Sites: 1. San Antonio Military Medical Center 2. Madigan Army Medical Center 3. William Beaumont Army Medical Center Site Faculty: 1. Program Director 2. Assistant Program Director 3. Research Director Sites: 1. San Antonio Military Medical Center Site Faculty: 1. Program Director 2. Assistant Program Director 3. Research Director 105

US Army Physician Assistant Handbook pertaining to ongoing and future training, including scheduling, student selection, student placement, and funding (Figure 9-2). Responsible for assisting in the development of the annual LTHET guidance by advising on issues such as numbers needed to train and necessary selection qualifications of PAs for postgraduate training. Responsible for managing the LTHET selection process for PAs, including recruitment, the application process, selection, and post-selection placement, working closely with PETD, Human Resources Command (HRC), and SP Corps leadership throughout the application and selection process. Serves as the responsible team member in conducting after action reviews for each LTHET selection board. Responsible for the annual revision of the Program and Positions Requirement Worksheet (PPRW): updating the PPRW ensures the SP Corps is offering the right training in the right numbers and right areas of concentration to meet the forces future needs. Responsible for standardization of training across all specialty DSc programs to ensure reproducibility of specialty skill sets in order to fill current TDA (table of distribution and allowances) and MTO&E (modified table of organization and equipment) requirements. Manages the admission process for all PA DSc candidates in conjunction with the Baylor University Graduate School, and supervises the admissions process for MHA/MBA, PhD, MS, and TWI programs for PAs; also serves as administrative liaison with Baylor University for faculty appointments, website maintenance, contract revisions, curriculum reports, and graduation requirements. Serves as chairman of the board during Army-Baylor doctoral defense for the clinical specialty DSc programs. The board is held annually in November. Coordinates with Baylor University and the program managers of the clinical specialty DSc programs to ensure logistical support of the Baylor doctoral brunch and graduation ceremony. The brunch and ceremony occur annually in December. Responsible for collaborating with the PA branch chief and the AMEDDC&S HRCoE Capability Development and Integration Directorate and the AMEDD Personnel Proponent Directorate for future doctrinal organizations requiring PAs; works with these personnel as a team to assess the requirement and develop actions plans to create and fill the personnel authorizations for both MTO&E and TDA requirements relating to specialty-trained PAs. 106

Additional Training for Physician Assistants LTHET board results PPRW Update Jul Jun Research course LTHET welcome letter Research manuscript mentoring Aug May New student enrollment Baylor Doctoral defense coordination LTHET board HRC LTHET message development Sep Annual GEM Cycle Apr Remind incoming students to turn in required documents for admission Oct Mar All documents to HRC LTHET Doctoral defense practice LTHET message Chair doctoral defense DSc finals Nov Feb Obtain PA consultant s concurrence for LTHET applicants Baylor graduation & doctoral brunch Dec Jan LTHET application documents review and processing LTHET applicant interviews and application mentoring Figure 9-2. Graduate education manager s annual workflow. GEM: graduate education manager; HRC: Human Resources Command; LTHET: long-term health education and training; PA: physician assistant; PPRW: Program and Positions Requirement Worksheet 107

US Army Physician Assistant Handbook Provides recommendations to the SP Corps Education Committee on matters relating to the postprofessional short courses. Provides updates to the SP Corps Research Committee on research efforts within the postgraduate programs; works closely with the program directors to ensure research efforts are recognized and published. Responsible for postgraduate student actions. If a student in a postgraduate program does not meet standards and requires discipline, remediation, probation, or release from the program, the GEM works closely with the program director, the program manager, and SP Corps Education Committee to ensure the student receives due process. Requirements Doctoral level degree. Rank of major or lieutenant colonel. Intermediate Level Education graduate. Desired Skills and Attributes Must be an excellent role model with the desire to mentor others. Solid leadership, administrative, and academic skills. Strategic vision for future education and training requirements. 108 Long-Term Healthcare Education and Training Purpose and Course Offerings LTHET opportunities are available to PAs to meet the education goals of the AMEDD as listed in Chapter 1, Section 1-5, of Army Regulation 351-3, Professional Education and Training Programs of the Army Medical Department: a. Provide the validated professional and administrative personnel to meet requirements of the AMEDD and the Army. b. Provide AMEDD personnel with (1) Opportunities for consistent and progressive professional education and training. (2) Opportunities for professional development that aid career progression.

Additional Training for Physician Assistants (3) Education and training in an orderly, logical, planned, and systematic manner under direction and guidance of qualified instructors. (4) Educational opportunities in support of the overall AMEDD mission. 2 Currently, the education opportunities available to PAs include the Army-Baylor DScPAS programs in emergency medicine, clinical orthopedics, and general surgery; TWI (1-year fellowships) with professional organizations such as American Academy of Physician Assistants, National Commission on Certification of Physician Assistants, National Registry of Emergency Medical Technicians; PhDs in education or epidemiology; MS in occupational health, education, or informatics; and Army-Baylor MHA/MBA. A 1-year fellowship in emergency medicine/critical care ultrasound is also available to PAs who have earned a DSc in emergency medicine or surgery. Prospective applicants may list three program preferences on the LTHET application. Programs are offered according to projected force needs and published 5 years in advance. The current 65D (PA military occupational specialty) 5-year plan for LTHET is outlined in Table 9-1. The plan is updated annually based on projected force needs. Qualifications Qualifications for LTHET applicants are published in the annual MILPER message and are subject to change. For 2018, prospective LTHET applicants must: be active duty in the rank of captain to lieutenant colonel; be a graduate of Captains Career Course (non-waiverable); have 5 to 13 years of active federal commissioned service (AFCS) OR be prior service and have less than 17 years active federal service (AFS) have completed 36 months time on station (or 24 months with an HRC waiver) for stateside assignments prior to the start of the program; if assigned overseas, have completed the entire overseas tour, including any extension, without curtailment prior to the start of the program; not be a non-select for promotion; have not previously attended a funded equivalent level LTHET degree program (if the applicant has completed a different degree 109

US Army Physician Assistant Handbook TABLE 9-1. 65D LONG-TERM HEALTHCARE EDUCATION Degree Documented Requirements Utilization/Mission 0 Residencies/IPAP DSc 23 MEDDAC/MEDCEN/residency staff DSc 35 MEDDAC/MEDCEN/MTOE CSH)/(future) MTOE BSB DSc 0 MEDDAC/MEDCEN/residency staff MHA/ MBA 0 Division/Corps positions/army Medical Personnel Proponency Directorate MPH 6 Military treatment facility occupational health programs MS 0 Defense Health Headquarters PhD 1 IPAP PhD 1 TWI 1 US Army Research Institute of Environmental Medicine or US Army Center for Health Promotion and Preventative Medicine Department of Combat Medic Training /IPAP/ Capability Development Integration Directorate/ US Army Training & Doctrine Command BSB: brigade support battalion CSH: combat support hospital IPAP: Interservice Physician Assistant Program MEDDAC: Medical Department activity MEDCEN: medical center MTOE: modified table of organization TWI: training with industry 110

Additional Training for Physician Assistants AND TRAINING 5-YEAR PLAN, BY DEGREE Concentration Projected FY Ultrasound Fellowship 16 20 Clinical Orthopedics 16 20 Emergency Medicine 16 20 General Surgery 16 20 Baylor Health Care Administration MHA and MBA option 16 Occupational Health 16 20 Informatics 17, 19 Higher Education/Adult Studies 16 17, 19 Public Health/ Epidemiology/Biostatistics/Sports Medicine National Commission on Certification of Physician Assistants/National Registry of Emergency Medical Technicians/American Academy of Physician Assistants 16 17, 19 16 20 111

US Army Physician Assistant Handbook level of LTHET, they must have completed the previous active duty service obligation (ADSO) prior to the start of the current program); and have 3 years of clinical experience (2 years with HRC waiver) at the start of the course. 3 Additionally, passing the GRE is required by the LTHET selection board, regardless of the individual program or university requirement, with a minimum score of 300. The Army-Baylor DSc programs currently accept a minimum score of 297. Individual universities determine the qualifying GRE scores for school of choice programs. Applicants to the DSc programs must also complete 40 clinical-shadowing hours in the desired specialty. A PA applying to more than one DSc program must complete shadowing in all desired medical specialties. The shadowing form can be accessed at the LTHET link on HRC. 3 Application Information PAs interested in attending one of these programs must apply to the LTHET selection board. The digital application is posted on the HRC Long-Term Health Education portal, 3 and annual application guidance is published through a military personnel (MILPER) message posted on the portal in mid- to late-november. Also posted is an applicant checklist containing specific directions, deadlines, and the GEM s contact information. In addition to the documents listed above, applicants need to review and update their individual Army military human resource record, have a recent Department of Army (DA) photo (taken within the last 2 years), and update their ORB in preparation for the LTHET selection board. The final application submission deadline is given in the annual MILPER message, usually in mid-march. Once the applicant receives the application with HRC, PA Consultant and Corps endorsement from the GEM, the applicant must then submit the completed checklist, LTHET application, DA 3838, official (degree-conferring) school transcripts (if not already posted on the AMHRR), and official GRE scores to the LTHET team according to the date and directions provided in the annual MILPER message. 112

Additional Training for Physician Assistants Planning Prospective applicants should review the entry criteria at least 1 year prior to application. Although there may be some changes in the future checklist, a year will provide adequate preparation time for any significant qualifications tasks such as the GRE and clinical shadowing. Once prospective applicants are eligible, they must review the current application guidelines in the annual MILPER message, usually no later than early December. The LTHET selection board results are generally published in July, approximately 1 year prior to the program start dates. For example, applications received in March 2017 will result in selection board results in July 2017 for programs starting in summer 2018. Active Duty Service Obligation Individual LTHET programs have different ADSOs. The current ADSOs, according to Army Regulation 351-3, Chapter 2, Section 2-7, are as follows: 3-year PhD program: 2 years for each year of training plus 6 months for the degree, resulting in a 6.5 year ADSO. DSc programs: 3.5 years. Ultrasound fellowship and TWI: 2 years. 2 Utilization tours are dependent on the program of completion. Prospective applicants should discuss utilization tours before applying for training with the current GEM, previously trained PAs in the desired specialty, and the PA consultant. Defense Strategy Course Another training opportunity for PAs is the US Army War College s Defense Strategy Course (DSC), a 4-month nonresident/distant learning course offered twice a year. 4 DSC is recommended for majors and lieutenant colonels, and enrollment is limited to 50 active duty, 25 reserve, and 25 National Guard officers. 4 This course is highly competitive and strongly recommended for senior PAs for several reasons: the training helps leaders develop critical thinking skills required for strategic-level decision-making; it presents the opportunity 113

US Army Physician Assistant Handbook to attend various fellowships; and it provides an additional skill identifier (6Z) per Personnel Selection and Classification: Military Occupational Classification and Structure, DA Pamphlet 611-21. 5 Prerequisites Applicants must have credit for Military Education Level 4, and they must not be enrolled in or have completed a Senior Service College program. Enrollment Instructions Review the course curriculum at https://dde.carlisle.army.mil/ curriculum.cfm. 4 Notify your assignment manager of your interest in attending the course. Submit a DA Form 3838 to your assignment manager. In the Army Training Requirements and Resources System (ATRRS), the school code is 217 and the course number is DSC. 6 Course Purpose The course is intended to improve officers understanding of the Defense Department s role in the development of the national security strategy, and the strategy s role in the international environment. 4 Curriculum The course is divided into four sections with 13 lessons each. Each lesson requires approximately 7 to 10 hours to complete. As described on the course website, the sections are as follows: 114 Section 1, Introduction: introduces the student to the online format of the course and critical thinking concepts. Section 2, Strategic and Military Theory: examines classical thinking about strategic theory, the military schools of strategic thought, the international system, strategy formulation frameworks, and states and strategy. 4 Section 3, The Department of Defense: reviews the roles of the Defense Department, civil control of defense, the interagency framework, and homeland security.

Additional Training for Physician Assistants Section 4, Policy Development and Security Environment: examines policy making, globalization and economic development, the current strategic environment based on both opportunities and threats, cultural relations and dimensions, multinational operations, centers of gravity analysis, and strategy at the combatant command level. 4 Evaluation Criteria Evaluation criteria consists of online forums, quizzes, examinations (multiple choice), and written essay requirements. 4 Additional Information Graduates receive an Army War College certificate signed by the college s commandant. Although the course awards an additional skill identifier recorded on the ORB under military education, it does not award a formal military education level nor does it provide college course credits. There is no formal academic evaluation report, although PAs can apply for continuing medical education (CME) 2 credit for professional development to support their credentialing requirements. Graduates should provide the course completion certificate to their assignment officer to have the course and 6Z additional skill identifier added to their ORB. 4 Additional Professional Military Education Upon completion of DSC, additional professional military education (PME) opportunities are available to PAs. In May 2015, the first pilot course for the Defense Planners Course was concluded. This training is projected to be an online course focused on joint planning, but there is currently limited information on its availability and enrollment procedures. The US Navy has a robust online PME program. For example, the US Naval War College s College of Distance Education accepts applications from Army majors and above, as well as civilians in grades GS-11 and above for some of its courses. 7 Additional offerings can be found through distance learning offered by the Air War College, the senior school in the Air Force professional military education system. The college s 44-week course for lieutenant colonels trains senior leaders for strategic-level employment of air, space, and 115

US Army Physician Assistant Handbook cyberspace forces. The curriculum emphasizes coalition war fighting and national security and includes seminars, simulation exercises, electives, international travel, and a national security symposium (contact the Air War College registrar directly for enrollment procedures). 8 References 1. Army Medical Department Center & School, Health Readiness Center of Excellence. Graduate Education Manager Handbook. January 2016. Unpublished document. Graduate School, AMEDDC&S HRCoE; San Antonio, TX. 2. US Department of the Army. Professional Education and Training Programs of the Army Medical Department. Washington, DC: DA; 15 October 2007. Army Regulation 351-3:1 3. 3. US Army Human Resources Command. Long Term Health Education MILPER Message: 16-333, AY2018 AMEDD-4 Long Term Health Education and Training (LTHET) Program Application Procedures and Selection Panel Announcement. November 30, 2014. https://www.hrc.army.mil/officer/long%20 term%20health%20education%20ahrc-oph-poh/. Accessed January 25, 2017. 4. US Army War College. Curriculum. Department of Distance Education website. https://dde.carlisle.army.mil/curriculum.cfm. Accessed May 27, 2015. 5. Department of the Army. Personnel Selection and Classification: Military Occupational Classification and Structure. Washington, DC: DA; January 2007. DA Pamphlet 611-21. http:// www.bing.com/search?q=da+pam+611-21&src=ie- TopResult&FORM=IE11TR. Accessed May 27, 2015. 6. Department of the Army. Defense Strategy Course. Army Training Requirements and Resources System. https://www.atrrs. army.mil/atrrscc/courseinfo.aspx?fy=2015&sch=217&crs=1-250-c22+(dl)&crstitle=defense+strategy+course ++(DSC)&phase=. Accessed May 27, 2015. 116

Additional Training for Physician Assistants 7. US Naval War College. College of Distance Education, webenabled program. https://www.usnwc.edu/academics/collegeof-distance-education/web-enabled-program.aspx. Accessed June 9, 2015. 8. US Air Force. The Air University website. http://www.au.af.mil/ au/ Accessed June 9, 2015. Useful Links US Army War College Blackboard: https://usawc.blackboard.com/ Online Academic Student Information Systems (OASIS): https:// www.carlisle.army.mil/oasis/ Naval Postgraduate School Distance Learning: http://www.nps.edu/ Academics/DL/index.html Joint Forces Staff College Advanced Joint Professional Military Education: http://jfsc.ndu.edu/academics/ AdvancedJointProfessionalMilitaryEducation/ AJPMEProspectiveStudent.aspx Attachment: Other Training Opportunities The following table is a listing of additional courses that PAs may attend to enhance their operational readiness, prepare for upcoming positions and new duties, and gain CME credit. Follow the directions below for the Army Training and Requirements Resources System (ATTRS) and Defense Medical Readiness Training Institute (DMRTI) courses: ATTRS (https://www.atrrs.army.mil/): Click on Course Catalog at the right of the screen and insert the course number into the search engine. This will bring up the course. Double click on the course, and the dates and locations, scope, and points of contact for the course will be shown. (To enroll, apply through your operations office or directly to the course point of contact.) DMRTI (http://www.dmrti.army.mil/): Click on Courses at the top of the screen. Tabs will appear for all DMRTI courses, providing contacts, dates, CME credits, training focus, and requirements for who can attend. 117

US Army Physician Assistant Handbook CATEGORY COURSE NAME ATRRS COURSE # Operational Brigade Healthcare Provider Course 7M-F12 Combat Casualty Care Course (C4) 6A-C4 Health Service Plans (HSP), Operations (OPS), Intelligence (INTEL), Security (SEC) & Training Medical Operations Course Preventive Medicine Short Course 6I-70H 6A-A0137 Medical Management of Chemical / Biologic Casualties Field Management of Chemical and Biological Casualties 6H-26 6H-F37 /300-F31 118

Additional Training for Physician Assistants DESCRIPTION Training focuses on AMEDD systems, policies, and a doctrinal knowledge common to all AMEDD providers and allows the flexibility to utilize separate functional area tracks of instruction for each provider s Area of Concentration. Additionally, this course will reinforce the MEDCOM priorities and increase readiness for units and Soldiers in operational and garrison environments. This course will eventually replace the current Brigade Surgeon course and Dental Surgeon course. Enhance medical readiness of physicians, physician assistants, nurses, dentists, and other medical specialties by providing training in field leadership, knowledge and skills that may be necessary for direct medical support in conditions related to any combat situation or contemporary Operational Environment. Provides qualified officers training in field medical operations and direction or coordination of staff functions pertaining to force health protection, force health support plans, operations, intelligence, security, and training. Focuses on Army Preventive Medicine (PM) and Force Health Protection (FHP) issues during deployments and in garrison. Provides a military-specific curriculum that is not available in civilian preventive medicine courses or meetings. Phase 1 focuses on biological agents and Phase 2 focuses on chemical agents, including a field exercise. Each phase of training is 3 days. This course is located at Aberdeen Proving Ground and is designed for military healthcare providers to gain knowledge on management of chemical or biological casualties through didactic, small-group, and field scenario exercises. LENGTH 2 weeks 4 days 3 weeks 4 days 6 days 1 week 119

US Army Physician Assistant Handbook CATEGORY COURSE NAME ATRRS COURSE # Management of Burns & Multiple Trauma Course 6H-300/ A0608 Military Tropical Medicine Course Army Public Health Center Predeployment Army Trauma Training Center 6H-F31/ 300-F18 Joint Forces Combat Trauma Management Course 6A-F19/ 300-F37 Tactical Combat Medical Care Course (TCMC) 6H-F35/ 300-F38 120

Additional Training for Physician Assistants DESCRIPTION Enhances military readiness in the management of burn and multiple trauma casualties. Provides didactic and practical lab training on the management of burn and multiple trauma injuries from point of injury to reintegration, with topics including: appropriate burn wound care, inpatient and outpatient burn rehabilitation, treatment of burns in an austere environment, amputee management, amputee rehabilitation, prosthetic use, TBI care, nutrition care, combat and operational stress control, and management of fractures. Special emphasis will be placed upon minimizing devastating and lifelong disability and maximizing functional outcomes. Provides opportunity for certification in Advanced Burn Life Support. Advanced training in tropical medicine for tri-service medical officers covering a broad range of medical topics including viral, bacterial, and parasitic infections; environmental illnesses; pre-and post-travel evaluations; outbreak investigations; and public health issues in the developing world. LENGTH 1 week Didactic: 4 weeks Field: 2 weeks (overseas in resourcepoor region Training co-located with the Ryder Trauma Center (RTC) at the University of Miami/Jackson Memorial Medical Center focused on forward surgical team (FST) development and overall advanced trauma life support. Members of the FST and slice elements work together within and across their sections to care for acutely injured patients, most of whom have injuries similar to those of combat casualties. Training focusing on combat casualty care at Role 3 facilities (such as combat support hospitals). Practical exercises for providers are conducted in airway management, surgical treatment of extremity trauma, chest, abdominal, head, neck and thermal wounds, application of portable ultrasound, and pain management/anesthesia delivery mechanisms. Training focusing on injury patterns of combat casualties and the constraints to deliver medical care on the battlefield and in urban warfare. 17 days 1 week 5 days 121

US Army Physician Assistant Handbook 5 days COURSE NAME ATRRS COURSE # Aviation / Flight Medicine US Army Flight Surgeon (Physician Assistant) Course 6A-61N9D (65DM3) Joint Enroute Care Course 6A-F12/ 300-F26 Clinical Basic Healthcare Administration Course 6I-F13/ 340-F8 Hospital Management (HM) of Chemical, Biological, Radiological, Nuclear, and Explosive (CBRNE) Incidents 6I-F10/ 340-F5 Medical Effects of Ionizing Radiation Course DNWS NO15 122

Additional Training for Physician Assistants DESCRIPTION Training reviews Army regulations pertaining to aviation medicine, Army flight surgeon responsibilities and procedures, Army flying duty medical exam administration, Army aviation organization and operations, rotary wing aerodynamics, aviation safety, aircraft accident investigation, flight physiology, aviation medicine issues of clinical specialties, health service support of aviation units and operations, aeromedical evacuation, and deployment medicine issues of the aviation operation environment. Provides knowledge and skills necessary to manage critical care patients of all demographics during tactical operations on aeromedical rotary wing evacuation platforms, and prepares graduates to recognize and limit the stressors encountered in the transport environment. LENGTH 6 weeks 2 weeks Training focuses on the various data systems used in daily clinical management and operations within military treatment facilities (MTFs). The course has 2 phases with Phase 1 being distance learning prior to attendance at Phase 2 (resident). This course features didactic classroom presentations and interactive discussions on chemical, biological and radiological agent effects. Topics include patient management, multi-casualty triage, personal protective equipment, decontamination, blast injuries, and hazard detection. Additional topics include epidemiology, the National Incident Management System and National Response Framework, and hospital emergency incident command and management. Instruction is also provided in the form of hypothetical CBRNE incident scenario planning sessions and class interactions. The course culminates in a multi-hospital tabletop exercise simulating community response to a major non-conventional event, challenging the students ability to apply hospital incident management and other learned concepts. CME, CEU/CNE, and CEH credit is available upon course completion. Provides medical personnel with background material relating to human injury and combat effectiveness in a nuclear weapons detonation or accident scenarios. Introduces physical principles of nuclear weapons and ionizing radiation, including external and internal contamination. Phase 1: 16 hours (DL) Phase 2: 5 days 1 week 4 days 123

US Army Physician Assistant Handbook 5 days COURSE NAME ATRRS COURSE # Leadership Army Medical Department Executive Skills Course 6A-F4 Iron Majors Week 6H-A0628 Lean Six Sigma Clinical Trial Management System The following courses are subject to change annually based on funding and operational need. Courses are advertised through the SP Corps office. Professional Postgraduate Short Course Program (PPSCP) Emergency Medicine PA Basic Skills Course Mary Lipscomb Hamrick Research Course European Physician Assistant Refresher Course AMEDD: Army Medical Department AOC: area of concentration ATRRS: Army Training and Requirements Resources System DL: distance learning MEDCOM: US Army Medical Command PA: physician assistant SP: US Army Medical Specialist Corps TBI: traumatic brain injury 124

Additional Training for Physician Assistants DESCRIPTION Course provides formal instruction in current and pertinent material designed to prepare new and projected deputy commanders for positions within AMEDD medical centers, medical activities, and dental activities. This course is designed for competitively selected Army Medical Specialist Corps captains promotable and majors to train them for senior corps and AMEDD leadership positions. The course provides a challenging professional development and professional education opportunity that leverages crossspecialty communication and initiative development to build the team. There are 3 levels of Lean Six training: Green, Yellow, and Black. These courses provide knowledge and skills to use Continuous Process Improvement Lean Six Sigma tools to effectively execute projects. Apply at: https://home.dcma.mil/ Command/performance_management/cpi/index.cfm LENGTH 5 days 5 days Varies by level of training Establishes clinical skills required by physician assistants in the evaluation and treatment of patients presenting with urgent or emergent conditions. Completion of the course is highly recommended for those applying to the DSc PA EM program. Distance learning course designed to enable researchers to establish a direction of future AOC specific and combined research. Provides an environment for the preparation of research projects in clinical practice. Provides current information on emerging trends in prevention, maintenance in primary care, emergency medicine, orthopedics, surgery, occupational health, pediatrics, and operational medicine. Opportunity for skill validation. 5 days 5 days 5 days 125

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