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PREPARED
TESTIMONY of VAL
G. HEMMING, M.D. DEAN
AND PROFESSOR F.
EDWARD HÉBERT SCHOOL OF MEDICINE before
the COMMITTEE
ON VETERANS' AFFAIRS SUBCOMMITTEE
ON OVERSIGHT AND INVESTIGATIONS November
14, 2001 334
Cannon House Office Building 10:00
a.m. Introduction
I am Val G. Hemming, M.D., Colonel, United States Air Force,
retired, Dean of the F. Edward Hébert School of Medicine of the
Uniformed Services University of the Health Sciences (USUHS), our
Nation's only military school of medicine.
Thank you for inviting me to share my views regarding the
present responsibility of medical educators to ensure that the
Nation's primary care practitioners are educated, trained and prepared
for the challenges of weapons of mass destruction (WMD). Background
Military physicians and military medicine planners and
educators have long expected that foes of the United States would
resort to the offensive use of WMD. Memories of World War I, when chlorine and phosgene gas were
used as weapons, the knowledge that the world powers had weaponized
chemical and biological agents such as anthrax, and vivid images of
the use of chemical weapons in the Middle East, made it mandatory for
American practitioners of uniformed medicine to be educated, trained
and prepared to treat casualties of WMD.
Therefore, since the arrival of its first class in 1976, USUHS
has provided in-depth instruction for more than 3,100 USUHS School of
Medicine graduates regarding the recognition, diagnosis, management
and decontamination of persons exposed to WMD.
To my knowledge, USUHS is the only school of medicine in the
United States with WMD as a formal part of its curriculum. USUHS
and WMD
In the few minutes allotted to me, it is not my intention to
inform you of the entire content of USUHS' educational programs in the
area of WMD other than to affirm that for more than twenty years,
USUHS has integrated WMD-related education and training throughout its
standard basic medical science and clinical sciences medical school
curricula. Where
appropriate, this background knowledge is supplemented with specific
WMD course work. All such
courses are organized and taught by experienced active duty and
retired uniformed subject matter experts, who also prepare the
students for two practical field exercises:
Operation Kerkesner and the Bushmaster Exercise.
These exercises require our military medical students to
demonstrate their WMD education and training during rigorous, graded,
week-long combat simulations at the Marine Corps base at Quantico,
Virginia, conducted at the end of the first year of medical school and
at Camp Bullis, Texas, conducted during the fourth medical school
year. A
Solution Using Existing Accrediting Organizations and Procedures
It is evident that modern care health practitioners must be
knowledgeable regarding potential WMD agents, risks for their use,
detection, diagnosis, decontamination and treatment of patients who
might, or have, documented exposure, injury or illness inflicted by
WMD. I believe that the
most effective means for ensuring the proper education and training
for potential first providers for WMD victims and for ensuring the
maintenance of essential knowledge and skills is to incorporate a
basic set of nationally-mandated education and skill objectives into
the Liaison Committee for Medical Education (LCME) -mandated
requirements for granting the M.D. Degree.
At the residency level of training, additional requirements
should be developed in partnership with the Accreditation Council on
Graduate Medical Education (ACGME) to add basic WMD education and
training to the general requirements for the Residency Review
Committee (RRC)/ACGME accreditation of all residency programs.
This recommendation is based on the premise that all
physicians, regardless of specialty, should have a basic understanding
of the WMD agents and the potential ways they may be addressed during
war or terrorism. Physicians
must be able to recognize patterns of illness, means of diagnosis and
potential therapeutic measures. Further,
I also propose that States include WMD requirements in their licensure
processes for primary care providers.
Credentialing would then require biennial educational updates
before privileges could be renewed.
The Joint Commission for Accreditation of Hospitals and Health
Organizations (JCAHO) could also expand its standards for disaster
preparedness to include the ability of accredited organizations to
recognize patterns of illness, and the means to diagnose and treat
potential and confirmed WMD.
The North American system for the voluntary setting of
standards for the training and certification of health care
practitioners has served the Nation well over the past 50 years.
This system must be revised with mandatory requirements to
ensure that practitioners are prepared to serve their respective
communities during these challenging times. USUHS/Department
of Veterans Affairs and WMD Education and Training
Recognizing the substantial experience, existing educational
materials at USUHS, and the recognized expertise within each of the
Services, USUHS could quickly develop courses, teaching materials and
web based materials for use
by other medical schools, residency programs, and by the JCAHO. I thank you for the opportunity to address you today. Back to Witness List |