MHSSPACS Military Civilian Partnership Portal Application

  • MHSSPACS Military Civilian Partnership Portal Application

  • Program Type*
  • Training platform offered:*
  • Military Participant Clinical Role offered:*
  • Status:*
  • Privileges:*
  • Provider types of military cadre/trainee available to integrate into program (select all that apply):*

  • Institutional Support

  • Is there institutional leadership support for program? Does hospital/health system leadership and a "surgeon champion" support the partnership in concept?*
  • Is there a budget available to support partnership and an identified source of funding?*
  • Is a policy in place for addressing licensing requirements for cadre/trainees?*
  • Is there a policy to cover the malpractice costs for military participants?*
  • Is there a memorandum of agreement or memorandum of the understanding to ensure that both embedded and rotating personnel are fully integrated into the trauma team?*
  • Is a process for collecting and reporting clinical activity in accordance with specific agreements/requirements?*

  • Governance/Administration

  • Is the institution an ACS-verified trauma center (or equivalent)?*
  • What level of trauma center verification does the institution possess?*
  • Does the institution have a coordinated approach to the care of emergency general surgery patients in addition to trauma and critically ill surgical patients?*
  • Does the program have a database established for the program to capture patient encounters, cases performed, courses attended, etc?*
  • Will the program have dedicated administrative support?*
  • Will the institution have an MOU outlining a plan for coverage during deployment?*
  • Is your institution willing to accept short notice (within 2 weeks) absence of licensed providers up to 9 months?*

  • Human Resources

  • Professional colleagues must fully support the partnership and provide an atmosphere to enhance learning for rotating military providers. The following individuals are committed to the program and demonstrate their support (select all that apply):*
  • Does your institution plan to provide any of the following to military members at the institution? Check all that apply.

  • Physical Resources - Patient Care

  • Will your institution allow military trauma teams to care for trauma patients, general surgery patients, and surgical critical care patients?*
  • Does the program maintain a trauma patient volume of >1,200 admissions?*
  • Does your institution provide experience in caring for and operating on specialty surgical patients, including but not limited to the following:*
  • Does your institution provide opportunities for military members to participate in regional trauma system development and oversight activities?*
  • Does your program provide leadership professional development opportunities for general and trauma surgeons to gain the expertise to become Trauma Medical Directors and nurses to become Trauma Program Managers?*

  • Education

  • Which of the following courses would be offered to military members (with cost supported by the institution)?*
  • Does your institution have an Accreditation Council Graduate Medical Education training program?*
  • Will your institution provide opportunities for military personnel to be exposed to and/or participate in trauma-related research?*
  • Does your institution provide military-unique curriculum elements?*
  • Does your program have access to simulation facilities?*

  • Evaluation Tools

  • Do military providers participate in peer review, morbidity and mortality, and trauma multidisciplinary meetings?*
  • Will your institution support detailed tracking and submission of clinical activity for military providers in order to identify clinical readiness value?*

  • Patient Encounters

  • How many patient encounters does each provider type have annually for each of the following procedures (average)?

  • Should be Empty: