Training the Military Surgical Resident for Tomorrow’s War: A Military-Unique Curriculum at the Uniformed Services University and Walter Reed National Military Medical Center

Future large-scale combat operations will produce casualty volumes and injury patterns that exceed current military surgical capacity, particularly in contested, resource-limited environments requiring prolonged, autonomous care. Concurrently, the Military Health System (MHS) faces the "peacetime effect" or "Walker Dip," with declining exposure to high-acuity trauma and reduced operative experience during residency, contributing to gaps in combat readiness. Despite this, no standardized Military Unique Curriculum (MUC) exists for surgical trainees. In this commentary, we describe a comprehensive, longitudinal MUC at the Uniformed Services University (USU) and Walter Reed National Military Medical Center (WRNMMC) designed to develop expeditionary surgical capability throughout residency. This model integrates four core domains: (1) military-civilian partnerships to ensure exposure to complex trauma and surgical pathology; (2) military-specific didactics and mentorship grounded in operational experience; (3) a robust simulation-based curriculum focused on austere, open surgical care; and (4) mission-aligned research and graduate education. While descriptive, this model demonstrates a feasible approach to embedding combat-relevant training within residency rather than relying solely on pre-deployment courses. The USU/WRNMMC MUC offers a scalable framework to standardize expeditionary surgical training across the MHS and better prepare surgeons for future conflict.