The US Army’s partnership with UNC Medical Center ensures readiness of the Army’s medical force by allowing military medical personnel to be on staff at UNC Medical Center. UNC Medical Center is the seventh Level I trauma center to partner with the AMEDD Medical Skills Sustainment Program and only the second hospital in the country to receive a military neurosurgeon.

This unique partnership was designed with the goal of sustaining the medical skills of physicians, nurses, and medical technicians. When military providers return state side from deployment, they are stationed at military treatment facilities with low trauma volume partnered with a healthy, active patient population. The big question was then, how can military providers maintain the skills required to save lives on the battlefield? The type of skills required to deliver combat casualty care requires ongoing repetition in order to maintain expertise.

“The military’s partnership with high volume, high acuity civilian trauma centers, such as UNC, keep military neurosurgeons’ skills sharp for deployment especially when between conflicts.”

Military-civilian partnerships allow military doctors to increase their surgical capacity by taking on more complex cases in a high acuity, high volume academic center. At UNC Medical Center’s level 1 trauma center, patients with traumatic brain injuries (TBI) are frequently seen and treated. Dr. Brian Sindelar is a board-certified neurosurgeon currently serving on active duty under the established military-civilian partnership between the US Army and UNC Medical Center. At the medical center, Dr. Sindelar’s clinical expertise and research interests in TBI are supported. “Surgery is a technical skill that is developed over years of training but then further cultivated with continuous exposure to complex cases in a surgeon’s everyday practice,” said Dr. Sindelar. “Due to various factors at military treatment facilities, civilian centers experience higher volumes of neurotrauma. For this reason, the military’s partnership with high volume, high acuity civilian trauma centers, such as UNC, keep military neurosurgeons’ skills sharp for deployment especially when between conflicts.”

UNC Medical Center also benefits greatly from the established partnership with the US Army. Dr. Daryhl Johnson, Adult Trauma Medical Director, and Director of the UNC Medical Center/US Army Military-Civilian Partnership, explains that this partnership is mutually beneficial for both the US Army and UNC. “From an academic standpoint, this type of partnership is a two-way street,” Said Dr. Johnson. “We aren’t just using Dr. Sindelar for his neurosurgical skill. He is our trauma neurosurgery liaison. For everything neurosurgery trauma related, I’m leaning on his opinion.”

While Dr. Sindelar is able to gain valuable skill sustainment working at UNC Medical Center, the partnership allows UNC Neurosurgery to further improve patient care. Both Dr. Sindelar’s military training and expertise in neurotrauma makes him, and other military surgeons, valuable assets to UNC Medical Center. “Things roll out faster on the Army side, so research is implemented right away,” said Dr. Johnson. “We can then use that to better our practices.” UNC Medical Center is also able to rely on Dr. Sindelar and other military doctors at the medical center for resident education.

Dr. Sindelar’s research focuses on TBI. His current research findings, if significant, will guide TBI management at institutions across the United States and world-wide. His research will also reduce unnecessary procedures and imaging, therefore reducing patient morbidity and improving patient outcomes.

TBI is a leading cause of mortality, morbidity, and long-term disability effecting millions of people worldwide. “UNC is a pioneer in traumatic brain injury research, and I am thankful to be part of such a dedicated group,” said Dr. Sindelar. “There are numerous projects underway at this hospital, but specifically I am interested in the use of blood biomarkers for traumatic brain injury to guide clinical management and the use of technical imaging modalities that previously where only available in a hospital setting, but adapted to to be implemented downrange bringing surgical care closer to the frontlines. The information gained from this research can be applied to combat situations to allow early surgical intervention, better triage MEDEVAC, and improve access to the limited but vital resource, the military neurosurgeon.”

UNC Neurosurgery was the perfect match for Dr. Sindelar, since he was already familiar with the campus. After his neurosurgery residency training, Dr. Sindelar completed an open and endoscopic skullbase surgery fellowship at UNC Medical Center.

“There are not that many active-duty military neurosurgeons in the Army. We are fortunate to have one at UNC Medical Center.”

UNC Neurosurgery along with Dr. Sindelar, hopes to continue the military-civilian partnership with the US Army, setting the precedent for other military neurosurgeons in the AMEDD Medical Skills Sustainment Program. “These partnerships should continue because bidirectional flow of knowledge gained on the battlefield and in civilian trauma centers is vital to improving the care of neurotrauma patients across both realms and improving the outcomes for our patients,” said Dr. Sindelar. UNC Medical Center also greatly benefits from having one of only a few active-duty neurosurgeons at its facility. “There are not that many active-duty military neurosurgeons in the Army,” explained Dr. Johnson. “We are fortunate to have one at UNC Medical Center.”

Dr. Brian Sindelar is currently serving on active duty under the established military-civilian partnership between the US Army and UNC Medical Center. This partnership was announced in November of 2020. Dr. Sindelar is a board-certified neurosurgeon with an appointment as Clinical Associate Professor in the Department of Neurosurgery at the University of North Carolina at Chapel Hill. His academic interests include cranial/spine neurotrauma along with pathologies of the skull base.

 

Written by Makenzie Hardy, Marketing Coordinator, UNC Health Department of Neurosurgery