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Burnout remains a persistent challenge for the physician workforce. In this context, the ability to identify and retain physician talent plays a crucial role in optimizing workforce capacity. Other disciplines, such as the military, use comprehensive frameworks to identify, develop, and retain talent. These approaches may offer valuable insights for medical education, particularly with the increasing emphasis on competency-based training. An integrative review examining the military's approach to talent identification, development, facilitation, and management was conducted in 2024, with an updated search performed in October 2025. A total of 477 articles were identified and screened at the title and abstract level using predefined inclusion criteria. Twenty-one articles were ultimately included for data extraction. Four major themes emerged: (1) the military defines talent holistically; (2) organizational structures align individual talent with specific positions to support well-being and maximize job performance; (3) individual talents are viewed as contributing to the success of a broader entity (e.g., a team, unit, or community); and (4) talent retention is a primary organizational focus. Reviewing the military's approach to identifying and retaining talent highlights the potential impact of a talent-focused framework in medical education. Addressing workforce challenges through a collective lens and aligning talent with specific roles may enhance physician well-being while also reducing burnout.

This study examined how the U.S. Department of Defense (DoD) and military branches disseminate information about behavioral health topics, including sexual assault and harassment, mental health, resilience, substance use, suicide, and other violence-related issues, through their official media platforms and online newsletters. This is key since a significant number of military personnel experience these issues, yet available health services remain underutilized. The goal is to analyze the frequency, timing, and content of the DoD, military branches, and installations' messaging around these behavioral health topics across their digital communication channels. Researchers manually collected data from official social media accounts (i.e., Twitter, Facebook, Instagram) and online newsletters of the DoD, military branches, and installations from January to November 2021. Data was coded for behavioral health topics, content types, and evidence-based interventions. Engagement metrics were also analyzed for social media posts. The Institutional Review Board of New York University approved the study protocol. The study found notable variations in how frequently different behavioral health topics were addressed across the DoD, military branches, and installations, with sexual assault and harassment, mental health, and suicide prevention being the most prevalent. Messaging often aligned with designated awareness months. The most common content shared about the included behavioral health topics focused on providing information and details about available services, although fewer posts addressed military culture, policies, or program/initiative effectiveness. Social media engagement was highest for mental health, sexual assault and harassment, and suicide-related topics. The findings suggest a lack of coordination and standardization in the military's digital health communication strategies, which can lead to ineffective and undesired outcomes. This study has also identified missed opportunities in military digital communications to leverage evidence-based best practices. Recommendations include developing a cohesive, systematic framework to guide consistent, effective messaging across branches and platforms to better reach and engage the military population on critical behavioral health issues. Although the study provides valuable insights, limitations include its manual data collection process, single-year timeframe, and focus on only three social media platforms. Future studies should expand the scope by including other social media platforms with distinct user demographics and engagement patterns, as well as extended timeframes, to better understand the full landscape of military digital health communication.

The discovery of nuclear fission nearly a century ago not only caused the production of significant quantities of radioactive materials, but also purposefully brought naturally occurring radioactive substances from the Earth's crust to the surface through mining. The use of these materials, particularly in nuclear weapons, has profoundly influenced our understanding of the Earth system, driven by the military's need to study the effects of nuclear explosions. This introduced the alarming possibility of irreversible, severe consequences on a global scale within a very short time frame. Despite their critical significance, radioactive materials are scarcely addressed within the Planetary Boundaries framework. This oversight may stem from the challenge of defining control variables or safe operating spaces for the two most consequential release pathways: nuclear power plant accidents and nuclear explosions. Applying the precautionary principle in this context would advocate for a world free of nuclear weapons and a cautious, well-considered approach to the use of nuclear energy.

In August 2025, the US Department of Defense (DoD) revised its grooming standards for military personnel across all branches of service. The changes included new policies for managing pseudofolliculitis barbae (PFB), a chronic inflammatory condition aggravated by shaving that can cause facial irritation and scarring. In this article, we review the revised PFB standards for each branch of the military and examine how recent changes affect policies on shaving waivers, which now will have shorter durations, require more frequent medical evaluations, and add administrative steps that apply to both service members and medical providers. Because PFB affects many individuals in the military, the new DoD-promulgated changes impact clinical management, readiness considerations, and retention policies. Civilian dermatologists, who frequently encounter patients with PFB, should be aware of the military's regulatory updates to ensure appropriate counseling of service members and prospective recruits.

The U.S. Coast Guard and the Department of Defense have implemented numerous health, wellness, and prevention programs aimed at improving readiness and supporting the holistic well-being of service members and their families. These include healthcare services, behavioral health interventions, Armed Forces Wellness Centers, Integrated Primary Prevention efforts, the Holistic Health and Fitness program, and family support initiatives. However, these programs often operate in silos, with limited cross-program coordination, fragmented communication, and inconsistent user experiences. This study explores these challenges within the Coast Guard to inform systems-level recommendations for improved integration, visibility, and user-centered delivery across the military health and wellness landscape. This study employed the elaborated Action Design Research methodology, which supports iterative problem-solving through cycles of diagnosis, engagement, reflection, and learning. Three diagnosis cycles were conducted, involving semistructured interviews with Coast Guard service members, family members, and senior leaders. Qualitative data analysis was guided by thematic analysis, drawing on structured coding techniques commonly used in qualitative research. Systems theory served as the conceptual framework to examine dynamic interdependencies and structural misalignments across the Coast Guard's health and wellness ecosystem. The study was exempt from Institutional Review Board review by Lake Erie College of Osteopathic Medicine. Five core themes emerged across stakeholder groups and diagnosis cycles: (1) fragmentation of services; (2) inconsistent and decentralized communication; (3) limited awareness and access to available resources; (4) disconnect between leadership intent and user experience; and (5) lack of structured feedback mechanisms. Participants described disconnected programs and services, scattered communication channels (outdated apps, isolated PDFs), and duplication of effort. Service members and their families reported difficulty navigating systems, with some paying out of pocket for services they were technically eligible for but unable to access because of gaps in provider or network coverage. Additionally, feedback mechanisms were described as informal and inconsistent, limiting the military's ability to adapt programs in real-time. This study highlights the pressing need to transition from a fragmented, program-centric model to a systems-based approach to health and wellness in the Coast Guard. Key recommendations include embedding cross-functional liaisons, establishing recurring interdisciplinary working groups, consolidating digital infrastructure, improving navigation, integrating family engagement, and institutionalizing real-time feedback loops. Implementing these strategies will require a paradigm shift from isolated, expert-led programs to coordinated, user-centered ecosystems. Without this shift, even innovative efforts risk remaining disconnected, duplicative, and insufficient to meet the evolving needs of the force. Aligning structures, strategies, and communication will be critical not only to improve well-being but also to strengthen performance, readiness, and retention across the military.

In this paper I explore the moral responsibility that is owed to post-enhanced military veterans who were enhanced with biotechnological interventions as part of their military service, but then suffer from these biotechnological interventions when returning to civilian life. By exploring two ways that these interventions can become detrimental to a veteran's quality of life, I suggest that the institutional duty of care to post-enhanced veterans arises even though the problems arise after service ends. When we see that soldiers can become disenhanced or de-enhanced, in both cases, the military as an institution owes those post-enhanced veterans a special duty of care because of the military's role in the initial enhancement. Finally, I argue why the conceptual clarity regarding enhancement, disenhancement, and de-enhancement is useful for assigning institutional responsibility with regard to post-enhanced veterans.

This study provides follow-on analysis of "A Description of the Dental Health and Treatment of Ukraine Military at U.S. Army Clinics in Germany" by Mendoza et al 2024. There is no information on the time and cost to support Allies and Partner Forces. During a combined deployment, the medical rules of eligibility (MEDROE) may require that U.S. dental providers treat military personnel who lack dental support. Yet there are no studies that discuss the impact of U.S. providers treating Allied military personnel. Analyzing the dental treatment performed by U.S. Army dentists will improve understanding of the Ukrainian military's dental readiness and treatment needs. The cost for each dental encounter was determined by using the Defense Health Agency Uniform Budget Office Dental Rate Table for the calendar year (CY) 2023. Current Dental Terminology (CDT) codes were used to organize dental encounters by dental treatment categories. Treatment costs were calculated by totaling the CDT codes. The authors also performed an unpaired t-test to compare the average cost of treating the Ukrainian military to those in a recent study on treating U.S. military patients in Iraq from 2007 to 2009. The total cost to treat the Ukrainian military cohort was $335,100.80 in CY 2023 USD. The estimated cost of treating the Ukrainian military was $1,288,849.24 per 1,000 individuals per year. The oral surgery dental treatment category had the highest cost at $153,287.86. The multiple dental treatment category incurred the next highest cost at $57,336.35. The multiple dental treatment category only involved 27 patients; however, these individuals required 102 procedures. Based on individual costs, the DoD W dental codes category, which included computer-aided design/computer-aided manufacturing (CAD/CAM) crowns, had the highest cost at $2,537.63 per person. Oral surgery accounted for 45.7% of total costs. Treatment involving CAD/CAM crowns had the highest cost per person at $2,537.63. Overall, there was a trend for resin-composite restorations with only 2 Ukrainian personnel receiving amalgam. The total cost to treat the Ukrainian military cohort was $335,100.80 in CY 2023 USD. The estimated cost for treating the Ukrainian military equated to $1,288,849.24 per 1,000 personnel per year. The $1.28M represents an estimate of the value cost of work that would be provided to this population over time. Dentists spent 31.83 hours per month treating dental emergencies among Ukrainian personnel. This study supports the need for medical planners to consider dental capabilities and support when determining MEDROE for allies and partners. U.S. military medical providers, whether in garrison or deployed, should also consider allied dental readiness and capabilities, especially since most allied and partner militaries may have limited dental support. Budgets should also account for the additional expenses associated with treating allies and partners. These findings support the assertion that U.S. dental officers must be proficient in oral surgery, restorative care with CAD/CAM utilization, and endodontics.

Military leaders must support health care and research to protect the health and readiness of their forces. Part of this effort entails conducting human subjects research to address current and emerging international health threats. The military is also attentive to the national security interests associated with global health, such as protection from widespread disruption due to disasters and epidemics. While military leaders' global health research objectives relate to the military's strategic goals, including force health protection and national security, it is only through longstanding partnerships with partner nations in several world regions that much of the relevant research is possible. Yet military priorities may differ starkly from those of the collaborating partner nations, raising concerns about the potential for exploitation in global health partnerships. However, in spite of differences in overall strategic priorities, a convergence of stakeholder interests allows for appropriate alignment in the choice of clinical research activities at global health sites supported by the military. These complex collaborative research arrangements depend on negotiating and navigating the selection of research goals and activities to ensure fairness and balancing of priorities among partners, thereby maintaining research infrastructure and capacity. Leaders of military institutions and partner nations must attend to the need for this sustained effort to balance priorities to ensure equity and successful maintenance of these essential relationships.

In the 1820s, Stockholm Observatory undertook a significant upgrade of its instruments. The new acquisitions included a meridian circle, crafted by Traugott Ertel in Munich, which - after extensive delays - was finally installed at the observatory in 1834. Despite its advanced capabilities, the instrument saw limited use during its first forty years, as observatory directors were largely occupied with geodetic projects for the Crown. The meridian circle only reached its full scientific potential when Hugo Gyldén became the Academy Astronomer in 1871, marking the end of the Observatory's geodetic era. In addition to observations for a major zone project, from 1879 the instrument became the engine of the Swedish standard time system. Throughout the nineteenth century it also had an important role as the zero meridian for the military's geodetic pursuits. The instrument remained in use until the Observatory relocated to Saltsjöbaden in 1931. This paper explores the various roles played by the Ertel meridian circle during its century-long history, with a focus on the strategies employed by astronomers to preserve the ageing instrument's relevance.

The Russian military's carnal crimes render certain Ukrainian areas uninhabitable. As a result, a significant portion of the population is experiencing stress-related issues caused by hostilities and forced displacement. This research aimed to examine the self-assessed mental health of pregnant women and new mothers (PNM) who faced relocation. This report presents findings from a study conducted as part of the Perinatal Mental Health for Refugee Women (PMH-RW) Project. This cross-sectional study used data from 191 PNM who are either internally displaced persons (IDP) or refugees (REF). A higher number of REF than IDP were from the capital, but fewer from rural communities, and new mothers were more likely to hail from major cities than pregnant women. The discrepancy in migration options likely causes the frequent relocation of some groups to inadequately equipped areas, thereby increasing their vulnerability. For example, REF experienced far less pregnancy complications than IDP. The Gini coefficient of 0.153 suggests minor income inequality among the respondents. However, there is a stark contrast between this relatively low inequality and the substantial reports on worsened financial conditions post-invasion. This finding underscores the significant impact of war-related financial instability on the perceived distress of pregnant women and new mothers, with financial burdens emerging as a primary predictor of their distress. The financial burden and socio-economic background of pregnant and new mothers during wartime migration can define their mental health resilience. The inconsistent availability of essential resources caused by wartime economic woes significantly influences the perceived well-being of PNM.

International research demonstrates that military sexual assault has far-reaching effects on the daily lives of women Veterans. The purpose of this study was to describe the impact of military sexual assault and subsequent posttraumatic stress disorder (PTSD) on participation in daily life activities among Canadian women Veterans. A qualitative exploratory study was based on interviews with 12 Canadian women Veterans purposively selected from a larger sample of 70 and on low participation scores. Qualitative interview data were analyzed using both inductive and deductive coding. Participants identified five daily activities they struggled with: being out in public, relationships, starting the day, self-care, and productivity. Participants attributed these difficulties to known consequences of sexual assault, such as depression and substance misuse, and symptoms of PTSD, such as hyper-vigilance and flashbacks. In addition, they volunteered that their trauma had been exacerbated and their recovery had been delayed by feeling targeted, held back, bullied, and betrayed. They attributed these feelings to the military's hierarchical culture. This study emphasizes the difficulties women Veterans had many years later as they struggled at work, relationships, and community participation. Participants volunteered that they felt betrayed by peers, superiors, and Canadian Armed Forces administration. This further diminished their capacity to trust others, maintain relationships, and venture out into public places. Military sexual assault and subsequent posttraumatic stress disorder (PTSD) had significant effects on the daily lives of 12 Canadian women Veterans. They struggled with being out in public, relationships, starting the day, self-care, and productivity. At the root of these difficulties were consequences of military sexual assault, such as depression and drug and alcohol misuse, and PTSD symptoms, such as hyper-vigilance and flashbacks. They felt that their experiences had been aggravated by the hierarchical environment of the military, and that their sense of duty had been exploited. They felt betrayed and diminished in their capacity to trust others, to maintain relationships, and to venture out into public places. This information can inform the development of resources to assist women Veterans of the CAF who experience difficulties in daily life after military sexual assault. Les recherches internationales démontrent que les agressions sexuelles des militaires ont des effets profonds sur le quotidien des vétéranes. La présente étude visait à décrire les répercussions des agressions sexuelles des militaires et du trouble de stress post-traumatique (TSPT) qui en découle sur la participation à la vie quotidienne chez les vétéranes canadiennes. L’étude exploratoire qualitative reposait sur des entrevues avec 12 vétéranes canadiennes sélectionnées à dessein parmi un échantillon plus vaste de 70 personnes en fonction de leurs faibles scores de participation. Les données des entrevues qualitatives ont été analysées à l’aide du codage à la fois inductif et déductif. Les participantes ont recensé cinq activités quotidiennes qui leur posait des difficultés : les sorties en public, les relations, le début de la journée, les soins personnels et la productivité. Elles attribuaient ces difficultés aux conséquences connues d’une agression sexuelle, telles que la dépression et le mésusage des substances psychoactives, et aux symptômes du TSPT, comme l’hypervigilance et les retours en arrière. De plus, elles ont souligné que leur traumatisme avait été exacerbé et leur rétablissement, retardé parce qu’elles s’étaient senties ciblées, freinées, intimidées et trahies. Elles attribuaient ces impressions à la culture militaire hiérarchique. Cette étude souligne les difficultés que les vétéranes éprouvaient encore des années plus tard alors qu’elles avaient du mal à s’adapter au travail, dans les loisirs et dans les lieux communautaires. Les participantes ont indiqué se sentir trahies par leurs collègues, leurs supérieur(e)s et l’administration des Forces armées canadiennes. Ce constat réduisait également leur capacité à faire confiance à autrui, à entretenir leurs relations et à s’aventurer dans des lieux publics.

This Viewpoint draws comparisons between the recent Los Angelese wildfires and the military’s experience with burn pit exposures to offer insights into understanding and mitigating the health challenges that result from these fires.

Between October 2023 and January 2025, the Israeli military's sustained attacks on Gaza resulted in an estimated 186,000 deaths and the systematic destruction of healthcare infrastructure. Despite the professed commitment to human dignity, justice, and the minimization of suffering within bioethics, major institutions and scholars in the field have largely remained silent or selectively engaged with the crisis. This paper argues that the Gaza genocide exposes a deeper crisis within bioethics: its growing detachment from urgent, real-world ethical challenges. Such detachment erodes public trust and raises fundamental questions about the discipline's relevance and credibility. The article interrogates the possible reasons and motivations for the silence and disengagement in the face of genocide in Gaza, and examines the institutional and disciplinary responsibilities that bioethics bears in response to health-destroying state violence. Framing the inaction as a moral failure with far-reaching implications, the article proposes alternative routes of ethical engagement and outlines steps toward a more inclusive and responsive bioethics. It calls for the urgent reorientation of the field toward a justice-driven, politically conscious practice capable of confronting today's most pressing ethical issues.

The role of Prehospital Medical Directors is pivotal in military medicine, integrating emergency medical services within the military's trauma system, particularly within the framework of Large-Scale Combat Operations (LSCO). This study aims to explore the impact of the current training variability among emergency medicine (EM) physicians, the only physicians required to receive any Emergency Medical Services (EMS) training in residency and thus the current gold standard, on their ability to effectively manage and direct medical operations in LSCO scenarios. The study focuses on understanding the training needs, leveraging technological advances, and adapting to high-intensity military medical operations. This cross-sectional study was approved by the Institutional Review Board of the Uniformed Services University of the Health Sciences. Data were collected using an online survey disseminated via Qualtrics XM Platform to active-duty EM physicians across U.S. military branches. The survey, which remained open from January 1, 2024 to September 30, 2024, evaluated the training, experience, and comfort levels of respondents in providing medical direction. Statistical analysis involved descriptive statistics, independent t-tests, and analysis of variance to identify significant disparities in training outcomes. The survey yielded responses from 139 EM physicians, revealing significant variability in EMS training across residency programs. Results demonstrate that physicians who had received a crash course reported consistently higher comfort levels in performing critical medical direction tasks. Specifically, these physicians reported greater proficiency in teaching medics (74.7 ± 13.6 vs. 67.9 ± 25.0, P = .0326), establishing protocols (76.9 ± 17.3 vs. 63.4 ± 27.6, P = .0079), providing QA/QI feedback (74.2 ± 17.7 vs. 66.6 ± 27.8, P = .0549), and guiding complicated resuscitations (77.3 ± 15.3 vs. 65.3 ± 28.6, P = .0087) and procedures over the radio (74.3 ± 19.4 vs. 64.2 ± 27.6, P = .0373) compared to the respondents without training outside of residency. Conversely, physicians without supplementary training and no practical exposure reported the lowest self-perceived proficiency, particularly in high-stakes LSCO scenarios. The study confirms a critical gap in the preparedness of EM physicians to serve as Medical Directors in LSCO, largely because of inconsistent EMS training during residency. These findings underscore the "Walker Dip" phenomenon-an observed decline in casualty survival rates when transitioning from peacetime to initial conflict phases due to inadequate medical service adaptation. The results support the need for standardized, comprehensive training programs that incorporate Tactical Combat Casualty Care principles, advanced decision-making skills, and the use of modern technology for remote medical direction. Addressing these training disparities can enhance the operational readiness and effectiveness of military medical teams. Future research should focus on developing a centralized training curriculum that aligns with the evolving demands of modern military operations and tests its efficacy in improving prehospital and battlefield medical outcomes.

As military institutions explore the use of enhancement technologies to improve combat readiness and operational effectiveness, critical ethical and policy questions emerge about the long-term consequences of these interventions. This paper examines the reintegration challenges facing enhanced veterans-those who undergo cognitive, neurological, genetic, or physiological modifications during service-and explores the military's obligations to support their post-service lives. We analyze how enhancements, though often framed as temporary or mission-specific, may result in lasting changes to cognition, emotion, and identity that complicate veterans' ability to rejoin civilian life. Drawing from military ethics, bioethics, and neuroethics literature, we examine issues of autonomy, informed consent, and structural coercion within the hierarchical nature of military service. We argue that enhancement may not only exacerbate existing barriers to healthcare, employment, and social belonging but also generate novel forms of stigma and challenge existing systems of support. To address these challenges, we recommend policy interventions including the establishment of an enhanced veteran registry, expanded research funding, and the development of tailored long-term care strategies. We conclude that protecting the rights and dignity of enhanced service members requires proactive ethical and institutional planning-before, during, and long after their time in uniform.

Patient satisfaction is an indicator of healthcare quality and may affect treatment adherence. It is particularly relevant for military personnel living with human immunodeficiency virus (HIV) because of their increased risks to deployment. However, this phenomenon remains understudied. To assess satisfaction among military personnel at an antiretroviral clinic in Namibia. Military's antiretroviral clinic in Namibia. A descriptive cross-sectional online survey was conducted using a validated third-generation short version of the Patient Satisfaction Questionnaire (PSQ-18). Data were collected between June 2022 and August 2022 from 166 participants through convenience sampling. Bivariable and multivariable logistic regression analyses were performed to identify factors. Adjusted odds ratios (AORs) with a 95% confidence interval (CI) and a p-value of 0.05 were used to determine significance. One hundred and sixty-six participants participated in this study. Significant factors influencing satisfaction included sex, age, marital status and place of residence. Individuals aged 31-44 years were 40 times more likely to be satisfied (AOR: 40.64; 95% CI: 14.16-116.60), while females (AOR: 0.25; 95% CI: 0.16-0.40), divorced individuals (AOR: 0.05; 95% CI: 0.02-0.12) and those residing in urban areas (AOR: 0.33; 95% CI: 0.17-0.62) were less likely to report satisfaction. The study found a high overall level of patient satisfaction. Based on the results, the study recommends using the Namibia case study to develop and tailor initiatives that improve patient satisfaction with antiretroviral therapy (ART) services among military personnel in other settings. To add to the literature on patient satisfaction with antiretroviral therapy services among military individuals in Namibia.

This column explores the inception, challenges, and prospects of robotic surgery in the military. It highlights the military's role in developing early prototypes, current utilization, training struggles, partnerships with civilian organizations, and potential future applications. The military's influence on the evolving landscape of robotic surgery is emphasized.

In July 2020, the government of Israel mandated cooperation between the Ministry of Health (MOH) and the Israeli Defense Forces (IDF) to address the COVID-19 crisis. Our research aims to reveal the consequences of this cooperation. We examine how the two organizations dealt with COVID-19 investigations and morbidity challenges. The article's theoretical framework is based on Pierre Bourdieu's theory of fields, showing the conflictual relations between the military and the civilian fields during COVID-19 efforts, as reflected in the relations between the IDF and the MOH. Twenty semi-constructed interviews were conducted with MOH and IDF personnel from February to May 2021. Results show cooperation alongside conflicts and demonstrate the military's extensive intrusion into a field outside its natural domain. The MOH acknowledged the potential benefit of the IDF's mobilization yet sensed that the IDF came to "save the day" while placing them in an inferior position. According to the IDF's interviewees, the MOH's "professional approach" often clashed with their action-based approach. In Bourdieu's terms, while the healthcare system can use human capital in its actions, the IDF system enjoys greater symbolic, social, cultural, and economic capital. This advantage in capital placed the two fields, MOH and IDF, in an unbalanced power relationship, explaining the IDF's taking over. We assumed that the securitization process of health services with alignment of expectations, division of authority, and open communication has the potential to help organizations better manage clashes in national and global crises.

The military's approach to medication use often evolves in response to operational issues that have the potential to impact the medical readiness and combat effectiveness of active duty service members (ADSMs). Historically, medications have been considered problematic because they serve as surrogate markers for deployment limiting health conditions or due to factors that make sustainment challenging in military/austere environments. This study aims to identify key concepts that capture the aspects of a medication that make it problematic in ADSMs. The goal of this effort would be to inform a future policy and establish criteria for Problematic Medications in Active Duty Servicemembers (ProMADS) to enhance the readiness and deployability of ADSMs. Concepts of ProMADS were elicited from 8 key informants (KIs). Key informants included care providers and care recipients from the Army, Navy, Air Force, and Defense Health Agency. Semi-structured interviews were conducted, and a phenomenological approach was used to summarize KI perspectives, and thematic analysis identified core elements and sub-elements. Five core elements were identified: (1) Adverse cognitive or behavioral effects, (2) sustainment issues, (3) controlled substance compliance and risk mitigation, (4) medication-related hemostasis interference, and (5) combat-readiness inhibitors. Key sub-concepts were related to whether a medication might impact cognition, cause sedation, have complex monitoring requirements (e.g., laboratory, adverse drug reactions, etc.), is temperature sensitive, or impacts the functioning of the immune system. This study generated core medication-related concepts and sub-concepts that KIs believe make a medication innately problematic among ADSMs. These findings can guide consensus-driven efforts to identify ProMADS which would enable Military Departments and Combat Support Agencies to create programs that improve lethality, warfighting, and readiness by optimizing medication use.