In the buildup to create the U.S. military's Medical Education & Training Campus in 2010, staff and faculty concentrated mainly on creating a joint school to train enlisted medical personnel for military operational missions.
But beyond the immediacy of standing up an institute to teach more than 20,000 medics, corpsmen, airmen and Cost Guardsmen in various health fields, a cadre of staff led by Navy Cmdr. Mitch Seal focused on a long-term goal — to build programs that would provide graduates with professional certifications or college credit they could use in the future.
For those focused on the challenge of melding five enlisted medical training programs from among three services, Seal's plan was a luxury, not a necessity.
But five years later, the effort is paying dividends for former students who have earned degrees or landed jobs as emergency medical technicians, paramedics, pharmacy technicians, nurses and more, in both the military and civilian worlds.
"We have a motto here: 'Train for the mission, educate for a lifetime,' " said Air Force Brig. Gen. Bob Miller, METC commandant and Defense Health Agency director of education and training.
"This is new for the enlisted medical training," Miller said, noting that in the past, such training was very mission-oriented. But now, the focus also includes providing an education that will contribute "to a lifetime of service — to their country, community, home — if they continue in health care."
The unemployment rate for post-9/11 veterans has dropped steadily from a high of 12.1 percent in 2011 to 6.5 percent in April, but it remains above the general population's jobless rate of 5.5 percent.
METC, based at Fort Sam Houston in San Antonio, aims to ensure that graduates of its 49 medical career programs don't become part of that 6.5 percent.
"Our occupations translate easier" to the civilian sector, Miller said. "The quality of our training, how consistent it is with the civilian standards ... colleges and universities didn't realize what we were doing here. Now they are giving the credit these folks are due."
The school trains basic medical technicians, medics and corpsmen, dental assistants, ultrasound specialists, respiratory therapists, pharmacy technicians, hospital administration and nearly every nonprofessional job available at hospitals.
Miller said that since METC has always trained to high standards, it was not much of a stretch to ensure it also taught to civilian accreditation standards.
The challenge was to inform credentialing organizations, colleges and universities so they could understand how rigorous METC's curriculum is, he said.
METC is affiliated with the Community College of the Air Force and many courses qualify for credit from the local community college in San Antonio. The staff also has forged partnerships with schools nationwide, including "bridge" programs with 43 schools in 23 states that provide a path for students to pursue career programs requiring associates, bachelors or graduate degrees.
At several bridge program schools, for example, experienced combat medics, corpsmen or medical technicians can become registered nurses with an associate degree with only one additional year of training and education.
Seal, a former enlisted sailor who became director of strategic planning and partnership at METC when the school was created in the wake of the 2005 round of military base closures and realignments, said it just made sense to build a campus that provides a foundation for lifelong learning.
He credits the Navy with providing him the opportunities to advance through education, from obtaining an associate and bachelor's degree in nursing to a master's degree in information technology and a doctorate in educational administration.
"I was familiar with the fact that college credit was not getting recognized," he said. "And I knew both sides of the fence. Once I started looking at these health care degrees, I realized the students should be getting a lot more credit."
According to both Seal and Miller, some of the proposals initially received pushback from those who thought the school should train solely for the military mission or believed that providing broader educational opportunities would hurt long-term retention.
But they believe they have convinced the naysayers that the emphasis on accredited education is a worthy investment.
"It is life-changing and not only supports the individuals, but if these folks go back to their communities and take on these important jobs providing health care, it serves our country and saves dollars," Miller said.
METC officials are working to expand their partnerships with universities, with new agreements forged this year at schools in Texas, California, Louisiana, Kansas, Arkansas and elsewhere.
And as METC works to train personnel to certification from the get-go, lawmakers, veterans' groups and former troops are trying to improve opportunities for those who trained before such opportunities were available or were unable to maintain their certifications or skills on active duty.
In 2013, First Lady Michelle Obama issued a "call to action" to the states through her Joining Forces initiative to take action to improve the process for qualified troops to get state credentials for certain jobs, including nursing, EMT and paramedics.
This year, Sen. Bill Cassidy, R-La., a physician, introduced a bill to help states streamline their certification requirements for corpsmen and medics with EMT training to get civilian certifications.
Retired Army Lt. Col. Ben Chlapek, a former Army medic who now serves as deputy chief of the Central Jackson Fire Protection District in Blue Springs, Missouri, has been working with the National Association of EMTs to advocate for Cassidy's bill and other similar legislative proposals.
Chlapek said the taxpayer investment made in these veterans should be cultivated, not squandered.
"The experience of those who have to do medicine under fire is training you don't get anywhere else, even on the streets," he said.