For 75 years, the Veterans Health Administration (VHA) has provided the highest quality health care to our country’s Veterans. Since the VHA’s inception, partnering with academic medical centers has been a key initiative in the promotion of research, innovation and in the training of new health care professionals to meet the needs of this unique patient population within the U.S. Department of Veterans Affairs (VA).

History 

The partnership dates back to the end of World War II when the VA faced a shortage of physicians to care for the many Veterans returning home with injuries and illnesses, many requiring lifelong care. To meet these needs, VA Policy Memorandum No. 2 was established, and the VA’s affiliation with the nation’s medical schools began.

Regionally, the W.G. (Bill) Hefner VA Medical Center in Salisbury started its partnership with Wake Forest School of Medicine in 1995. The affiliation includes clinical care, residency training and research. 

“This academic affiliation brings the best and brightest to Veterans for care,” said Robin Hurley, MD, associate chief of staff for research and academic affairs at the W.G. (Bill) Hefner VA Medical Center and professor of psychiatry and behavioral medicine for Wake Forest School of Medicine. “This integrated relationship is crucial to our Veterans who receive comprehensive care and have access to the very latest medical technology, research and specialists.”

Julie Ann Freischlag, MD, FACS, FRCSEd(Hon), DFSVS, reflects on her involvement with the VA as the Veterans Health Administration celebrates its 75th anniversary.

Exceptional Care

As the country’s largest integrated health system, the VHA is dedicated to providing exceptional care at its 1,293 health care facilities, which includes 171 medical centers and 1,112 outpatient sites. Services include traditional hospital-based services such as surgery, critical care, mental health, orthopedics, pharmacy, radiology and physical therapy. Specialty services including audiology and speech pathology, dermatology, dental, geriatrics, neurology, oncology, podiatry, prosthetics, urology, and vision care. 

The VA’s commitment to excellent care is apparent in the culture, according to Jimmy Ruiz, MD, associate professor of hematology and oncology at Wake Forest School of Medicine.

“This affiliation has allowed us to enrich our environment, an environment full of teaching, and more importantly, of innovation in the way we take care of cancer patients,” said Ruiz, who is also chief of oncology and director of the oncology clinical trials unit at the W.G. (Bill) Hefner VA Medical Center. “This innovation also stems from clinical trials, allowing Veterans to receive cutting-edge technologies and clinical trials closer to home.”

An Environment of Learning

Through academic partnerships, the W.G. (Bill) Hefner VA Medical Center has residency training in 23 specialties such as primary care, psychiatry, ophthalmology, infectious diseases, dermatology, otolaryngology, urology and general surgery. Since 2008, these programs have experienced rapid growth. In 2020, the Center had 750 trainees in these programs.

Through these residency programs, even experienced physicians benefit from the teaching environment of the VA.

“I think our physicians at VA are better at what they do because they are working in a teaching capacity,” said Randall Gehle, DO, acting chief of staff of the W.G. (Bill) Hefner VA Medical Center. “That to me is the value to VA. When you know that a bright mind is going to be working with you and challenging you in your knowledge base, you’re a better doctor. That’s one of the biggest benefits.”

From an education standpoint, learning in a VA environment is invaluable, according to James Hoekstra, MD, senior vice president and associate dean, clinical and academic network development for Atrium Health Wake Forest Baptist, president of High Point Medical Center.

“The academic affiliation with the VA is a synergistic partnership that has flourished,” said Hoekstra. “The relationship has been very beneficial for us and for our Veterans.”

Miranda Orr, PhD, a VA Career Development Award recipient, talks about the impact the award has had on her career.

A Commitment to Research

The VA ranks as one of the nation’s leaders in health research, which has significantly contributed to advancements in health care for Veterans. The VA’s research program includes preclinical research, clinical trials and a focus on innovations and rehabilitation for Veterans who are disabled from injury or disease.

One research program is the Million Veteran Program, a large study to examine how genes, lifestyle and military exposures affect health and illness. The program launched in 2011 and is now one of the largest genetic research programs in the world.

VA research is primarily focused on Veterans’ unique needs. For example, Miranda Orr, PhD, VA research health scientist and assistant professor of gerontology and geriatric medicine at Wake Forest School of Medicine, is a recipient of a VA Career Development Award, which was established for early career researchers. Orr’s research focuses on the intersection between healthy brain aging and Alzheimer’s disease. 

According to Orr, Veterans have a heightened risk of developing chronic neurodegenerative diseases such as Alzheimer’s and ALS.

“The award is a unique opportunity to investigate Alzheimer’s disease because our service men and women are at an increased risk,” said Orr. “The VA supporting me in my career development and providing me this funding really has set me on a path of independence in my career and allowed this important research.”

With such a strong commitment to research, the VA attracts some of the nation’s leading experts, a win for both providers and Veterans receiving care.

“This commitment to research allows some of the best physicians and scientists to be associated with the VA,” said Don McClain, MD, PhD, professor of endocrinology and metabolism at Wake Forest School of Medicine. McClain is also a physician investigator at the Kernersville VA Medical Center where he conducts type 2 diabetes research.

“There’s a particular joy in serving those who have served,” McClain said.

For more information about the relationship between the Veterans Health Administration and academic medical centers, visit the U.S. Department of Veterans Affairs website.

Don McClain, MD, PhD, who conducts type 2 diabetes research, discusses the VA’s commitment research to improve the health of Veterans.