Leveraging Natural Ecosystems to Reoptimize Education and Training for Great Power Competition in the Air Force Medical Service

Organizations today are complex, hyperdimensional, and continuously changing in response to the environment. Over the past decade, the Military Health System has seen continuous organizational change to transform healthcare delivery, and the Air Force Medical Service (AFMS) is currently transitioning to an Air Force Medical Command (AFMEDCOM) structure to best prepare for Great Power Competition and other challenges ahead. The current state of the enterprise involves decision making, resourcing, and execution of education and training that is largely decentralized in nature. To support these efforts, in February 2024, a team of diverse AFMS stakeholders gathered in Washington, D.C. to examine the future of medical education and training for the U.S. Air Force in a new way: through systems theory and ecosystem mapping. This ecosystem approach enables development of an organizational structure and process for change that considers how all stakeholders relate, what external factors threaten the desired transformation, and how the resulting enterprise could become more resilient with future uncertainty and change. This paper discusses the theory behind the ecosystem approach and how it was used to develop a transformed model for the AFMS to organize its education and training. Additionally, a dialogue is presented on how this unique methodology to understanding stakeholder relationships can be leveraged in the re-optimization efforts for Great Power Competition.