These U.S. Medical Fellows Are Quietly Preparing the World for the Next Crisis

USU MHAP residents serving as State Department Fellows assess and strengthen global medical systems to support U.S. missions worldwide.

Army Lt. Col. Jesse Tafoya, pictured center, stands with members of the MHAP cohort on the last day of Spring Term 2025. The State Department Fellowship creates a brand of interagency fluency that goes beyond health administration, as fellows spend their year "absorbing being in the room" where global crisis responses are formulated. (Photo courtesy of Army Lt. Col. Jesse Tafoya)

July 15, 2026 by Hadiyah Brendel

Residents in the Uniformed Services University of the Health Sciences’ (USU) Master of Health Administration and Policy (MHAP) program who serve as State Department Fellows spend their residency checking oxygen storage rooms in foreign trauma wards, reviewing surgical backup logs, and assessing embassy evacuation corridors — the unglamorous infrastructure work that keeps military medicine operational at the diplomatic frontier. The questions on their checklist read like scenario cards from a classified exercise: if the U.S. Secretary of State’s motorcade met an emergency on this road, would this facility hold? If a natural disaster struck the embassy, could the staff “sit on patients” for 72 hours? 

This is their day-to-day. The fellowship — built in response to the 2012 Benghazi attacks to ensure that when American diplomacy goes abroad, a vetted medical safety net is waiting — stands as one of the most operationally distinctive, highly specific training platforms at USU.

The Benghazi Catalyst: Diplomacy Meets Med-Intel

The program’s origins are rooted in the hard lessons of 2012. “Post-Benghazi, a bunch of investigations happened," says Army Lt. Col. Jesse Tafoya, an associate professor of Preventive Medicine and Biostatistics at USU and senior strategic medical planner on loan to the State Department. 

Tafoya’s advisory role was born out of that vacuum. “The State Department really didn’t have anything in terms of medical plans, operations, or crisis management. So, my position got created on loan back in 2012.”

What began as a single advisory role evolved into a formal Memorandum of Agreement between what is now the Department of War and the State Department. Today, it is a cornerstone for all Army 70H officers (Health Services Plans, Operations, Intelligence, and Security and Training) within the MHAP program, typically post-company command. However, the opportunity extends across the services; Navy and Air Force officers entering the MHAP track can also volunteer for this strategic residency.

Regardless of their parent service, service members undergo a shift in legal status once embedded; they do not wear military uniforms and operate under Title 22 authority rather than traditional military command. By functioning as fully funded State Department representatives, they act as "independent brokers" between agencies.

Tafoya notes this role is essential for managing expectations and maintaining open lines of communication during global medical crises. “They are involved in every sort of crisis,” he says. “Their day-to-day operations really depend on what’s going on in the world.”

In Gambia and Indonesia, this meant running MASCAL (Mass Casualty) drills. They didn’t just teach triage; they evaluated whether an embassy’s physical layout could support a surge of patients. In Canada, Malaysia, South Korea, and Zambia, they performed the “homework” of VIP medical security. The Fellows walked the halls of local hospitals as evaluators — checking oxygen supplies, surgical readiness, and evacuation routes for the Secretary of State. The work is that precise.  

The Operational Audit

Operationally, the Fellows serve as the State Department’s analytical eye. Their primary mission is VIP Medical Planning: exhaustive three-to-four day hospital surveys that assess local EMS capabilities, surgical readiness, and evacuation routes to ensure a seamless medical handoff for the Secretary of State or other high-ranking officials.

When they aren't scouting for VIPs, fellows lead Embassy MASCAL training with a specific focus: holding capacity. They evaluate "point of injury" protocols and triage flows, working through whether a facility can sustain patients for 72 hours or more when evacuation is off the table. What gives first — supplies, space, or command structure — is exactly what they're there to determine.

U.S. Army Maj. Kristina Nauck, Army Lt. Col. Jesse Tafoya, and Air Force Maj. Ja’llen Ricks take a selfie with Dr. Ana Gabriela Benitez, pictured center, the locally employed provider in the U.S. Embassy Quito atop the helicopter landing zone of Emergencias Hospital de los Valles in Quito, Ecuador. (Photo courtesy of Army Lt. Col. Jesse Tafoya)

Virtual Reach and Global Contingency

Beyond these predictable cycles, the Fellows act as vital intermediaries in contingency planning driven by current geopolitical events. This includes conducting "virtual" missions where they verify medical infrastructure data with embassy health units or coordinate with the FBI and other Federal agencies to address medical needs ahead of foreign elections. 

They also participate in high-level tabletop exercises with commands like INDOPACOM (United States Indo-Pacific Command) or USAFE (United States Air Forces in Europe), focusing on classified medical logistics and campaign planning. By identifying vulnerabilities in host-nation systems before a crisis begins, these officers manage expectations and ensure that American diplomacy is backed by a vetted, resilient medical safety net.

High Oversight, Higher Autonomy

The fellowship employs high professional oversight with high personal autonomy. Tafoya provides the preceptorship — the structural and strategic guidance — while the fellows operate without a formal mentor. They are expected to act as independent agents who "choose their own adventure" within the State Department’s global mission.

For those interested in the "day-to-day" of the fellowship, the most frequent question Tafoya receives is about the operational tempo and travel requirements. He explains that most officers spend approximately one week to 10 days per month on the road.

However, the program is designed to accommodate personal preference. Fellows are issued three separate passports to facilitate frequent international movement. While some choose to travel almost continuously, pausing during the winter holidays, those with family or other constraints can tailor the program to focus on policy and interagency coordination within the D.C. area. 

The Professional “Sting” of Success

Reflecting on the program’s long-term impact, Tafoya emphasizes that the fellowship’s value lies in building “open dialogue” and “open lines of communication” between the military and the diplomatic corps. He describes the residency as the "best training and education" an officer can receive, because it challenges them to operate effectively within the lean, streamlined parameters of the State Department. This experience provides a stark, educational contrast to the extensive logistical footprint and ready infrastructure found within DoW networks.

This immersion creates a brand of interagency fluency that goes beyond health administration, as fellows spend their year "absorbing being in the room" where global crisis responses are formulated. Ultimately, Tafoya sees the program as a vital bridge for the future, noting the State Department’s eagerness to sustain and potentially expand this partnership to include more services and clinical roles.

Tafoya admits the transition back to the regular military can be jarring. Losing the autonomy of a State Department post "stings a little bit," he says, but the service members return to the DoW with a lens that few others possess. Army officers often move into elite roles at the Joint Special Operations Command or U.S. Army Special Operations Command, carrying with them a firsthand map of how medical readiness stabilizes American interests abroad.