Classroom to combat, changes to Capstone

Photo By Sean Hall | Madigan Army Medical Center completed its annual, weeklong Capstone exercise. Originally a series of lectures to finish off a Resident’s training time at the hospital, Capstone has evolved into a week of in-depth training and simulations to prepare our residents for what they may experience in a combat zone.  

JOINT BASE LEWIS-MCCHORD, WASHINGTON, UNITED STATES

06.03.2025

Story by Sean Hall 

Madigan Army Medical Center

JOINT BASE LEWIS MCCHORD, WA – On Friday, May 16 Madigan Army Medical Center
completed its annual, weeklong, Capstone exercise. Originally a series of lectures to finish off a
Resident’s training time at the hospital, Capstone has evolved into a week of in-depth training
and simulations to prepare our residents for what they may experience in a combat zone.
Retired Col. Imad Haque was one of the doctors who was instrumental in transforming
Capstone into what it is today. “I came back here as staff in 2008 from fellowship and I trained
here as a resident and promptly deployed three weeks after I graduated from residency, I was
deployed and recognized that, hey, we've got to do better, we've got to do a better job as a
training center to get residents ready to go out and do their deployed job” said Haque.
Prior to 2011, Capstone consisted primarily of lectures and classwork, but Dr. Haque and
other Madigan staff who deployed during the early years of the War on Terror recognized the
need for a dramatic change to prepare residents for the realities of the environments they would
likely be deploying to.
“By 2009 it was a very different time, it was right after the surge in Iraq,
we had folks who were deploying immediately, and so we really had a need, a vast majority of
our graduating residents were going and within a year they were being deployed” recalled
Haque. “So we really felt strongly that we had to do something as part of graduate medical
education towards the end of the year for any intern going into GMO assignments or graduating
residents, especially if they're going to operational assignments that we were helping prepare
them for deployment.”
Capstone now provides resident Soldiers with valuable opportunities to refine their skills
as medical professionals, military leaders, and Soldiers operating in a field environment. It also
fosters joint learning experiences by bringing together peers from across the armed services.
Throughout the rigorous exercise, participants demonstrated adaptability and resilience
by combining their medical expertise with critical Soldiering tasks. These included patrolling,
administering Tactical Combat Casualty Care (TCCC), conducting casualty evacuations and
executing 9-Line Medical Evacuation Requests.
Despite being retired and working as a surgeon in Seattle, Dr. Haque still takes time to
return to Madigan to assist with training residents during Capstone. “Madigan is very
dear to me, I spent a lot of time here, and this is kind of a culmination of a lot of work for a
number of years, and to be able to keep it going, I think speaks of its value, and I feel that I
recognize the value of an exercise like this.”
For graduating residents, the event serves as a crucial learning experience, offering
firsthand insight into the distinct challenges of providing medical care in a deployed setting
versus a traditional hospital environment. It also deepened their understanding of their

responsibilities at the battalion, brigade and field hospital levels where teamwork and
coordination with seasoned Soldiers are essential to mission success.

• Date Taken: 06.03.2025
• Date Posted: 06.03.2025 13:53
• Story ID: 499540
• Location: JOINT BASE LEWIS-MCCHORD, WASHINGTON, US