Grady Hospital is home to one of the largest level I trauma programs in the United States with over 11,000 trauma activations per year. The Grady Hospital System has a preexisting and active Military-Civilian partnership agreement with the United States Army and is applying for support from the Trauma Readiness Grant Program/Mission Zero Act. The goals of the program are to enhance the existing partnership with the United States Army, provide targeted skills training and sustainment opportunities for military providers, support growth an innovation of skills simulation opportunities, and to encourage bidirectional education and academic advancement. The objectives are to train military providers in a busy trauma center with high volume penetrating and operative trauma, to enhance the educational opportunities with more frequent access to cadaver and non-cadaver based simulation training, improve preparedness for multi-casualty trauma scenarios, better understand the principles of trauma triage and resuscitation, level-appropriate enhancement of knowledge and skills acquisition, prioritization of team training and effective communication skills, and to provide opportunity for professional development. The expected outcomes include performance improvement on skills evaluations, enhanced triage, judgement, and communication skills, participation and contribution to the innovation of simulation skills education, academic productivity and contribution to national trauma research, and generation of leadership opportunities for military providers. The products from this project include ongoing reporting of clinical volume and skills sustainment, development of a standardized tiered training structure within the Grady system for skills acquisition and sustainment including a reproducible outcome reporting methodology, joint research publications, participation in national committees and conferences.