Caring for injured persons in the operational setting, especially in a combat environment, requires critical thinking and operative proficiency. Changes in the law regarding military health insurance often make it difficult for providers to get exposure to high-acuity, complex trauma patients in military treatment facilities. Numerous endeavors are underway to ensure that providers, especially surgeons, get exposure to high-acuity, clinically, and operatively complex patients in order to maximize their ability to save lives and function in a resource-restricted environment. These efforts include educational efforts, skills courses, embedded and rotational partnerships with civilian and Veteran’s Administration hospitals, and opportunities for off-duty employment.