The war in Ukraine, the US exit from Afghanistan, and the coronavirus disease 2019 (COVID-19) pandemic have all converged to create a perfect storm of volatility, uncertainty, complexity, and ambiguity (VUCA). These crises highlight the critical need to invest, develop, and grow civilian and military partnerships in our increasingly complex geopolitical health landscape. During the COVID-19 pandemic, the US medical system has relied on unprecedented domestic support from the Department of Defense (DOD) and other government agencies to augment our fragile health care system. DOD support included 3 distinct efforts: leading multiagency vaccination development and logistics (Operation Warp Speed), embedding medical teams in US hospitals and auxiliary care sites (ie, field hospitals), and administering vaccines at 33 Community Vaccination Centers at the request of the Federal Emergency Management Agency. As the COVID-19 pandemic has demonstrated, and the current world stage reinforces, the interdependence and collaboration of civilian and military resources has been critical to mitigate the negative impacts of large-scale disasters on communities. Disasters have become more frequent and costly: from 2015 to 2020, severe weather and climate disasters alone caused in excess of US$600 B in damages.1 In many cases, our hospital and public health systems are critical components of disaster response, often bearing significant burdens during the events and facing long-term consequences during recovery. Therefore, making hospital systems resilient is of paramount importance. In several examples over the past decade including Hurricanes Katrina, Maria, and Harvey, DOD resources have assisted in reconstituting infrastructure when civilian communities were in desperate situations. But Military Civilian Partnerships (MCPs) are not reserved for disaster response. Countless medical advances have been developed during wartime due to the necessity of rapid innovation to improve battlefield care. Many of these advances have translated to civilian medical care settings, but gaps remain due to knowledge, education, and implementation challenges of our matrixed private US health care sector. In parallel, the Military Health System (MHS), has experienced recurrent historical cycles where mortality rates at the beginning of a war often exceed mortality rates at the end of the previous war. Survivability rates then improve through the course of each conflict. This cycle, known as “the Walker Dip,” was conceived by Vice Admiral Alisdair Walker, the former Surgeon General of the British Armed Forces, who hypothesized that lessons are forgotten and must be relearned at the onset of the next war.2 The Walker Dip has been linked to every US conflict since the US Civil War. The root cause of the Walker Dip relates to the MHS’ priority shift during peacetime: maintain the readiness and health of service members and their dependents. Many factors contribute to this cycle including a limited case mix index at military hospitals, loss of essential skills, lack of institutional memory, and staff turnove.2 To counter the Walker Dip and improve bidirectional translation, MCPs have been established across the nation and have evolved into 2 broad categories: Trauma Training Platforms and Sustainment Collaboratives. Approximately 70 MCPs are spread across US civilian trauma centers with a handful of international partnerships. Most are service specific, have varying aims (clinical skills, team-based training, etc.), and vary across discipline (subspecialties and profession). The DOD has also invested in developing the Knowledge, Skills, and Abilities (KSA) Clinical Readiness Program, which provides an innovative approach to measuring, evaluating, and sustaining individual clinical proficiency, in collaboration with the American College of Surgeons.3 The KSA program identifies skills in peacetime medical practice that are similar to those skills a deployed surgeon would need to establish a threshold for battlefield trauma care readiness. In 2016, The National Academies of Science, Engineering and Medicine (NASEM) highlighted the need for bidirectional knowledge translation between the military and civilian sectors with the goal of developing a national trauma care system.4 While battlefield survivability was at its peak, injury was the leading cause of death for those under age 46 in the civilian sector. As many as 1 in 5 deaths due to traumatic injury may have been preventable if military innovations were translated to civilian care. NASEM’s committee identified critical steps to improve translation and implementation of MHS medical advances to improve civilian trauma care. On the basis of the recommendations of the NASEM report, The MISSION ZERO Act was signed into law in 2019. The legislation created a grant program within the US Department of Health and Human Services (HHS) to establish MCPs by defraying the administrative costs of trauma centers to embed military trauma professionals into civilian trauma centers. MCPs present 2 complementary aims. For the civilian medical world, military assets, people, logistics, and equipment augment and support hospitals and public health during disasters. For the military, response provides an opportunity to maintain critical clinical and operational skills in the absence of a current conflict. Domestic deployments also provide unique opportunities—in many cases, the first such opportunities—for the military to interact with the US public in direct service, whereas the US military’s deployments are typically overseas. Despite each of these collaborations, we have only scratched the surface on what is needed to provide sustained improvement of medical care for both the US public and military communities. A recent review of MCPs highlighted the challenges of multiple programs, including a lack of standardized training across all three services, difficulty demonstrating the value of the training, and lack of validation of training against outcome and performance improvement.5 In addition, we have a very limited understanding of the measurable impacts of each of the DOD’s efforts in response to disasters. The increasing frequency of disasters, the COVID-19 pandemic, the United States withdrawal from Afghanistan, and the escalating conflict in Europe each the demonstrate need to reimagine strategic partnerships across the US military and civilian academic medical centers to maintain, support, and strengthen medical care in both domains. Several initial steps can be taken to bridge these gaps. First, a detailed after-action review of the DOD’s COVID-19 response encompassing quantitative and qualitative metrics is essential to inform future response plans.6 Applying the DOD’s innovative requirements-driven research and focused empiricism to disaster response could help mitigate preventable deaths due to these catastrophic events. Second, academic centers and the MHS should build regional partnerships for daily, routine operations that are more easily and effectively leveraged during disaster response. The DOD, academic medical centers, the National Disaster Medical System, the Veterans Health Administration, and the Federal Emergency Management Agency should clearly define roles and responsibilities and minimize redundancies in response. Critical issues to be addressed include communication, coordination, funding, staffing, and surge capacity. Finally, professional medical societies should follow the lead of the American College of Surgeons and actively partner with the DOD for enhanced bidirectional innovation to share best practices from newly formed regional collaboratives. Unfortunately, the “Walker Dip” is a phenomenon not solely reserved to battlefield mortality. Many have suggested that preventable deaths are common in disasters, particularly COVID-19, as hard-learned lessons are often forgotten and repeated.7,8 We can, however, bend the arc by investing in more comprehensive military civilian alliances to strengthen our combined resilience in the volatility, uncertainty, complexity, and ambiguity world and mitigate preventable deaths during peacetime or war.