Public brief · Defence-industrial ecosystems · 2026

The military medical training function Canada hasn't built yet.

The United States runs military medical simulation as a single, named enterprise capability. Canada runs it as fragments. The gap is nameable, documented in public sources - and it is an ecosystem opportunity, not a procurement line.

In brief

Before proposing anything, we asked whether the function already exists somewhere in Canada's system. On the public record, it does not. The US Defense Health Agency houses a Medical Modernization & Simulation Division - one office that coordinates medical modelling & simulation, governs training requests across the Military Health System, and builds a unified, skills-based learning architecture. Canada's equivalent functions are spread across a training schoolhouse, contracted delivery, ad-hoc military–civilian partnerships, and an enterprise simulation office whose directive does not mention medicine. The unified skills-tracking layer is absent entirely.

The finding is instructive rather than discouraging: Canada's first Defence Industrial Strategy (February 2026) already names Training and Simulation as a sovereign capability - and medical appears nowhere within it. The missing module of a named national capability is a white space a coordinated Western Canadian ecosystem can credibly fill, with benefits that flow to civilian health care regardless of the pace of any defence decision.

Benchmark
US DHA - Medical Modernization & Simulation Division
Policy frame
Defence Industrial Strategy 2026 · ITB Key Industrial Capabilities
Scope
Dual-use - defence readiness & civilian health workforce
Evidence
Public sources only, cited below
01 - The base Canada can mobilize

Substantial, already operating - and holding no defence mandate.

British Columbia holds the distinctive anchor: the CF Trauma Training Centre (West) at Vancouver General Hospital, where military clinicians maintain trauma skills inside a civilian facility - an operating military–civilian model, alongside university medical-education research capacity and an active health-technology SME base.

19
Royal College-accredited simulation centres across Canada
CMEJ, 2023
4,000+
Simulation professionals in Simulation Canada's network, across 200+ institutions
simulationcanada.ca
~25
Programs at the CF Health Services Training Centre, CFB Borden - a schoolhouse, not an enterprise office
canada.ca
0
Canadian organizations holding the enterprise medical simulation mandate
Public record, 2026
Clinician working with a patient simulator in a hospital simulation room
An operating military–civilian model: military clinicians maintain trauma skills inside a civilian facility.

Documented demand pressure on the defence side: the Auditor General's 2025 report found a 4,700-recruit shortfall with 13% of military occupations at risk - and clinical readiness already depends on embedded civilian partnerships.

02 - The policy white space

A named capability with a missing module.

Canada's first Defence Industrial Strategy (February 2026) names ten sovereign industrial capabilities. Training and Simulation is one of them - as a single, undivided capability, with no medical dimension named within it. Health enters the ten only as medical-countermeasure stockpiling under Personnel Protection. Separately, "Training and Simulation" is one of ISED's 17 Key Industrial Capabilities under the Industrial and Technological Benefits policy - meaning medical-simulation investment can already score as ITB value today.

Exhibit 2

Ten sovereign capabilities, DIS 2026: medical named in none

AerospaceNamed
AmmunitionNamed
Digital SystemsEV mandate
In-Service SupportNamed
Personnel ProtectionMed. countermeasures only
SensorsEV mandate
SpaceEV mandate
Specialized ManufacturingNamed
Training & SimulationMedical absent - the white space
Uncrewed & AutonomousNamed
Building the medical module of Training & Simulation is a contribution to a capability Canada has already declared sovereign - not a request to create a new one.
03 - The benchmark

How the United States organizes this function.

Within the US Defense Health Agency's Education & Training Directorate, the Medical Modernization & Simulation Division and the Defense Medical Modeling & Simulation Office coordinate medical M&S across the Department of Defense, act as gatekeeper for medical education and training requests, and work toward standardized training data with skills-based tracking at enterprise, service and individual levels.

The relevant feature for comparison is not size but function: a single, named office owns the capability. The benchmark requires three things - an enterprise office, gatekeeping authority over medical training, and a unified skills-tracking learning architecture.

Exhibit 1

Function by function, public record only

Function (US benchmark)United StatesCanada
Enterprise medical M&S officeDHA - Medical Modernization & Simulation Division / DMMSONo single equivalent office
ABSENT
Coordination of medical education & trainingGoverned enterprise-wide within DHA J-7Training establishment (CFHSTC, Borden) + contracted delivery
FRAGMENTED
Unified skills-based learning architectureA stated objective of the enterprise officeNot established as a unified system
ABSENT
Forces-wide M&S coordination incl. medicalCoordinated through the enterprise officeSynthetic Environment Coordination Office - no medical scope in its directive
ABSENT (MEDICAL)
Clinical-readiness delivery modelMilitary treatment facilities across the servicesEmbedded civilian arrangements - e.g. CF Trauma Training Centre (West) at Vancouver General Hospital
OPERATING
04 - What closing the gap takes

An ecosystem problem, not a firm-level one.

No single SME, hospital or schoolhouse can close this gap alone, because its components are shared goods: a common operating picture of companies, training sites and buyers; shared standards and a competency framework so clinical readiness can be measured the same way everywhere; and a route to market connecting the firms that build simulation products to the defence and health-system buyers who need them. That is the coordination function the United States institutionalized - and the one Canada can now build deliberately, anchored in the assets Western Canada already holds.

See
Shared operating picture

A maintained view of simulation companies, training sites, buyers and programs - the sector's common map.

Measure
Competency infrastructure

A common framework and skills-tracking architecture so readiness is measured, not assumed.

Connect
Route to market

Buyer access, showcases and advisory so Canadian SMEs can sell into defence and health markets.

Convene
A standing table

A recurring convening point where defence and civilian medical simulation meet in Western Canada.

The dual-use dividend. Every element above returns value through civilian health channels - clinician skill-fade, rural and remote readiness, workforce shortages - independent of the pace of any defence decision. That is what makes the investment resilient, and what makes the ecosystem worth building now.
Sources - public record
  1. US Defense Health Agency, Education & Training - Defense Medical Modeling & Simulation Office / Medical Modernization & Simulation Division. health.mil
  2. Canadian Forces Health Services Training Centre, CFB Borden. canada.ca
  3. DND, Evaluation of Military Health Care, ADM(RS), 2018. canada.ca
  4. DAOD 2010-1, Modelling & Simulation Management. canada.ca
  5. Canada's Defence Industrial Strategy, February 2026 - ten sovereign capabilities. canada.ca; corroborated by CGAI and Torys commentary
  6. ISED, Industrial and Technological Benefits policy - Key Industrial Capabilities. ised-isde.canada.ca
  7. Office of the Auditor General of Canada, Report 7 (2025) - CAF recruitment and retention. oag-bvg.gc.ca
  8. Royal College-accredited simulation centre count, Canadian Medical Education Journal, 2023
  9. Simulation Canada network figures. simulationcanada.ca

Public sources only · For information purposes · © 2026 Element Ventures (Canada) Ltd.

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