Now that we are in the 21st century, military medicine struggles with critical issues. One of the most important is how we train in peace for the realities of conflict. Training 100,000 active duty military medical personnel is becoming insurmountable. A more effective solution may be training through computer simulation. Success requires a strategic plan and coordination among experts in their own fields, e.g., medical personnel, engineers, to ensure useful, valuable products. Research and development in fundamental sciences is required to permit realistic representations of anatomy and medical procedures. Enabling technologies are required, e.g., tissue modeling, haptics, physiological representations, systems architecture, learning systems. Medical Simulation Training Initiative (MSTI) is a visionary military program to develop a multi- functional simulation platform based on a personal computer, with 3-D imaging of anatomic compartments or body structures. Interfaces will likely be an exoskeletal robotic device, haptic gloves, and other interactive devices. MSTI will provide risk-free, realistic learning environments for the spectrum of medical skills training. This will enhance hands-on training opportunities and revolutionize how we train medically. High fidelity modeling will permit manufacturers to prototype new devices. Engineering designers can then test devices in varieties of simulated anatomical representations, permitting them to practice medicine.