Abstract: This review addresses current educational and research efforts in disaster medical education (DME) in the United States. Since the events of 9/11, DME has received greater attention. However substantial problems remain in terms of ensuring that large numbers of medical students and residents are exposed to high quality DME – not only Emergency Medicine residents. Barriers to widespread adoption of DME include lack of performance metrics, disagreement task areas, and lack of emphasis on physician leadership. Further, such efforts must ensure retention of key information over periods that are disaster free; utilize objective training metrics that will allow for an evidence base to form; and develop low cost, scalable training approaches that offer greater fidelity to the disaster environment than classroom based instruction. To improve the state of the art, we argue that DME research must move toward a translational science model that integrates important advances in basic information science into application that improve the clinical performance of frontline medical staff who are called on to respond to individual and community needs in the aftermath of disaster. Mid-fidelity, team-in-the-loop simulations developed for disaster manager training may provide an avenue toward improved DME by exposing medical students to scenarios that fundamentally challenge their assumptions in real-time game play. This can be accomplished with lower costs and greater scalability than live exercise or mock-up training approaches. © 2012 ISCRAM.