To address the highest single cause of medical attrition in United States Air Force Basic Training, we conducted a study to evaluate the impact of integrating a team of Certified Athletic Trainers with a board-certified sports medicine physician. The team of certified athletic trainers was integrated into one of six training squadrons with outcomes compared against two control training squadrons after 36 months of intervention. At the completion of this study, the squadron with integrated athletic trainers had 25% lower MSK attrition and 15% lower attrition for any cause compared to control squadrons. In addition, the intervention squadron demonstrated improved fitness scores, decreased incidence of stress fractures, and decreased referrals for specialty care (orthopedics and physical/occupational therapy). The cost avoidance due to saved attrition in the intervention squadron amounted to $10.9 million. Interim analysis half way through this study showing persistent improvement in MSK attrition was used to justify decision by Air Education and Training Major Command to fund a full expansion of integrated athletic trainers throughout all USAF Basic Training. This study demonstrates the success that can be achieved when medical expertise targeted to a specific identified threat to mission success is integrated within an operational unit in the USAF.