Military Physicians

Ever since the establishment 20 years ago of the Uniformed Service University of the Health Science--the Defense Department's (DOD) medical school in Bethesda, Maryland--proposals have been made to close it. Those who proposed closing the University assert that DOD's need for doctors can be met at a lower cost using physicians educated at civilian medical schools. GAO found that when all federal costs are factored in, the University nearly equals the cost of the regular scholarship program and is lower than the cost of the deferred scholarship program. This difference arises because University graduates are expected to serve much longer in the military and the University received much less non-DOD federal support than do civilian medical schools. Medical education at the University compares well with that of other U.S. medical schools. DOD retention data suggest that University graduates are likely to provide DOD with a cadre of experienced physician career officers. Scholarship program doctors, who comprise the majority of new physicians accessions, are retained in the military for shorter period, on average, than are University graduates. However, given changes in operational scenarios and DOD's approach to delivering peacetime health care, the military's physician needs and the means to acquire and retain these doctors should be reassessed. For example, alternative strategies such as an additional scholarship option with a longer service obligation could be considered as a potentially less expensive way to increase the length of military physicians' careers.

GAO found that: (1) by most measures, USUHS is the most expensive source of military physicians; (2) HPSP provides the majority of military physicians; (3) when all federal costs are considered, USUHS nearly equals the cost of the regular scholarship program and is less costly than the deferred scholarship program; (4) USUHS graduates are expected to have longer military careers, and USUHS receives less non-DOD federal support than civilian medical schools and graduate training programs; (5) the quality of USUHS medical education compares well with that of all medical schools and its graduates' abilities are at or above those of other military physicians; (6) although USUHS graduates appear to be better trained in military medicine than their civilian peers, the significance of their additional readiness training is unclear; (7) if USUHS is closed, USUHS officials believe that DOD would need to continue funding other USUHS services, such as academic affiliation for several military graduate medical education programs, training and education for other health care and related professions, and research, consultation, and archival activities; (8) on average, USUHS graduates, particularly those in critical military medical specialties, tend to remain longer in the services than civilian-educated physicians; and (9) because its changing physician needs are not known, DOD needs to assess whether alternative strategies for obtaining certain experienced, long-term physicians at less cost are available.

Recommendations

Our recommendations from this work are listed below with a Contact for more information. Status will change from "In process" to "Open," "Closed - implemented," or "Closed - not implemented" based on our follow up work.

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