Military doctor recruiting takes wartime hit

Concerned about racking up hundreds of thousands of dollars in debt, Erik Olson, a first-year student at the University of Nevada School of Medicine in Reno, responded to a Navy recruiter's e-mail offering a chance to apply for a scholarship that would pay for his tuition, books, lab fees and medical supplies, as well as give him a stipend of about $1,300 a month.

He received the scholarship, and by accepting it, he has agreed to serve in the Navy one year for each year that the military helps pay for his education.

"Being able to not have to worry about money during school and coming out of school debt free" was the deal-maker for Olson. He said the chance that he could end up deployed into a war zone, like Iraq, wasn't an issue for him.

Olson, though, is among a shrinking pool of medical students choosing to pay for school with the help of the military's Health Professions Scholarship Program. In 2005, the Navy, which also supplies doctors to the Marine Corps, achieved just 56% of its goal to give scholarships to 291 medical students. The Army reached 77% of its goal, falling 70 medical students shy of its target.

Military officials say HPSP is responsible for recruiting 80% to 90% of the physicians in the Army and Navy, and continued low numbers could create a serious shortage of physicians within these military branches. In addition, HPSP graduates, along with graduates from the Uniformed Services University of the Health Sciences, supply the bulk of the medical military's leadership.

To try to turn around these figures, Army and Navy officials said they have ramped up medical student recruitment efforts, something neither branch had done much of before.

"It sold itself," said Col. Bernard DeKoning, MD, the Army's assistant surgeon general for force projection. "There was little competition [from other scholarships] and no war. Now we are in a very challenging situation. We realize we need to make an effort to attract students into the Army."

Cmdr. David McLean, MD, Navy Medical Corps, director of medical department accessions, said the global war on terrorism certainly plays a role in why fewer medical students are applying for the HPSP, a program established in 1972 during the Vietnam War and a year before the draft ended.

But, he said, several other factors also are at work: Students today are more willing to graduate with debt. There are more scholarship and loan programs for medical students to tap. And an all-volunteer military means that students are less likely to have a parent in the armed forces -- a connection that often makes a child more likely to join.

Recruitment efforts

Beyond e-mailing medical students, for the first time Army and Navy representatives are visiting campuses. Each branch has set up speakers' bureaus through which active military physicians go to campuses to speak. Dr. DeKoning has been among those to meet with students.

"The best way [to attract more students] is to have practicing Army physicians going out and speaking with premedical and medical students, talking about what it's like to be a doctor in the Army, telling the story in their own words -- that generates interest in the students," he said.

Olson, having heard a physician from the Army speak about the HPSP during his orientation week, agreed.

"I had already applied by then to the Navy," Olson said, "but I did find it helpful. He talked about how the Army's deployment works, where he has got to travel, and what it's like if you stay after your payback time."

In addition, the Defense Dept. has a package before the Senate that aims to improve physician recruitment among medical students, medical residents and practicing physicians. The military is asking Congress to:

• Double the stipend for HPSP scholars, bringing the total to $30,000 annually.
• Triple the stipend for medical residents who are part of the military's scholarship program aimed toward them, the Financial Assistance Program, from $15,000 a year to $45,000.
• Offer to help offset the military's lower salaries with a signing bonus of up to $400,000 for practicing physicians in war-critical specialties, such as maxillofacial, thoracic and orthopedic surgery, if they agree to serve at least four years.

Meanwhile, the Air Force has seen its HPSP numbers stay at or above recruitment targets.

Col. Arnyce Pock, MD, Air Force Medical Corps director, attributed this to its deployment schedule. The Air Force gives its members a window of time when they will be deployed if a deployment occurs.

"One of the things the Air Force has worked hard on is to instill predictability," she said. "We have predictable rotations, and they are limited to 120 days, so people can plan to some degree."

Cynthia Smith with the Defense Dept. press office said the Pentagon had no plans to create a physician draft.