I don't think that this article has all the facts completely straight...but it is on topic of this thread.
http://www.aamc.org/newsroom/reporter/march08/military.htm
AAMC Reporter: March 2008
Armed Forces Look to Boost Medical Student Scholarship Enrollment
By Barbara A. Gabriel, Special to the Reporter
Sara Michael had a chance to travel abroad for research after her first year of medical school. But instead, she took a slightly different kind of journey.
The University of Maryland School of Medicine student spent six weeks in San Antonio, Texas, sleeping in tents, firing M-16 rifles, and rising at 4:30 a.m. for pre-breakfast calisthenics. Granted, the tents were air-conditioned and the guns were loaded with blanks, but nevertheless, this is probably not how most doctors in training spend their summers.
The daughter of Army physicians and the sister and cousin of several soldiers, Michael said she always liked being part of what she called "the military family." "I had a blast," Michael said. "My mother couldn't believe it. But giving back to them was something I felt like I needed to do," she said. "I feel that military physicians are working toward a common good for a very worthy population."
As medical students in the Armed Forces Health Professions Scholarship Program (HPSP), Michael and her companions are commissioned officers, although this is probably the closest they will ever get to actual combat. The Army, Navy, and Air Force each offer comparable packages to entice both would-be and established medical students into the HPSP. Each branch pays for accepted students' full tuition, including any fees for books and course-required equipment. HPSP students also receive a stipend for living expenses. That stipend has increased over the past few years as the armed forces continue to fall short of their recruiting goals. While students collected $1,349 per month four years ago, this year it's $1,905.
Nevertheless, Michael is an increasingly rare breed these days. The Army, Navy, and Air Forceeach of which runs similar but discrete HPSP programsare all struggling to recruit medical students into their scholarship slots. In 2007, the Army filled only 82 percent of its HPSP slots. The Air Force fell further short with 72 percent of its slots filled, and the Navy trailed them all, awarding only 62 of its available scholarships. Recruiting heads give various reasons for this trend: The upcoming generation of medical students is less likely to come from post-draft military families; students today are less afraid of racking up medical school debt than they've been in the past; the income disparity between military physicians and their civilian counterparts is growing; and, whether the top brass rank it at the top or bottom of their lists, the ongoing war on terrorism is undoubtedly scaring students and doctors away from service.
"Certainly the war in Iraq plays a role in it," says Commander David B. McLean, M.D., associate dean of students and deputy program manager of the Navy's medical accessions department. "My father was Navy and told me all kinds of wonderful stories about how great it was to be in the Navy, and that certainly influenced me
We don't have that anymore."
To apply for a scholarship, a student must already be accepted into an accredited medical school and have high MCAT® exam scores (approximately 25 for the Army; the Air Force and Navy differ only slightly). All branches also have high GPA standards. If a student meets these prerequisites, is a U.S. citizen, and can pass a physical and a background check, he or she is a good candidate for the program. While competition for these slots was fierce only four to five years ago, today's qualified applicants stand a very goodperhaps guaranteedchance of acceptance.
Michael attributes the falling ranks of military physicians in training in part to recruiting efforts that fall short. Despite being the child of two military physicians, Michael didn't learn about the HPSP until an Air Force recruiter approached her at college. She wanted to know more, but it was the Army that most appealed to her. "Unfortunately, it was very difficult to find an Army recruiter, which was kind of odd," Michael said. "My father actually had to go to... a big head honcho to find one for me... They advertise that they need physicians, yet it was hard for me to find a recruiter, and I was actually looking for one."
Col. Raphael Montagno, M.D., commander of the U.S. Army Medical Recruiting Brigade, agreed that the Army falls short in its education and recruiting efforts for the HPSP.
"I think a lot of it can be blamed on ourselves," he said. "We just don't have enough people to get out to each and every medical school that we need to."
Michael and other HPSP students said they had lots of questions about the program before they applied, and once they learned more, they discovered that many of their assumptions were unfounded. Chances of seeing live action are low, and students are not placed on active duty until after completing their residencies.
According to Montagno, 2005 was the first year the Army did not meet its recruiting goal, filling only 237 of its 307 HPSP slots. This 77 percent success rate was in stark contrast to previous years in which the Army either reached or exceeded its goals. In 2006, the numbers barely budged, the Army achieving 78 percent of its goal. Last year it reached 82 percent, and Montagno is hopeful that the slow upward trend will continue.
But the Army's numbers look downright sparkling when compared to those of the Navy. According to McLean, in 2005, the Navy was only able to fill 162 HPSP slots, or 56 percent of its goal of 300. In 2006, the Navy did better, but still filled only 66 percent of its goal of 290 students; in 2007, the branch attracted 181 (62 percent) qualified students out of its 290 goal.
Although the Air Force has the best numbers in comparison to the Army and Navy in terms of meeting its annually prescribed HPSP slots, it too is slipping. In 2005, the Air Force was 18 percent short of its goal; in 2006, it was 11 percent short; and in 2007, it was 28 percent off the mark. Col. Molly J. Hall, M.D., chief of the Air Force's Physician Education Branch, says that four to five years ago, the Air Force was sifting through 800 to 1,200 HPSP applications from qualified applicants to fill approximately 300 slots per year, giving them an application/acceptance ratio of 4:1 or 5:1. The Air Force hasn't altered its qualifications, Hall said, but interest in the program has gone considerably downhill: "Right now, to be perfectly candid with you, it's 1:1."
Now, HPSP officials are taking steps to bring enrollment back up. For the first time the Army and Navy are now offering $20,000 signing bonuses for HPSP students that it says is already turning heads. According to McLean, last year's pool of applicants began to increase "significantly" after the signing bonus was announced. Captain Sandra A. Yerkes, M.D., program director of the Navy Medical Accessions Department, said the Army is currently in the process of pursuing congressional permission to offer its own signing bonus, and the Air Force is considering it.
Of course, nothing is free. As commissioned officers, HPSP students are required to train in facilities within their respective branches for 45 days each year of medical school. These rotations help students decide where they would like to complete their residencies. In their fourth year, HPSP students participate in the Military Match, which is essentially run in the same manner as the national resident Match. Once they complete their residencies they must fulfill their military obligation. For each year they are in the program, they must serve one year of active duty service and one year of reserve service. Depending on their expertise and where they are most needed, military physicians may work in any number of various capacities around the world.
While some HPSP-trained physicians thrive on the military medicine environment and choose to make a career of it, others return to civilian life after they've been on active duty for four years to pursue clinical interests in private practice, academia, or as researchers. But they must still remain military reservists for another four years, during which time they may or may not be called up for duty. Hall cautioned that eligible undergraduates should carefully consider the payback time required before signing up for the HPSP program.
"I would imagine it's difficult feeling easy about making such a long-term commitment in your life at such a young age," she said. "For example, if you go to medical school at age 22, graduate at 26, and then perhaps opt for a five-year general surgery residency, your payback begins at age 31. Now you're looking at age 35 before you've completed your [active duty] obligation."
