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Updated July 11, 2024
The Uniformed Services University of the Health Sciences
In 1972, Congress established two programs to support the
Since its inaugural class in 1980, USUHS has awarded over
recruitment and retention of uniformed medical
10,000 degrees. The university continues to supply DOD,
professionals: (1) a health professions scholarship program
the U.S. Public Health Service [USPHS], and the U.S.
to train and prepare civilian students for a variety of careers
Coast Guard (USCG) with physicians, advanced practice
as military medical professionals and (2) the Uniformed
nurses, health scientists, specialized medical technicians,
Services University of the Health Sciences (USUHS) for
and medical researchers.
members of the uniformed services and certain civilians.
As the supply and demand of military medical personnel
USUHS is the only federally administered medical and
fluctuates over time, Congress periodically conducts
health sciences school in the United States.
oversight activities in an effort to ensure the military has a
Background
sufficient medical force to support U.S. military operations
during peacetime and wartime.
Between the late 1960s and early 1970s, Congress and the
Executive Branch initiated a series of reviews to consider
Governance
reforms to the military draft and the Selective Service
Statute (10 U.S.C. §2113) requires the Secretary of Defense
System as part of the transition to an all-volunteer force.
(SECDEF) to appoint a “President of the University.” DOD
Coinciding with these efforts were some congressional
Instruction 5105.45 designates the USUHS President as the
concerns about how the Department of Defense (DOD)
university’s chief executive officer, responsible for offering
would address critical shortages in military medical
academic health programs, administering medical research
personnel, including the recruitment and retention of health
initiatives, and maintaining other requirements that support
professionals.
certain military operations or national security objectives.
Congress identified several factors influencing DOD’s
The president works under the “authority, direction, and
critical shortage of military physicians, such as
control” of the Assistant Secretary of Defense for Health
•
Affairs. The law (10 U.S.C. §2113a) establishes a Board of
Nationwide Physician Shortage. In 1970, the Carnegie
Regents to assist and provide independent advice to the
Commission on Higher Education estimated that the
USUHS President and the SECDEF. The Board consists of
United States had a shortage of approximately 50,000
nine voting members appointed by the SECDEF. Non-
physicians.
•
voting members also serve on the Board, including the
Low Medical Officer Retention. A 1972 Senate Armed
surgeons general of the uniformed services.
Services Committee report stated DOD’s military
physician retention rate—for those with at least two
Funding
years of service—was approximately 1%.
•
The Defense Health Program account, under Operation &
“Doctor Draft Law” Expiration. Section 5(a) of the
Maintenance in the annual defense appropriation, funds
Military Selective Service Act (P.L. 92-129, as
USUHS. Between FY2009 to FY2024, the annual
amended), which authorized the President to draft a
appropriation for USUHS increased by 120% (see Figure
certain number of physicians into the military, expired
1). For FY2025, DOD requested $204 million. USUHS also
on July 1, 1973.
receives external funding from other academic institutions,
Given these concerns, DOD advocated to Congress the
research organizations, federal agencies, and private entities
“urgent need” for establishing a health professions
to conduct certain medical research or programs. In
university (see S.Rept. 92-827). In response, Congress
academic year 2021-2022, USUHS received $363.6 million
passed the Uniformed Services Health Professionals
in total research funding awards, of which $46.9 million
Revitalization Act of 1972 (P.L. 92-426), which established
(13%) was from non-DOD sources.
USUHS and the Armed Forces Health Professions
Scholarship Program (AFHPSP).
Academic Programs
In addition to physician training, Congress has directed the
USUHS’s mission is to educate and develop “uniformed
establishment of other health professions training programs
health professionals, scientists, and leaders; by conducting
at USUHS. The university offers a range of accredited
cutting-edge, military-relevant research; by leading the
degree or certificate-granting academic programs, such as
[Military Health System (MHS)] in key functional and
Doctor of Medicine (MD), Doctor of Philosophy (numerous
intellectual areas; and by providing operational support to
fields), Doctor of Nursing Practice, and several master’s
units around the world.” The university is co-located with
and bachelor’s-level degrees organized under four school or
Walter Reed National Military Medical Center at Naval
colleges:
Support Activity Bethesda, MD. USUHS also partners with
several military treatment facilities and military units across
• F. Edward Hébert School of Medicine
the United States that serve as student clinical sites and host
• Daniel K. Inouye Graduate School of Nursing
certain research projects.
• Postgraduate Dental College
https://crsreports.congress.gov
The Uniformed Services University of the Health Sciences
• College of Allied Health Sciences
Figure 1. USUHS Appropriations, FY2009-FY2025*
Source: CRS graphic based on analysis of Defense Wide Budget Documentation, Defense Health Program, FY2009-FY2025.
Notes: *The FY2025 figure is the amount requested by DOD. Actual year-dollars, not adjusted for inflation. Figures are rounded.
Eligibility and Admissions
Considerations for Congress
Statute (10 U.S.C. §2114) requires the SECDEF to establish
The following lines of inquiry may support congressional
eligibility and admission requirements for USUHS. Each
oversight of the university and clarify the effectiveness of
academic program establishes certain “academic,
USUHS in addressing military medical personnel shortages.
intellectual, and personal” admission requirements.
Military Recruitment and Retention
Congressional nominations are not required for admission
• Critical shortages in certain clinical specialties (e.g.,
to USUHS. This statute also states that all students in the
general surgery, anesthesiology, critical care, mental
MD program must be a commissioned officer of a
health) continue to challenge the military’s medical
uniformed service. Civilians accepted into the MD program
workforce requirements. What actions can USUHS take
are commissioned as a second lieutenant or ensign (O-1 pay
to address these shortages?
grade) prior to matriculation and remain in an active duty
• Numerous studies have reported that USUHS graduates
status during their studies. Prior military experience is not
tend to serve on active duty longer than their peers who
required. However, all applicants must meet commissioning
have entered military service through other medical
requirements, including standards for physical and medical
accession programs (i.e., AFHPSP, direct commission,
fitness prior to matriculation. Programs in the Postgraduate
financial assistance program). What authorities or
Dental College and College of Allied Health Services are
resources would be required to increase the capacity of
available to active duty servicemembers only, while other
USUHS’s programs?
programs in the School of Medicine and the School of
• Historically, Congress has directed the establishment of
Nursing are available to active duty servicemembers and
other health care training programs at USUHS. How can
civilians.
Congress best help these training programs meet DOD,
Military Service Obligation and Tuition
USPHS, and USCG requirements for other health care
professionals (e.g., nurses, dentists, technicians)?
Servicemembers attending USUHS are typically required to
fulfill a military service obligation (or service at a
Training Costs
designated federal agency, if a USPHS member). The
• Since 1976, numerous studies have noted that the annual
length of obligated service varies by academic program.
education costs are lower for scholarship (i.e., AFHPSP)
MD graduates are statutorily required, by 10 U.S.C. §2114,
students than USUHS students. What role should
to serve a minimum of 10 years, of which 7 years must be
economic and noneconomic benefits or costs have in
on active duty and the remaining time in the reserve
determining future program growth or reduction?
component. Time spent on graduate medical education (i.e.,
• In 2019, the Institute for Defense Analyses published a
medical residency program) does not count toward the
report that recommended USUHS “improve its cost
service obligation. Generally, civilian graduates do not
efficiency” and “enhance its readiness value to the
incur a military or national service obligation. USUHS does
MHS.” What actions, if any, has USUHS implemented,
not charge tuition. Students may be required to pay certain
or could be implemented to address its cost and
costs for books or other materials.
readiness value to the MHS?
Research Activities
Training Quality
•
USUHS conducts biomedical research focusing on
In December 2023, the Deputy Secretary of Defense
“operational medical readiness and the needs of the
directed actions intended to “reattract beneficiaries” to
Warfighter” through its research centers, hubs, programs,
military treatment facility care. What effects, if any,
and institutes. The university also partners with other
could these actions have on the quality of USUHS’s
federal and nonfederal organizations through grants,
health professions training programs and training sites?
contracts, cooperative agreements, and memoranda of
understanding.
https://crsreports.congress.gov
The Uniformed Services University of the Health Sciences
•
IF11385
Bryce H. P. Mendez, Analyst in Defense Health Care
Policy
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https://crsreports.congress.gov | IF11385 · VERSION 3 · UPDATED