image
Surgeon Norris Childs, MD, right, with junior navy medical officer in snow cave they built at cold weather medicine course at Marine Corps Mountain Warfare Training Center in Bridgeport, California.

By Monica J. Smith

The majority of physicians who pursue a career in military medicine set their sights on that goal before they even begin medical school as they seek eligibility to participate in the Health Professions Scholarship Program (HPSP), which funds students’ education in exchange for required periods of duty in the U.S. Army, Navy or Air Force.

The benefits of this approach are clear: The scholarship covers most or all of their education and training, books and materials, as well as provides a monthly stipend and military pay. In return, doctors serve one year for each year of the military’s support, with a minimum commitment of two years. They begin their careers free of medical school debt, and if they choose to continue in the military, which about two-thirds of HPSP participants do, they can look forward to retiring relatively young with a healthy benefits package.

But there is a small proportion of military physicians who enter through direct accession later in life, sometimes after years or even decades in civilian practice, occasionally beginning their military career at the point when an HPSP recipient would be retiring. The common thread that unites these late joiners is a desire to serve their country and take care of those who defend it.

image
Norris Childs, MD, with members of the Advanced Trauma Life Support training class in Malindi, Kenya.

When U.S. Navy Capt. (ret) Norris Childs, MD, finished his residency, he set out to pursue his surgical career as a solo practitioner in Philadelphia. He regularly received letters from the armed services spelling out the perks and benefits of joining, letters that he ignored. But a letter that he received in 1988, simply stating a desperate need for physicians, touched a chord.

“There were no promises of money, adventure, allure or anything like that. Just ‘we need doctors badly,’ and that appealed to me,” Dr. Childs said.

Rear Adm. Michael Baker, MD, chairman of surgery at John Muir Hospital, in Walnut Creek, Calif., who spent 30 years in uniform, did everything he could think of to avoid the military while attending college and medical school during the Vietnam War.

“I even went into U.S. Public Health Services for a while,” he said. But as his residency came to a close, he felt so grateful to have had the chance to get the education and training to become a surgeon that he no longer had qualms about service.

“By that time, the Vietnam War was nearly over, but I decided that no matter what the politics were, I could put on a uniform and take care of those who had served our country,” Dr. Baker said.

Maj. Paula Oliver, MD, FACS, spent 20 years in a single-specialty practice when her involvement with an army officer exposed her to the acute shortage of general surgeons in the military, and she felt her own call to duty. At the same time, she was feeling increasingly frustrated with practice in the civilian setting, and this is another common thread among physicians who enter the military later in life: Medical practice isn’t what they’d expected, or a once-satisfying career is beginning to turn sour.

“I often see that there is a general dissatisfaction with life in the civilian surgical world, a feeling that there is no higher sense of purpose in what they are doing,” said Col. Tommy Brown, MD, general surgery consultant to the Surgeon General.

At the time that Dr. Childs decided to join, part of his practice was taking care of nonpaying, inner-city trauma patients. “Occasionally I’d come across a person who was totally unappreciative. I knew I’d never get paid for taking care of that patient, and there was a high risk of being sued for unhappy results,” he said. “I had this fantasy that in the military I might find a more appreciative audience for my trauma care. I’d say in the 22 years I served, the military has not disappointed me in that regard at all.”

image
Maj. Paula Oliver, MD, FACS, spent 20 years in a single-specialty practice when her involvement with an army officer exposed her to the acute shortage of general surgeons in the military, and she felt her own call to duty.