Specialty Choices, Practice Characteristics, and Long-term Outcomes of Two Cohorts of USUHS Medical School Graduates Compared with National Data

Abstract

Introduction: The education of health professionals and the assessment of their long-term goals are essential. Additionally, in the military health system (MHS), such programs also have the goals of improving readiness, providing high-quality care and meeting the needs and challenges of the MHS. The Uniformed Services University F. Edward Hebert School of Medicine (USUHS) has existed for over 40 years and the assessment of the longer term outcomes of its medical school graduates is an important endeavor. The purpose of this study is to describe the relationship of USUHS on the care in the MHS by reporting specialty choices, practice characteristics and locations of two consecutive cohorts of USUHS graduates and to compare these cohort findings with national data. Two cohorts were chosen as the first cohort has reached retirement and we sought to describe the impact of our graduates following their military service commitment.

Materials and methods: We performed a retrospective analysis of our graduates (1980-2009) using data obtained from the American Medical Association Physician Masterfile in two 15-year cohorts. USU graduate data are described and compared with national allopathic medical school data in order to explore USUHS graduates' practice characteristics and how these contrast with national data.

Results: Family medicine was the most commonly identified primary care specialty across both USUHS cohorts. Other primary care specialties such as Internal Medicine and Pediatrics became more popular among USUHS graduates over time. There were a lower percentage of inactive USUHS graduates from the 1980-1994 cohorts than the U.S. national sample (3.23% vs. 3.98%). The proportion of USUHS graduates working in an office-based practice increased from 34.8% (1980-1994) to 43.6% (1995-2009) yet still was lower than U.S. national data (1980-1994: 73.5%; 1995-2009: 73.8%). The type of practice in which the majority of USUHS and national graduates were involved was direct patient care (over 70% of the population). Practice locations for medical school graduates included all 50 states. Furthermore, though several states such as Mississippi, Nevada, South Carolina, and Utah were among the top 20 practice locations among USUHS graduates, they did not appear among the top 20 practicing states for U.S. graduates.

Conclusions: USUHS can play a major role by training health care professionals needed to meet the large health care strategic goals of a transforming military health system. A high percentage of USUHS graduates had significant changes in practice characteristics over time, are staying in practice for longer time compared with U.S. graduates, and practice in all 50 states including those that are underserved.