Academic Medicine in the Military Health System: Problems and Solutions for Academic Leadership Development

The opinions and assertions contained herein are the private views of the authors and are not to be construed as official or as reflecting the views of the Uniformed Services University or the Department of Defense. A physician trained in the military system is more proficient from a readiness aspect in their first assignment than those trained outside the Military Health System (MHS). Their clinical skills may be similar. Yet, through continual exposure to the military mission and culture, and modeling of military faculty, these physicians are more familiar with the MHS requirements. The difference gradually resolves over that first assignment. It takes time for physicians to learn the balance of the sometimes competing aspects of peacetime and wartime health care, and residency training often is that “time.” Academic medicine is integral to the MHS and strengthens the MHS. In addition to creating mission ready physicians, it also inspires staff physicians to stay current with cutting-edge medicine and skills and at times provides the necessary infrastructure that underlies much of the research done in our system. Better understanding of the essential benefits and requirements of medical education by leadership and policymakers would help sustain a ready force, including physicians being prepared for peace or wartime service immediately after residency graduation. Effective medical education relies on more than the stellar clinicians of yesteryear. With the ever changing accreditation requirements and changes in physician education, academic leaders must not only be competent medically but be strong collaborative leaders. These academic leaders must be able to manage change rapidly while often working with subordinates of senior rank disproportionate to other areas of the military. These leadership skills require approaches different from the typical military paradigm. Notwithstanding its many challenges, the MHS is primed as a closed system, where physicians train and stay within the health care system after graduation, to identify and appropriately train medical educators and academic leaders. Codifying an academic career track and performing enhanced and consistent strategic talent management can demonstrate the impact of institutional support on academic leadership development and could serve as a model for civilian systems. If the MHS values the product academic programs deliver to the services, namely the next generation of MHS physicians and leaders, then academic leaders need a designated standardized career track embedded in military medicine’s culture to guarantee future medical force sustainment. This article will initially review key changes in academic medicine, next present data from the Uniformed Services University (USU) Faculty Development program, and finish with three key issues requiring resolution to create a standardized academic track.