Factors Associated With U.S. Army Physician Service After Obligation Completion.

Area of Science:

• Military Medicine
• Physician Workforce Studies
• Public Health Policy

Background:

• Approximately 320 physicians enter U.S. Army active duty annually.
• Significant costs are associated with physician education and training.
• Factors influencing physician retention after service obligations are not well-studied.

Purpose of the Study:

• To identify factors associated with continued active service among U.S. Army physicians after fulfilling initial obligations.
• To examine predictors of reaching retirement eligibility for physicians entering service before October 1998.

Main Methods:

• Retrospective cohort study of U.S. Army physicians (graduated 1987 or later, entered service by Dec 31, 2015).
• Cox proportional hazards model for continued service likelihood.
• Logistic regression model for retirement eligibility.

Main Results:

• Years of active service accumulated at obligation completion, preventive medicine/infectious disease specialization, and male gender were independently associated with higher likelihood of continued service.
• Physicians with more accumulated service years at obligation completion were most likely to continue serving and retire.

Conclusions:

• Accumulated service years at obligation completion is a key factor for physician retention and retirement in the U.S. Army.
• While Uniformed Services University (USU) graduates have longer initial obligations, their greater total service contributes to similar retention outcomes.
• Adjusting service obligations and incentives in other accession programs to mirror the USU model could enhance physician service continuity.