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From combat to medical school

Since transferring to Stanford and joining the political science research honors track, I have focused most of my individual research on veterans’ affairs and the military. The decision to study military history and theory, veterans’ political behavior and domestic public perception of veterans is intuitive given my upbringing. I was born in Hawaii and lived in Japan for the first eight years of my life. My father served 20 years in the Navy, my mother served in the Navy and is currently serving for the Army in Baghdad and my brother served in the Marines. Recently, I was selected as a Truman Scholar finalist as a student focused on fixing the Department of Veteran Affairs. I would like to apply some of my research and experiences to explore an idea to improve the amount of medical professionals working in the Veterans’ Health Administration.

The capabilities of the 152 U.S. Veterans’ Affairs (VA) medical centers are significantly limited, specifically regarding the lack of medical professionals in the Veterans’ Health Administration. VA hospitals need more full-time doctors, specifically doctors that understand veterans’ unique medical challenges. Here are some statistics to set the stage:

  • As of September 1, 2015, over 52,000 Iraq and Afghanistan war veterans had been wounded in combat.
  • An estimated 300,000 veterans are suffering from traumatic brain injuries and an estimated 400,000 veterans are suffering from post-traumatic stress disorder.
  • Regarding veterans of past wars, including Iraq and Afghanistan, 35 percent of pending enrollment applicants for VA healthcare had died before receiving it, according to an internal investigation by the VA.
  • In July 2015, Deputy Undersecretary for Health and Management Janet Murphy confirmed at a Congressional hearing that the VA has more than 41,000 vacancies nationwide for medical professionals. Many of the medical professionals employed at the VA are part-time, which further breaks down communication, continuity of care and accountability.
  • Nearly a third of all VA clinics do not have OB/GYNs. The share of women among the enlisted ranks has increased sevenfold and the share among commissioned officers has quadrupled since 1973 — the year the military became an all-volunteer force.
  • The VA-enrolled veteran population has increased by 78 percent from 2001 to 2014, and the demand on VA hospitals is only expected to increase. There are currently close to 22 million veterans living in the United States and with continued involvement in the Middle East, the veteran population will increase along with the need for more medical professionals.

The Veterans’ Health Administration should create a pathway program for servicemen and women to go through formal civilian education for paramedics, registered nurses and physicians. Several American high schools offer pathways to medical school that only require six to eight years of undergraduate and medical school. This program would allow combat medics and corpsmen and -women to enroll and complete a pre-medical bachelor’s degree after their enlistment and then enroll in a medical school to pursue a Doctor of Medicine degree. Once enrolled in the program, the student would receive guaranteed acceptance into an in-state medical school given certain academic standards are met. Several high schools have a similar program. The students would also be enrolled in a specific Pay As You Earn (PAYE) federal loan forgiveness program. The PAYE program would have an interest rate of 3 percent – close to 4 percentage points lower than the Stafford loan. If the recent graduates are able to maintain a consistent payment plan, after five years, their debt will be forgiven. Funding will originate from the Department of Defense’s (DOD) Overseas Contingency Operations (OCO) portion of the budget.

Funding the program is a major obstacle. The Department of Defense should show its commitment to strengthening the relationship between the two departments by utilizing funds that Secretary of Defense Ash Carter claimed to be a slush fund to support the veterans’ healthcare. Another obstacle will be recruiting participants and publicizing the program. The third obstacle would be to accommodate combat veterans who suffer a service-connected injury or mental health problem who wish to participate in the program.

The program would offer several benefits. Primarily, the VA will have more physicians. Men and women who are looking to explore the medical field will now have a cost-effective option when choosing a civilian career without bypassing necessary medical training and education. Secondly, the program will fit with the benefits of the GI Bill and with the VA initiative to increase the number of registered nurses and physician assistants. Finally, veterans, who already understand the medical, social and psychological challenges other veterans face, will be able to provide specialized preventative healthcare. A program like this could help veterans who are afraid and who suffer from injuries that aren’t visible. The Department of Veterans’ Affairs, with over 30 reports of poor wait-time management in the past decade and with various scandals being investigated across the country (e.g. the latest in Atlanta), must improve on developing accessible healthcare to veterans.

 

Contact James Stephens at james214 ‘at’ stanford.edu.

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