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The Honolulu Advertiser
Posted on: Monday, July 10, 2006

Medical students grow scarce

By Tom Philpott

The number of medical students accepting Army and Navy scholarships has fallen sharply over the past two years, in part because of the mayhem in Iraq as depicted in daily news reports, service medical leaders say.

A scholarship program that the Army surgeon general calls "our lifeblood" for recruiting physicians is failing to attract enough qualified applicants by wide margins, except in the Air Force.

Difficulties in recruiting the next generation of Army and Navy physicians and dentists have spurred the Senate to approve new authorities to dramatically increase medical bonuses and stipends. The increases are before a House-Senate conference committee and could win the full support of Congress by fall.

The services recruit roughly 70 percent of physicians and 80 percent of dentists through the Health Professions Scholarship Program, or HPSP. The rest graduate from a military-run medical school, accept military financial aid while in residency training or enter service as fully trained doctors.

HPSP scholars see full tuition covered in their civilian medical schools, plus books and fees, and receive a monthly stipend of $1,289. In return, students agree that for every year of schooling provided, they will serve a year as a military physician or dentist.

All the services had been meeting HPSP goals until fiscal 2005. The Navy had expected to sign 291 medical school students but could attract only 162. Numbers for fiscal 2006 look about the same or a little worse, said Vice Adm. Donald C. Arthur, the Navy surgeon general.

The Army in 2005 expected to award 307 scholarships. It fell 70 short. Through nine months of fiscal 2006, the Army has awarded 179 scholarships, 61 percent of its goal.

Dental school students are another concern. In fiscal 2004-05, the Navy hoped to sign 85 dental students under HPSP. It attracted 65. The Army last year awarded 10 fewer dental scholarships than the 93 planned. It also wanted to sign 30 dentists through direct accession but could get only 16.

With three months remaining in fiscal 2006, the Army Dental Corps has less than half the HPSP students it seeks — 54 of 115 — and has enticed seven of the 30 dentists planned to be brought in through direct accession.

Lt. Gen. Kevin C. Kiley, the Army surgeon general, and Arthur, in separate interviews, blamed some of their downturn on news and images out of Iraq. Young people, Kiley said, "look at this and say either, 'I don't agree with our war,' or 'I sure don't want to be over there.' So they see signing up for a scholarship as tantamount to enlisting and going right into combat. (In fact) it's going to be anywhere from four to nine years before that would happen."

Kiley noted that more than half of medical school students are now women, a gender historically less interested in military service. Also, he said, the HPSP stipend of $1,279 a month "is not a lot to live on" and stay debt-free.

Arthur pointed out that more scholarship alternatives to HPSP are offered by large managed-care companies and even by rural communities sponsoring the education of students who become local doctors.