Summary: Ever since the establishment 20 years ago of the Uniformed Service University of the Health Science--the Defense Department's (DOD) medical school in Bethesda, Maryland--proposals have been made to close it. Those who proposed closing the University assert that DOD's need for doctors can be met at a lower cost using physicians educated at civilian medical schools. GAO found that when all federal costs are factored in, the University nearly equals the cost of the regular scholarship program and is lower than the cost of the deferred scholarship program. This difference arises because University graduates are expected to serve much longer in the military and the University received much less non-DOD federal support than do civilian medical schools. Medical education at the University compares well with that of other U.S. medical schools. DOD retention data suggest that University graduates are likely to provide DOD with a cadre of experienced physician career officers. Scholarship program doctors, who comprise the majority of new physicians accessions, are retained in the military for shorter period, on average, than are University graduates. However, given changes in operational scenarios and DOD's approach to delivering peacetime health care, the military's physician needs and the means to acquire and retain these doctors should be reassessed. For example, alternative strategies such as an additional scholarship option with a longer service obligation could be considered as a potentially less expensive way to increase the length of military physicians' careers.
