Military graduate medical education in internal medicine: An outcomes study

Military Medicine, Apr 2001 by Cation, Lannie J

Our study has several limitations. First, we studied only one internal medicine military residency program with a relatively small number of graduates. We feel that this residency program is representative of other Air Force and military internal medicine residency training programs in the quality of residents and faculty. Indeed, most military GME programs are similar because of the frequent rotation of faculty between various programs and the high-quality residents in these programs. Second, we did not have a civilian GME-trained comparison group. Beyond what has been cited here, data on the performance or retention of civilian GME-trained internists is not readily available. Also, we did not survey the cohort on satisfaction with their training; however, a previously published survey of military GME graduates found a high degree of satisfaction with their military residency training.8 Finally, it should be noted that the residency graduates who were studied completed their residency training before the start of TRICARE in the region. The impact of TRICARE on military GME is unknown, but this study may be used as a baseline for studies that attempt to assess this impact.

We feel that there are several keys to the success of military GME programs such as the one at WPMC. First, the quality of residents who are available for military GME programs is outstanding. Second, the high-quality, full-time active duty faculty available to residents in military GME programs is unparalleled. Most faculty members are graduates of military GME programs themselves who go on to perpetuate the cycle of excellence. Indeed, the number of full-time faculty members in a program has been correlated with the success of residency programs and passage of the ABIMCE.10 Finally, there is a wide variety of clinical material available at military medical centers in both the inpatient and outpatient arenas.23

In our study of the graduates of the internal medicine residency program at WPMC, we have attempted to document some of the most important outcomes of military GME in internal medicine: residency performance, active duty performance, and active duty retention. Our study reveals that military GME produces highly competent internists who can function effectively in a wide variety of active duty clinical and administrative positions and who are likely to remain in the military beyond their initial ADSC. These findings attest to the value of military GME in internal medicine and the significant contributions its graduates make to military medicine. It confirms that military GME trains the best of both-officers and physicians.

References

1. Gunby P: For military medicine, 'nothing in the world constant but inconstancy.' JAMA 1996; 276: 1859-61.

2. Gillert DJ: Graduate education bolsters military health care. Available at http:// www.dtic.mil:80/cgi-bin/mul. . . -FT%ofEXT HTML 0 :ct-text/html. 3. Burkhalter EL: Graduate medical education in the Department of Defense. Milit Med 1996; 161: 102-4.