link to page 1 
December 12, 2019
The Uniformed Services University of the Health Sciences
In 1972, Congress established two programs to support the
Since its inaugural class in 1980, USUHS has awarded
recruitment and retention of uniformed medical
nearly 10,000 degrees. The university continues to supply
professionals: (1) a health professions scholarship program
DOD (and the U.S. Public Health Service [USPHS]) with
to train and prepare civilian students for a variety of careers
physicians, advanced practice nurses, health scientists,
as military medical professionals and (2) the Uniformed
specialized medical technicians, and medical researchers.
Services University of the Health Sciences (USUHS) for
As the supply and demand of military medical personnel
members of the uniformed services and certain civilians.
fluctuates over time, Congress periodically conducts
USUHS is the only federally administered medical and
oversight activities in an effort to ensure the military has a
health sciences school in the United States.
sufficient medical force to support U.S. military operations
Background
during peacetime and wartime.
Between the late 1960s and early 1970s, Congress and the
Governance
Executive Branch initiated a series of reviews to consider
Statute (10 U.S.C. §2113) requires the Secretary of Defense
reforms to the military draft and the Selective Service
(SECDEF) to appoint a “President of the University.” DOD
System as part of the transition to an all-volunteer force.
Instruction 5105.45 designates the USUHS President as the
Coinciding with these efforts were some congressional
university’s chief executive officer, responsible for offering
concerns about how the Department of Defense (DOD)
academic health programs, administering medical research
would address critical shortages in military medical
initiatives, and maintaining other requirements that support
personnel, including the recruitment and retention of health
certain military operations or national security objectives.
professionals.
The president works under the “authority, direction, and
Congress identified several factors influencing DOD’s
control” of the Assistant Secretary of Defense for Health
critical shortage of military physicians, such as:
Affairs. The law (10 U.S.C. §2113a) establishes a Board of
Regents to assist and provide independent advice to the
Nationwide Physician Shortage. In 1970, the Carnegie
USUHS President and the SECDEF. The Board consists of
Commission on Higher Education estimated that the
nine voting members appointed by the SECDEF. Non-
United States had a shortage of approximately 50,000
voting members also serve on the Board, including the
physicians.
surgeons general of the uniformed services.
Low Medical Officer Retention. A 1972 Senate Armed
Services Committee report (S.Rept. 92-827) stated
Figure 1. USUHS Appropriations, FY2009-FY2020*
DOD’s military physician retention rate—for those with
at least two years of service—was approximately 1%.
“Doctor Draft Law” Expiration. Section 5(a) of the
Military Selective Service Act (P.L. 92-129, as
amended), which authorized the President to draft a
certain number of physicians into the military, expired
on July 1, 1973.
Given these concerns, DOD advocated to Congress the
“urgent need” for establishing a health professions
university (see S.Rept. 92-827). In response, Congress
passed the Uniformed Services Health Professionals
Revitalization Act of 1972 (P.L. 92-426), which established
USUHS and the Armed Forces Health Professions
Scholarship Program (AFHPSP).
USUHS’s mission is to “educate, train, and
Source: Prepared by CRS, based on a compilation of Defense Wide
comprehensively prepare uniformed services health
Budget Documentation, Defense Health Program, for FY2009-2020.
professionals, scientists, and leaders” to support the
Notes: *The FY2020 figure is the amount requested by DOD. Actual
readiness of the uniformed services and the U.S. National
year-dol ars, not adjusted for inflation. Figures are rounded.
Security Strategy. The university is co-located with Walter
Reed National Military Medical Center at Naval Support
Funding
Activity Bethesda, Maryland. USUHS also partners with
The Defense Health Program account, under Operation &
several military treatment facilities and units across the
Maintenance in the annual defense appropriation, funds
United States that serve as student clinical sites and host
USUHS. From FY2009 to FY2019, the annual
certain research projects.
appropriation for USUHS increased by 95% (see Figure 1).
For FY2020, DOD requested $170.6 million. USUHS also
https://crsreports.congress.gov
The Uniformed Services University of the Health Sciences
receives external funding from other academic institutions,
contracts, cooperative agreements, and memoranda of
research organizations, federal agencies, and private entities
understanding.
to conduct certain medical research or programs. For
academic year 2018-2019, USUHS received $210.6 million
Considerations for Congress
in total research funding awards, of which $41.5 million
The following lines of inquiry may support congressional
(20%) was from non-DOD sources.
oversight of the university and clarify the effectiveness of
USUHS in addressing military medical personnel shortages.
Academic Programs
Military Recruitment and Retention
In addition to training physicians, Congress has directed the
Critical shortages in certain clinical specialties (e.g.,
establishment of other health professions training programs
general surgery, anesthesiology, critical care) continue
at USUHS. The university offers a range of accredited
to challenge the military’s medical workforce
degree or certificate-granting academic programs, such as
requirements. What actions can USUHS take to address
Doctor of Medicine (MD), Doctor of Philosophy (numerous
these shortages?
fields), Doctor of Nursing Practice, Doctor of Public
Numerous studies have reported that USUHS graduates
Health, and several master’s and bachelor’s-level degrees.
tend to serve on active duty longer than their peers who
Academic programs organized under four schools:
have entered military service through other programs
F. Edward Hebert School of Medicine
(i.e., AFHPSP, direct commission, financial assistance
Daniel K. Inouye Graduate School of Nursing
program). How can USUHS increase the capacity of its
Postgraduate Dental College
MD program and what resources would be needed?
College of Allied Health Sciences
Historically, Congress has directed the establishment of
Eligibility and Admissions
other health care training programs at USUHS. How can
Congress best help these training programs meet DOD
Statute (10 U.S.C. §2114) requires the SECDEF to establish
and USPHS requirements for other health care
eligibility and admission requirements for USUHS. Each
academic program establishes certain “academic,
professionals (e.g., nurses, dentists, technicians)?
intellectual, and personal” admission requirements.
Training Costs
Congressional nominations are not required for admission
Since 1976, numerous studies have noted that the annual
to USUHS. This statute also states that all students in the
education costs are lower for scholarship (i.e., AFHPSP)
MD program must be a commissioned officer of a
students than USUHS students. What role should cost
uniformed service. Civilians accepted into the MD program
have in determining future growth or reduction of these
are commissioned as a second lieutenant or ensign (O-1 pay
programs?
grade) prior to matriculation and remain in an active duty
In 2018, the GAO recommended “USUHS develop a
status during their studies. Prior military experience is not
reliable method to accurately determine the cost to
required. However, all applicants must meet commissioning
educate its medical students.” USUHS has since
requirements, including standards for physical and medical
contracted with the Institute for Defense Analyses (IDA)
fitness prior to matriculation. Programs in the Postgraduate
to “determine the value proposition of USUHS
Dental College and College of Allied Health Services are
students.” What are the findings of the IDA study? How
available to active duty servicemembers only, while other
will these findings inform the university’s ability to
programs in the School of Medicine and the School of
monitor its education costs and effectiveness compared
Nursing are available to active servicemembers and
to other medical accession programs?
civilians.
Military Service Obligation and Tuition
Relevant Statutes and Regulations
Servicemembers attending USUHS are typically required to
10 U.S.C. §§ 178, 2112-2117
fulfill a military service obligation (or service at a
32 C.F.R. §§ 242.1-242.10
designated federal agency, if a USPHS member). The
length of obligated service varies by academic program.
CRS Products
MD graduates are statutorily required, by 10 U.S.C. §2114,
CRS In Focus IF10530, Defense Primer: Military Health System, by
to serve a minimum of 10 years, of which 7 years must be
Bryce H. P. Mendez
on active duty and the remaining time in the reserve
component. Time spent on graduate medical education (i.e.,
Other Resources
medical residency program) does not count toward the
DOD Instruction 5105.45, Uniformed Services University of
service obligation. Generally, civilian graduates do not
Health Sciences (USU), May 30, 2019
incur a military or national service obligation. USUHS does
GAO, Military Personnel: Additional Actions Needed to Address
not charge tuition; however, students may be required to
Gaps in Military Physician Specialties, GAO-18-77, February 2018
pay certain costs for books or other materials.
DOD, Report to Congress on Additional Actions Needed to
Research Activities
Address Gaps in Military Physician Specialties, September 2019
USUHS conducts biomedical research related to “military
health needs” and “improvement in the health and well-
being of the warfighter” through its 15 research centers,
Bryce H. P. Mendez, Analyst in Defense Health Care
programs, and institutes. The university also partners with
Policy
other federal and non-federal organizations through grants,
IF11385
https://crsreports.congress.gov
The Uniformed Services University of the Health Sciences
Disclaimer
This document was prepared by the Congressional Research Service (CRS). CRS serves as nonpartisan shared staff to
congressional committees and Members of Congress. It operates solely at the behest of and under the direction of Congress.
Information in a CRS Report should not be relied upon for purposes other than public understanding of information that has
been provided by CRS to Members of Congress in connection with CRS’s institutional role. CRS Reports, as a work of the
United States Government, are not subject to copyright protection in the United States. Any CRS Report may be
reproduced and distributed in its entirety without permission from CRS. However, as a CRS Report may include
copyrighted images or material from a third party, you may need to obtain the permission of the copyright holder if you
wish to copy or otherwise use copyrighted material.
https://crsreports.congress.gov | IF11385 · VERSION 1 · NEW