In March 2024, the Association of American Medical Colleges (AAMC) projected that the United States will face a physician shortage of up to 86,000 physicians by 2036.1 Additionally, a recent National Public Radio (NPR) report noted that, “50% of active-duty military installations stand within federally designated health professional shortage areas. Those are places where medical services are hard to find.” The report went on to indicate that these shortage areas included primary care, mental health care, and maternity care.2   However, what was absent in the NPR report, is that there is also a shortage of preventive medicine physicians, both broadly across the country and in the military. The United States is facing a persistent and worsening shortage of physicians specializing in preventive medicine, according to a study in the Journal of Public Health Management and Practice.3 This is because many of the current preventive medicine physicians are older and nearing retirement age, there are less trainees in preventive medicine residency programs now than there were 25 years ago, and the ongoing insufficient funding of preventive medicine residency training programs only exacerbates this dismal situation.

“In the military, preventive medicine physicians can work in hospitals and clinics on land and aboard ships. They can serve in both combat and non-combat areas. Preventive medicine physicians research environmental factors that influence health. They direct health, education, and control measures for preventable disease and injuries. They assess the living and work environment of military members to promote healthy communities. In the military, these physicians are often experts on the specific conditions that may arise during a soldier’s deployment.” 4

In a combat zone, in addition to the obvious and inherent risks of combat, another enemy is illness and disease present in the area where soldiers live and work, referred to as disease non-battle related injury (DNBI). In fact, one third of all injuries sustained in Iraq and Afghanistan were related to DNBIs.5

Thus, the job of a preventive medicine physician in combat zones is namely to keep the forces healthy. This means paying attention to the basics of public health and general preventive medicine, such as:
  • Food sanitation
  • Sampling of the air, food, water, soil and even for noise
  • Sanitation/Waste management procedures
  • Rodent control and vector control
  • Handling of hazardous materials
  • Preventing the harboring and spreading of harmful bacteria and virus that can lead to gastrointestinal tract problems 
Given this situation, even as ACPM continues to advocate for increased preventive medicine residency funding, if you are so inclined, the military, both active duty and the reserves are looking for a few good preventive medicine physicians to help keep their forces healthy!

Mirza I. Rahman, MD, MPH, FAAFP, FACPM
ACPM President
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