Military Medics Face Steep Barriers in Transition to Civilian Medicine

Veteran Dave Manning served two combat deployments in Iraq and was the sole medical provider for more than 100 people on a Navy ship. But as he contemplated his post-military job prospects, he struggled.

“Nothing I’ve done really translates over [to civilian jobs] beyond basic EMT,” said Manning, who served 15 years in the Navy and five more in the Army. “Trying to find something in the medical field without any credentials, without any licensure is tough. There’s nothing out there.”

Manning is in the inaugural class of a physician assistant training program launched this month by the University of North Carolina at Chapel Hill and geared at recruiting non-traditional students — specifically, veterans, as the country seeks to improve health care by expanding the number of primary care providers. UNC staff worked with Army officials at Fort Bragg to figure out how to translate troops’ medical experience into jobs.

Manning’s story is becoming more common as the US winds down wars in Iraq and Afghanistan, and it’s especially important for North Carolina which is home to eight military bases, including some of the country’s largest installations. Manning has experience that can’t be found in a classroom, and some in the UNC medical community wanted to capitalize on that.

“The medics and the corpsmen are often very skilled in acute medical care of younger people,” said Dr. Paul Chelminski, the director of UNC’s new Physician Assistant Program. “They’re extremely skilled in trauma care if they’ve been deployed.”

But Chelminski said there are some gaps in the veterans’ ability to diagnose and manage chronic illness, which is a large part of civilian health care. UNC’s program will fill in those gaps. The program will also accept some field experience in lieu of other, more standard, training.

Insurance company Blue Cross and Blue Shield of North Carolina is donating $1.2 million to help launch the training program and provide scholarships. North Carolina Blue Cross CEO Brad Wilson said the program will also help with a growing need for primary care providers in the state as more people get insurance through the Affordable Care Act.

“The customers who are accessing the health care system through the ACA are using more services than any other groups,” he said. “Many are in need of primary care, and the physician assistant plays a key role in delivering high quality, high value health care.”

Physician assistants work under the supervision of doctors but still diagnose and treat patients.

The first class is underway with 20 students, including nine veterans. The program is open to students of all backgrounds and takes two years to complete. Chelminski said this first class has an extraordinary amount of clinical experience compared to the national average. Its members are also a few years older than what is typical, with an average age of 33.

UNC research shows many troops with medical training are more interested in becoming a physician assistant than a doctor, and Manning, who is 43, said he is definitely in that camp.

“As I was coming out of the military in my early 40s, I didn’t want to spend a decade training and being in school,” he said. “I just wanted to get in and get out, and physician assistant is perfect for that.”

This story is part of a reporting partnership with NPR, WFAE and Kaiser Health News. Republished with permission. Kaiser Health News (KHN) is a national health policy news service that is part of the nonpartisan Henry J. Kaiser Family Foundation.