The founding of USU: 50 years of caring for those in harm’s way
The founding of USU: 50 years of caring for those in harm’s way
As the guns of World War II cooled and the conflict rumbled to an end, the U.S. military returned home to face a new challenge — one ultimately leading to the creation of the Uniformed Services University of the Health Sciences (USU)USU webpage.
“Defense medicine was struggling to keep people,” says Dr. Dale Smith, USU’s retired professor of Military Medicine and History. Many of the military’s health professionals were ready to return to their civilian lives. However, says Smith, “the wounded needing care and rehabilitation after the war tend to stay around — even after the war is over.”
The solution, championed by Rep. F. Edward Hébert was to create what he termed a “West Point for doctors”, providing the military with a steady supply of career military physicians. Hébert worked for more than three decades before his idea of a military medical school finally came to fruition.
This year USU is celebrating the 50th anniversary of its founding on Sept. 21, 1972, and its mission to care for members of the United States military both on and off the battlefield.
‘West Point for doctors’
In 1945, Hébert, a journalist and ultimately Louisiana’s longest-serving congressional representative, offered a solution to the problem of losing military physicians, many of whom returned to their private practices.
“Hébert offered the proposal of creating…a training school, and General (soon to be President) Eisenhower said, ‘you don’t understand Congressman, we need doctors today, not in 10 or 15 years,’” says Smith. “Hébert responded that — ‘we’ll solve the problem today but you’re still going to need doctors in 15 years and unless we plan now you’ll have another 15 years to wait when we get around to talking about it then.’”
During the Korean War, the issue continued to plague the military, resulting in the establishment of a draft for doctors that continued through the 1970s.
“Virtually every male graduating physician in the country was obligated for two years of military service,” Smith says. “And very few stayed in for a career. The average doctor stayed one year beyond obligation if they got specialty training.”
In 1970, the Gates Commission determined the draft was not equitable and three years later, it ended, turning the military into an all-volunteer force.
“At this point, Congressman Hébert was the chairman of the House Armed Services Committee,” Smith says. “So he says ‘you’re going to set up my West Point for doctors’ and he puts in a bill in 1971 and everybody is dead set against it. The American Medical Association is against it, the Association of American Medical Colleges is against it, the Pentagon is against it — and much of Congress is against it.”
Smith says essentially Hébert didn’t yet understand the problem was retention and that an academy couldn’t create enough doctors.
He would soon come to realize a graduate school was needed.
The answer that was needed to solve the problem of losing military physicians was ultimately a three-pronged solution.
In 1972, the Defense health bill called the Uniformed Services Health Professions Revitalization Act was put forward, passed by Congress and signed into law by President Nixon on Sept. 21, 1972.
The act included the Health Professions Scholarship Program (HPSP), which offers military scholarships that can help cover civilian medical school tuition, pro pay, which created professional pay for military doctors who were specialists — and for the creation of a medical school within 25 miles of the District of Columbia.
“HPSP would begin to give you people quickly, pro pay would help you keep people a little longer and — long term, if the university panned out, you’d have a cadre,” Smith says. “So the law was passed in ’72. At that time, the DOD had wanted pro pay and the HPSP program immediately, set both of them up and simply ignored the university portion of the law.”
Smith says three years later, as President Nixon was preparing to leave office, Hébert used his leverage to get the university jump started.
“Hébert says ‘you need to be aware there will be no defense budget next year unless a board of regents for my university is appointed.’ Well, not having a defense budget would be inconvenient — so they immediately began to look for a board.”
The newly-selected board of regents then appointed a site selection committee to choose a location for the medical school, ultimately deciding on 100 acres of land on the grounds of the National Naval Medical Center in Bethesda, Md., three miles from the capital. The new school’s administrative offices sat above a Peoples Drug Store and a bank in downtown Bethesda.
“By the summer of ’76 they had 30-odd students signed up to come,” says Smith.
Meanwhile, Sen. William Proxmire thought the university was a bad idea and needed to be stopped, says Smith. Proxmire wanted the U.S. Government Accountability Office (then known as the General Accounting Office, GAO) to investigate the university’s cost.
Due to the GAO’s delay the faculty had to get creative that first year.
“Through the summer, while GAO was investigating the cost, the students were reporting in but they didn’t start school,” Smith says. “(Instead,) they went on a tour.”
Those first students went to Newport to “save the USS Buttercup,” a mock ship intended to teach the Navy about how to, among other things, fight fires onboard ships. They went to Fort Sam Houston and Camp Bullis and camped, and traveled to Alabama to see Maxwell Air Force Base.
Based on the initial tour, the school leadership decided going into the future that each student would get the opportunity to experience their unique service branch before coming to the university.
“Finally, the GAO reported in September that ‘yes, the place is going to cost more than the health professional scholarship program, but if you keep two-thirds of them for a career, the taxpayer will win. Because we need the colonels and we need the experience — and we really don’t want to draft them later on.’”
Smith says Proxmire removed his objection and the students started attending the school.
“Of course ’76 was an election year and in January, the new Secretary of Defense Harold Brown, under President Carter, recommended the closure of the school. So it had been open four months, and it had its first attempt to close it.”
Brown was quickly brought up to speed on the background, history and ultimate goal leading to the school’s creation.
“The next week he promised he wouldn’t try to close the school anymore,” Smith said.
America’s Medical School
In 1978, a Washington journalist, Jerry Brazda, made a $100 bet with the deputy chief medical director of the Veterans Administration, ret. Navy Vice Admiral (Dr.) Donald L. Custis, that the school would never graduate a single student.
Custis, a strong supporter of USU, took that bet — and won.
On May 24, 1980, the Uniformed Services University celebrated the graduation of its first class of medical school students, and Brazda promptly paid his debt.
“They began to build the other buildings, and they opened the campus in 1980,” Smith says. “At which time we had over 100 students admitted for the first time… The school began to turn out a regular number of doctors, hired faculty and it is what it is today.”
Smith says the university began bringing in female faculty members from other schools to teach, making the university a forerunner for women professors and perhaps more important, role models in military medicine.
“And began to lead a dynamic change in military medicine socially by including everybody,” Smith says, adding the school’s early faculty made the argument that military medicine was a state of mind requiring physicians to be able to care for those in harm’s way — wherever they were in the world. It included what had previously been called military (land) medicine, naval medicine, and aviation medicine; it was a way of thinking about a unique practice environment and population.
“That early faculty was both socially creative and intellectually creative in ways that are sometimes forgotten but are profoundly important,” Smith says.
Today USU, which started with just 33 students, now has more than 11,000 elite health care professionals and researchers across the military and the Public Health Service. Since that first graduating class, USU has grown to include the Daniel K. Inouye Graduate School of Nursing, the Postgraduate Dental College, the College of Allied Health Sciences, a vast array of graduate programs in biomedical sciences, public health, health professions education, and health policy, and is also home to an exceptional group of centers dedicated to research that improves the lives of service members and their families, as well as the public, both nationally and internationally.
Over the past 50 years, USU students, faculty, staff, and alumni have all worked with a common goal: to support the readiness of America’s Warfighter and caring for the health and well-being of those in harm’s way.
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