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The US government has a legacy of providing support for veterans. Pensions were offered to disabled veterans as early as 1776, and benefits were expanded to cover medical needs as the country grew and modernized.1,2 Enacted during the Civil War, the General Pension Act increased benefits for widows and dependents.2 Rehabilitation and vocational training assistance benefits were added after World War I, and the US Department of Veterans Affairs (VA) was created in 1930 to consolidate all benefits under one umbrella organization.2,3

Prior to World War II, the VA lacked the bed capacity for the 4 million veterans who were eligible for care. This shortage became more acute by the end of the war, when the number of eligible veterans increased by 15 million.4 Although the VA successfully built bed capacity through acquisition of military hospitals, VA hospitals struggled to recruit clinical staff.2 Physicians were hesitant to join the VA because civil service salaries were lower than comparable positions in the community, and the VA offered limited opportunities for research or continuing education. These limitations negatively impacted the overall reputation of the VA. The American Medical Association (AMA) was reluctant to directly admit VA physicians for membership because of a “lower” standard of care at VA hospitals.2 This review will describe how passage of 2 legislative actions, the Servicemen’s Readjustment Act and Public Law (PL)79-293, and a key policy memorandum set the foundation for the partnership between the VA and academic medical centers. This led to improved medical care for veterans and expansion of health professions education for VA and the nation.5,6

GI Bill of Rights

The passage of the Servicemen’s Readjustment Act of 1944, better known as the GI Bill of Rights, provided education assistance, guaranteed home loans, and unemployment payments to veterans.5 All medical officers serving during the war were eligible for this benefit, which effectively increased the number of potential physician trainees at the end of World War II by almost 60,000.7 Medical education at the time was simultaneously undergoing a transformation with more rigorous training and a push to standardize medical education across state lines. While prerequisite training was not required for admission to many medical schools and curricula varied in length based on state licensing requirements, more programs were adding premedical education requirements and transitioning to the 4-year curricula seen today. At this time, only 23 states required postgraduate internships for licensure, but this number was growing.8 The American Board of Medical Specialties was established several years prior to World War II in 1934 to elevate the quality of care; the desire for residency training and board certification continued to gain traction during the 1940s.9

 

 

Medical Training

In anticipation of an influx of medical trainees, the Committee on Postwar Medical Service conducted a comprehensive survey to understand the training needs of physician veterans returning from World War II.7 The survey collected data from medical officers on their desired length of training, interest in specialty board certification, time served, and type of medical practice prior to enlisting. Length of desired training was categorized as short (up to 6 months), which would serve as a refresher course and provide updates on recent advances in medicine and surgery, and long (> 6 months), which resembled a modern internship or residency. Nineteen percent did not want additional training, 22% wished to pursue short courses, and 51% were interested in longer courses. Most respondents also wished to obtain board certification.7 The AMA played a significant role in supporting the expansion of training opportunities, encouraging all accredited hospitals to assess their capacity to determine the number of additional residents they could accommodate. The AMA also awarded hospitals with existing internship programs temporary accreditation to allow them to add extended training through residency programs.7

Medical schools devised creative solutions to meet the needs of returning physician veterans and capitalize on the available educational benefits. Postgraduate refresher courses that varied in length from hours to months were developed focusing on an array of topics. In addition to basic medical principles, courses covered general topics, such as advances in medicine, to specialty topics, such as nutrition or ophthalmology.7 Although the courses could not be counted toward board certification, participation increased by almost 300% in the 1945/1946 academic year relative to the previous year.7 Increasing access to the longer training courses, including internships and residencies, was often achieved through experiences outside the clinical setting. Yale University modified its curriculum to reduce time devoted to lectures on published materials and encourage active learning and community outreach.10 Northwestern University assigned residents to spend 1 of their 3 years “out of residence” in basic science and clinical instruction provided by the medical school. Tuition assistance from the GI Bill supported the additional expenses incurred by the medical school to fund laboratory space, equipment, and the salaries of the basic science instructors and administrative staff.11

Public Law 79-293

Public Law 79-293 was passed on January 3, 1946, establishing the Department of Medicine and Surgery within the VA. The law, which became the basis for Title 38 chapters 73 and 74, allowed VA hospitals flexibility to hire doctors, dentists, and nurses without regard to the civil service regulations and salary restrictions associated with other federal positions.6

Concerns about quality of care had been mounting for years, and the release of several sensationalized and critical articles motivated VA leadership to make sweeping changes. One article described neglect at VA hospitals.12 Excessive paperwork and low economic benefits were identified as barriers to the recruitment of qualified clinicians at the VA.2 The VA Special Medical Advisory Group investigating the claims recommended that the VA encourage their hospitals to affiliate with medical schools to improve the quality of care. This group also recommended that new VA hospitals be constructed near academic medical centers to allow access to consultants.2 Three large veterans service organizations (American Legion, Veterans of Foreign Wars, and Disabled American Veterans) conducted their own investigations in response to the media reports. The organizations reported that the quality of care in most VA hospitals was already on par with the community but indicated that the VA would benefit from expansion of medical research and training, increased bed capacity, reduction in the administrative burden on clinicians, and increased salaries for clinical staff.2

 

 

Policy Memorandum No. 2

The relationship between VA and academic medical centers was solidified on January 30, 1946, with adoption of Policy Memorandum No. 2.13 This memorandum allowed for the establishment of relationships with academic medical centers to provide “the veteran a much higher standard of medical care than could be given him with a wholly full-time medical staff.” Shortly after this memorandum was signed, residents from Northwestern University and the University of Illinois at Chicago began clinical rotations at the Hines VA facility in Chicago, Illinois.2 By 1947, 62 medical schools had committed to an affiliation with local VA hospitals and 21 deans’ committees were in operation, which were responsible for the appointment of physician residents and consultants. The AMA extended direct membership privileges to VA physicians, and by 1947 the number of residency positions doubled nationally.14,15 The almost universal support of the relationship between VA and academic affiliates provided educational opportunities for returning veterans and raised standards for medical education nationally.

Current State

Since the passage of PL 79-293 and PM No. 2, the VA-academic health professions education partnership has grown to include 113,000 trainees rotating through 150 VA medical centers annually from more than 1400 colleges and universities.16 Most VA podiatrists, psychologists, optometrists, and physicians working in VA medical centers also trained at VA, and trainees are 37% more likely to consider a job at VA after completing their clinical rotations. This unique partnership began 76 years ago and continues to provide clinicians “for VA and the nation.”

References

1. Glasson WH. History of military pension legislation in the United States. Columbia University Press; 1900.

2. Lewis BJ. Veterans Administration medical program relationship with medical schools in the United States. Dissertation. The American University; 1969.

3. Kracke RR. The role of the medical college in the medical care of the veteran. J Med Assoc State Ala. 1950;19(8):225-230.

4. US Department of Veterans Affairs, Office of Public Affairs. VA History in Brief. VA Pamphlet 80-97-2. Washington, DC: United States Department of Veterans Affairs; 1997.

5. Servicesmen’s Readjustment Act of 1944. 38 USC § 370 (1944).

6. To establish a Department of Medicine and Surgery in the Veterans’ Administration. 38 USC § 73-74 (1946). Accessed August 2, 2022.

7. Lueth HC. Postgraduate wishes of medical officers: final report on 21,029 questionnaires. J Am Med Assoc. 1945; 127(13):759-770.

8. Johnson V, Arestad FH, Tipner A. Medical education in the United States and Canada: forty-sixth annual report on medical education in the United States and Canada by the Council on Medical Education and Hospitals of the American Medical Association. J Am Med Assoc. 1946;131(16):1277-1310.

9. Chesney AM. Some impacts of the specialty board movement on medical education. J Assoc Am Med Coll. 1948;23(2):83-89.

10. Hiscock IV. New frontiers in health education. Can J Public Health. 1946;37(11):452-457.

11. Colwell AR. Principles of graduate medical instruction: with a specific plan of application in a medical school. J Am Med Assoc. 1945;127(13):741-746.

12. Maisel, AQ. The veteran betrayed. How long will the Veterans’ Administration continue to give third-rate medical care to first-rate men? Cosmopolitan. 1945(3):45.

13. US Veterans Administration. Policy Memorandum No. 2: Policy in association of veterans’ hospitals with medical schools. January 30, 1946.

14. American Medical Association. Digest of Official Actions: 1846-1958. JAMA. 1946;132:1094.

15. Wentz DK, Ford CV. A brief history of the internship. JAMA. 1984;252(24):3390-3394. doi:10.1001/jama.1984.03350240036035

16. US Department of Veterans Affairs, Veterans Health Administration, Office of Academic Affiliations. Health professions education academic year 2022-2021. Accessed August 8, 2022. https://www.va.gov/OAA/docs/OAA_Stats_AY_2020_2021_FINAL.pdf

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aOffice of Academic Affiliations, Veterans Health Administration, US Department of Veterans Affairs, Washington, DC
bDepartment of Ophthalmology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
cDivision of Ophthalmology, Warren Alpert Medical School, Brown University, Providence, Rhode Island
dDepartment of Internal Medicine, Virginia Commonwealth University School of Medicine, Richmond

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The authors report no actual or potential conflicts of interest or outside sources of funding with regard to this article.

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bDepartment of Ophthalmology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
cDivision of Ophthalmology, Warren Alpert Medical School, Brown University, Providence, Rhode Island
dDepartment of Internal Medicine, Virginia Commonwealth University School of Medicine, Richmond

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The authors report no actual or potential conflicts of interest or outside sources of funding with regard to this article.

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Andrea D. Birnbaum, MD, PhDa,b; Paul B. Greenberg, MD, MPHa,c; Karen M. Sanders, MDa,d
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bDepartment of Ophthalmology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
cDivision of Ophthalmology, Warren Alpert Medical School, Brown University, Providence, Rhode Island
dDepartment of Internal Medicine, Virginia Commonwealth University School of Medicine, Richmond

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The US government has a legacy of providing support for veterans. Pensions were offered to disabled veterans as early as 1776, and benefits were expanded to cover medical needs as the country grew and modernized.1,2 Enacted during the Civil War, the General Pension Act increased benefits for widows and dependents.2 Rehabilitation and vocational training assistance benefits were added after World War I, and the US Department of Veterans Affairs (VA) was created in 1930 to consolidate all benefits under one umbrella organization.2,3

Prior to World War II, the VA lacked the bed capacity for the 4 million veterans who were eligible for care. This shortage became more acute by the end of the war, when the number of eligible veterans increased by 15 million.4 Although the VA successfully built bed capacity through acquisition of military hospitals, VA hospitals struggled to recruit clinical staff.2 Physicians were hesitant to join the VA because civil service salaries were lower than comparable positions in the community, and the VA offered limited opportunities for research or continuing education. These limitations negatively impacted the overall reputation of the VA. The American Medical Association (AMA) was reluctant to directly admit VA physicians for membership because of a “lower” standard of care at VA hospitals.2 This review will describe how passage of 2 legislative actions, the Servicemen’s Readjustment Act and Public Law (PL)79-293, and a key policy memorandum set the foundation for the partnership between the VA and academic medical centers. This led to improved medical care for veterans and expansion of health professions education for VA and the nation.5,6

GI Bill of Rights

The passage of the Servicemen’s Readjustment Act of 1944, better known as the GI Bill of Rights, provided education assistance, guaranteed home loans, and unemployment payments to veterans.5 All medical officers serving during the war were eligible for this benefit, which effectively increased the number of potential physician trainees at the end of World War II by almost 60,000.7 Medical education at the time was simultaneously undergoing a transformation with more rigorous training and a push to standardize medical education across state lines. While prerequisite training was not required for admission to many medical schools and curricula varied in length based on state licensing requirements, more programs were adding premedical education requirements and transitioning to the 4-year curricula seen today. At this time, only 23 states required postgraduate internships for licensure, but this number was growing.8 The American Board of Medical Specialties was established several years prior to World War II in 1934 to elevate the quality of care; the desire for residency training and board certification continued to gain traction during the 1940s.9

 

 

Medical Training

In anticipation of an influx of medical trainees, the Committee on Postwar Medical Service conducted a comprehensive survey to understand the training needs of physician veterans returning from World War II.7 The survey collected data from medical officers on their desired length of training, interest in specialty board certification, time served, and type of medical practice prior to enlisting. Length of desired training was categorized as short (up to 6 months), which would serve as a refresher course and provide updates on recent advances in medicine and surgery, and long (> 6 months), which resembled a modern internship or residency. Nineteen percent did not want additional training, 22% wished to pursue short courses, and 51% were interested in longer courses. Most respondents also wished to obtain board certification.7 The AMA played a significant role in supporting the expansion of training opportunities, encouraging all accredited hospitals to assess their capacity to determine the number of additional residents they could accommodate. The AMA also awarded hospitals with existing internship programs temporary accreditation to allow them to add extended training through residency programs.7

Medical schools devised creative solutions to meet the needs of returning physician veterans and capitalize on the available educational benefits. Postgraduate refresher courses that varied in length from hours to months were developed focusing on an array of topics. In addition to basic medical principles, courses covered general topics, such as advances in medicine, to specialty topics, such as nutrition or ophthalmology.7 Although the courses could not be counted toward board certification, participation increased by almost 300% in the 1945/1946 academic year relative to the previous year.7 Increasing access to the longer training courses, including internships and residencies, was often achieved through experiences outside the clinical setting. Yale University modified its curriculum to reduce time devoted to lectures on published materials and encourage active learning and community outreach.10 Northwestern University assigned residents to spend 1 of their 3 years “out of residence” in basic science and clinical instruction provided by the medical school. Tuition assistance from the GI Bill supported the additional expenses incurred by the medical school to fund laboratory space, equipment, and the salaries of the basic science instructors and administrative staff.11

Public Law 79-293

Public Law 79-293 was passed on January 3, 1946, establishing the Department of Medicine and Surgery within the VA. The law, which became the basis for Title 38 chapters 73 and 74, allowed VA hospitals flexibility to hire doctors, dentists, and nurses without regard to the civil service regulations and salary restrictions associated with other federal positions.6

Concerns about quality of care had been mounting for years, and the release of several sensationalized and critical articles motivated VA leadership to make sweeping changes. One article described neglect at VA hospitals.12 Excessive paperwork and low economic benefits were identified as barriers to the recruitment of qualified clinicians at the VA.2 The VA Special Medical Advisory Group investigating the claims recommended that the VA encourage their hospitals to affiliate with medical schools to improve the quality of care. This group also recommended that new VA hospitals be constructed near academic medical centers to allow access to consultants.2 Three large veterans service organizations (American Legion, Veterans of Foreign Wars, and Disabled American Veterans) conducted their own investigations in response to the media reports. The organizations reported that the quality of care in most VA hospitals was already on par with the community but indicated that the VA would benefit from expansion of medical research and training, increased bed capacity, reduction in the administrative burden on clinicians, and increased salaries for clinical staff.2

 

 

Policy Memorandum No. 2

The relationship between VA and academic medical centers was solidified on January 30, 1946, with adoption of Policy Memorandum No. 2.13 This memorandum allowed for the establishment of relationships with academic medical centers to provide “the veteran a much higher standard of medical care than could be given him with a wholly full-time medical staff.” Shortly after this memorandum was signed, residents from Northwestern University and the University of Illinois at Chicago began clinical rotations at the Hines VA facility in Chicago, Illinois.2 By 1947, 62 medical schools had committed to an affiliation with local VA hospitals and 21 deans’ committees were in operation, which were responsible for the appointment of physician residents and consultants. The AMA extended direct membership privileges to VA physicians, and by 1947 the number of residency positions doubled nationally.14,15 The almost universal support of the relationship between VA and academic affiliates provided educational opportunities for returning veterans and raised standards for medical education nationally.

Current State

Since the passage of PL 79-293 and PM No. 2, the VA-academic health professions education partnership has grown to include 113,000 trainees rotating through 150 VA medical centers annually from more than 1400 colleges and universities.16 Most VA podiatrists, psychologists, optometrists, and physicians working in VA medical centers also trained at VA, and trainees are 37% more likely to consider a job at VA after completing their clinical rotations. This unique partnership began 76 years ago and continues to provide clinicians “for VA and the nation.”

The US government has a legacy of providing support for veterans. Pensions were offered to disabled veterans as early as 1776, and benefits were expanded to cover medical needs as the country grew and modernized.1,2 Enacted during the Civil War, the General Pension Act increased benefits for widows and dependents.2 Rehabilitation and vocational training assistance benefits were added after World War I, and the US Department of Veterans Affairs (VA) was created in 1930 to consolidate all benefits under one umbrella organization.2,3

Prior to World War II, the VA lacked the bed capacity for the 4 million veterans who were eligible for care. This shortage became more acute by the end of the war, when the number of eligible veterans increased by 15 million.4 Although the VA successfully built bed capacity through acquisition of military hospitals, VA hospitals struggled to recruit clinical staff.2 Physicians were hesitant to join the VA because civil service salaries were lower than comparable positions in the community, and the VA offered limited opportunities for research or continuing education. These limitations negatively impacted the overall reputation of the VA. The American Medical Association (AMA) was reluctant to directly admit VA physicians for membership because of a “lower” standard of care at VA hospitals.2 This review will describe how passage of 2 legislative actions, the Servicemen’s Readjustment Act and Public Law (PL)79-293, and a key policy memorandum set the foundation for the partnership between the VA and academic medical centers. This led to improved medical care for veterans and expansion of health professions education for VA and the nation.5,6

GI Bill of Rights

The passage of the Servicemen’s Readjustment Act of 1944, better known as the GI Bill of Rights, provided education assistance, guaranteed home loans, and unemployment payments to veterans.5 All medical officers serving during the war were eligible for this benefit, which effectively increased the number of potential physician trainees at the end of World War II by almost 60,000.7 Medical education at the time was simultaneously undergoing a transformation with more rigorous training and a push to standardize medical education across state lines. While prerequisite training was not required for admission to many medical schools and curricula varied in length based on state licensing requirements, more programs were adding premedical education requirements and transitioning to the 4-year curricula seen today. At this time, only 23 states required postgraduate internships for licensure, but this number was growing.8 The American Board of Medical Specialties was established several years prior to World War II in 1934 to elevate the quality of care; the desire for residency training and board certification continued to gain traction during the 1940s.9

 

 

Medical Training

In anticipation of an influx of medical trainees, the Committee on Postwar Medical Service conducted a comprehensive survey to understand the training needs of physician veterans returning from World War II.7 The survey collected data from medical officers on their desired length of training, interest in specialty board certification, time served, and type of medical practice prior to enlisting. Length of desired training was categorized as short (up to 6 months), which would serve as a refresher course and provide updates on recent advances in medicine and surgery, and long (> 6 months), which resembled a modern internship or residency. Nineteen percent did not want additional training, 22% wished to pursue short courses, and 51% were interested in longer courses. Most respondents also wished to obtain board certification.7 The AMA played a significant role in supporting the expansion of training opportunities, encouraging all accredited hospitals to assess their capacity to determine the number of additional residents they could accommodate. The AMA also awarded hospitals with existing internship programs temporary accreditation to allow them to add extended training through residency programs.7

Medical schools devised creative solutions to meet the needs of returning physician veterans and capitalize on the available educational benefits. Postgraduate refresher courses that varied in length from hours to months were developed focusing on an array of topics. In addition to basic medical principles, courses covered general topics, such as advances in medicine, to specialty topics, such as nutrition or ophthalmology.7 Although the courses could not be counted toward board certification, participation increased by almost 300% in the 1945/1946 academic year relative to the previous year.7 Increasing access to the longer training courses, including internships and residencies, was often achieved through experiences outside the clinical setting. Yale University modified its curriculum to reduce time devoted to lectures on published materials and encourage active learning and community outreach.10 Northwestern University assigned residents to spend 1 of their 3 years “out of residence” in basic science and clinical instruction provided by the medical school. Tuition assistance from the GI Bill supported the additional expenses incurred by the medical school to fund laboratory space, equipment, and the salaries of the basic science instructors and administrative staff.11

Public Law 79-293

Public Law 79-293 was passed on January 3, 1946, establishing the Department of Medicine and Surgery within the VA. The law, which became the basis for Title 38 chapters 73 and 74, allowed VA hospitals flexibility to hire doctors, dentists, and nurses without regard to the civil service regulations and salary restrictions associated with other federal positions.6

Concerns about quality of care had been mounting for years, and the release of several sensationalized and critical articles motivated VA leadership to make sweeping changes. One article described neglect at VA hospitals.12 Excessive paperwork and low economic benefits were identified as barriers to the recruitment of qualified clinicians at the VA.2 The VA Special Medical Advisory Group investigating the claims recommended that the VA encourage their hospitals to affiliate with medical schools to improve the quality of care. This group also recommended that new VA hospitals be constructed near academic medical centers to allow access to consultants.2 Three large veterans service organizations (American Legion, Veterans of Foreign Wars, and Disabled American Veterans) conducted their own investigations in response to the media reports. The organizations reported that the quality of care in most VA hospitals was already on par with the community but indicated that the VA would benefit from expansion of medical research and training, increased bed capacity, reduction in the administrative burden on clinicians, and increased salaries for clinical staff.2

 

 

Policy Memorandum No. 2

The relationship between VA and academic medical centers was solidified on January 30, 1946, with adoption of Policy Memorandum No. 2.13 This memorandum allowed for the establishment of relationships with academic medical centers to provide “the veteran a much higher standard of medical care than could be given him with a wholly full-time medical staff.” Shortly after this memorandum was signed, residents from Northwestern University and the University of Illinois at Chicago began clinical rotations at the Hines VA facility in Chicago, Illinois.2 By 1947, 62 medical schools had committed to an affiliation with local VA hospitals and 21 deans’ committees were in operation, which were responsible for the appointment of physician residents and consultants. The AMA extended direct membership privileges to VA physicians, and by 1947 the number of residency positions doubled nationally.14,15 The almost universal support of the relationship between VA and academic affiliates provided educational opportunities for returning veterans and raised standards for medical education nationally.

Current State

Since the passage of PL 79-293 and PM No. 2, the VA-academic health professions education partnership has grown to include 113,000 trainees rotating through 150 VA medical centers annually from more than 1400 colleges and universities.16 Most VA podiatrists, psychologists, optometrists, and physicians working in VA medical centers also trained at VA, and trainees are 37% more likely to consider a job at VA after completing their clinical rotations. This unique partnership began 76 years ago and continues to provide clinicians “for VA and the nation.”

References

1. Glasson WH. History of military pension legislation in the United States. Columbia University Press; 1900.

2. Lewis BJ. Veterans Administration medical program relationship with medical schools in the United States. Dissertation. The American University; 1969.

3. Kracke RR. The role of the medical college in the medical care of the veteran. J Med Assoc State Ala. 1950;19(8):225-230.

4. US Department of Veterans Affairs, Office of Public Affairs. VA History in Brief. VA Pamphlet 80-97-2. Washington, DC: United States Department of Veterans Affairs; 1997.

5. Servicesmen’s Readjustment Act of 1944. 38 USC § 370 (1944).

6. To establish a Department of Medicine and Surgery in the Veterans’ Administration. 38 USC § 73-74 (1946). Accessed August 2, 2022.

7. Lueth HC. Postgraduate wishes of medical officers: final report on 21,029 questionnaires. J Am Med Assoc. 1945; 127(13):759-770.

8. Johnson V, Arestad FH, Tipner A. Medical education in the United States and Canada: forty-sixth annual report on medical education in the United States and Canada by the Council on Medical Education and Hospitals of the American Medical Association. J Am Med Assoc. 1946;131(16):1277-1310.

9. Chesney AM. Some impacts of the specialty board movement on medical education. J Assoc Am Med Coll. 1948;23(2):83-89.

10. Hiscock IV. New frontiers in health education. Can J Public Health. 1946;37(11):452-457.

11. Colwell AR. Principles of graduate medical instruction: with a specific plan of application in a medical school. J Am Med Assoc. 1945;127(13):741-746.

12. Maisel, AQ. The veteran betrayed. How long will the Veterans’ Administration continue to give third-rate medical care to first-rate men? Cosmopolitan. 1945(3):45.

13. US Veterans Administration. Policy Memorandum No. 2: Policy in association of veterans’ hospitals with medical schools. January 30, 1946.

14. American Medical Association. Digest of Official Actions: 1846-1958. JAMA. 1946;132:1094.

15. Wentz DK, Ford CV. A brief history of the internship. JAMA. 1984;252(24):3390-3394. doi:10.1001/jama.1984.03350240036035

16. US Department of Veterans Affairs, Veterans Health Administration, Office of Academic Affiliations. Health professions education academic year 2022-2021. Accessed August 8, 2022. https://www.va.gov/OAA/docs/OAA_Stats_AY_2020_2021_FINAL.pdf

References

1. Glasson WH. History of military pension legislation in the United States. Columbia University Press; 1900.

2. Lewis BJ. Veterans Administration medical program relationship with medical schools in the United States. Dissertation. The American University; 1969.

3. Kracke RR. The role of the medical college in the medical care of the veteran. J Med Assoc State Ala. 1950;19(8):225-230.

4. US Department of Veterans Affairs, Office of Public Affairs. VA History in Brief. VA Pamphlet 80-97-2. Washington, DC: United States Department of Veterans Affairs; 1997.

5. Servicesmen’s Readjustment Act of 1944. 38 USC § 370 (1944).

6. To establish a Department of Medicine and Surgery in the Veterans’ Administration. 38 USC § 73-74 (1946). Accessed August 2, 2022.

7. Lueth HC. Postgraduate wishes of medical officers: final report on 21,029 questionnaires. J Am Med Assoc. 1945; 127(13):759-770.

8. Johnson V, Arestad FH, Tipner A. Medical education in the United States and Canada: forty-sixth annual report on medical education in the United States and Canada by the Council on Medical Education and Hospitals of the American Medical Association. J Am Med Assoc. 1946;131(16):1277-1310.

9. Chesney AM. Some impacts of the specialty board movement on medical education. J Assoc Am Med Coll. 1948;23(2):83-89.

10. Hiscock IV. New frontiers in health education. Can J Public Health. 1946;37(11):452-457.

11. Colwell AR. Principles of graduate medical instruction: with a specific plan of application in a medical school. J Am Med Assoc. 1945;127(13):741-746.

12. Maisel, AQ. The veteran betrayed. How long will the Veterans’ Administration continue to give third-rate medical care to first-rate men? Cosmopolitan. 1945(3):45.

13. US Veterans Administration. Policy Memorandum No. 2: Policy in association of veterans’ hospitals with medical schools. January 30, 1946.

14. American Medical Association. Digest of Official Actions: 1846-1958. JAMA. 1946;132:1094.

15. Wentz DK, Ford CV. A brief history of the internship. JAMA. 1984;252(24):3390-3394. doi:10.1001/jama.1984.03350240036035

16. US Department of Veterans Affairs, Veterans Health Administration, Office of Academic Affiliations. Health professions education academic year 2022-2021. Accessed August 8, 2022. https://www.va.gov/OAA/docs/OAA_Stats_AY_2020_2021_FINAL.pdf

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