Postgraduate Professional Education Beyond Clinical Training Among Military Physicians: Career Benefits and Association with Likelihood of Retention.

Abstract

Introduction: Postgraduate professional education (PPE), defined as post-medical school education other than residency and fellowship training, is used within the Military Health System (MHS) to support physician development and offers the potential to promote retention, yet its effectiveness in promoting both of these outcomes remains unclear. This study examined (1) military physicians' perceptions of PPE career utility, and (2) whether PPE was associated with self-reported retention likelihood beyond obligatory commitments.

Materials and methods: Data were drawn from the Uniformed Services University (USU) Alumni Survey (N = 1,629/4,724; 34% response rate). Participants reported PPE participation, perceived career utility, and-among active-duty respondents-likelihood of remaining in the military beyond initial commitments. Twenty-eight percent (n = 464) of respondents reported a total of 670 PPEs, most of which were military funded (n = 449, 67%). Inductive content analysis was applied to the free text responses for perceived career utility of PPE.

Results: On average, PPE were perceived to be quite useful for respondents' careers (mean = 3.98 on a 5-point scale), with some variation among PPE categories. Content analysis found that PPE was highly useful to participants in the domains of skill acquisition, career progression, and leadership development. Regarding likelihood of retention, respondents with any form of PPE reported a higher likelihood of retention than those without PPE (adjusted M = 3.46 vs. 2.88; P < .001, Cohen's d = 0.41). Retention likelihood varied somewhat by type of PPE. Although both military-funded and non-military-funded PPE at civilian institutions were linked to higher retention than those with no PPE, only military-funded PPE was associated with a statistically significant increase (Cohen's d = 0.41, P = .003). Satisfaction with educational opportunities was also positively associated with likelihood of retention (r = 0.29, P < .001).

Conclusions: PPE appears to support physicians' perceived professional development and is associated with modest increases in retention, but it represents only 1 of many factors associated with retention within the MHS.