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2/12/2003

Armed Forces Implement Recruitment and Retention Incentives

Donna Young

The pharmacy staffing shortage that has vexed health systems and community pharmacies nationwide in recent years has also been a problem for the United States military.

Former Navy Surgeon General Vice Admiral Richard A. Nelson, in his February 2001 testimony before a Senate subcommittee, said that pharmacists were among the officers that presented the “greatest challenges” for the Navy to recruit and retain.

A substantial pay gap between military and civilian licensed professionals, he noted, has resulted in a decreasing retention rate.

Air Force Personnel Deputy Chief of Staff Lieutenant General Donald L. Peterson, testifying before a House committee in July 2001, said that only 80% of the Air Force’s clinical pharmacy positions were filled.

MeierBut new incentives, including sign-on bonuses, reenlistment pay increases, educational opportunities, and student-loan repayment programs, have helped the armed forces increase their recruitment and retention rates for pharmacists and pharmacy technicians over the past year, said Colonel Ardis Meier, pharmacy consultant for the Air Force Surgeon General.

In fiscal year 2000, she said, 10 pharmacists joined the Air Force. But in fiscal year 2001, after the new incentives had been initiated, 24 pharmacists signed on for active-duty service in the Air Force; in 2002, 38 pharmacists joined.

Making salaries equitable. For more than 25 years, the armed forces have been staffed entirely by volunteers, not draftees, Meier noted.

A key goal of military work-force management, she said, has been to find ways to attract and retain health care professionals.

The military finds it difficult to compete with the high salaries offered by community pharmacies to recent pharmacy school graduates.

Recognizing the challenges faced by military recruiters, Congress passed legislation in 2001 that authorized bonuses for pharmacists joining the military and special pay for active-duty pharmacy officers serving in the Army, Navy, or Air Force.

There are no pharmacists serving in the Marine Corps, part of the Department of the Navy, according to Navy spokesman Brian Badura. Military health care professionals could be assigned to serve with a Marine Corps unit, he said, but those professionals would wear a Navy uniform.

Pharmacy Personnel in U.S. Armed Forces

Pharmacy Personnel

No. Filled Positions as of January 2003

 

Navy

Army

Air Force

Pharmacists, active duty

151

122

240

Pharmacists, civil service

108

320

28

Pharmacists, contract

49

65

17

Technicians, active duty

867

587

980

Technicians, civil service or contract

72 civil service, 92 contract

800* civil service, 200* contract

85 civil service

*Estimated number.

 

Show me the money. The National Defense Authorization Act for Fiscal Year 2001 has helped military recruiters in their efforts, Meier said.

As a recruitment tool for the armed forces, bonuses of up to $30,000 were authorized by Congress for pharmacists who join the military and commit to four years of active-duty service.

But because of budget constraints, fiscal year 2003 is the first year that the Army, Navy, and Air Force could offer the full $30,000.

The military generally commissions pharmacists joining the armed forces up to age 35. However, the Air Force recently expanded its age limit to 45 years old, Meier said.

Age waivers are available for those pharmacists over 35 years old seeking to join the Army or the Navy. They must meet certain criteria, including passing a medical exam and preliminary physical fitness test.

Special pay. In the 2001 legislation, Congress also authorized the military to offer special pay of $3,000–$12,000 to pharmacy officers who agree to remain on active duty. The amount is based on years of military service.

HeathThe cap on special pay was recently increased to $15,000 for fiscal year 2003, said Colonel Mike Heath, pharmacy consultant to the Army Surgeon General.

As a direct result of the bonuses, special pay, and other new incentives, Heath said, the Army has increased its recruitment and retention numbers.

In 1999, he said, 7 pharmacists joined the Army’s active-duty roster. But in 2002, Heath declared, 18 pharmacists signed on for active duty, surpassing by two the goal he had set for recruiters.

To retain pharmacists, he noted, the Army uses its residency programs.

The Army offers residencies accredited by the American Society of Health-System Pharmacists (ASHP) in oncology, nuclear pharmacy, and pharmacy practice at Walter Reed Army Medical Center in Washington, D.C.

The Army also offers ASHP-accredited pharmacy practice residencies at its bases in San Antonio, Texas; Honolulu, Hawaii; and the Seattle area of Washington.

The Navy has ASHP-accredited residency programs at its medical centers in Bethesda, Maryland, and San Diego, California.

Active-duty pharmacy officers who are certified by the Board of Pharmaceutical Specialties receive additional pay of $2000–$5000 based on the number of years of certification.

All three military forces provide paid tuition programs for pharmacy officers with a bachelor of science degree seeking to complete a doctor of pharmacy (Pharm.D.) or other advanced degree program.

As a recruitment incentive, the Army offers up to $106,000 in student loan repayment, whereas the Air Force offers up to $50,000.

However, pharmacists can accept only the initial bonus or the student loan repayment, Heath said.

Competition. Congress wrote the legislation that authorized special pay and bonuses so that the various branches of the military would not compete for pharmacy officers, the Air Force’s Meier said.

But budgets vary among the armed services, so benefit programs have been implemented differently, she noted.

“Eventually we will all look the same,” Meier said.

The Navy currently does not offer special pay for pharmacy officers signing on for additional years of duty and does not offer student-loan repayment programs like those offered by the Air Force and Army.

Nolan“We offer other incentive programs,” such as scholarship programs, said Captain Elizabeth A. Nolan, pharmacy consultant for the Navy Surgeon General.

Pharmacy students who commit to three years of active-duty service and who qualify can receive two years of paid tuition through the Navy’s Health Sciences Collegiate Program.

Students must be in their third year of pharmacy school to apply for the scholarship program, Nolan noted.

Students in the program receive full military pay and benefits and, on completion of their Pharm.D. degree, enter active service at the rank of lieutenant—equivalent to the Army’s and Air Force’s rank of captain.

The Navy also provides a full-tuition scholarship program for active-duty pharmacy technicians seeking to become pharmacists.

The key to the Navy’s successful recruitment and retention, Nolan said, is that the Navy had the insight to prepare for the pharmacy staffing shortage by offering scholarship programs.

“We also offer attractive locations to live because most of them are coastal areas,” she said. “But not all benefits are economic. Serving in the nation’s military is a highly honorable profession.”

Naval pharmacists and pharmacy technicians serve at various health care installations and on amphibious ships, Nolan noted. One pharmacist and two pharmacy technicians are aboard the Navy’s hospital ship, the USNS Comfort, which departed from Baltimore, Maryland, on January 6 for the Indian Ocean to support troops in the Persian Gulf.

Students in a Pharm.D. degree program who are seeking to join the Air Force, Meier said, can apply for the Health Professions Scholarship Program (HPSP), which pays for up to two years of tuition. The Air Force is holding open 13 pharmacy officer positions for students who will graduate this summer under the program.

The Army plans to initiate an HPSP scholarship program in 2004, Heath said.

As another retention incentive for pharmacy officers, the Air Force trains at least one pharmacist per year in pharmacoeconomics, Meier said.

The Army also offers similar training opportunities, Heath added.

“We provide our officers with opportunities to train in degree programs and nondegree programs in industry,” he said, noting that the Army’s Lieutenant Colonel Jasper W. Watkins III is completing a special one-year residency in patient safety with ASHP’s Center on Patient Safety.

Pharmacists serving in the armed forces, or who work for the military as civil servants or under contract, have opportunities to travel, noted Heath.

Civil servant pharmacists serving overseas in Army installations are provided medical benefits under the military’s program, he said.

“We offer programs and opportunities for our civil servant pharmacists, who are our continuity” at any particular military treatment facility, he said. These programs “aren’t any lesser, they are just different. We try to provide for all of our pharmacists.”

Technicians. The military trains most of its pharmacy technicians, said Chief Master Sergeant Ronald Richard, the Air Force’s pharmacy technician career field manager.

Those who join the Air Force seeking to become a pharmacy technician must complete 6 weeks of basic training followed by 10 weeks of pharmacy training at Sheppard Air Force Base in Wichita Falls, Texas, Richard said. Three weeks of final training occur at an Air Force base in San Antonio or Biloxi, Mississippi.

“Our technicians are highly trained and are a commodity that are sought after by the private sector,” Richard said.

Many military pharmacy technicians joined the armed services directly after graduating high school, he noted.

“We are trying to do a better job of educating the young ones straight out of high school about the good quality of life the military offers,” Richard said.

President George W. Bush and Congress provided the military an additional recruitment tool as part of the federal education initiative known as the No Child Left Behind Act of 2001. Under the law, high schools must provide military recruiters the names, addresses, and telephone listings of students in grades 11 and 12 when requested. However, parents and students may request that a student’s information be withheld from the military.