Military doctors and nurses need more hands-on patient care experience to care for troops in combat and discourage them from leaving the service because of a lack of training opportunities, according to a Pentagon inspector general report.

“Across the Military Departments … medical personnel we interviewed stated that they faced challenges maintaining their wartime readiness skills,” according to the report from earlier this year. “The Army and Navy are more likely than the Air Force to assign their medical personnel to locations that do not provide opportunities for direct patient care. As a result, Army and Navy medical personnel likely have fewer opportunities to maintain wartime readiness skills.”

Instead of being assigned primarily to military treatment facilities and secondarily to military-civilian partnerships, soldiers were assigned to “low-case-volume and low-complexity locations,” like U.S. Army Forces Command, the report found. Just one-quarter of Army emergency medicine physicians were assigned to a military treatment facility or military-civilian partnerships as of fiscal year 2024, according to the report.

Though the Army collected data on wartime readiness skill attainment for its medical personnel, “the data may not yet be complete or accurate enough to inform assignment decisions,” the report found.

As a result of being assigned to locations that may not provide direct patient care opportunities, medical personnel may be unable to render combat care when troops need it most.

“Military Department data collected to assess wartime readiness skills shows that individual medical personnel often fall below the established Military Department threshold for procedure volume and acuity and, therefore, may not have the skills required to execute trauma-related and other critical wartime medical missions,” the report found.

Soldiers in wartime specialties “may choose to separate from the military because of their inability to obtain wartime readiness skills,” according to the report. The Army Medical Corps personnel retention rate decreased by 7% since 2015, “which is attributed, in part, to a low volume of [knowledge, skills and abilities] opportunities in the [Military Health System],” the report says.

“Concerns about skill degradation is the number-one factor contributing to junior officer attrition,” according to a January 2024 Medical Corps Retention and Burnout study cited in the report. “A medical service member from the survey said, ‘My biggest reason for wanting to get out is simply because I desire to do emergency medicine.’ ”

The report recommends that the Army secretary require personnel commands to use wartime readiness requirements for medical troops when they make assignment decisions, among several others.

In its response to the report, the Army said that it “will be able to match medical personnel training requirements to training opportunities at [military treatment facilities]” as the "comprehensive medical personnel assignment process matures.” The service also said it will “further prioritize” military treatment facility assignments for “critical wartime specialties.”

Read the full report.