Journal of General Internal Medicine

, Volume 28, Issue 7, pp 953–956 | Cite as

Coming Home from War

  • Jean-Paul Chretien
  • Katherine C. Chretien


Many American military personnel who served in the Iraq and Afghanistan wars will need long-term management of war-related conditions. There is pressing need for expertise in veterans’ care outside of the Military Health System (MHS) and Department of Veterans Affairs (VA), as many will seek care elsewhere: Veterans receive free MHS care only while on active duty; enhanced eligibility for VA healthcare ends 5 years after military discharge; many veterans eligible for VA healthcare use non-VA services instead; and the Affordable Care Act will expand Medicaid coverage for uninsured veterans. Families of veterans also may need care for conditions related to war service. Most medical schools lack veteran-focused curricula beyond VA clerkships, which often do not provide specific training on service-related conditions. The VA, Department of Defense (DoD), veterans groups, and medical professional organizations should partner to develop technical competencies in veteran and family health care for clinicians at all career stages, and cultural competencies to ensure contextually appropriate care. National and state licensing boards should assess these competencies formally. Partnerships between VA, DoD, and the community for care delivery can improve transitions and the quality of veterans’ post-deployment care.


veterans military health Operation Enduring Freedom Operation Iraqi Freedom medical education 



The authors would like to thank Anita Navarro, Association of American Medical Colleges (AAMC), for her assistance in providing AAMC webinar data. This work was not funded.

Conflict of Interest

The authors declare that they do not have a conflict of interest.


The views expressed are those of the authors and do not necessarily represent those of the Department of Defense or U.S. Department of Veterans Affairs.


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Copyright information

© Society of General Internal Medicine 2013

Authors and Affiliations

  1. 1.Division of Integrated BiosurveillanceArmed Forces Health Surveillance CenterSilver SpringUSA
  2. 2.Washington DC Veterans Affairs Medical CenterWashingtonUSA

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