All We Can Be: Innovations to Improve the Pipeline of Military Veterans in Medical Schools.

ISSUE: Medical schools are increasingly identifying military veteran applicants as a source of diversity, resiliency, and commitment-often derived from their personal experiences in the military. Yet, veterans remain significantly under-represented in entering classes; moreover, those veterans who do matriculate are not yet fully reflective of the diversity that the Armed Forces have to offer. Fortunately, specific measures have been shown to be effective at increasing both the number and diversity of student veterans in medical school. EVIDENCE: In 2019, there were less than 60 military veterans who entered the 144 civilian medical schools in the United States, according to the Association of American Medical Colleges. We identify common barriers faced by military veterans and propose best practices for medical schools to recruit and sustain them. We draw on the existing medical education literature about veteran support systems, and we underscore the unique challenges of veterans in medicine. Finally, we highlight innovative programs currently in place at several US medical schools that seek to address the needs of student veterans. This article provides a guide for how to recruit, assess, and nurture student veterans, suggesting a new way of thinking about this population of nontraditional medical students. IMPLICATIONS: This dearth of servicemembers significantly below what would be expected based on national demographic data is indicative of how medical schools offer few pathways to entry for military servicemembers-and far fewer for enlisted personnel and other populations traditionally under-represented in medicine. Should schools aim to recruit a veteran population that is truly representative of the military, additional measures need to be taken into consideration during the admissions review process.

Does Chronic Unpredictable Stress during Adolescence Affect Spatial Cognition in Adulthood?

Spatial abilities allow animals to retain and cognitively manipulate information about their spatial environment and are dependent upon neural structures that mature during adolescence. Exposure to stress in adolescence is thought to disrupt neural maturation, possibly compromising cognitive processes later in life. We examined whether exposure to chronic unpredictable stress in adolescence affects spatial ability in late adulthood. We evaluated spatial learning, reference and working memory, as well as long-term retention of visuospatial cues using a radial arm water maze. We found that stress in adolescence decreased the rate of improvement in spatial learning in adulthood. However, we found no overall performance impairments in adult reference memory, working memory, or retention caused by adolescent-stress. Together, these findings suggest that adolescent-stress may alter the strategy used to solve spatial challenges, resulting in performance that is more consistent but is not refined by incorporating available spatial information. Interestingly, we also found that adolescent-stressed rats showed a shorter latency to begin the water maze task when re-exposed to the maze after an overnight delay compared with control rats. This suggests that adolescent exposure to reoccurring stressors may prepare animals for subsequent reoccurring challenges. Overall, our results show that stress in adolescence does not affect all cognitive processes, but may affect cognition in a context-dependent manner.