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  • Russia has invaded Ukraine and many people - including doctors and other healthcare workers

  • - are worried about the possibility of a draft should things escalate to a global scale.

  • If youre a nurse, resident, doctor, or another healthcare worker, should you be worried?

  • How likely is a medical draft?

  • And if one were to occur, what would it look like?

  • Let’s talk about it.

  • Dr. Jubbal, MedSchoolInsiders.com.

  • As the conflict between Russia and Ukraine continues to unfold, many are fearful that

  • the situation will escalate into a multinational conflict.

  • Ukraine borders several NATO allies including Poland, Slovakia, Hungary, and Romania.

  • If Russia were to engage even one of these countries, then the US, France, Germany, UK,

  • and the rest of the NATO allies would be forced to respond.

  • The implications of such a global war could be catastrophic given the prevalence of nuclear

  • weapons.

  • The United States and Russia possess a combined total of over 13,000 nuclear warheads - which

  • is 90% of the estimated global inventory.

  • Just one of these weapons has the potential to destroy a large city and kill millions

  • of people.

  • The use of tens or hundreds of nuclear weapons has the potential to disrupt the global climate

  • the consequences of which would be immeasurable.

  • As such, many are fearful that the situation in Ukraine has the potential to start a much

  • larger conflict and involve many more countries.

  • Today were going to discuss the history of the draft, what a medical draft would look

  • like, and how likely it is to happen.

  • Well focus primarily on the US but stick around to the end because well also cover

  • the United Kingdom, Canada, and India.

  • Conscription, more commonly known asthe draft,” is the mandatory enrollment of individuals

  • into the armed service.

  • There have been several instances throughout American history where drafts have been used

  • including the Civil War, World War I, World War II, and more recently, the Vietnam War.

  • The last draft in the US occurred in 1973 and the military has been voluntary enlistment

  • ever since.

  • That being said, the US government has continued to collect information on civilians who are

  • eligible to serve should the need arise.

  • Today, every male between the ages of 18 and 25 is required to register for the Selective

  • Service System.

  • This creates a large database of individuals who can be called upon to serve in the event

  • of a national emergency.

  • If you are a male living in the United States, you were probably already aware of this as

  • you likely registered for Selective Services at the age of 18.

  • What many people aren’t aware of, however, is that the US has standby plans developed

  • by the Selective Service System to draft doctors, nurses, and other medical technicians into

  • the military in the event of a national crisis.

  • It is called the Health Care Personnel Delivery System, or HCPDS for short.

  • In previous wars, including WWII and the Vietnam war, doctors have been considered strategic

  • assets and had to participate in separate drafts - often with higher rates of selection.

  • The HCPDS was designed in 1986 as a way to more quickly mobilize specialized healthcare

  • personnel in the event that the military’s existing medical capabilities are insufficient

  • and there is a shortage of volunteers.

  • It was designed to be implemented in connection with a national mobilization and requires

  • approval from both Congress and the President to enact.

  • If implemented, this would allow healthcare professionals between the ages of 20 and 45

  • to be drafted into the military - including women, unless otherwise directed by Congress

  • or the President.

  • In fact, some argue that it is very likely that women would be included in a medical

  • draft given it would be difficult to get enough professionals within certain specialties without

  • them.

  • So even if you are outside of the age or gender requirements for a general draft through Selective

  • Services, you still may be eligible for recruitment in a medical draft should the need ever arise.

  • If the HCPDS were enacted, the Selective Service System notes that they would be able to begin

  • mass registration of healthcare workers across over 60 medical and related specialties in

  • as little as 2 weeks.

  • Since draftees would already be trained professionals, the training process would also be fairly

  • quick.

  • If youre a healthcare worker, aged 20 through 45, and Congress authorizes a medical draft,

  • you could be enlisted in a matter of a few months.

  • So we know these standby plans exist, but how likely is the US government to actually

  • enact a medical draft?

  • To start, there would have to be a sufficient national emergency to warrant a medical draft.

  • At the time of recording this video, the White House has made it clear that it is not interested

  • in directly engaging with the Russian military.

  • Additionally, the approach by NATO at this time has been to influence the success of

  • Ukraine by providing support instead of getting directly involved.

  • But even in the event that the US were to become involved in the conflict, there is

  • no guarantee that their involvement would warrant the use of a draft - medical or otherwise.

  • We can talk hypotheticals all we want, but nobody can predict for certain how this situation

  • will pan out.

  • As it stands, however, most Americans are strongly opposed to a military draft - nearly

  • 80% according to a 2016 poll by Cornell University.

  • To no surprise, most physicians and healthcare workers are also strongly opposed to a medical

  • draft.

  • When drafted, the needs of the military dictate when and where you are deployed.

  • You are sent where the military determines you are needed.

  • In addition, most physicians have been trained and equipped to deal with civilian medical

  • issues, not battlefield casualties.

  • As such, many see engaging in war and militarism as contradictory to the Hippocratic oath they

  • took when they became a doctor.

  • Although the idea of a medical draft is wildly unpopular, the fact is that the military needs

  • doctors during times of crisis and we are already experiencing significant shortages

  • in military physicians.

  • A report from the Government Accountability Office warned that the Department of Defense

  • is experiencing gaps between funded positions for military physicians and the number of

  • physicians filling those positions by the end of the year - includingpersistent

  • gaps in specialties identified as critically short wartime specialties.”

  • They attributed these shortages to difficulty attracting and retaining military physicians

  • due to national shortages and competition with the private sector.

  • They conclude thatuntil the DoD is able to alleviate gaps in critical specialties,

  • it may be hindered in its ability to provide medical support for its service members during

  • wartime.”

  • Another 2018 report from the Inspector General concluded that the military health system

  • lacks the manpower to even handle the routine health needs of service members during normal

  • conditions.

  • At one sampled Air Force facility, there was only one provider for every 1,600 patients.

  • This far exceeds the recommended regulation of 1,250 patients per provider which is already

  • considered a heavy caseload.

  • Weve already seen glimpses of these shortages during the coronavirus pandemic.

  • To address the needs of COVID patients, the Army had to reach out to retired military

  • doctors and medics to return to service as a part of a voluntary recall.

  • Fortunately, over 25,000 volunteers stepped forward to assist; however, in the event of

  • a major crisis, this would likely be far from enough.

  • Given existing shortages, many argue that a medical draft would be more likely to occur

  • than a general draft in the event of a crisis as the military would need individuals with

  • specialized skills far sooner than they would need a general draft of young men.

  • Up until this point, weve focused mainly on the United States; however, conscription

  • - healthcare workers or otherwise - is not unique to the US.

  • According to the Pew Research Center, the US is one of 23 countries where the military

  • draft is authorized but not currently implemented.

  • There are another 60 countries with some form of active draft program and the remaining

  • 108 countries have no laws authorizing conscription.

  • Let’s cover the likelihood of a draft in a few other countries.

  • The United Kingdom has implemented military drafts only twice during modern times - once

  • during World War I and again during World War II.

  • At that time, police officers, medical personnel, prison workers, students, government employees,

  • and ministers were exempt from the draft.

  • After World War II, the United Kingdom implemented the National Service Act, which required all

  • physically fit males between the ages of 17 and 21 to serve in one of the armed forces

  • for an 18-month period and remain on the reserve list for an additional four years.

  • The service requirement was later increased from 18 months to 2 years; however, National

  • Service ended in 1960 with the last national servicemen being discharged in 1963.

  • Since then, there has been no conscription legislation in the UK and, unlike the US with

  • the Selective Service System, there are no remnants of the draft.

  • That being said, Parliament could theoretically pass a law reestablishing it during a time

  • of national crisis; however, many believe this is unlikely.

  • Similar to the UK, the Canadian government has only enacted military drafts twice in

  • its history - again, during WWI and WWII.

  • Both instances created sharp divisions between English Canadians, who generally supported

  • the practice, and French Canadians, who generally did not.

  • The Canadian armed forces have been voluntary since then and there has been no conscription

  • legislation since WWII.

  • Given the deep divisions that conscription created and the unease that remains surrounding

  • the practice, it is thought to be unlikely that Canada would reintroduce the draft.

  • Unlike the UK and Canada, India has never utilized a military draft.

  • Throughout its history, the Indian army has always been voluntary - even during World

  • Wars I and II.

  • Despite this, India has the second-largest army in the world in terms of active-duty

  • military personnel - positioning itself just between the United States in third and China

  • in first.

  • As such, it is thought to be unlikely that India would ever implement a military draft.

  • This is a crazy time in the world right now.

  • Our thoughts are with those in Ukraine.

  • Although there is a lot of uncertainty and many are fearful about how this can unfold,

  • it is best not to dwell on situations that may or may not occur.

  • Although it is interesting to explore hypotheticals from time to time, it is important to remember

  • that these are not certainties.

  • You can spend your time and energy worrying about something that may happen only for that

  • situation to never come true.

  • As the stoic philosopher Seneca put it, “we suffer more often in imagination than in reality.”

  • Thank you all so much for watching.

  • Slava Ukraini.

  • If you enjoyed this video, be sure to leave a like, subscribe, and share it.

  • Much love, and I’ll see you in that next one.

Russia has invaded Ukraine and many people - including doctors and other healthcare workers

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