Physician Learning and Forgetting: Evidence from the US Military

Trevor Fitzgerald; Atul Gupta; Stephen D. Schwab

doi:10.3386/w35502

Physician Learning and Forgetting: Evidence from the US Military

Trevor Fitzgerald, Atul Gupta & Stephen D. Schwab

Working Paper 35502

DOI 10.3386/w35502

Issue Date July 2026

Physicians in the U.S. military health care system are quasi-randomly assigned to combat deployments, leading to gaps of varying durations in their clinical practice. We leverage this unique setting to provide novel causal evidence on skill depreciation (forgetting) and learning-by-doing among physicians. We find robust evidence that readmission rates increase by 48% in the first two months after a surgeon returns from a deployment. However, surgeons return to baseline performance within 6 months of resuming practice. In contrast, obstetricians maintain elevated cesarean section rates for up to 9 months, implying a deeper change in clinical judgment. Finally, we interpret these patterns through the lens of a learning model and estimate learning-by-doing rates for surgeons and obstetricians. A doubling of recent procedure volume reduces readmission and C-section rates by 17% and 11% for surgeons and obstetricians, respectively.

We are grateful for helpful comments from Austin Bean, Stuart Craig, Guy David, Jason Hockenberry, Jonathan Skinner, seminar participants at UT San Antonio and Uniformed Services University of the Health Sciences, and conference participants at the the Wharton People Analytics Conference, The Midwest Health Economics Conference, the Conference of the American Society of Health Economists, and the Empirical Management Conference (HBS). We thank the Army Analytics Group Research Facilitation Laboratory Person-Event Data Environment for facilitating this research. Gupta was a Dorinda and Mark Winkelman Distinguished Faculty Scholar while working on this paper. The opinions and assertions expressed herein are those of the authors and do not reflect the official policy or position of Brooke Army Medical Center, the Defense Health Agency, the Department of Defense, or the U.S. Government. The views expressed herein are those of the authors and do not necessarily reflect the views of the National Bureau of Economic Research.

Stephen D. Schwab
Stephen Schwab discloses he is a retired member of the United States Army and maintains external research relationships with Brooke Army Medical Center and the United States Military Academy's Office of Economic and Manpower Analysis. He received non-financial support for this research through Army Analytics Group Person-Event Data Environment.
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Trevor Fitzgerald, Atul Gupta, and Stephen D. Schwab, "Physician Learning and Forgetting: Evidence from the US Military," NBER Working Paper 35502 (2026), https://doi.org/10.3386/w35502.

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Physician Learning and Forgetting: Evidence from the US Military

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