The Bureaucratic Fix to the Military Recruitment Crisis

The U.S. Armed Forces are facing an unprecedented recruiting crisis. The inability of the military to fill its ranks is an obvious national security issue that every American should care about. There is divergence on the cited reason for declining recruitment numbers, varying from propensity to serve, access to interested audiences, the temperament of Generation Z, and physical and mental fitness to serve. All of these are worthy discussion topics, but exceptionally difficult to resolve.

One simpler option for mitigating the recruitment challenge could be to rethink the military’s recent medical modernization effort designed to streamline medical care, before, during, and after service—specifically the application of Military Health System Genesis (MHS Genesis). This system was conceived to minimize medical attrition, ease downstream disability payments by early identification of disqualifying conditions, and reduce the time spent by a recruiter tracking down medical documentation. Instead, it has extended timelines, created unintended impediments to service, and generally slowed recruiting efforts for all services nationally. MHS Genesis should be stopped and adapted at every level to address its negative effects on recruiting now.

As a colonel in the Marine Corps, I was most recently responsible for officer and enlisted recruiting for one-sixth of the country. This included assessing expert perspectives, understanding the unique factors of recruiting today, and developing a vision to accomplish the assigned recruiting mission and its contribution to Marine Corps end strength. While I acknowledge that the broader factors mentioned above have had some impact, my experience points to one objective reason for the sudden decline in military recruitment: the Department of Defense application of MHS Genesis has overwhelmed the system. Our elected officials sense it also.  In September, Senators Elizabeth Warren (D-MA) and Richard Blumenthal (D-CT) wrote Defense Secretary Lloyd Austin a letter seeking answers about whether MHS Genesis “may be contributing to delays in the military recruitment process,” and citing a report indicating that in one case, “a healthy applicant tried to enlist but had to wait two extra months to process her application because she had sprained her wrist as a child.” While sixty days may not seem like an unreasonable period, for an eighteen-year-old prospective recruit it can seem like a lifetime—and a deal-breaker for their consideration of military service. Multiply this type of issue across the more than a hundred thousand individuals the military is working to recruit each year, and it clearly represents a significant problem in reaching enlistment targets.

The process of joining the military is not straightforward. Aside from possessing the desire to serve, one must pass a mental aptitude test and a medical evaluation. At the national level, the organization responsible for implementation and arbitration of the Department of Defense (DOD) medical standards for service is known as the Military Entrance Processing Command (MEPCOM). Every potential service member must go through a MEPCOM facility for physical and medical assessment and final execution of an enlistment contract. More about this later.

An initial medical modernization attempt associated with recruiting occurred in December 2021, when recruiting forces were recovering from the turmoil created by the COVID-19 pandemic. This modernization attempt had an immediate adverse impact on recruiting. For example, my unit’s productivity was 31 percent lower than the previous five-year average for the same period. The program stopped, processes were changed, and a more controlled rollout was executed. The newer version, MHS Genesis, went into effect in March 2022, but “even after making some fixes, the processing time for prospective sailors was still at 59.9 days,” according to the Warren-Blumenthal letter. A year later, my unit’s productivity remained approximately twenty percent less per month than historic norms.

Conceived to help, MHS Genesis has fallen short. It has, in fact, added to the recruiter’s burden and increased the volume of medical documentation to be reviewed by MEPCOM personnel dramatically. Recruiters are forced to track down medical documents not found by the system, sometimes repeatedly returning to a doctor for clarity and context as the original doctor’s notes are deemed insufficient by MEPCOM doctors. According to Military Times, “Senators Warren and Blumenthal’s letter cites the chief of naval personnel, Vice Adm. Rick Cheeseman, reporting that the ‘time between first interview and contract for Navy applicants rose from 33.8 days to 63.4 days after Genesis was put in place.’” This increase in time further taxes an already heavily engaged recruiting force and causes an applicant delays until they eventually lose interest altogether.

MHS Genesis has also revealed deficiencies within MEPCOM. MEPCOM itself is understaffed and unable to execute the timely handling of the voluminous data now available. While there could be a future artificial intelligence solution, in the next sixty to ninety days, DOD should:

• hire more medical professionals to enable services to clear the backlog and shorten enlistment timelines early in fiscal year 2024;
• while working through that hiring process, allow military treatment facilities to provide consultative assistance for applicants or utilize uniformed medical providers to surge support to MEPCOM near term;
• pause at least some aspects of the MHS Genesis modernization initiatives at the entry level, until the system is resourced to handle the level of information the new systems and processes generate in a timely manner;
• create a people-resourced solution, pay experts for their expertise, and retain that most valued resource with competitive salaries;
• request a study by an external organization to assess and report on the application of all elements of MHS Genesis to recruiting and other areas where efficiencies could be gained;
• direct an evaluation of current DoD instructions surrounding medical qualification addressing whether requirements themselves have been modernized, and whether they should be.

These recommendations should be enacted quickly so recruiting can return to pre-MHS Genesis levels. All but the Marine Corps and the Space Force have missed their recruiting goals since MHS Genesis implementation, with fiscal year 2023 appearing to be the worst yet. A continued loss of manpower via recruiting will lead directly to readiness and capacity issues at a moment when the world appears to be growing less stable by the day. While we can debate the wide-ranging obstacles to recruiting cited at the outset of this piece, this is something DoD can do now to aid today’s recruiting force. The Joint Force of the future must represent the best of our great nation. We must invest in every echelon of our recruiting efforts, acknowledge this significant problem, and be open to ideas and change. Our nation’s security depends on it.

This post was written for the Council on Foreign Relations’ Renewing America initiative—an effort established on the premise that for the United States to succeed, it must fortify the political, economic, and societal foundations fundamental to its national security and international influence. Renewing America evaluates nine critical domestic issues that shape the ability of the United States to navigate a demanding, competitive, and dangerous world. For more Renewing America resources, visit https://www.cfr.org/programs/renewing-america and follow the initiative on Twitter @RenewingAmerica.

Colonel Ash is currently serving as the Marine Corps fellow at the Council on Foreign Relations. The thoughts and opinions expressed here are his own and not those of the Council on Foreign Relations or the United States Marine Corps.