Over the years I have noticed a not so rare trend: A young person is treated in the military medical system and then when it comes time to receive DODMERB clearance they are disqualified for some treatment they received from a military physician. When this happens one of the first responses from applicants/parents is "why didn't the doctor know better" or "why didn't the doctor warn me" or "why were they allowed to do that when it's not allowed for the Academies." Having now worked in the military medical system for several years and coming up on two years as a military physician I hope to answer/put to rest some of the reasons. For children who come in to see the physician one of the last things that we would even imagine to think of is "where is this patient going to go to college?" A more pressing issue is ruling out "bad stuff" and then coming to a reasonable diagnosis and treatment plan. Our goal as a physician is to provide the best/most reasonable treatment for a particular diagnosis and to return that patient to a state of well being. Various factors can play into what treatment plan we choose; however, if we don't know what those factors are we can't do anything about it. I have never had a patient who is of high school age come to me and say "doc, I want to go to an Academy so keep that in mind." Now for the majority of military physicians even if you said that it probably wouldn't register that they need to consider disqualifying treatments. The great majority of military physicians have zero experience dealing with the service academies and their only experience with DODMERB is getting their own medical clearance when applying to medical school. The military physician is not a subject matter expert when it comes to DODMERB physicals and disqualifying diagnoses/treatments. Remember, we don't even do the physicals, they are contracted out. With that in mind we have very little interaction with any step in the Academy selection and therefore would not think of how a particular treatment would effect someone's DODMERB clearance. The other factor in play is that many treatments can begin before someone even considers the Academies as a college choice. This can be true for those diagnosed as ADHD or some other problems. Overall, please don't blame the military physician. Their ultimate responsibility is to treat the patient as best they can. If you are considering a Service Academy please consider informing your physician so they can become familiar with the regulations regarding your particular diagnosis and come up with a treatment plan that will work within your situation.