There's more demand for doctors across the board, and they take longer to make than a pilot... The air force trains a pilot and gets a 10 year ROI via the ADSC. And there's no shortage of young Americans that want to fly jets. The AF gets a 1:1 return for the doctors who take the scholarship money to pay for their medical school, so at best a 4 year ROI. Then again, the AF only pays about $400k to get a doctor, while the cheapest pilot (C-17) is $800k in direct training plus roughly $200k in pay/allowances, so the payback is about the same ($100k per year old ADSC) It takes roughly 2 years to have a basic pilot trained, and roughly 2-4 years to become an AC/IP/4FL, so 4-6 years to get a "fully qualified" pilot. It takes 4 years med school plus 1-6 years in residency, so 5-10 years to get a certified doctor who can practice. Not all doctors get rock star pay either. https://www.dfas.mil/militarymembers/payentitlements/Pay-Tables/HPO4/ If they don't sign a retention bonus, many get paid about the same after they complete their residency as a pilot on the bonus after their initial commitment ($43k for most medical specialties, compared to the $12k+35k=$47k for a pilot, though the pilot has a multi year ADSC the doctor does not have). The big money goes to certain specialties, and those spots to get into those specialties are competitive nationwide (mil and civ). One thing the doctors on scholarship give up is their selection of specialty: no matter how good they match to residencies, they are still needs of the AF. So even if they scored well enough to go to say anesthesiology to make the big bucks ($300k+ a year on the outside in a major city), if the AF needs flight docs that year, well, they are going to go be flight docs/general practice. Even if there's an anesthesiologist residency position in the military, all med school graduates can compete for that spot, not just the ones on military medical scholarships. This also essentially locks them into that specialty for the rest of their career, and switching specialties means recompeting for a residency match (which again are limited, and competing against the new med school grads), and then completing the new residency at resident pay (1-6 years at $25k-50k/year working 60-80 hours a week. That last part is why my brother decided not to take an offer for a military medical scholarship-there's a loss of control over your career at a critical point, the initial residency match, which has a significant impact on your career earnings potential.