James Roudebush entered the Air Force in 1975 after receiving a Bachelor of Medicine degree from the University of Nebraska at Lincoln, and a Doctor of Medicine degree from the University of Nebraska College of Medicine. He completed residency training in family practice at the Wright-Patterson Air Force Medical Center, Ohio, in 1978, and aerospace medicine at Brooks Air Force Base, Texas, in 1984. From 2006 to 2009 he served as the 19th Surgeon General of the Air Force, and retired in 2009 as a U.S. Air Force Lieutenant General.