aatrek,

Now that you've had a few months under your belt as an active duty physician, how would you assess all the gripes that I posted before.

What do you think of what I've stated about the state of mil med before and after going on AD.

aatrek,

Now that you've had a few months under your belt as an active duty physician, how would you assess all the gripes that I posted before.

What do you think of what I've stated about the state of mil med before and after going on AD.

I too, am curious to hear what your answer to the above question is.

In answer to your question in my other thread, my specialty is FP. I gather that you are either GS or rads? Thanks for the advice. Will be drawing for tumor markers and arranging for PET Mon AM.

aatrek,

Now that you've had a few months under your belt as an active duty physician, how would you assess all the gripes that I posted before.

What do you think of what I've stated about the state of mil med before and after going on AD.


Mil MD,
thanks for the email and your note.
To be honest, I have been so busy.. it is ... well.. let me explain.
First, I want make it known that i do agree with many things you have said in the past Mil MD. However, what I don't not agree with is generlizing to all mil med.

I have to say that what I do now as AD in surgery is just a dream come true. I not only have my own two days of week worth of OR time, one hald day a week work of Endoscopy and two and half days of clinic.. I have my own sec, and three corpmen doing all my paperwork.
In 8 wks I have managed to get more than 30 "major" cases. Furthermore, I I am working with four other partners that are just amazing. We cover for each other all the time. I live to mainland or go diving almost on a biweekly basis (so far). I have a beautiful house on the beach ..

oh yeah I forget.. I also teach at two univeristies, mostly cause I like teaching, but also its another source of income.

Why am I able to do all this... simply because I did not do HPSP.. so I skipped all that GMO BS.. but thats another story.. and simply because I am in surgery.
We make our own schedule and our own choices. I choose to come here and I have already lined up where I am going to go in two years.. all set.

I am also part of the world surgical foundation and am acually scheduled to go to thialand for three weeks of underserved area surgery.. and (I am still working on it) but I might just pull that off as TAD... .

so is it all roses,.. .NO of course not. I am not allowed to do pancrease surgery here.. cause of lack of supplies.. which bothers me.. we also are missing a couple equipment.. which I find unacceptable.. and am working to fix that.. I had the CO and XO over for dinner last week and had my list of ".. lets get our act together and fix these things.. " and got some promises.. but so far only words.. and the whole 4pm work stops just bothers me to the bone.. in fact I had already screamed at too people b/c of that altidtude.. (I never scream .. by the way.. so that was a shock for me as much as it was for them.)..

so there you have it mil MD. Althought I agree with many things you say.. and you certianly have more experiance that i do.. I must say that I have it better than (not most) but ALL the junior surgeons that I know in the states in academic and coummuity programs (however).. why .. simply because a junior surgeron.. NEVER gets the previlages that I have now.. however, now that senior and junior surgeons in mil are the same.. have the same previlages...

so what are the keys to have it great in the mil:
simple.... oviod HPSP.. Do surgery(or something surgical).. and leave before you are senior.. lol

Best of luck..
back to operating..
I am doing a gastric bypass in a couple of hours.. do you know how many 8wks out of residency surgeons get to do two gastric surgeries, three colon surgeries and 8 other smaller surgeries in the same week.... uhmm let me think .. NONE>>

A.

So then you went FAP?

sounds like things are going really well....I'm glad to hear it...is this Okinawa?

One of the other things that needs to be said is the differences between East and West coast and overseas...each is very different...

I came from the East Coast Navy if that makes a difference to anyone.

One of the other things that needs to be said is the differences between East and West coast and overseas...each is very different...

I came from the East Coast Navy if that makes a difference to anyone.

I agree mil MD..
overseas and west coast tend to be similiar.. the east a is a little different..
this includes everything... from who controls who to simple things like putting on a uniform.. and so on..
I mean I have been here for 8 wks.. and I have had to put my uniform on ONCE.. when I had to meet the CO the first day.. and I prob did not need to do that anyway.. I mean I go to my office in shorts and sandels everyday.. and even round on my pts like that.. lol

ok.. its my day off.. going scuba diving..
take care you all.
A.

So then you went FAP?


that I did.

I agree mil MD..
overseas and west coast tend to be similiar.. the east a is a little different..
this includes everything... from who controls who to simple things like putting on a uniform.. and so on..
I mean I have been here for 8 wks.. and I have had to put my uniform on ONCE.. when I had to meet the CO the first day.. and I prob did not need to do that anyway.. I mean I go to my office in shorts and sandels everyday.. and even round on my pts like that.. lol

ok.. its my day off.. going scuba diving..
take care you all.
A.

Gee, it is very laid back on my Island, and yet, even I can't come to work in shorts and sandals, although many of my patients do, and they also come in Bikinis. Do your patients wear Bikinis? :D I do wear scrubs though, just as you do.

aatrek,

It sounds like you got very lucky. I have had almost the complete opposite experience upon entering active duty. The operative volume sucks. The support staff suck.

Volume: I'm stationed at a base with a total of three surgeons. There is maybe enough workload for one. My average is 5 "cases" per week, but 4 of those 5 are colonoscopy. My skills allow me to get most of the complex cases, but those are much too rare for my liking. For example, in the last year I've done approximately 5 bowel resections (4 lap, 1 open), 3 lap nissens (1 re-do after primary failure from another surgeon), 1 lap right adrenal, 20 hernias (15 lap, 5 open), and 20 lap choles. That pretty much sums up the entire year's worth of major cases and I'm the busiest one here. Pathetic.

Support staff: With this level of operative volume, the OR staff are seriously lacking for experience. They rotate the techs through so that they each scrub one case per week. They have never had a laparoscopic case set-up correctly for me...and I'm pretty easy to please. The clinic is staffed with 1 nurse, 1 aid, and 1 "patient-squadron" tech. That means the tech is basically on disability and can't do his usual job so he gets stuck in our clinic. I do almost all of the administrative tasks myself (I have plenty of time since I'm not in the OR much).

My parole can't come soon enough.

aatrek,

It sounds like you got very lucky. I have had almost the complete opposite experience upon entering active duty. The operative volume sucks. The support staff suck.

Volume: I'm stationed at a base with a total of three surgeons. There is maybe enough workload for one. My average is 5 "cases" per week, but 4 of those 5 are colonoscopy. My skills allow me to get most of the complex cases, but those are much too rare for my liking. For example, in the last year I've done approximately 5 bowel resections (4 lap, 1 open), 3 lap nissens (1 re-do after primary failure from another surgeon), 1 lap right adrenal, 20 hernias (15 lap, 5 open), and 20 lap choles. That pretty much sums up the entire year's worth of major cases and I'm the busiest one here. Pathetic.

Support staff: With this level of operative volume, the OR staff are seriously lacking for experience. They rotate the techs through so that they each scrub one case per week. They have never had a laparoscopic case set-up correctly for me...and I'm pretty easy to please. The clinic is staffed with 1 nurse, 1 aid, and 1 "patient-squadron" tech. That means the tech is basically on disability and can't do his usual job so he gets stuck in our clinic. I do almost all of the administrative tasks myself (I have plenty of time since I'm not in the OR much).

My parole can't come soon enough.

dang duplicate post

This is a great thread. Thanks for the information aatrek, flightsurgeon, milmd. It helps a lot for us future surgical types.

that I did.
For the unenlightened gives us a brief on FAP.
Is there any loan repayment or do they just pay you a salary during residency?

For the unenlightened gives us a brief on FAP.
Is there any loan repayment or do they just pay you a salary during residency?


crooz..
please look at the sticky" FAP: Read before signing HPSP " it has loads on info on FAP..
please feel free to ask if things still not answered.
A.

aatrek,

It sounds like you got very lucky. I have had almost the complete opposite experience upon entering active duty. The operative volume sucks. The support staff suck.

Volume: I'm stationed at a base with a total of three surgeons. There is maybe enough workload for one. My average is 5 "cases" per week, but 4 of those 5 are colonoscopy. My skills allow me to get most of the complex cases, but those are much too rare for my liking. For example, in the last year I've done approximately 5 bowel resections (4 lap, 1 open), 3 lap nissens (1 re-do after primary failure from another surgeon), 1 lap right adrenal, 20 hernias (15 lap, 5 open), and 20 lap choles. That pretty much sums up the entire year's worth of major cases and I'm the busiest one here. Pathetic.

Support staff: With this level of operative volume, the OR staff are seriously lacking for experience. They rotate the techs through so that they each scrub one case per week. They have never had a laparoscopic case set-up correctly for me...and I'm pretty easy to please. The clinic is staffed with 1 nurse, 1 aid, and 1 "patient-squadron" tech. That means the tech is basically on disability and can't do his usual job so he gets stuck in our clinic. I do almost all of the administrative tasks myself (I have plenty of time since I'm not in the OR much).

My parole can't come soon enough.


Flitsurg.
Your right, there is some luck invovled.. but I also have to say that I don't play fair either.
I called almost every duty station that was open and that I wanted to go to 9 months prior to my AD date. I talked to one or two surgeon in each location and got the scoop about every place... then I choose this place.
since I was early.. and they needed surgeons I got it.. but it certianly was not by chance..

For that reason I am already teaching in two univeristies here, I started applying in dec of last year (was not even AD until June)..
The operative vol. here is good but not fantastic. I mean I have prob. done similiar numbers to what you mentioned .. but in 2 months.. not a year. but (as you know) that is good, but not what we are used to.. thus
I am nogiating with a few in town community surgeons to spend one half day a month with them .. doing liver and panc. cases..

so I rec. you try to branch out and do things out side. As long as you and your partners cover the job and help each other out.. no one will ever have a problem with it.

good luck
A.

From what I've heard from other places, you must've struck the gold mine. Almost every single base that has surgeons is seriously hurting for operative volume.

The thing that really gets my shorts in a wad...this base had never had three surgeons before, but one of the surgeons was complaining to the CO that he was way too busy and that they really needed another surgeon. He was telling everyone how busy he was and, unfortunately for me, they were listening. When I first got wind of my assignment, I tried to fight it. I had tons of staff surgeons write letters about how great I was at teaching and that I really should be at a teaching facility...that if I weren't leaving for the military that they would hire me to stay at their residency...etc. They were very close to changing it, but this guy kept complaining about how busy he was...he even called me to tell me how busy it was here. LIAR! I wonder if this guy was a recruiter in a another life? This isn't the only dubious dealing I've had with him.

For the first 6 months, I was really depressed at my lack of cases. I kept hoping that things would pick up, afterall, the other surgeons always told everyone that they were super busy. Then the administrators had a clinic efficiency meeting with each clinic. Much to my surprise, I found out that I had more RVUs than the other young "busy" surgeon and I had twice as many as the senior "busy" surgeon. My depression then turned to anger. I then knew that my volume was NEVER going to be any better because I was already the busiest "busy" surgeon there.

I talked to my commander and he apologized profusely when I told him everything. He said he was responsible for pushing the assignment through, but that he was doing it because that same surgeon had been coming to him begging for help because he was too busy. My CO tried to get me reassigned, but the assignment office said they'd only do that if I was willing to extend my obligation. FAT CHANCE! My only saving grace is that my time as a flight surgeon moves up my parole to next summer.