ABT: baffled about residency, can someone clarify?

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I'm a little confused in regard to all the talk about civilian residency vs. military. For example, let's say you want to do surgery. Let's say that your branch doesn't particularly need surgeons at that time, but needs OB/GYN's or something else. Can they trap you into a specialty you're not interested in to suit their needs? Or, let's say you have no desire to do a military residency for whatever reason. Is there a process that allows you to choose a civilian residency that is more suited to your goals?

Edit: Lastly, let's say you wish to do a fellowship right after residency. Do they typically give you a hard time about this?

No, they cannot "force" you to do a particular specialty. They CAN advise you that your chosen specialty's quota is full for the year and you have the choice to a) do a transition year and reapply for the next year, b) pick a different specialty that does have open slots, c) do a transition year, then a 2 year GMO tour, then come back and reapply for surgery, d) do a 4 year GMO tour, come back and reapply for surgery or e) do a transitional year, then 4 years of GMO, and apply to civilian residencies, separate from the military and go do your choice residency at a civilian institution.

The military will not let you opt out and choose a civ residency simply to suit your own desires. They are filling numbers to meet projected needs in the fighting force. The only way that you can do civilian residency is if the military decides that, while they have filled their surgical training slots, they still need more surgeons, so they will allow you to match into a "Civilian Deferment." Then you have to apply to the civilian match and match into a civilian residency slot.

Per the Army GME powerpoint on MODS, about 50% of IM residents applying for straighthrough fellowship training got it, then about 50% of those applying for fellowship after a utilization tour also got it.

Another way to do a civilian residency of your choice is to completely avoid the military all together while in med school. If you do not take their money you are not beholden to their rules. Then you can just be a civilian doc, join via FAP during residency, or wait until you are residency complete and join as a BC/BE physician.

Originally Posted by DocArmy

Per the Army GME powerpoint on MODS, about 50% of IM residents applying for straighthrough fellowship training got it, then about 50% of those applying for fellowship after a utilization tour also got it.

Just want to add on that the Army is super fellowship friendly. Not so much in the other services. Not sure which branch OP is thinking, but they are highly dependent.

A few questions...

They CAN advise you that your chosen specialty's quota is full for the year

At what point would you find out that your specialty's quota is full? After you submit your residency application?

and you have the choice to a) do a transition year and reapply for the next year, b) pick a different specialty that does have open slots, c) do a transition year, then a 2 year GMO tour, then come back and reapply for surgery, d) do a 4 year GMO tour, come back and reapply for surgery or e) do a transitional year, then 4 years of GMO, and apply to civilian residencies, separate from the military and go do your choice residency at a civilian institution.

Why would you have to do a transitional year before a 4-year GMO to be able to apply for civilian residencies when you're done? In other words, if you don't do the transitional year first but do a 4-year GMO, do you still owe anything to the military?

And lastly, do you know if these specific things vary between branches?

Originally Posted by Akr

A few questions...


At what point would you find out that your specialty's quota is full? After you submit your residency application?



Why would you have to do a transitional year before a 4-year GMO to be able to apply for civilian residencies when you're done? In other words, if you don't do the transitional year first but do a 4-year GMO, do you still owe anything to the military?

And lastly, do you know if these specific things vary between branches?

You have to complete an internship before your GMO tour and internship doesn't count for your AD payback time.
Everything is branch dependent and can vary dramatically over time.

Originally Posted by Akr

Why would you have to do a transitional year before a 4-year GMO to be able to apply for civilian residencies when you're done? In other words, if you don't do the transitional year first but do a 4-year GMO, do you still owe anything to the military?

Originally Posted by IlDestriero

You have to complete an internship before your GMO tour and internship doesn't count for your AD payback time.

...because you must have an unrestricted medical license to be a GMO. No state will confer a license without at least an internship.

Originally Posted by Akr

At what point would you find out that your specialty's quota is full? After you submit your residency application?

On match day when you only get an internship.

During the application season, you'll want to have a few conversations with people in-the-know - program directors, residents, etc. They should be able to give you a sense of whether or not you're competitive for their specialty. Most medical schools do this for all students, but the dean at your medical school is unlikely to have military specific knowledge.

The program directors might also be able to tell you how many people are applying for the same specialty, which is critical because there is more variance in the military match.

Just like in the civilian match, there is a lot of self-selection that goes on.

Originally Posted by Akr

And lastly, do you know if these specific things vary between branches?

Generally, the Army has fewer GMOs because its GME is larger. I've also found the GMO tours to be shorter; I can think of 6 people off the top of my head from my own specialty that only did a 1-year GMO tour.