Hospitalists in the Air Force

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For those who haven't seen my previous threads, I'm a 3rd year planning on applying for an EM residency in the AF. However, recently I've learned how great hospitalist sounds, and I think I'm going to use it as my "back up" speciality - so apply for EM, but then put IM in the next spots on my ranking.

I want to be a hospitalist more than an internist, but the hospitalist I'm working with right now told me the major way to get into the speciality is to do a IM residency then get hired as a hospitalist. Does anyone know if the AF has these positions?

Also - this is a silly question just because I'm sure I know the answer but I'd like to hear someone confirm it for me - if I do IM/hospitalist with the military, when I've completed my commitment to the AF can I do an EM "fellowship" and do civilian EM if I still feel that is what I need to do? Thanks for reading and I will appreciate all responses.

Jake

Originally Posted by Dr Fleischman

For those who haven't seen my previous threads, I'm a 3rd year planning on applying for an EM residency in the AF. However, recently I've learned how great hospitalist sounds, and I think I'm going to use it as my "back up" speciality - so apply for EM, but then put IM in the next spots on my ranking.

I want to be a hospitalist more than an internist, but the hospitalist I'm working with right now told me the major way to get into the speciality is to do a IM residency then get hired as a hospitalist. Does anyone know if the AF has these positions?

Also - this is a silly question just because I'm sure I know the answer but I'd like to hear someone confirm it for me - if I do IM/hospitalist with the military, when I've completed my commitment to the AF can I do an EM "fellowship" and do civilian EM if I still feel that is what I need to do? Thanks for reading and I will appreciate all responses.

Jake

Yes, the AF has hospitalists...IM is the specialty, hospitalist is just a job withing the specialty (as I understand it.)

As for fellowships in EM, at least for FM they are few and disappearing. Only two states that i know of, FL and TX, even recognize a fellowship trained EM doc as board certified.
As I understand it, you can work in an emergency room as an IM or FM doc, but it tends to be the lower level care settings and not the trauma centers.

You might find yourself doing both inpatient and outpatient work simultaneously like my friend did!

Most hospitalists in the community are internists but there are some FPs as well. In milmed, you are a general internist and your ratio of inpt/outpt work is highly dependent on where you get stationed (more than your preference). Most people do some of both but more outpt than inpt.

Originally Posted by Gastrapathy

Most hospitalists in the community are internists but there are some FPs as well. In milmed, you are a general internist and your ratio of inpt/outpt work is highly dependent on where you get stationed (more than your preference). Most people do some of both but more outpt than inpt.

Ditto. I don't know how the USAF could support a pure hopsitalist give the relatively small size of their facilities. In the Navy at least, pretty much ALL the IM specialists do some time as a general medicine ward attending (except the cards guys who run the CCU). I've had attendings who were board certified in : Nephro, endorcrine, rheum, GI, ID, and pulm/cc.

And, based on what I saw in the civilian world, I'm not sure the hospitalist life is all that great. Imagine a census of 25-35 people (most of whom you didn't admit) you have to round on and write notes on. It's like being a cross cover attending (i.e. not fun!).

Don't count on the Air Force letting you be a hospitalist during your payback time. Some places have more inpatient than others, but I don't think there are pure hospitalist positions right now. Also, if you want to do emergency med as a career, do the EM residency. I'd decide on EM vs. IM first (i.e. long-term career goals). If it really is hospital medicine you want to do, doing an IM residency and then 4 years in the AF doing some inpatient, some outpatient, is not a horrible thing - lots of docs go into hospital med after they separate. And that's a really easy transition.

Originally Posted by AFIM

Don't count on the Air Force letting you be a hospitalist during your payback time. Some places have more inpatient than others, but I don't think there are pure hospitalist positions right now. Also, if you want to do emergency med as a career, do the EM residency. I'd decide on EM vs. IM first (i.e. long-term career goals). If it really is hospital medicine you want to do, doing an IM residency and then 4 years in the AF doing some inpatient, some outpatient, is not a horrible thing - lots of docs go into hospital med after they separate. And that's a really easy transition.

My IM buddies do 95% outpatient work at the MTF. They all moonlight as hospitalists. Agree that you probably couldn't spend all your time in the AF as a hospitalist. Simply not enough inpatients to support a service.