Navy GMO tour length

[bobbyseal]

Just curious, has anyone heard of the 1 year hardship GMO where you would be able to go to okinawa with the Marines for a year and then be able to get into residency after that?

Are people able to get into some of the more competitive surgical residencies, like ortho, ENT, or uro after just a one year GMO in Okinawa?

Thanks.

[Navy Dive Doc]

At least when I went thru internship, there were still one year hardship GMO tours in Okinawa, though I think Iwakuni posted awhile back that the Marines are doing away with them. However, if they are still there you can be competitive. I know 3 General surgery and one ENT resident(s) who did just that.
DD

[GMO_52]

They were still there for the last detailing cycle but the Marines are doing away with all 1 year Okinawa tours (which will probably include the GMO billets). Just as an aside, I know 2 people who are returning to training this year after doing 1 year of a 2 year GMO. You need your CO's permission and it's not a guarantee but is a possibility.

[Navy Dive Doc]

Generally, returning after one year of a projected 2 year tour can only happen if you manage to stay in the same geographic area as your internship and residency. Someone did it this year for Radiology, internship at Portsmouth, ship out of Norfolk, returning to Portsmouth. If you incur a PCS move, they'll make you stay 2 years before moving again, unless it's a hardship tour.
DD

[aznwangsta]

So if the Marines are taking away the 1 year tour in Okinawa, what's replacing those positions then?

aznwangsta

[iwakuni_doc]

They're moving from 1-yr tours to the standard 2-yr tours.

While this has been approved & stated as new policy, I haven't actually heard of anyone with the new 2-yr tours....the young 2Lt's showing up here in Iwakuni are still on 1-yr tours at this point, but it should be changing within this year.

[bobbyseal]

What about Guam?

Do they take GMO's out there? Or is it just PCP's?

BTW, does anyone know of a net resource which shows all the MD billets available in the navy?

[Navy Dive Doc]

I think all of the GMO billets in Guam went away, but there are 3 DMO billets...one EOD Mobile UNit (good job), one Submarine squadron job (so-so job), one clinic Job (kiss of death for most DMOs). I don't know about FS jobs. These jobs are 2years minimum, 3 years accompanied though all GMO/DMO/FS are eligible for residency after 2 years in their billets regardless of geography.

Go to the BUPERS website (www.bupers.navy.mil) I think that's the right address. Otherwise just Google BUPERS. Once there, go to "detailers" then to "Staff Corps", then to "medical corps" and then to subspecialty. That will show currently available billets that the detailers are trying to fill. Not a complete list, but a good sample.

DD

[iwakuni_doc]

Guam has two FS billets - one with the hospital & one with HC-5 (you'll spend most of your time on Guam & not deploying with your squadron - they've come out here a couple times & the FS has never come out with them).

[GMO_52]

There is one GMO from my class in Guam right now but he filled an FP billet.

[regnaR175]

Ok, I am honestly not sure if this is the appropriate thread to post this message.

I am applying for the 2009 entering classes of 22 schools, including USUHS. I am also highly considering HPSP depending on where I go. What's interesting is that I was enlisted as a Battboy (1st Batt 75th Ranger Regiment [Army]) from '01 to '04, but am considering Navy medicine for numerous reasons, many of which stem from being able to raise my son in places like SD, Bethesda, or Portsmouth.

I have been reading a lot of posts that make reference to GMO tours in the Navy. I have at least figured out what the GMO tour is, but cannot find a decent reference to its obligations. Not even the recruiters will give me a reliable answer (surprise surprise.) So, my question is -- after graduating med school with HPSP or from USUHS, is a GMO tour an obligation? If so, how long? Is it something that only happens if I do not match at my specialty choice (ortho surg as of now)? And if so, when would I have the option to re-apply? Furthermore, regarding the Army to Navy switch, is this a bad decision (minus the riff-raff of overall military cons)? I suppose I have the impression that residencies in the Navy, especially for ortho, are a bit better. Am I also wrong about that? I am totally open to input, and greatly appreciate anyone willing to provide it. The simple fact is that I just do not know enough. Coming from a USASOC unit, as an enlistee at that, I really can't say I know enough about the conventional military to make a solid judgment call.

That's another question for which someone here may or may not have an answer. What about the Special Operations route? I would love to be able to become a Batt Surgeon for the 75th (considering I went Army) and be able to do my old job that I miss so much, while fusing that with my calling for medicine. Or maybe I could do that in the NAVSOF arena. But the fact is, there really is no source of information for finding out about how to do that. What is the route to take to get that way? Please don't answer with "well, that's only for the toughest." Been there, done that, and have the psychological issues to prove it. I do not like plush, and I will sleep in llama s@#$ for a dollar. J/K on the psych issues btw.

Oh, and off the point, for anyone whom assumes that a Battalion Surgeon in the 75th Ranger Regiment does not get to do what the rest of the unit does...um...yeah he does. Our Batt Surgeon was on every jump I was on, went through every shoot-house I went through, did all the things overseas I go to do, while simultaneously running the show on the medical end. For people like me, that is an absolute dream come true.

If anyone has any poop on these questions (especially the GMO ones) I would love to hear it.

I wish you all well

[Kingfisher]

Originally Posted by regnaR175

Ok, I am honestly not sure if this is the appropriate thread to post this message.

I am applying for the 2009 entering classes of 22 schools, including USUHS. I am also highly considering HPSP depending on where I go. What's interesting is that I was enlisted as a Battboy (1st Batt 75th Ranger Regiment [Army]) from '01 to '04, but am considering Navy medicine for numerous reasons, many of which stem from being able to raise my son in places like SD, Bethesda, or Portsmouth.

I have been reading a lot of posts that make reference to GMO tours in the Navy. I have at least figured out what the GMO tour is, but cannot find a decent reference to its obligations. Not even the recruiters will give me a reliable answer (surprise surprise.) So, my question is -- after graduating med school with HPSP or from USUHS, is a GMO tour an obligation? If so, how long? Is it something that only happens if I do not match at my specialty choice (ortho surg as of now)? And if so, when would I have the option to re-apply? Furthermore, regarding the Army to Navy switch, is this a bad decision (minus the riff-raff of overall military cons)? I suppose I have the impression that residencies in the Navy, especially for ortho, are a bit better. Am I also wrong about that? I am totally open to input, and greatly appreciate anyone willing to provide it. The simple fact is that I just do not know enough. Coming from a USASOC unit, as an enlistee at that, I really can't say I know enough about the conventional military to make a solid judgment call.

That's another question for which someone here may or may not have an answer. What about the Special Operations route? I would love to be able to become a Batt Surgeon for the 75th (considering I went Army) and be able to do my old job that I miss so much, while fusing that with my calling for medicine. Or maybe I could do that in the NAVSOF arena. But the fact is, there really is no source of information for finding out about how to do that. What is the route to take to get that way? Please don't answer with "well, that's only for the toughest." Been there, done that, and have the psychological issues to prove it. I do not like plush, and I will sleep in llama s@#$ for a dollar. J/K on the psych issues btw.

Oh, and off the point, for anyone whom assumes that a Battalion Surgeon in the 75th Ranger Regiment does not get to do what the rest of the unit does...um...yeah he does. Our Batt Surgeon was on every jump I was on, went through every shoot-house I went through, did all the things overseas I go to do, while simultaneously running the show on the medical end. For people like me, that is an absolute dream come true.

If anyone has any poop on these questions (especially the GMO ones) I would love to hear it.

I wish you all well

I can answer some questions as far as the Navy goes. The GMO is an option (and maybe a requirement) for many specialties. Let me try and break down the process:

1. You match into a Navy internship. FM and Psych are offering some straight through contracts this year. No one else is (I know ortho has their own process where it is technically categorical but they, at least currently, still require you to serve GMO time).
2. About 4 months into internship you apply for your GME-2 spot of choice. This may be the same program you are in if you are IM, FM, surgery, Psych, etc. You may be applying to something else like transitional year to EM, ENT, gas, pathology or whatever. You can also apply for a GMO position like FS or Dive just in case you aren't selected to continue GME-2 (some people choose to go this route versus continue at their current program). If you are not selected to continue residency you will be notified if you've been accepted for the FS or dive programs (as long as you applied). If you don't go to these you will do a "regular" GMO tour at various places like the Marines, on a ship, or other spots. The tours are usually 2-3 years. You would then re-apply to your program or to another program if you have changed your career path while out on your tour. After being out on a GMO your chances of getting what you want should greatly increase.

There are plans to "phase-out" the GMO option and I believe the number if billets have been reduced this year. We'll just have to wait and see how this goes.

Good luck.

[Tired]

Originally Posted by Kingfisher

1. You match into a Navy internship. FM and Psych are offering some straight through contracts this year. No one else is (I know ortho has their own process where it is technically categorical but they, at least currently, still require you to serve GMO time).

I hadn't heard anything about straight-through contracts in anything except Neurosurg. Which programs for FP or Psych are doing that?

For Ortho, like the rest of the specialties with a categorical internship, you apply during internship for PGY-2. At my program last year, 2 of the 3 of us picked up PGY-2 slots.

While they are pushing hard to convert to all straight-through, this will rely on bringing back all the current GMOs without creating new ones. Some of the options floated to do this include (1) not taking any Ortho interns for a year or two, or (2) sending all the current GMOs out for FTOS civilian training. From the scuttlebutt I've heard, (1) seems more likely to occur than (2).

[Kingfisher]

Originally Posted by Tired

I hadn't heard anything about straight-through contracts in anything except Neurosurg. Which programs for FP or Psych are doing that?

This year all FP and Psych are doing it. According to the higher-ups it should work like this:

1. After all GME-1 apps are submitted they will decide on the number of straight through positions that will be offered. Currently estimated at about 50%.
2 Each program will be given a number to offer.
3. It will be up to each program do decide which person to offer the contract to.

note: not everyone who wants straight through, will get it.

[Tired]

Originally Posted by Kingfisher

This year all FP and Psych are doing it. According to the higher-ups it should work like this:

1. After all GME-1 apps are submitted they will decide on the number of straight through positions that will be offered. Currently estimated at about 50%.
2 Each program will be given a number to offer.
3. It will be up to each program do decide which person to offer the contract to.

note: not everyone who wants straight through, will get it.

Very interesting. This seems more like a recruiting tool than anything else, since there are already a fair proportion in those fields that go straight through.

[NavyFP]

Originally Posted by Tired

I hadn't heard anything about straight-through contracts in anything except Neurosurg. Which programs for FP or Psych are doing that?

For Ortho, like the rest of the specialties with a categorical internship, you apply during internship for PGY-2. At my program last year, 2 of the 3 of us picked up PGY-2 slots.

While they are pushing hard to convert to all straight-through, this will rely on bringing back all the current GMOs without creating new ones. Some of the options floated to do this include (1) not taking any Ortho interns for a year or two, or (2) sending all the current GMOs out for FTOS civilian training. From the scuttlebutt I've heard, (1) seems more likely to occur than (2).

Ortho will continue to take interns as always. Current GMOs given a deferment or FTOS is a real possiblility.

Originally Posted by Kingfisher

This year all FP and Psych are doing it. According to the higher-ups it should work like this:

1. After all GME-1 apps are submitted they will decide on the number of straight through positions that will be offered. Currently estimated at about 50%.
2 Each program will be given a number to offer.
3. It will be up to each program do decide which person to offer the contract to.

note: not everyone who wants straight through, will get it.

Very true. Admittedly most who are offered straight through would have gotten it anyway, but you have to start somewhere and change the culture.

[Tired]

Originally Posted by NavyFP

Ortho will continue to take interns as always. Current GMOs given a deferment or FTOS is a real possiblility.

While I hope you're right, I have my doubts. We'll see, I guess.

[regnaR175]

I really appreciate all of your prompt input. For those of you who have done a GMO, or know many whom have, do you feel it has enhanced your overall GME experience?

[IgD]

Originally Posted by Tired

Very interesting. This seems more like a recruiting tool than anything else, since there are already a fair proportion in those fields that go straight through.

The speculation I've heard is the military can't change the high churn rate of physicians leaving at the first tour so what they are trying to do is compensate by increasing the supply pipeline. For example, they can increase the number of Psych and FP positions.

[BigNavyPedsGuy]

Originally Posted by regnaR175

I really appreciate all of your prompt input. For those of you who have done a GMO, or know many whom have, do you feel it has enhanced your overall GME experience?

No. My GME experience is to train me to practice pediatrics. I haven't see na patient younger than 18yrs in months. It is largely unrelated to my GME experience.

It has really allowed me to see what kind of practicing physician I am. Most people don't get to see that until they finish residency and are out on their own.

[pgg]

Originally Posted by regnaR175

I am applying for the 2009 entering classes of 22 schools, including USUHS.

By the time you get through med school, Navy GMO tours will likely be the exception and not the rule. Disclaimer - 11 years ago when I was talking to recruiters, they all said (with a straight face) that GMO tours were being phased out. This time, however, it feels different - there is a concrete plan and they're actually sticking to it and systematically changing billets. I would expect that continuous contracts will become the norm over the next few years. Obviously no guarantees, though.

As for GMO tours, I did 3 years as a Marine GMO - same place Tired is now. Overall a good, rewarding experience and one I still look back on with satisfaction. Not medically challenging at all - if anything it was counterproductive from a training perspective. Lots of GMOs will talk about brain rot when they return to residency. I forgot a lot of medicine doing 3 years of sick call for healthy 18-30 year old Marines, and the learning curve as a new PGY-2 was probably a bit steeper because of it ... but it's worked out well in the end.

99% of the time - even when deployed - I had easy access to board certified specialists. I will admit though, that I felt weak at handling psych issues. I may have simultaneously overreferred and underreferred to division psych, and probably overcalled some of my recs to admin sep guys with personality disorders. I don't worry about that so much as I worry that I wasn't very good at picking out the guys with PTSD. I would have liked some psych trained people other than the chaplain closer to the unit.

Originally Posted by Tired

Seriously, being a GMO is the easiest job you will ever have, from an academic/intellectual standpoint. Other than this board, just about everyone in Navy medicine will confirm this fact. As long as you approach it with a sense of humility, recognize when something seems funny, see you patients back if you have the slightest doubt, and consult when necessary, there's really nothing to it.

It's fun, it's easy, and if you have to do it (at least with the Corps) you'll probably really enjoy it.

What he said.

[trail doc]

Originally Posted by pgg

As for GMO tours, I did 3 years as a Marine GMO - same place Tired is now. Overall a good, rewarding experience and one I still look back on with satisfaction. Not medically challenging at all - if anything it was counterproductive from a training perspective. Lots of GMOs will talk about brain rot when they return to residency. I forgot a lot of medicine doing 3 years of sick call for healthy 18-30 year old Marines, and the learning curve as a new PGY-2 was probably a bit steeper because of it ... but it's worked out well in the end.

I agree completely. I'm finishing up three years as a NFS rather than GMO, but in respect to the interruption in training- I think it's been worth it. Granted, my med school classmates are finishing up residency now, but it's not like the pace of their practice is dropping off any. I've enjoyed a few light years in the interim.
The primary care burden of the military is not decreasing whether they phase out GMOs or not, so this means that folks who go straight through will inheirit my job and have difficulty maintaining their skills when they do. Given the choice, I'd rather have a job that's "not medically challenging at all" before I spend the effort to specialize.
One advantage I did not appreciate until recently was the edge that 3 years as a military doc would give me in the civilian interview process. I have matched to a specialty widely considered to be competitive. All my interviewers, not just those prior military, were very receptive to my military experience. I think this is because by and large most 4th year med students are indistinguishable from one another. Having something other than AOA, research and 4th year rotations to talk about will be looked upon favorably.