Civilian v. Army

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ZeroHourMedic

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What are the pros and cons of working for the Army versus in the civilian sector (county/private)?

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What are the pros and cons of working for the Army versus in the civilian sector (county/private)?

When you say 'working for the Army' are you asking about working at a contractor at a military hospital, or about actually joining the military as medical officer?

Also where are you at in your medical career? Premed, medical student, resident, or attending?

Do you have any military experience?
 
Army: you will owe time and make less money. Also, good chance of getting moved around from base to base and getting deployed overseas. Not conducive to a good family life. You will have no debt, excellent benefits, and a great pension. I know an infectious disease doc who was in the army, retired with a full pension and is now working in the private sector, while he earns money and gets a pension!

Civy side: you will owe money and plenty of it. But if you move to certain high paying areas, you will make a lot more too. No time commitments, freedom to live and move as you like.

My take: only do the military route if you want to be in the military, no because it will pay your tuition. Not worth it IMO


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Also, someone told me about some loophole in the military where the time you spend in residency counts towards the years of service you owe Uncle Sam. If true, that may be worth it since you make more money in residency in the military than the civilian sector!


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Also, someone told me about some loophole in the military where the time you spend in residency counts towards the years of service you owe Uncle Sam. If true, that may be worth it since you make more money in residency in the military than the civilian sector!


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I took the HPSP (Navy) scholarship for medical school

Short answer is no. If you do a military residency you will leave owing either the number of years you owed going in, or the length of the residency. Whichever is more.
 
Also, someone told me about some loophole in the military where the time you spend in residency counts towards the years of service you owe Uncle Sam. If true, that may be worth it since you make more money in residency in the military than the civilian sector!


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I think that's confusion as to the whole "served concurrently" thing that you can do. So you owe the military 4 years for paying for medical school. But you also owe the military 1 year for each year of residency you do. Nice thing is, they let you serve them simultaneously- It's 4 years total, not 4+4. Then there's the 4 of inactive, but... Well, let's just hope that that stays as inactive as it is supposed to be.
 
There is a section on Military Medicine that has enough discussion on this topic that by the time you finish reading it all you would be ready to retire.

Quick summary: There are some advantages to military service, there are also disadvantages. It all depends on the individual. Emergency Medicine is one of the specialties where it can work particularly well. If your desire is to be a Radiation Oncologist, or a Pediatric Cardiologist, there are many additional problems you would face these days that would make it very difficult. Especially from what I hear in the Army. However, with "primary care" (not the same definition one normally uses in the civilian world) it is do-able.

Real quick summary: Do not get all (or even most of) your information from a message board or an internet site.

PS: No matter how well things work out in the military, there will come at least one moment when you wonder why you just didn't pay for medical school yourself. The corollary is that even if you are the most anti-military pacifist out there, there will come a moment when you are making you student loan payment that you wonder why you didn't have the military pay for medical school. That is the paradox. Or conundrum. Or whatever the heck it actually is. Where is an English major when you need them? (A question that is asked only once a century.)
 
Real quick summary: Do not get all (or even most of) your information from a message board or an internet site.
Quicker summary: don't get any information from a recruiter.
 
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Don't do the military route for the money. If you want to be a military doctor, then join the military. If not, don't. It really is that simple.

The White Coat Investor, Maj. USAF

P.S. One of the most competitive specialties in the military match is EM. People that want an adventure enough to go into the military also tend to like stuff like EM. More competitive than civilian derm many years. Half the people who applied my year didn't get to do it. 50 applied, something like 10 went to the program in San Antonio, something like 5 went to the civilian/military program at Wright State (mostly civilian), and 10 of us were deferred to go into the civilian match. The other 25 were sent to surgical internships etc, did their year of training, then served 2 years as a flight doc or its equivalent before going through the military match again. The Army now guarantees you can go get your training without an interruption like that, but they then use a fully trained doc (such as a pediatrician) as a battalion surgeon. (the army equivalent of a flight doc, not a surgical position.)

You must understand the military match. It can be the single biggest downside of the HPSP scholarship.
 
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The thing about the military is that everyone is going to have a different experience. you can take three people who trained EM in the military, and they will all have a completely different experience of the military. One guy will end up working at an ER in a major MTF for the majority of his commitment, never deploying, doing sweet humanitarian missions, and getting out after his initial ADSO. Another guy will go work with SF group, falling in love with operational medicine, and spending 20+ years in uniform. another guy yet will be made a battalion surgeon at Fort Garbage immediately after residency. He will work under LTC Terrible Leader who never lets him moonlight, and will deploy of 2 years of his 4 year payback. He will be left with a bad taste in his mouth and atrophied clinical skills.

Obviously, you can have bad experiences outside the military as well as in. However, outside the military if you have a bad group practice or a terrible boss, you can put in your two weeks and walk off to greener pastures. If you're in the Army, this is called going AWOL...
 
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The other 25 were sent to surgical internships etc, did their year of training, then served 2 years as a flight doc or its equivalent before going through the military match again. The Army now guarantees you can go get your training without an interruption like that, but they then use a fully trained doc (such as a pediatrician) as a battalion surgeon. (the army equivalent of a flight doc, not a surgical position.)

The Army does not guarantee this... I am an Army GMO who is about to complete his Flight Surgeon time and go back to residency in August. The only way you can go straight through if you don't get picked up for your specialty of choice is to go through 'rebuttal board' after the initial match and go into a different specialty. The specialties usually available to scramble into are FM, IM, path...

you are correct in that EM has ranked in top 3 most competitive specialties in the Army match for the last 5 years...
 
The Army does not guarantee this... I am an Army GMO who is about to complete his Flight Surgeon time and go back to residency in August. The only way you can go straight through if you don't get picked up for your specialty of choice is to go through 'rebuttal board' after the initial match and go into a different specialty. The specialties usually available to scramble into are FM, IM, path...

you are correct in that EM has ranked in top 3 most competitive specialties in the Army match for the last 5 years...

When did that change? At one point they were guaranteeing to let you go all the way through training rather than using GMOs.
 
When did that change? At one point they were guaranteeing to let you go all the way through training rather than using GMOs.

Uncertain really. I went to BOLC 6ish years ago, and at that time they even said that if we failed to match, we either scrambled into a different specialty, or went GMO... The saying was that they wouldn't "force us to do a specialty that we don't want." Whatever that means... I know a lot of people that didn't want to do aerospace medicine but are now fs gmos. I've made the most and best of the experience.


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Emergency Medicine is one of the specialties where it can work particularly well.

Depends on what you mean. I spent 4 years on active duty in the Navy for EM after doing a civilian residency. I made $250,000 less per year than I would have in the civilian sector. In my four years of payback, I made salaries of 90-120K. So in the end, I came out debt free (YEAH!!!) but made almost $1,000,000 less in gross salary in those four years (BOOO!). For higher paying specialties, the military is definitely NOT worth it from a strictly monetary standpoint. But on the otherhand, I had a great time, met great people, loved my job, had a fairly safe and simple deployment, and got to live in San Diego for several years. Would I do it again? Probably not, but in the end I'm glad in retrospect I did do it. I love not having student loan payments and I loved my experience. But on a strict financial basis, the govt wins in the long run, at least where EM is concerned.
 
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My point was more related to the nature of the practice of certain specialties in the military.

It is clear that EM is very competitive when it comes to getting a residency. However, that is a very different situation from, say, "radiation oncology" (for example), where there is a decent chance for your year that there is a 0 in the column for the number of slots from the Physician Forecast Board. I also believe it is possible to come out of military EM as a reasonably competent physician even if you end up with a brigade surgeon/flight medicine assignment at some point. That is again very different from something like, say, pediatric cardiology where you might end up for a couple of years practicing "general pediatrics" somewhere and it is tough to recover from that.

It is also possible to match some of the leadership/administrative skills you might pick up in the military with a career in emergency medicine. That can be somewhat wasted in a sub-sub-specialist, because it is more unusual for them to be doing non-clinical work.

Imagine you are making a flow-chart for the decision to go into military medicine. "What specialty do you want to do?" If it is, "there are several things I can be happy doing", or if it is family med, or internal med, or EM, etc., then I think you can continue to the other questions. On the other hand, if your answer is "The only think I can possibly be happy doing is liver transplant", then it should say "Stop. Thank you for participating. Do not continue any further."
 
If you really want, join the reserves or national guard. They are paying off my med school loans right now and I've had my entire education paid for since I enlisted after graduating high school
 
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