Giving back as veterans, calling military non-trads

[Erakis]

As many of you realize, with the wars drawing to a close, veteran health issues are going to be a major issue for the healthcare system in the future.

There are some obvious issues that the medical system will face: mental health and disabilities from direct combat injuries, as well as TBI.

Some of the less obvious effects of deployment include infectious disease, cancer, latent inhalation injuries and many other unexpected illnesses.

As aspiring physicians, how do you plan on serving these needs? Do you have any particular research or outreach interests?

AAMC has endorsed a veteran's initiative known as joining forces

https://www.aamc.org/initiatives/258074/joiningforces.html

This initiative is designed to find ways to serve returning veterans through academic medicine. This program is in its infancy, and as a new medical student, you may be in a unique position to help focus and develop your school's program.

So, as military non-trads, what are your current aspirations to serve veterans?

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[SpartanGuy]

Good question! Something I have recently pondered myself and honestly I'm not sure. I absolutely want to help my bellow veterans and their families out but I know I don't ever want to work, at least full time, for the VA. Also I have no idea what my specialty will end up being this early on so everything is speculative for now. If my current interest in EM continues and I end up as an ER physician I hope to work part time at a VA hospital and to continue with being a mentor for Veterans Court in the community I will be living in. Nothing we can do is going to reverse the amounts of toxins we were exposed to or the wear and tear on our bodies so I'm curious as to what you are considering to address the issues you stated?

 

[Erakis]

One thing that I plan to work on over the summer is to work on cultural competence training for medical students to understand military culture. The school I am accepted to and will most likely attend already has a joining forces program underway that I am heavily involved in. I am trying to put together classes to describe veteran mental health issues, communicating with veterans, and how to expand the differential diagnoses based on carcinogen exposures and travel to different disease endemic areas. The school of social work is involved too, and I have organized meetings between the Univeristy hospital social workers and military social workers so that they can learn about some additional resources that are available to soldiers and veterans.

I would eventually like to lobby the school of public health to develop a Veteran's Health elective for their MPH program.

My major research areas of interest right now are neurology, regenerative medicine, and genetics/oncology. There is some obvious benefits to veterans from these areas.

There is also a school wide veterans student group being started for the next school year that will include students from the school of medicine, the undergraduate schools, and the MBA school to provide mentorship for veterans, as well as faculty consultation on veteran issues. As you know, we are pretty good at seeing if one of our own has problems adjusting or problems at home.

These are some of the things I plan to accomplish as a medical student. Focus on mentorship and cultural competency.

 

[xffan624]

It's definitely a good and necessary thing that medical schools are recognizing that as the war winds down there will be many veterans entering the health care system and many who will not be covered 100% by the VA. I am currently in the process of getting out.

One thing I think would benefit all providers would to be to familiarize themselves with the current environmental monitoring that the military does. It's a topic near and dear to myself as that is my current position in the Army. The days of the black box of the Gulf War syndrome where nobody really knew what the soldiers were exposed to is over. When I was deployed, I performed comprehensive air, water, and soil samples at locations all over southern Iraq, as well as Environmental Health Site Assessments. This data was uploaded to an online database. Much of the data is unclassified and can be accessed with anyone with an account (you have to request an account, but anyone with a good reason should be able to get one.

 

[silleme]

I was drawn to change my career field because I wanted to continue making a difference. I've seen the changes from TBI up close and personal and was looking at trying to do a dual Neuro/Psych residency to treat both the head injury and the personality changes that may come as a result of that. I think that not being treated together hinders the process of healing and further frustrates the veteran that may already be dealing with other issues. Yes, you could work closely one doctor with the other, but in what fantasy reality does that really happen?

Another issue I wouldn't know how to address, but I could see coming up a whole lot down the line is the assorted pulmonary illnesses thanks to the burning of everything and anything as trash plus the lovely toxic dust storms. Someone with a research bent could look into focusing on that. I know people on bases I've been at have gotten health statements put into their medical files for when they get out thanks to just how toxic the air is over here.

 

[Erakis]

I was drawn to change my career field because I wasnted to continue making a difference. I've seen the changes from TBI up close and personal and was looking at trying to do a dual Neuro/Psych residency to treat both the head injury and the personality changes that may come as a result of that. I think that not being treated together hinders the process of healing and further frustrates the veteran that may already be dealing with other issues. Yes, you could work closely one doctor with the other, but in what fantasy reality does that really happen?

I'm not aware of any multi-disciplinary TBI centers in civilian hospitals, but I have seen the multidisciplinary approach work very effectively in burn centers, a UC clinic, and some cancer centers. It is something worth looking into and advocating for the expansion of.

 

[chirodocjrd]

My plan is to (hopefully) practice interventional radiology and work at the VA hospital after I make it into, and through, medical school. I've always wanted to give back to my fellow vets and have even attempted to go into the reserves as either an officer or as a corpsman with the intent of becoming a physician on active duty after med school, but it hasn't worked out. So I will continue on and hopefully be able to serve at the VA hospital one day.

 

[Herk Flyer]

I left active duty a few weeks ago at the 10 year point and joined the Reserves. Currently I'm in aviation but I left AD to pursue medical school. I'm looking at HPSP once I'm complete with pre-reqs but if I stay in the reserves or after I retire from AD, I would definitely like to work at a VA hospital. They are so overwhelmed and undermanned. My best friend's father (who is like my adopted Dad) is a Vietnam vet who suffered an ischemic heart attack due to Agent Orange. He also has Parkinson's and the beginning stages of dementia. The time interval between his appointments is really shocking.

I am also interested in the effects of the toxic air. I've received the health statements (like Silleme was talking about) from every deployed location I've been to over the last decade and they all say the same thing: "we don't know the health effects at this point". This is something that will effect a LARGE number of people and needs to be addressed.

Erakis, thanks for starting this thread! I'm so glad to hear about veteran student groups and was very pleased at how many schools are participating in the Joining Forces initiative.

 

[Erakis]

I left active duty a few weeks ago at the 10 year point and joined the Reserves. Currently I'm in aviation but I left AD to pursue medical school. I'm looking at HPSP once I'm complete with pre-reqs but if I stay in the reserves or after I retire from AD, I would definitely like to work at a VA hospital. They are so overwhelmed and undermanned. My best friend's father (who is like my adopted Dad) is a Vietnam vet who suffered an ischemic heart attack due to Agent Orange. He also has Parkinson's and the beginning stages of dementia. The time interval between his appointments is really shocking.

I am also interested in the effects of the toxic air. I've received the health statements (like Silleme was talking about) from every deployed location I've been to over the last decade and they all say the same thing: "we don't know the health effects at this point". This is something that will effect a LARGE number of people and needs to be addressed.

Erakis, thanks for starting this thread! I'm so glad to hear about veteran student groups and was very pleased at how many schools are participating in the Joining Forces initiative.

Thank you! I am happy to be in a position, along with other military pre-meds, to be on the ground floor of these initiatives to make sure that they are focused towards real needs.

Veteran issues are going to become a larger societal issue over the next several years, and for everything I've been through, I feel relatively blessed. There are plenty others who have not fared so well, and the longest period of war the US had ever faced is a tremendous burden, especially to people who are so young.

 

[MedPR]

If any of you are from the St. Louis area I know of an organization you might be interested in working/volunteering with.

 

[firedup0311]

Without the VA I would never be looking on the student doctor network forum.

 

[Erakis]

Without the VA I would never be looking on the student doctor network forum.

I'd like to hear more about your story

 

[NontradCA]

Post -Deployment Psych (in particular) evaluations are terrible the last I checked. I know there are a lot of individuals and money in the system that has greatly strengthened the services available to Active Duty members but the VA is seriously lacking. The government does a terrible job with the transition, and the problem is an alienation of the Wars and Veterans from the general public. So you're right, there is and will be an increased need for continuity of care for Veterans.

 

[firedup0311]

I'd like to hear more about your story

Not a very exciting story. Vocational rehab. Great opportunity for vets.

 

[NontradCA]

Not a very exciting story. Vocational rehab. Great opportunity for vets.

Voc rehab pointed you to Medicine? I'm surprised. Care to pm about this?

 

[firedup0311]

Voc rehab pointed you to Medicine? I'm surprised. Care to pm about this?

They did not point me to it. I had it in mind when I applied. I have the aptitude for it and I did a lot of legwork in order to get a plan developed. Now, the plan is currently for pharmacy but when my pre-reqs are fulfilled I am thinking about applying to med school. I was going to start a thread because the wife and I are debating this choice and I need some opinions/advice.

 

[Erakis]

They did not point me to it. I had it in mind when I applied. I have the aptitude for it and I did a lot of legwork in order to get a plan developed. Now, the plan is currently for pharmacy but when my pre-reqs are fulfilled I am thinking about applying to med school. I was going to start a thread because the wife and I are debating this choice and I need some opinions/advice.

I will likely use voc rehab for medical school. I have already been accepted and I am in the middle of a med board for lymphoma. I am curious to hear more about your background. I am biased towards encouraging military and veterans into becoming physicians, but I would like to hear more about your history and motivations.

 

[firedup0311]

I'll start a new thread so people can continue to post on this one. Regards this thread, there is going to be a flood of new veterans using the VA in the coming years and there is good opportunity to serve again by working there in some capacity.

 

[JCUnontrad]

RLTW!

 

[esob]

Biggest issue for many vets and active duty is that hardly anyone accepts tricare, which anyone with an over 30% rating will likely have. I say its the biggest issue b/c every vet I know including myself cares more about their family's healthcare than their own. Its more frustrating that I can't get my kids in to see a civilian doc b/c no one accepts tricare than it is that the VA just sucks in general.

 

[MrLogan13]

I've never heard this was the case. I was medically retired at 30% and have used Tricare Prime for the last 13 years. I've never had any issues with my PCP, and have never been denied referrals. What kind of issues have you encountered?

 

[esob]

Well there are usually no shortage of PCP providers that take tricare, but when it comes to specialists, I've had nothing but problems. I have found, if u live in a "military town" such as San Antonio, its not an issue. But here in the Dallas area, we have to drive typically an hr to see any specialist, as there are only a few that take tricare, and some things we couldn't get anyone in the metroplex to take at all. about 4 years ago my wife got hit with a baseball and had to go see an oral maxillofacial surgeon. After calling more than 2 dozen in the metroplex, none of which took tricare, we finally had to end up driving to Waco to find one that would take tricare. Many major providers that even accept insurance for the needy (such as CHP in Texas) don't even accept tricare. I've never been able to take my kids to any of cooke's children's specialists because they won't take tricare. TBH i'm continually astounded that all doctors don't take it, no matter how badly it pays, even if only on a limited basis. The same people who fly their flags on the 4th of July don't seem to have enough patriotism to accept the kids of retired vets as patients, SMH.

 

[trev5150]

with the wars drawing to a close,

What color is the sky in your world?

 

[alethiologist]

What color is the sky in your world?

Thank you for saying this, there are plenty MSMs still deployed despite the utter lack of media coverage or civilian awareness.

 

[alethiologist]

Civilians are more separated from and unaware of what veterans go through than ever before. The disconnect is immense and the only reason I know any little scrap of anything is because I have close friends who are veterans and I have a 96 year old grandfather who served in Guadalcanal--this issue is VERY close to my heart. I did a presentation for a molecular neuropathology class on blast induced TBI and PTSD when I was in undergrad and it was absolutely shocking how little my classmates knew. No-one in that class except for the professor and a daughter of an Army psychologist knew what an IED was. I showed a clip of an MRAP hitting an IED and had to explain that no one was going to the hospital to get CAT scans in the Korengal Valley after this. I brought up the MACE, the VA, and gave a brief outline of military culture as well as combat PTSD that I supplemented with a veteran made short film (It's called Now, After by SSG Kyle Hausmann-Stokes US Army, Infantry, OIF 07-08--I was referred to it as being a good portrayal of what living with PTS is like by a friend of mine who's a Marine OIF veteran ), and again it was all new and very shocking information. In my mind, it's a serious medical issue to be losing 22 veterans a day and I was completely blown away by how little my class knew.

As far as the OP, I plan on pursuing psychiatry and I want to provide pro bono care for veterans, whether it's from a practice setting or from a clinic. Ideally, I could set up a free clinic for veterans that would either be mobile or have the capacity to make house calls.

I can't pretend to know what combat is like, all I can know is what I'm told by people who lived it, and obviously that's only a fraction of the experience. I think it's my job as a civilian, especially as a civilian health professional, to not ask stupid questions and force a conversation about someone's experience with combat and war. Frankly, it's none of my business what happened unless I need a patient to tell me about symptoms. It's my job to listen and not judge if someone decides to confide in me, because it's an honor for anyone to confide in you.

I just want to help turn that 22 into a 0.