How long to stay in one place before PCS move

[twinning]

Hi all,

I am entering USUHS for the class of 2018 and I had some questions that I don't think the school will be able to help me with. No one in my family has been in the military but I hear a lot about moving around. This is one of the downfalls for me in attending USUHS/ military. I don't mind moving around now while I'm still young but when I'm trying to have a family I think it is going to be a bit harder.

I wanted to know for those of you who are more experienced:

1) Are physicians required to move around a lot even as you achieve higher rank?
2) How often do you move?
3) Do you move because you want a higher position like head of surgery at a different location or because the military needs you to fill the position? (Do you get a pay increase for this? Doesn't seem like there's a pay listed anywhere for this)
4) Is there any specialty that moves less than others? (I'm okay with deployments, but just want my family life to be stable.)

If you can let me know based on what branch you are in that would be great. I have decided to go navy so if the experiences differ greatly between branches that would be nice to know.

Thank you.



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[deleted444089]

BLUF: the answer to all your questions is "it depends."

Breaking it down question by question (I'm in the Navy):

1, 2) You should expect to move every 2-3 years, even as you achieve more senior ranks. There are certainly some cases where attendings have carved out a niche for themselves (someone who is both a residency program director and ICU director, for example) and can be stationed at one location for a long time, but they still tend to deploy from there from time to time.

3) Generally, you will move because the military will need you to fill a position. There are certain positions in executive medicine that will require you to apply/interview but you will get paid according to your rank and medical specialty, not your job title.

4) There are plenty of specialties (ex. Cardiology, Allergy/Immunology, among many others) for which there are limited billets/assignments, because the smaller, remote or overseas hospitals (i.e. the Navy doesn't have any Cardiology billets in Japan, unless that's changed in the last year) don't have the resources for that particular specialist, or whatever other reasons the service has for not having a particular specialist assigned there. The Army is known to send specialists on tours to administrative-heavy, non-clinical jobs so no specialty is theoretically 100% safe; I believe this is more rare in the Navy but I can't be sure.

The norm in your military experience will be moving often; if you get lucky you can coast at a stateside MTF in a large academic department and avoid the pain of a remote duty station, but that is extremely unlikely and it is best to expect frequent disruptions/moves that a civilian physician would rarely deal with, hence the term 'military service.'

Best of luck.

Hi all,

I am entering USUHS for the class of 2018 and I had some questions that I don't think the school will be able to help me with. No one in my family has been in the military but I hear a lot about moving around. This is one of the downfalls for me in attending USUHS/ military. I don't mind moving around now while I'm still young but when I'm trying to have a family I think it is going to be a bit harder.

I wanted to know for those of you who are more experienced:

1) Are physicians required to move around a lot even as you achieve higher rank?
2) How often do you move?
3) Do you move because you want a higher position like head of surgery at a different location or because the military needs you to fill the position? (Do you get a pay increase for this? Doesn't seem like there's a pay listed anywhere for this)
4) Is there any specialty that moves less than others? (I'm okay with deployments, but just want my family life to be stable.)

If you can let me know based on what branch you are in that would be great. I have decided to go navy so if the experiences differ greatly between branches that would be nice to know.

Thank you.



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[colbgw02]

In the Army, the conventional career path for those staying until retirement usually went something like this: residency --> Ft. Elsewhere tour/fellowship --> medical center --> homestead until retirement --> get contractor job. When it comes to higher up, but still clinical, positions - like department chairs or program directors - people move, but typically willingly. I feel like that this timeline is changing, as the Army is finding new and different ways to "mess" with you. I've known several people chosen to be brigade surgeons. And I know several more that were either forced or highly encouraged to move away from medical centers for "leadership opportunities". The historical norm that the Army wouldn't move a physician just for the hell of it is dying, IMO.

 

[twinning]

In the Army, the conventional career path for those staying until retirement usually went something like this: residency --> Ft. Elsewhere tour/fellowship --> medical center --> homestead until retirement --> get contractor job. When it comes to higher up, but still clinical, positions - like department chairs or program directors - people move, but typically willingly. I feel like that this timeline is changing, as the Army is finding new and different ways to "mess" with you. I've known several people chosen to be brigade surgeons. And I know several more that were either forced or highly encouraged to move away from medical centers for "leadership opportunities". The historical norm that the Army wouldn't move a physician just for the hell of it is dying, IMO.

Can you explain the thinking of why the military would do this? So that people don't get complacent?


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[colbgw02]

Can you explain the thinking of why the military would do this? So that people don't get complacent?


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See my reply in your other thread. It's equally appropriate here.

 

[Droopy Snoopy]

Hi all,

I am entering USUHS for the class of 2018 and I had some questions that I don't think the school will be able to help me with. No one in my family has been in the military but I hear a lot about moving around. This is one of the downfalls for me in attending USUHS/ military. I don't mind moving around now while I'm still young but when I'm trying to have a family I think it is going to be a bit harder.

I wanted to know for those of you who are more experienced:

1) Are physicians required to move around a lot even as you achieve higher rank?
2) How often do you move?
3) Do you move because you want a higher position like head of surgery at a different location or because the military needs you to fill the position? (Do you get a pay increase for this? Doesn't seem like there's a pay listed anywhere for this)
4) Is there any specialty that moves less than others? (I'm okay with deployments, but just want my family life to be stable.)

If you can let me know based on what branch you are in that would be great. I have decided to go navy so if the experiences differ greatly between branches that would be nice to know.

Thank you.
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For the AF:
1 and 2) Yes. You should expect to move every 4 years at a minimum (3 years mandatory if you're stationed OCOUNS, although there are rare 'hardship' billets like Korea that you may volunteer for that give you base-of-preference following a 1- or 2-year fill. There are also rare exceptions, mostly in the case of subspecialists, who are stationed in the same major CONUS locations for multiple tours on end because their skills are best utilized there (i.e. neurology, radiology, interventional cards).
3) Pay is entirely independent of billet... you are paid for your years of service, your rank, your specialty/board certification, and your status in terms of whether you have fulfilled your initial service obligation.
4) Your family life will not be stable. If your family life happens to be stable you should consider it a rare perk and not the default. See #3 above.

 

[deuist]

I'm okay with deployments, but just want my family life to be stable.

There aren't many things that destabilize a marriage more than being gone 6-12 months at a time.

 

[pgg]

OP, it depends.

I'm going to throw out a contrary opinion to the above. Overall, I think we're likely to see LESS arbitrary movement of doctors in the future. PCS moves cost a ton of money. Moving a doctor for the hell of it is wasted money. The flip side of this is that it may become a lot harder for people who WANT to make distant PCS moves to get the orders they want (say, from east to west coast).

Mid-late career people at the big med centers routinely spend many years there ... and the ones that leave seem to be going voluntarily, often because they need something for their record to get promoted to O6 (there's a perception that it is hard to break out as one of a horde of faceless O5 doctors at a big med center). Homesteading is not always career enhancing.

I'm coming up on 5 years at my current duty station. I'm PCS'ing this summer, and minus an anticipated year for fellowship at some point, I expect I'll be able to stay where I'm going for at least that long. But nothing is certain.

Frequent moves are easier if your spouse has no job outside the home, or an easily mobile job. Moves - even q5 or q6 years - can be very hard on professional spouses trying to maintain and grow their own careers. They sacrifice a lot.

There aren't many things that destabilize a marriage more than being gone 6-12 months at a time.

I think "destabilize" is a pretty dramatic word. A deployment is certainly a stressor, but it's easier now than it was even 10 years ago, with many (most?) deployed locations having private 24/7 near-broadband internet available. Last year I was deployed and talked to my family multiple times per day, just about every day. Being apart sucks, sure, but if you leave for a while and she doesn't want you to come back, there's more than a deployment going on.

 

[notdeadyet]

Being apart sucks, sure, but if you leave for a while and she doesn't want you to come back, there's more than a deployment going on.

I think you might be underselling the impact deployments can have on a marriage. Or on children (you can make a very neat line graph of kids in need of mental health treatment for anxiety disorders and the number of deployments mom or dad has been on).

I would be hard pressed to tell someone struggling to keep a job and raise kids while their spouse was deployed for a year that the experience isn't dramatic enough to constitute destabilized. For some military families, the deployment is more hard on those left behind than those overseas.

 

[pgg]

I think you might be underselling the impact deployments can have on a marriage. Or on children (you can make a very neat line graph of kids in need of mental health treatment for anxiety disorders and the number of deployments mom or dad has been on).

I would be hard pressed to tell someone struggling to keep a job and raise kids while their spouse was deployed for a year that the experience isn't dramatic enough to constitute destabilized. For some military families, the deployment is more hard on those left behind than those overseas.

Fair enough. My deployed life last year was pretty easy on me; 8+ hours of sleep every day plus naps, nice gym, someone making all my meals, safe comfy quarters (albeit with a roommate), good cases, busy enough to be occupied but not overwhelmed with work. My wife is a full-time stay-at-home mom so we've had it easier than some. I don't mean to completely dismiss the family stress of a deployment. My 2nd deployment was pretty hard on my then-4-year-old (he's now 14; no apparent scars). As a marital stress, maybe I'm just not a very understanding guy, but I don't really understand it. I guess I can see a response like "that deployment sucked, you either get outta the military first chance or I'm leaving" but honestly if a marriage can survive med school, internship, and residency then I don't see a deployment as much worse.

But definitely something everyone joining the military should be aware of, whether in a medical field or not.

 

[Simplestone]

How does the whole deployment and moving aspect work for spouses who are both military physicians within the same branch? My wife and I are in medical school together and are considering the HPSP scholarship, but I'm having trouble finding information on how the military match and post-residency process would work for us.

 

[deuist]

How does the whole deployment and moving aspect work for spouses who are both military physicians within the same branch? My wife and I are in medical school together and are considering the HPSP scholarship, but I'm having trouble finding information on how the military match and post-residency process would work for us.

They may keep you at the same location, or they may separate you. You may even deploy at the same time.

 

[MaximusD]

Just say, "No" if you have this extensive list of predemands.

 

[Kilgoretrout 65]

How does the whole deployment and moving aspect work for spouses who are both military physicians within the same branch? My wife and I are in medical school together and are considering the HPSP scholarship, but I'm having trouble finding information on how the military match and post-residency process would work for us.

Usually, but not always, in my Air Force experience, the military tries to keep joint spouses together through residency and staff assignments. Deployments would be harder to predict. It would be harder, I think, to have one military physician spouse and another a physician but not in the military, unless that spouse was primary care and flexible to work at doc in the box.

I was witness to one episode where the higher ups did not want married spouses working together in the same residency and "forced" one to do a civ-sponsored residency
in the same field. I thought that the program could have figured out a way to have them not supervise each other.

 

[jabreal00]

How does the whole deployment and moving aspect work for spouses who are both military physicians within the same branch? My wife and I are in medical school together and are considering the HPSP scholarship, but I'm having trouble finding information on how the military match and post-residency process would work for us.

Well speaking from experience it's going on two years that I am separated from my wife who also is an active duty physician. My consultant said something about "Army needs" come first.

 

[twinning]

Well speaking from experience it's going on two years that I am separated from my wife who also is an active duty physician. My consultant said something about "Army needs" come first.

Separated as in stationed in different locations or separated as in about to get a divorce due to the different stations?


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[BigNavyPedsGuy]

Separated as in stationed in different locations or separated as in about to get a divorce due to the different stations?


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He means different stations. I have a residency classmate (Active Duty Doc) who has spent the last 3 years geographically separated from her (Active Duty Doc) spouse. They deployed him on an IA. While he was gone they moved her (she was also pregnant) across the country. When he returned they said, "oh, there's no billet for you there, you have to stay where you were" - which was across the country from his wife and infant son. That game went on for 2.5 more years. This summer they will both be reunited after getting out of the military.

 

[jabreal00]

Separated as in stationed in different locations or separated as in about to get a divorce due to the different stations?


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Geographically separated. Our stations are 800 miles away. So it means flights every 2 weeks.