Military EM

[Perrotfish]

Are there any military EMs that could offer a description of their job, particularly as it compares to civilian EM and difficulty of matching into the residency?

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[TerraMedicX]

I'm going to bump this. I'd be interested in even hearing a little broader of answers. Would you guys tell us your general impression of EM in the military? I've searched the archives and found some good information, but I still would like more perspective. From my research it seems that the Army has the most available positions for EM docs and residency slots, but what about the Navy and AF? Also, are there many positions for EM docs other than at the major military hospitals? When deployed, what types of duty can you expect? Anything else you'd like to share for those of us considering the route would be great!

Thanks,
Nate.

 

[The White Coat Investor]

I'm going to bump this. I'd be interested in even hearing a little broader of answers. Would you guys tell us your general impression of EM in the military? I've searched the archives and found some good information, but I still would like more perspective. From my research it seems that the Army has the most available positions for EM docs and residency slots, but what about the Navy and AF? Also, are there many positions for EM docs other than at the major military hospitals? When deployed, what types of duty can you expect? Anything else you'd like to share for those of us considering the route would be great!

Thanks,
Nate.

I did HPSP, Civilian residency, and have been active duty since that time. I'm currently deployed.

EM in the military bites sufficiently that the retention rate is less than 5%. This for several reasons:

1) You don't really get to practice Emergency Medicine, even at the big academic centers. The patient population isn't very sick. There aren't very many old cardiac/septic patients and there aren't very many traumas compared to many/most civilian EDs. There are a LOT fewer procedures in military EDs/UCCs.

2) The usual military stuff...deployments, being told where you can live, not having control over your work environment etc

3) The pay. I make $115-120 a year out of residency. My residency mates signed for $200-$240K/year, more after making partner in 2-3 years.

A few deployments are pretty interesting, for example going to the big trauma center at Balad. But MOST EPs don't get to go there. They get sent places like where I am now. Not only do I not see any emergencies, but I don't see any trauma either. In fact, I am currently doing stuff I wasn't even trained in, such as taking care of high cholesterol and high blood pressure.

While the military needs good EPs for the occasional times when it has a need for us, I cannot in good conscience tell someone to sacrifice their career, their freedom, and their family life by signing up for HPSP/USUHS.

Military EM is like internal medicine. I'm glad someone is willing to do it, but I'm not.

 

[Ex-44E3A]

Good reply from ActiveDutyMD.

My experience was much the same. Most of my deployments were urgent-care work, and could easily have been covered by an FP and a clutch of PAs. Very rarely did they have a patient who needed the skills of a fully-trained EP. When I got back, it had been so long since I'd practiced any real EM that I actually had to stop and think for a second when an old person with chest pain rolled in the door... that's scary for a boarded EM doc; you ought to be able to do that with your eyes closed.

Skill atrophy is real... you'd better moonlight as a military EM doc if you want to stay competitive for jobs when you separate. When I was interviewing for civilian gigs around separation time, I was asked by every single group whether I moonlit outside of my military hospital; the word's out.

The military interference in your life is substantial, and you get paid about half or less compared to your civilian colleagues. Financially, military EM is a losing deal, hands down.