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Military Rotations/Bases

Discussion in 'Military Medicine' started by Homunculus, 01.11.05.

  1. psychbender

    psychbender Cynical Member

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    Physician Army SDN 7+ Year Member

    SDN Members don't see this ad. (About Ads)
    From the Holiday Inn commercials. "Oh, I'm not a doctor, but I did stay at a Holiday Inn last night."

    Anyone have reviews of Army EM programs? Specifically MAMC and Darnall?
  2. Capt_Mac

    Capt_Mac Member

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    As of May 1, Darnall will have MEDCEN status.
  3. psychbender

    psychbender Cynical Member

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    So what, exactly, does that mean aside from a name change?
  4. Capt_Mac

    Capt_Mac Member

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    Funding, they are also planning on expanding serivces. Right now, not much more than a name.

    I was pretty impressed with the ER residents up there. They deal exclusively with staff when they call for consults. They have their information put together and know what is up with their patients.
  5. RichL025

    RichL025 Senior Member

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    Errr, that's because (aside from FP) there are no other residents there!
  6. Capt_Mac

    Capt_Mac Member

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    Yes, I realize that. If one of their residents called the surgery staff with the stuff that the guys at my facility call about they would get roasted. They approach it much more like a civilian practice and with more professionalism.
  7. monkeybaronjr

    monkeybaronjr New Member

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    Can anyone share some experiences they've had with Army surgical rotations??

    I am studying for my USMLE Step 1 right now and am attempting to get my army rotations set. As of now, I am specifically interested in BAMC (loved San Antonio down at OBC) and Madigan, but am still cnsidering other sites. How would you rate your site compared to other sites? What were some of your experiences with the surgery rotation? Pros and cons of your rotation? Things you wish you had known?

    As far as residency programs are concerned, at this time I am very interested in trauma, but haven't decided on a general surgery or orthopedic route. For those of you Army surgical residents that follow these forums, what are your opinions about some of the Army surgical sites? How is the caseload (most important to me at this time) and what would you recommend? What is your city like? Overall pros and cons??

    I thank everyone in advance for their input.
  8. generalks

    generalks Life is Dance

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    The hospital is beautiful. It consists of different buildings, and you can walk outside to get to each of them, which means enjoying the beautiful southern California weather.

    Service: 2 weeks of Spine, 2 weeks of Major Joint during summer 2005

    Spine
    The service is basically just 1 attending and 1 chief resident. There are only 2 OR days out of the week, and 3 clinic days. Clinic was useful, and I learned how to thoroughly assess spine problems. The main attending on this service was tough, would pimp on anything under the sun (in orthopedics and outside of orthopedics). The resident on this service was in his last year of residency, and was very helpful and knowledgeable.

    Days typically start at 6-6:30 AM with conference. On surgery days, cases start around 7 AM, and goes typically until around 5 PM, with breaks in between. Clinic is located at a separate site, which required some driving. On clinic days, you could be done as early as 3:30 PM, but typically 5 PM. Weekends, I came in just one day to round on one patient, then was done. I was responsible to present one paper per week, and the resident was very helpful in teaching how to critically present a paper.

    Pros: great resident, extra time to read, experience presenting research papers
    Cons: tough attending, low case load

    Major Joint
    The service consisted of 2 attendings, 2 chief residents, 1 junior resident, and 1 intern. Weekly schedule: 2 OR days, 3 clinic days. OR days were great, got to scrub in and get right in there to be helpful with retraction, and even participate in the surgery itself. Best cases were the joint replacements. I did not particularly enjoy the cases with scopes, found it unexciting and difficult to appreciate. Clinic was useful, and learned how to perform a thorough knee and hip exam.

    Days start 6ish, finish around 5 PMish. I got one full weekend off. Chief resident can be rather tough. Junior resident and intern were great to work with. Attendings were generally nice but can be rather stand offish. I was responsible for presenting one paper per week, which was educational.

    Pros: great OR experience, experience presenting research papers
    Cons: none really

    I only took call a few times, which meant staying late at night in the Cast Room. No overnight call, because they wanted you to be present all day the next day.

    People in this department were great, they wanted you to have a good amount of free time to see and enjoy San Diego, which I definitely did :)

    Feel free to contact me with any questions about NMCSD and the Orthopedics Dept.
  9. generalks

    generalks Life is Dance

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    National Naval Medical Center (NNMC) Bethesda
    Trauma, Vascular Surgery, and Pediatric Surgery (i.e. red team) - early fall 2005

    This was a very busy service. Almost all of the patients were young marines injured in Iraq. All my 4 weeks was devoted to this service. It was, however, a valuable experience and memorable one to be involved in the care of service members involved in OIF (Operation Iraqi Freedom)
    Schedule: Get in as early as 4:30 AM, pre-round, then round, then conference at 6-7ish, then day’s work. Out by evening, average around 7:30 PM. I can easily go through the day without any sun exposure. I would get one day off per week (Sunday or Saturday).
    The trauma service definitely took up most of the time, b/c of the shear caseload (lots of injured marines)
    Two clinic days were mainly allotted for the vascular service. But pediatric surgery was scheduled on those days too. There were only a few pediatric surgery cases.

    Do not do this service if you are looking for bread-and-butter general surgery. Most of the OR cases were wash-outs or some kind of revision surgery. Some cases were bread-and-butter vascular (CEAs, etc.)

    There were a lot of students on the service, two subinterns and three 3rd year USUHS med students, and even one week, there was an overlap of four subinterns, including myself. This is good for pre-rounding, b/c you can more evenly split the patients. But bad for OR experiences.

    Didactics in this rotation overall were quite bad. It was very busy, but also, there was a lack of devoted teaching sessions. Some of the residents were great, and so were a few of the attendings. But overall, I felt that the teachings were mainly grueling pimping sessions during morning conferences. This fact turned me off to NNMC Bethesda for general surgery.
  10. monkeybaronjr

    monkeybaronjr New Member

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    I have made this question a separate thread. Thanks, generalks, for your persepective.
  11. former military

    former military Member

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    I just left travis after five years... the surg residency is integrated with uc davis so there is plenty of traveling to sacramento and other places too. At Travis, there are not a lot of cases and lots of staff deployment. In general, the hospital morale is as low as could possibly be... train civilian
  12. gabrieldlt

    gabrieldlt New Member

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    Hello. I am sort of new to this. Regardless, I am an MS IV with the Navy HPSP looking for info on general surgery and came upon this message. It is sort of dissappointing b/c I was planning to do a gen. surgery clerkship at NNMC, which is my interest in GME. Have you any idea how the surgery programs compare between Bethesda, San Diego, and Portsmouth?

    Thanks
  13. aidith

    aidith Junior Member

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    Hello!

    I am starting my Internal Medicine clerkship next week at NMC San Diego. Has anybody completed this rotation? Can you please share your experience? Thank you!
  14. Tired

    Tired Still winning.

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    I'm actually Navy HPSP, but I had the chance to do a month at TAMC Ortho, so I figured I'd share my experiences in case any of you Army kids are considering it.

    Structure
    0500-0545 Round on your patients and bang out your notes, usually 1-3
    patients per student. There were 4 of us in July when I was
    there.
    0545-0630 Rounds with the residents and the Chief. Get used to giving a 15 second summary of your patient. If you can't talk fast, you
    don't belong in Ortho, go do IM.
    0630-0730 Morning rounds with the Staff. Students sit and listen, and I
    was never asked a pimp question unless I presented a patient.
    You don't have to present cases, but they respect you more if
    you stand up and be a man about it.
    0730-1630 Cases or cast clinic (see below)

    Call
    Once a week, and you actually get called a lot for ER cases. Make sure you find out where the call room is. I slept the cast clinic for 3 weeks before I finally found it.

    OR Cases/Clinic
    The chief assigns you to follow one team per week, which gives you a nice diversity of experiences, but also makes it much harder to get noticed by the Staff or Residents. Most teams do three days of OR and two days of clinic. Like most places, the case load is extremely varied depending on which team you are on, and how many OIF/OEF guys are in house. All the attendings I worked with were very serious guys, but were also very committed to teaching, even in the OR.

    Cast Clinic
    The most unique and impressive part of TAMC Ortho. Everything Ortho runs through this clinic, and it is entirely run by the R2 guys. They are *constantly* slammed, and saw something like 40-50 patients every day. Fortunately, the cast room techs were awesome, and the clinic really moved efficiently. Students were given free reign to see any patient who came in the door, and the R2s were very open and friendly and glad to have you around. Normally I hate clinics, but this one was actually a blast.

    Be Prepared for a Few Quirks
    1) 15 second summaries of you inpatients. They don't want long-winded complete presentations, just the things that are relevant to the patient's care that day. Get used to hitting important bullet points, and being super-efficient. They will roll their eyes if you talk too long, but they will really crack the whip if you fail to mention something important (ie - fevers, refusing PT).
    2) Every morning in Staff rounds, a student stands up and gives a brief summary of the important news events and sports scores. It seems silly at first, but DO NOT UNDERESTIMATE THE IMPORTANCE OF THIS ACTIVITY. This is how the Staff remembers your name, and if you can speak clearly you will score big extra points with both staff and residents. While I was on service, North Korea tested their first ICBM, and the student giving the news failed to mention this. This was talked about for a week.

    Keys to Success
    Since I am Navy, and had no opportunity to apply to this program, I felt like I had a fairly objective viewpoint of what worked and what didn't. I saw a couple students stand out, and at least one fail miserably. Let me offer a couple thoughts
    - Like everything Ortho, know your anatomy cold. Staff is much more willing to teach if you appear to have read about the cases the night before.
    - Every student is expected to give a 10-15 minute talk on a subject. Get together with a resident to review it before you give it. I had an awesome R3 review my talk, and he gave me *excellent* editing that got me a lot of compliments.
    - Learn to tell (and take) a joke. If you've done any Ortho, you know that it is a very social specialty, where the residents love to talk about sports and joke around a lot. I got a ton of cracks about my Summer Whites, most of which were actually really funny. As much as possible, stay loose and roll with the jokes, it's all in good fun.
    - Be efficient or be gone. The days of 20 minute patient presentations you gave as an MS3 are gone. If you need help figuring out what's important, talk to the R2s about it, they will be happy to help you out.
    - To repeat, do not underestimate the importance of giving the news.

    In summary, the Army has a great department in TAMC Ortho. I had a fantastic month, to the point where I actually considered trying to switch over to the Army so I could apply there. In the end I decided against it, and after doing my rotation at NNMC I'm glad I didn't. I would recommend this rotation for any Army student with any interest in Orthopedics.

    I also did Ortho rotations at NNMC and NMCSD, but it seems prudent to wait until after the Selection Board results are released before I write about Navy programs.
  15. Ziehl-Nielsen

    Ziehl-Nielsen That had not occurred to us, Dude.

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    Now that the hubub has died down and I've already gotten my spot; I'll post a bit for students considering the dark and mysterious beast of army path. I only rotated at 2 of the 3 spots and will confine my comments to such, so caveat emptor (or lector as the case may be) and all that good stuff.

    Madigan
    If one is familiar with the daily workings of of an academic pathology department this is not much different. Roll in about 0730, grab a cup of coffee and head back to the cubicle. I was there during the 2 month break from the academic calendar so there were not any lectures during my rotation; however, residents told me that the lectures are generally quite good and are oriented toward board sort of material. They also mention that a heavy burden for these lectures falls on the residents (as the faculty is not as large here as a major academic institution). Morning report occurs on Mondays and Fridays when the on-call resident discusses interesting issues or cases that may have occurred during the intervening time. Then, its off to work. The attendings pair the student with a senior resident on an surg path rotation and you follow him/her for the majority of the time. One really gets a good sense of life on surg path. Day 1--gross with the resident: there are no PA's to help with grossing so it is a pretty grueling day in the grossing room (8-5 with a 45 minute lunch is the norm)--they cap at 75 specimens per day. Day 2 is pure preview with the entire day protected for preview of the slides. Day 3 is sign out with the attending and Day 4 frozens and QC stuff. They also have you spend a week on hemepath to get a bit of experience on the CP side of things. Those days were pretty much normal CP with lots of reading in the morning and review of any specimens and lecture with the attending and any procedures (pathologists do bone marrow biopsies here) in the afternoon. One is expected to do a 15 minute presentation on a pathologic issue at the end of the rotation.


    Pros and Cons:
    The rotation is extremely well structured--the best I have encoutered and I have done a number of path rotations. On most path rotations the student is left to fend for himself and kind of has to dig up things to do because there is no way in which a student can really help the service. This is not the case here. From the first day I was paired with a senior resident and did what he did. The learning curve is steep and its a great introduction to path for the uninitiated. Obviously, so much depends upon a red wheelbarrow, just kidding, on the resident and I found the residents there to be just awesome. All were smart, convivial, and great teachers who were always willing to answer a question, show you something cool, or even invite you out to do something with them and see Seattle. CP here is like CP everywhere with a lot of independent reading time. The attendings were great, without exception. They were willing to give advice, sign out with you, and are great teachers. The small department really fosters a great atmosphere and you will learn a ton. I cannot think of a negative aspect of this rotation.

    Walter Reed
    The typical path rotation. You show up at 0730 and go to morning lecture. Lectures here were very good. The lecturers are primarily faculty from the AFIP and so are recognized experts in their fields. The result is what you'd expect: expansive lectures on many topics with much of the current thinking presented and less of an orientation toward the stuff you'll see on the boards. Lectures occur at Reed and NNMC so there is a complicated AV hook up for the residents at the other institution. The rest of the day is spent reading, wandering around, and hoping a resident or attending will throw you a bone and ask you to look at some stuff or help with something with the occasional afternoon lecture or tumor board thrown in for good measure.

    Pros and Cons
    I don't want to dog the rotation that much because it truly is the typical pathology rotation for med students. Pathology is unique in that there is no defined role for students and they are indeed a burden on the docs who are trying to get the work done. Path and Rads are known as 4th year blow off rotations for a reason, because the work gets done despite your presence and you are not required to be there. Path is even less user friendly to students because in rads you can at least sit back and look at the screen as scans are reviewed, while path is limited by heads at the scope. It is assumed that a student wants a light month and you will be treated accordingly. That said, the reseidents are quite friendly and I was asked many times by them to look at some slides or take a look at something cool. One even offered to take me to NNMC to see the other half of the program (I though this was quite kind). Suffice it to say, this is a typical path rotation, and the excellent rotation at Madigan had me expecting more. Hopefully, I can improve things next year there for med students.

    Tips For Success
    There is only one tip: show the programs that you are an individual with whom they would like to work. Again, path is unique because medical students possess no knowledge of pathology and cannot contribute in any meaningful way. Attendings and residents know this and do not care if you cannot recognize a junctional nevus or a hyperplastic colon polyp, you will learn as a resident. The one thing programs do care about is personality. As a specialty, pathology requires more social interaction with one's colleagues than any other and there is nothing that sucks the life out of a day quicker than a person who is difficult to deal with. So be eager to learn, jump at the chance to look at something even if you don't want to, do not be surly, show up on time every morning, don't shirk responsibilities, help in any way that you can, and have normal conversations with people so they can learn that you are a nice, normal, generally pleasant person. In other words: DO NOT BE AN ASS!
  16. lp=md

    lp=md

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    If so, I would love to hear about it, and any advice you have to offer. I think EM residency is only offered at SAUSHEC/Brooke, Madigan, and Darnall? Does anyone know the pro's and con's of each place?

    Also, is getting into EM residency very competitive/somewhat competitive in the military? Are you more likely to be deployed if you are an Army EM doc?
    Thanks!:D
  17. SquidDoc

    SquidDoc Member

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    Well, how did it go? I am doing a GI rotation there starting on Jan 22nd, and would love to get a heads-up. Thanks!
  18. 46&2

    46&2 Member

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    Lodging / getting around: AF does practically everything. You'll probably get a rent car and live in the AF Lodge, which is a hotel right next to the hospital. Only problem is they'll bill you directly for these perks, but you can fill a reimbursement form and get your $$$ back.

    Schedule: 3 weeks at Wright Patt, 1 week at Miami Valley Hospital for trauma. I typically got up around 5-6 AM, rounded, then went to OR. Went to clinic once awhile. One day a week with 2-3 hours of M&M and discussion. Got out around 4-5 PM. Took one night of trauma call. At Wright Patt, you can ask the person on call to page you if an operation will happen.

    Pros: Really enjoyed my time there. Attendings were helpful, very reasonable. Wright Patt pretty calm overall. Dayton seems to have a decent amount of trauma. Scrubbed into a Whipple at MVH with only the attending and chief present (compared to Wilford Hall where you had to fight to get on a lap chole). Wore BDUs every day. Cheap cost of living. Interviewed for the program while I was there (2 with civilian, 1 military). This is basically a Wright State civilian program. You spend >90% of your time in Dayton.

    Cons: Census and caseload are low. Number of attendings will vary due to deployments, which means OR can also suffer. Interns Q3. This program is getting more competitive in the AF since many want to avoid Kessler and the 7 year San Antonio program.

    Overall would not have mind matching here. Worth rotating here.
  19. chriseli

    chriseli Mom. Wife. Neo-to-be.

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    I'm currently a 3rd yr HPSP student planning my 4th yr electives. Does anyone have any reviews of the different residency or 4th yr clerkship programs in the AF?

    Also, does anyone know what the life is like as an AF peds resident in the program at NMCP??

    Thanks!
  20. finnyel

    finnyel

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    Is surgery in the AF any different from surgery in the private world? - the descriptions of the hours seem like it might be more sane. I'd love to entertain the idea of a surgery residency, but not at the price of not being around to watch my daughter grow up.

    Also I'm curious how you work with more than one program before having to apply. I thought we only got one away rotation our 4th year (HPSP). So it feels like I have to practically make my decision of where I want to be for residency in where I do that rotation.

    thanks!
  21. psychbender

    psychbender Cynical Member

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    You have one ADT for each year of scholarship. Your third-year ADT can actually be taken in your fourth year (remember, the military year starts October 1). So, your third-year ADT can be September of your 4th year, while your 4th year ADT can be in October of the same year. Additionally, you can do all the NADT rotations that your school will allow, and you can arrange. Example: my 3rd year ADT is being used for OBC (couldn't go before school started, and we're year-round so after MS1 was out of the question), and I'm doing ADT and NADT months in September/October of 4th year. I'm also doing 2 NADT rotations in my 3rd year, to get acquainted with the Army medical system.
  22. buglady

    buglady We need more cowbell

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    I've already posted this elsewhere, but since this is the official thread for rotations/bases....

    I've done both Family Medicine rotations at Camp Pendleton and Bremerton. While I thought both programs were great in their own way, I decided to rank Bremerton as my number one choice for this year's military match. I'm heading off to Bremerton in June....So here's what I have to say about each program:

    Camp Pendleton: In Oceanside, almost always sunny and the FP clinic chock full of young Marines and their dependents! You will not be disappointed in the variety. I was surprised by some of the zebras I saw while there this summer. Many of the zebras where seen in Marines returning from Iraq...All the residents were great and easy to get along with. The staff was a bit sparse, mostly because of deployments, so I didn't have that much interaction with them. There was a civilian physician that was assigned as my advisor and did a poor job helping me out. She seemed totallly disinterested in me. Most of the residents did not like her either, so I was glad it wasn't just me she was weird to!

    Typical days included morning report, short lecture/case presentation then either clinic or inpatient stuff. Most days you were done by 1630-1700 (not counting call of course). Most of my clinic days I worked with residents. I was on the inpatient team for Family Med for a week and it was pretty slow. A few chest pains and some gyn stuff. I spent a few on-call nights on the Labor Deck. If you really want a busy OB experience, CP is a great place to catch some babies. The program has 12 resident spots vs. Bremerton's six spots.

    Bremerton: On the beautiful Kitsap Peninsula, surrounded by evergreens and view of the Olympic Mtn range. Nearby bases include the sub base in Bangor and the Puget Sound Naval Shipyard in Bremerton. The Family Medicine Clinic was recently renovated/rebuilt and the views are amazing. Lots of windows and a great view of Mt. Ranier on clear days.

    Typical day very similar to CP's. Morning report, short case report by the residents on call and then a mini-lecture, then either clinic or inpt stuff. Again, the residents were great to work with, and the staff physicians impressed me. They were all extremely intelligent, did their jobs well and most importantly, were good, patient teachers. The patient population in Bremerton was different from CP. In CP, you'll deal with 99% Marines. In Bremerton, you see alot of nukes and sailors from whichever ships are in port at the shipyard. I think I saw one Marine at one of the branch clinics at Bangor. Although the montly births were higher at CP, there are less residents to go around at Bremerton, so they're kept busy!

    For me, Western Washington is more my style than Southern CA and I could easily afford to buy a house in WA vs. CA. I liked the smaller program at Bremerton and overall, I just thought it would be a better fit for me...
  23. 46&2

    46&2 Member

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    Schedule: Spent several weeks at WHMC. The general surgery deparment is divided into two teams: Falcon and Eagle. They alternate call nights for Level I trauma. Eagle (if this is still current) specializes in breast, while Falcon does colorectal. Both do an assortment of general surgery procedures depending on the attendings (advanced laparoscopic, Whipples, etc) I took call on the weekends, partly because we had a lot of students on both teams. Expect to arrive before 0500, leave ????.

    I remember a *lot* of clinic (at least 2 full days + 1 half day) and very little OR time (2 OR days to split among 4 students and 3-4 interns). This probably varies on your team and which attendings are there. Deployments really change the atmosphere.

    Pros: Biggest AF hospital, lot of different attendings & residents to meet. Also has subspecialties in nearly everything (ENT, neurosug, vascular, etc). Best diversity of cases for general surgery, including lap gastric bypass. Level I trauma can be interesting. Some very good attendings. Guaranteed research (if you like that). Will spend around 3/4 time at U of Texas San Antonio to get even more experience. High acuity Level I trauma, good transplant program at UTSA. Cheap area to live, traffic not bad considering San Antonio's size.

    Cons: Too crowded for students; there will be at least 3 UT San Antonio students plus whatever MS-IVs doing an audition. This equals few opportunities to go to the OR unless you're on call. Clinic is very painful. A chaotic and odd scheduling system, as both teams perform bread and butter general surgery and take Level I trauma simultaneously on alternating days. I experienced the worst attending (non-AF) I've ever met there. Morale overall seemed low. 7 year program, little hands on experience first two years. Grand rounds done at UTSA (which is 15-20 minutes away). UT San Antonio will fail you based on repeated 'poor' ABSITE performances.

    Overall: Did not like it. Perhaps worth it to see the major AF hospital and its capabilities. I know other students who enjoyed there time there, and others who were unhappy. See for yourself.
  24. aidith

    aidith Junior Member

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    Has anybody done a General Surgery clerkship at NNMC Bethesda?? I will also be doing Plastic Surgery there so if anyone has any feedback on either (or both!) that would be awesome! Thank you very much. :cool:


    I am wondering if the Trauma/Vascular/Peds Surgery rotations is the same service as General Surgery. Maybe I wasn't reading it right but it almost sounded as though the post was also describing General Surgery, however I'm confused since it started with a different title. :confused:


    Any help is MUCH appreciated.
  25. Scooby007

    Scooby007

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    How difficult is it to do an Internal Medicine ADT rotation at Tripler?

    What about the competitiveness of a residency there?

    Any thoughts/suggestions on what to do or who to contact to improve competitiveness and/or receive more information? Also, can you work in the ER as an IM doc in the military? (I know you can as a civilian - alot of the ER docs at my hospital are IM or FP. Not sure how this works in the military.)

    Thanks!!
  26. texdrake

    texdrake Stand-Up Philosopher

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    It is not difficult to do any rotation here at Tripler. They are very welcoming to students. If you are interested in IM then go for it, however, most students choose to do other specialties when the visit Tripler so that they can get out and see the island more (IM is pretty busy...)

    IM is not that competitive at any of the military locations, their usually close to 1:1 match rate.

    You can work in ER in the military if you are FP, ER, or IM certified, however it is often not up to you. You just get assigned there. At Tripler I do not think we have any IM in the ER but we do have a couple FP's and the rest are ER certified (We may be different than others though as a lot of the docs in the ER here are not military (Most ER docs are deployed rapidly).
  27. NJEMT1

    NJEMT1 Member

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    Anyone rotated at either of these places? I'm going to Wilford Hall in June and Wright Patterson in Sept/Oct. Thanks for any heads up you can give me!

    - Lauren
  28. mar8d

    mar8d

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    I'm currently at Willford Hall finishing up my last week of my EM rotation, and will do another one at Wright Patt to in July to help me figure out which program I'll rank 1st.

    Cons: At first the rotation was a little disorganized. The staff had no idea I was starting when I arrived, so my schedule wasn't set. (To be fair, my med school ends our 3rd year a bit earlier than most, so admin might have misunderstood that I was a new 4th year coming in to do a rotation.) Also, unlike previous clerkships, I presented my pts mostly to the residents and not the attendings, so I felt hesitant to ask the attendings for letters of recommendation (which you will definitely need if planning on applying to the program.) As far as prospectives for residency - some residents weren't enthusiastic (and honestly I'm not 100% excited) about living in San Antonio, but I don't know how this compares to OH.

    Pros: Really great senior residents, (who unfortunately are leaving in June, so this might not apply to students coming in after me). They were really great mentors - compassionate, quick on their feet, calm in the face of chaos, and remarkably great multitaskers...all that you'd strive for as an aspiring EM physician. They seemed to really look out for me, (esp when it came to grilling from other services that might not want to admit our pt.) And they were very candid about the program, its plusses and minuses, and spent a some time advising me on getting my Recs, about my long term career goals, and how to think as an EM physician. Another huge plus was the exposure to Code III traumas, which were run by the ED team (vs. general surgery), and learning about intubations, chest tubes, general mgt of a trauma etc. Great opportunity to do procedures - LPs and I and Ds. Also, a requirement of the clerkship is to get evaluated after every shift you do, which I thought was a good way for you to get feedback and see where you needed to improve and whether or not you were recommended for the program. Lastly, diverse population of pts. - peds, geriatrics, and young trainees...interesting surgical (lots of ortho), medicine, and OB/GYN emergencies.


    Overall, solid rotation, esp if you are AF and considering doing EM a great way to get a feel for the program and the satisfaction of the residents. Like any residency program it sounds like they appreciate students who work hard, have good presentation skills, can come up with a broad differential with an appropriate plan, and have a good attitude. Be prepared to take an exam at the end of the rotation (haven't done that yet so can't comment too much.) Expect to work days, evenings, and nights.
  29. bustbones26

    bustbones26 Senior Member

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    EM in the army for the past couple of years has been very competitive. But please do not let that stop you from applying. There were three transitionals in my intern class who applied to EM for PGY2 year, only one got picked up and he pretty much had to repeat an R1 year, but hey, it was worth it to him.

    Yes, EM docs get deployed a lot, but so does FP, PEDS, SURGERY, and IM. As long as we are not at peacetime, expect to get deployed at least once in your career. So in summary, don't let that influence your decision.

    I am at MAMC, I am NOT an EM resident, but certainly can tell you a thing or two about them and I did rotate through the ED as an intern. If you want more details than that, please PM me.
  30. jbernar1

    jbernar1 Senior Member

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    Anyone currently working at Madigan who can give me a general idea of what the hospital environment and Tacoma is like?
  31. ArmyDO

    ArmyDO

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    Hi, could anyone provide some information regarding OB/GYN within the Army? Such as how competitive it is, which of the programs give better training, how many spots are there, and any specific information about each of the 4 locations.

    Thanks in advance!
  32. BostonSean

    BostonSean Junior Member

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    I am interested in IM. I am rotating at WRAMC, BAMC, and Madigan soon. Is there anyone out there who has rotated at these spots or is currently a resident at any of these places that can speak about there experience?
  33. texdrake

    texdrake Stand-Up Philosopher

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    Not sure on spots. There are around 5 at all the programs. They are all very busy (The military attracks a lot of young people who don't apparently realize that you don't have to have kids at 19). You will likely get very good training at any.
  34. Haversian

    Haversian Haversian

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  35. sls1425

    sls1425

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    does anyone have any info on the WH rotations or residency? im heading down in two weeks for my audition rotation and just wanted to be prepared.
  36. Angel

    Angel Member

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    Has any one done Anesthesiology at these Army Facilities. Any insight on these these rotations would be great. Thanks:)
  37. Jaundice101

    Jaundice101

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    For those interested, I completed some time with the medicine folk at Wright-Patt a short while back and had some thoughts:

    1) Wright-Patt is not too terribly busy of a hospital. This wasn't a huge surprise as it seems most military hospitals are as such these days. This is not to say there were no patients and that the residents were merely idling their days away staring at each other and playing farkel, but compared to many civilian hospitals I have worked at elsewhere the load was definitely a few patients lighter on average.

    2) One being said, interns and residents also work at Miami Valley, Good Samaritan, and the VA thus giving them more exposure and variety.

    3) Apparently a lot of the Air Force's nursing staff gets trained at Wright-Patt. This can mean a lot of things, some good some bad, but just keep in mind that a lot of the nursing staff are not particularly experienced. (Though there are of course a good portion who are.)

    4) The residents seemed happy enough, but the interns depressed. Depressed is actually probably too strong a term -- perhaps more melancholy -- and it may have been related to them just starting, but one did not get a sense that there was too terribly much joy to be had.

    5) The attendings were all fairly cordial, intelligent people. That, unfortunately, seemed in many cases to be all they were. It seems like many of them never really connected with their interns/residents and never really developed much more than a casual, superficial working friendship in many cases. There were of course exceptions here as well, but all in all I did not get the feeling that the attending/intern dynamic was as positive as at other hospitals I have worked at.

    6) Training comes through pimping and the training never stops. It's not necessarily a belligerent pimping, but not a friendly pimping either. Just continuous, mechanical pimping. Perhaps this makes for better doctors, but after a while it makes for tired, frustrated, and annoyed doctors as well.

    7) Because the hospital is not too terribly large you do have very easy access to the different subspecialties. It seemed fairly easy to get patients the care they needed even if that meant getting them seen by a few different people that day.

    8) It's a fairly clean, well organized hospital.

    9) It's a fairly nice looking base for what it's worth, and Dayton doesn't seem to be too bad a place to live.

    This is all from only a month of observation and interaction mind you. Perhaps I came at the wrong time in some respects. Hopefully others can verify/contradict.

    All that said, I was wondering if anyone had recently been to or is currently training at Wilford Hall's medicine program and could tell me generally how they thought/felt about it?
  38. blee

    blee Senior Member

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    This is a very useful thread, both to current and prospective HPSPers.

    Can someone tell me about IM at either Portsmouth or Bethesda?
  39. RugbyJC

    RugbyJC Junior Member

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    Just wanted to give some feedback on my rotation at NMCSD, where I did two weeks of child psych and two weeks of consult psych.

    General:
    Tues and Friday mornings there would be a half hour morning report where a case was presented and interns, residents and attendings would disscuss and/or pimp each other in a non-confrontational way. Some mornings there were lectures that students could attend if they wanted. ECT was conducted in the morning and watching this was an option.

    Child psych was after morning report to- 4:30ish, sometimes 6pm. The patients were dependents of sailors/marines and it was mostly the same as non-military child psych with perhaps a few deployment related issues. Wide range of pathology, but comparable to my child psych rotation in NY. I spent time with the docs and therapists and all were great to work with and good with teaching, although at times I felt I was providing supportive therapy to them. I wish it was more interactive, but it is difficult to do that with child psych when you are a student.

    CL psych was a reasonably busy service that provided hospital consults, ER consults, emergency visits, and follow up visits if no psych was availible soon enough. Hours were variable depending on when you finished your notes--4pm to 10pm one night. We also evaluated med-evaced patients for PTSD. I like CL in general and liked this service, although I butted heads a little with a faculty member. "Butt heads" is probably an overstatement. I basically didn't agree with a few things he said and said so and when he insisted he was right and I was wrong I dropped it. A little chaotic at times, but that is half the battle with CL. The pathology was mostly adjustment disorders, delerium, wants out of the navy by faking suiside, and real suiside attempts. Med students work as interns.

    Pros: I liked most of the faculty and the program director is great. The facility is beautiful and comparable to, (but different from) Portsmouth, at least based on my interview there. The residents did not seem like that were beaten into the ground, but I hear it can be a busy service. If the medical students weren't there, the interns and residents on the CL service would have been overloaded. Everyone seemed to be happy with their position and it was a fun atmosphere. Call did not seem too bad for the residents, but I am not exactly sure what it is. Nice beaches, good surfing, a lot to do in SD. Traffic not as bad as they say it is.

    Cons: High staff turnover--like any of the programs. Little medical management could be done on the psych unit (NO IVs!!) (like the other programs). Seemed somewhat dissorganized as far as didacts were concerned, but my view of this was limited. SoCal has a different attitude than the East Coast--can be good or bad. Weather is warm all year, but if you like seasons and green (not brown) grass, there is little of that.

    I did this rotation a while back, so there's probably more I could say. I interviewed at the other programs, but didn't do rotations. Feel free to PM any questions.
  40. runninkyle17

    runninkyle17 New Member

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    Just wondering if anyone has done either of these rotations recently? Trying to schedule all my away rotations for this summer.

    Thanks in advance.
  41. miketike42

    miketike42 Junior Member

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    Bottome line,
    How do I start the process and how does it end? Thanks for the help.
  42. NavyFP

    NavyFP Senior Member

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    Which service are you?
  43. NAVYdoc07

    NAVYdoc07

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    Does the Navy offer any rural rotations? Preferably in the Bethesda area...
  44. NavyFP

    NavyFP Senior Member

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    You have got to be kidding. Bethesda?????? No. The closest you will find would be LeJeune. Costal Carolina is quite rural.
  45. trish10

    trish10 Junior Member

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    Anyone done a rotation at Camp LeJeune?
  46. Crossfitstrong

    Crossfitstrong

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    Anyone know anything about Navy Derm?
    How/where/when/with who to set up rotations with?
    I have heard there are 5 spots in San Diego, and 2 in Bethesda, are they combined Army Navy?
    I'm a 3rd year HPSP student who wants to go Derm, after flight surgery, after a Transitional year, any Thoughts? Comments? Suggestions?

    Thank you!
  47. Ziehl-Nielsen

    Ziehl-Nielsen That had not occurred to us, Dude.

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    Setting up rotations is the same for all specialties. Plan to rotate where you want to match (in your case at NNMC and NMCSD). Make sure to schedule your rotation as early as possible. Popular specialties have only so many spots for medical students to rotate and it is first come first serve. You will want to contact the GME coordinator at the the hospital to set up the rotation, and if memory serves the earliest one can schedule is January of the year you plan on rotating.

    I don't know anything about NMCSD, but here at NNMC the department is combined army navy with 3 green spots and 2 blue. Army residents match straight through from a transitional year and navy residents go the transitional year-gmo-derm route.

    As Navy residents uniformly do gmo tours before matching into derm you may want to think about rotating with an eye toward matching at your desired transitional spot. Your record as a GMO and interviews with the department years hence will have more influence on a derm spot than a rotation youd did 4 years ago as a med student.
  48. finnyel

    finnyel

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    tell me about the family medicine rotations you've seen. i'd like one with a good bit of EM. Does that exist??

    EM is my first choice, but i'm flexible and from what i am gathering, FM is a bit less likely to land me in a 2yr GMO. So my current plan is to be unconventional and list a second choice (EM->FM). Comments on the sanity of this plan are appreciated as well.
  49. Gastrapathy

    Gastrapathy no longer apathetic

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    Are you really willing to spend the next 30 years in a specialty that you didn't want because of a GMO tour?!? If you list FM, you'd better be prepared to be an FP for a CAREER. Those are very different jobs.
  50. NavyFP

    NavyFP Senior Member

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    I agree. If you don't want to do FM, don't do it.

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