military route for infectious diseases?

[blissworm]

This is for all the military-familiar folks -

I've slowly developed this idea that going the military route might be lucrative for infectious disease research. maybe I watched world war z too many times but I think I am fairly correct in believing military labs (usamriid) and the military in general have more access to/do more work with next gen and 'up and coming' pathogens, right? furthermore, maybe this is misinformed by media stuff but if there is a major fatal outbreak somewhere doesn't our military fly their docs in first to check the scene out?

the reason I ask is I am considering the HPSP because I think it would be awesome to serve the country but also become an ID doc through the military, treat our vets and military for infections and then get 'insider passes' to the best ID labs. my biggest concern is 1) is any of what I think about military and ID true at all or just a movie inspired fake and 2) doesn't HPSP gatekeep specialization? I know this has been discussed before but last I checked the navy and AF both had like 2 ID spots so am I setting myself up for likely failure and getting locked out of my chosen speciality this way?

thanks

---

Members don't see this ad.

 

[TelemarketingEnigma]

I didn't end up going the military route so someone on the inside can probably tell you more, but I looked into it with the same interest in ID. There are a few interesting opportunities you should look into, like the NIAID sponsored PHS spots at USUHS - it's my understanding that these may not be offered every year though, and when they are there's only like 2 of them total.

Are you more interested in laboratory research or clinical infectious disease? A lot of these "best" ID labs you're talking about probably do employ many physician scientists, but the people doing any "top secret" type research like you see in movies are probably more likely to have PhDs than just MDs. And DoD labs often employ civilian scientists, so you don't need to go the military route to end up working there. Military ID docs do probably get a lot of interesting opportunities to treat diseases that aren't common in the US (either on deployment or in patients brought back from overseas). But you can still see some fascinating stuff in civilian hospitals - the county public hospital associated with my school sees some really interesting things, just due to the size of the health system, characteristics of the patient population, and the fact that they take some international transfers

There definitely is interesting ID research being done by the military (I have a family member who did exactly that, including the top secret kind of stuff, though it was many many years ago). But that's not by any means the only route to interesting ID research. Someone who is in the military can probably speak more to the flexibility (or lack thereof) of a military career - just because you may have the option, doesn't always mean that's what the military wants/needs from you

 

[TelemarketingEnigma]

To add, if by "best labs" you mean BSL-4 labs capable of working with the nastiest stuff, here are your options in the US:

There are currently only four operational BSL-4 laboratory suites in the United States: at the Centers for Disease Control and Prevention in Atlanta; at the United States Army Medical Research Institute for Infectious Diseases at Fort Detrick in Frederick, Maryland; at the Southwest Foundation for Biomedical Research in San Antonio, Texas; and at the University of Texas at Galveston. Georgia State University in Atlanta has a small BSL-3/BSL-4 glove box facility. In addition, a small BSL-4 facility exists on the NIH campus in Bethesda, Maryland, but it is currently being operated only at a BSL-3 level for research on important emerging infectious diseases.

The Need for Biosafety Labs

Introduction In the past century, medical research has led to improved health and increased life expectancy largely because of success in preventing and treating infectious diseases. This success has come about through the use of antibiotics and vaccines, improved hygiene, and increased public...

www.niaid.nih.gov

 

[deleted555445]

I didn't end up going the military route so someone on the inside can probably tell you more, but I looked into it with the same interest in ID. There are a few interesting opportunities you should look into, like the NIAID sponsored PHS spots at USUHS - it's my understanding that these may not be offered every year though, and when they are there's only like 2 of them total.

Are you more interested in laboratory research or clinical infectious disease? A lot of these "best" ID labs you're talking about probably do employ many physician scientists, but the people doing any "top secret" type research like you see in movies are probably more likely to have PhDs than just MDs. And DoD labs often employ civilian scientists, so you don't need to go the military route to end up working there. Military ID docs do probably get a lot of interesting opportunities to treat diseases that aren't common in the US (either on deployment or in patients brought back from overseas). But you can still see some fascinating stuff in civilian hospitals - the county public hospital associated with my school sees some really interesting things, just due to the size of the health system, characteristics of the patient population, and the fact that they take some international transfers

There definitely is interesting ID research being done by the military (I have a family member who did exactly that, including the top secret kind of stuff, though it was many many years ago). But that's not by any means the only route to interesting ID research. Someone who is in the military can probably speak more to the flexibility (or lack thereof) of a military career - just because you may have the option, doesn't always mean that's what the military wants/needs from you

i agree, a lot of the super-cool pathogen research is done by PhD's in the Army, not MD's. look into the NAMRU's and WRAIR for more information. if you want to be doing Outbreak type stuff, research on emerging diseases in a BSL-4 environment, thats where you want to be.

 

[anniekat2025]

You don't need to be military to work at USAMRIID. There are plenty of civilian scientists/physicians that work there.

USAMRIID

HPSP does gatekeep for residency slots. I think if you are dead set on ID (or even pretty sure it's what you want to do) you should avoid HPSP. You can always come back into the military after completing residency and there are programs for loan forgiveness.

I can speak more specifically to the work I have seen ID physicians do during my time in the military if you shoot me a message. I have worked closely with them in a few capacities.

 

[blissworm]

You don't need to be military to work at USAMRIID. There are plenty of civilian scientists/physicians that work there.

USAMRIID

HPSP does gatekeep for residency slots. I think if you are dead set on ID (or even pretty sure it's what you want to do) you should avoid HPSP. You can always come back into the military after completing residency and there are programs for loan forgiveness.

I can speak more specifically to the work I have seen ID physicians do during my time in the military if you shoot me a message. I have worked closely with them in a few capacities.

hi, it says i cant view your profile, how may I contact you?

 

[blissworm]

I didn't end up going the military route so someone on the inside can probably tell you more, but I looked into it with the same interest in ID. There are a few interesting opportunities you should look into, like the NIAID sponsored PHS spots at USUHS - it's my understanding that these may not be offered every year though, and when they are there's only like 2 of them total.

Are you more interested in laboratory research or clinical infectious disease? A lot of these "best" ID labs you're talking about probably do employ many physician scientists, but the people doing any "top secret" type research like you see in movies are probably more likely to have PhDs than just MDs. And DoD labs often employ civilian scientists, so you don't need to go the military route to end up working there. Military ID docs do probably get a lot of interesting opportunities to treat diseases that aren't common in the US (either on deployment or in patients brought back from overseas). But you can still see some fascinating stuff in civilian hospitals - the county public hospital associated with my school sees some really interesting things, just due to the size of the health system, characteristics of the patient population, and the fact that they take some international transfers

There definitely is interesting ID research being done by the military (I have a family member who did exactly that, including the top secret kind of stuff, though it was many many years ago). But that's not by any means the only route to interesting ID research. Someone who is in the military can probably speak more to the flexibility (or lack thereof) of a military career - just because you may have the option, doesn't always mean that's what the military wants/needs from you

that makes sense. i am torn between wanting to do clinical patient work and running a lab. any way i can do both?

 

[TelemarketingEnigma]

that makes sense. i am torn between wanting to do clinical patient work and running a lab. any way i can do both?

MD/PhD would be your best option there, though it's my understanding that many people end up choosing/prioritizing one or the other in the end. I'm sure there are many people who do both but I'm not as familiar with that route

 

[r2med]

I believe @Matthew9Thirtyfive is the SDN expert on all-things military.

 

[Matthew9Thirtyfive]

I believe @Matthew9Thirtyfive is the SDN expert on all-things military.

Hardly an expert, but I am in the military and a USUHS student lol.

To answer OP’s question, no path through the military is really lucrative. ID as a civilian isn’t particularly lucrative, and neither is practicing as a mil med doc.

Now that that’s out of the way, there are ID labs that do super cool stuff. As a military doc you may be able to work at them (and if you’re a Navy ID doc, that’s a pretty great possibility from what I’ve seen). However, some things you should know:

1) we don’t often stay at the same gig for a long time. So you can work at an ID lab, but when that tour is over you will likely move on. Doesn’t mean you can’t do that work again.

2) most people who go into ID have to do a utilization tour between residency and fellowship (this is for all branches). So that means once you finish your IM training, you’ll likely have to practice as a general internist for a few years before going to fellowship.

3) the number of ID spots is small. That doesn’t mean you can’t get one. There are ways to make yourself super attractive and really likely to match. You also can keep applying for the match every year you’re eligible to, and at least in the Navy, having more fleet time makes you more competitive than the straight through folks.

As for HPSP/USUHS gate keeping specialties. Yes and no. No, they will not tell you which specialty you are going to do. But yes, if they decide they don’t need any ID docs one year and the billet number is 0, then you can’t match into ID that year and have to reapply the next year (assuming there is a spot). However, ID seems to pretty solidly be at 1-2 spots for the Navy basically every single year. This year in fact they also have an ID crit care billet.

 

[blissworm]

Hardly an expert, but I am in the military and a USUHS student lol.

To answer OP’s question, no path through the military is really lucrative. ID as a civilian isn’t particularly lucrative, and neither is practicing as a mil med doc.

Now that that’s out of the way, there are ID labs that do super cool stuff. As a military doc you may be able to work at them (and if you’re a Navy ID doc, that’s a pretty great possibility from what I’ve seen). However, some things you should know:

1) we don’t often stay at the same gig for a long time. So you can work at an ID lab, but when that tour is over you will likely move on. Doesn’t mean you can’t do that work again.

2) most people who go into ID have to do a utilization tour between residency and fellowship (this is for all branches). So that means once you finish your IM training, you’ll likely have to practice as a general internist for a few years before going to fellowship.

3) the number of ID spots is small. That doesn’t mean you can’t get one. There are ways to make yourself super attractive and really likely to match. You also can keep applying for the match every year you’re eligible to, and at least in the Navy, having more fleet time makes you more competitive than the straight through folks.

As for HPSP/USUHS gate keeping specialties. Yes and no. No, they will not tell you which specialty you are going to do. But yes, if they decide they don’t need any ID docs one year and the billet number is 0, then you can’t match into ID that year and have to reapply the next year (assuming there is a spot). However, ID seems to pretty solidly be at 1-2 spots for the Navy basically every single year. This year in fact they also have an ID crit care billet.

this is very helpful, was secretly waiting for you to respond lmao. I will think about it, still have 2 yrs.

as for lucrative, if i think i get what you mean yeah the big scare going into ID was not being able to pay off loans lol, especially after i saw medicare or something cut ID doc pay 4% in a pandemic. only gonna go down imo. hopefully I get loan forgiveness later on.

 

[Matthew9Thirtyfive]

this is very helpful, was secretly waiting for you to respond lmao. I will think about it, still have 2 yrs.

as for lucrative, if i think i get what you mean yeah the big scare going into ID was not being able to pay off loans lol, especially after i saw medicare or something cut ID doc pay 4% in a pandemic. only gonna go down imo. hopefully I get loan forgiveness later on.

I mean you won’t starve. Even in the military you’ll make decent money. And if you do HPSP or USUHS you won’t have med school debt.

However, I would say that even with all the benefits, you really need to want to serve. To be okay deploying, doing unconventional stuff, and sacrificing things to treat a fantastic patient population. It’s really not a good road for people just looking to avoid debt. They often end up miserable.

 

[xffan624]

During my time in the Army, I had the opportunity to do a short (3-4 day) biological agent defense training at USAMRIID. The people who gave the lectures were mostly military docs (probably some PhDs as well), some ID and some pathology. They worked with some pretty nasty stuff (smallpox, Ebola, etc). We even got to tour the BSL-4 lab (from the outside). As a military doc there's definitely a possibility to do some really cool stuff, but it's not a guarantee and I wouldn't sign my life away if that was your only motivation (only maybe a cool side effect).

If you're looking for the boots on the ground outbreak disease detective role, participating in the CDC's Epidemic Intelligence Service fellowship might be a long term goal.

 

[anniekat2025]

hi, it says i cant view your profile, how may I contact you?

I messaged you.

 

[Med Ed]

This is for all the military-familiar folks -

I've slowly developed this idea that going the military route might be lucrative for infectious disease research. maybe I watched world war z too many times but I think I am fairly correct in believing military labs (usamriid) and the military in general have more access to/do more work with next gen and 'up and coming' pathogens, right? furthermore, maybe this is misinformed by media stuff but if there is a major fatal outbreak somewhere doesn't our military fly their docs in first to check the scene out?

the reason I ask is I am considering the HPSP because I think it would be awesome to serve the country but also become an ID doc through the military, treat our vets and military for infections and then get 'insider passes' to the best ID labs. my biggest concern is 1) is any of what I think about military and ID true at all or just a movie inspired fake and 2) doesn't HPSP gatekeep specialization? I know this has been discussed before but last I checked the navy and AF both had like 2 ID spots so am I setting myself up for likely failure and getting locked out of my chosen speciality this way?

thanks

My impression of military ID is a lot of time spent treating drug-resistant STIs. If you seriously want to work with the exotic bugs then you need to go MD/PhD or develop a really strong research portfolio as an MD. Neither of those requires HPSP, and in fact you're probably better off staying civilian so you have maximum control over your training.

 

[blissworm]

My impression of military ID is a lot of time spent treating drug-resistant STIs. If you seriously want to work with the exotic bugs then you need to go MD/PhD or develop a really strong research portfolio as an MD. Neither of those requires HPSP, and in fact you're probably better off staying civilian so you have maximum control over your training.

That helps. Generally, do you think based off what my goals for a career seem to be I should aim to apply MD/PhD from the get-go? Or can an MD and then reseragc heavy fellowship work?

 

[Med Ed]

That helps. Generally, do you think based off what my goals for a career seem to be I should aim to apply MD/PhD from the get-go? Or can an MD and then reseragc heavy fellowship work?

The career goals you have expressed on this thread are not specific enough to give good advice. I suggest you find some role models, individuals who are doing the sorts of ID work you think you want to pursue, and look at their credentials and training paths.

 

[TelemarketingEnigma]

That helps. Generally, do you think based off what my goals for a career seem to be I should aim to apply MD/PhD from the get-go? Or can an MD and then reseragc heavy fellowship work?

What year are you in school? If you still have time left in undergrad (or are planning to take gap years), I strongly recommend getting some experience in a microbiology or virology or related laboratory if you don't have any already. If you love it, a PhD may be a good path for you. If you still like the concepts but find the lab work tedious (many do) and want to spend more time with people, MD/DO may be a better choice. If you still want to combine both, then perhaps the MD/PhD path is right. I think if you want to run a lab or be primarily on the research side, the combined path may be better than just the MD (but there are other factors to consider, like length of training etc).

 

[blissworm]

What year are you in school? If you still have time left in undergrad (or are planning to take gap years), I strongly recommend getting some experience in a microbiology or virology or related laboratory if you don't have any already. If you love it, a PhD may be a good path for you. If you still like the concepts but find the lab work tedious (many do) and want to spend more time with people, MD/DO may be a better choice. If you still want to combine both, then perhaps the MD/PhD path is right. I think if you want to run a lab or be primarily on the research side, the combined path may be better than just the MD (but there are other factors to consider, like length of training etc).

Second year, done research in infectious diseases since 9th grade and realized I really do love lab work. That being said, I've always wanted to work with patient with complex infections, the detective and cognitive side of clinical ID is super appealing to me. It sounds like I need to maximize research (because I lost a year from Covid), take a gap year or two and head to an MD/PhD

 

[Med Ed]

Second year, done research in infectious diseases since 9th grade and realized I really do love lab work. That being said, I've always wanted to work with patient with complex infections, the detective and cognitive side of clinical ID is super appealing to me. It sounds like I need to maximize research (because I lost a year from Covid), take a gap year or two and head to an MD/PhD

You should spend some time in the Physician Scientists forum. MD/PhD is an extraordinary commitment, and the majority who go this route do not end up running labs. There is something to be said for 4-year MD and a research-oriented residency. You can also do a postdoc as an MD.

All I'm saying is gather some more information and perspectives before you settle on the way forward.

 

[Nata Herman]

I didn't end up going the military route so someone on the inside can probably tell you more, but I looked into it with the same interest in ID. There are a few interesting opportunities you should look into, like the NIAID sponsored PHS spots at USUHS - it's my understanding that these may not be offered every year though, and when they are there's only like 2 of them total.

Are you more interested in laboratory research or clinical infectious disease? A lot of these "best" ID labs you're talking about probably do employ many physician scientists, but the people doing any "top secret" type research like you see in movies are probably more likely to have PhDs than just MDs. And DoD labs often employ civilian scientists, so you don't need to go the military route to end up working there. Military ID docs do probably get a lot of interesting opportunities to treat diseases that aren't common in the US (either on deployment or in patients brought back from overseas). But you can still see some fascinating stuff in civilian hospitals - the county public hospital associated with my school sees some really interesting things, just due to the size of the health system, characteristics of the patient population, and the fact that they take some international transfers

There definitely is interesting ID research being done by the military (I have a family member who did exactly that, including the top secret kind of stuff, though it was many many years ago). But that's not by any means the only route to interesting ID research. Someone who is in the military can probably speak more to the flexibility (or lack thereof) of a military career - just because you may have the option, doesn't always mean that's what the military wants/needs from you

Yes, that's good practice, but how about money. What are the salaries of these specialists? In general, war and the military are profitable, but probably not for doctors.

 

[xffan624]

Yes, that's good practice, but how about money. What are the salaries of these specialists? In general, war and the military are profitable, but probably not for doctors.

If you're looking for money, ID is the last specialty to consider military or otherwise.