Navy GMO and Prior Service?

[BOHICA-FIGMO]

My question is simple: does prior service with multiple deployments and overseas PCS assignments make me less likely to do a GMO tour with the Navy? Or will I have a better chance of going straight into residency?

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[IgD]

My question is simple: does prior service with multiple deployments and overseas PCS assignments make me less likely to do a GMO tour with the Navy? Or will I have a better chance of going straight into residency?

I think it gives you a very slight advantage but not much. The system is weighed so that you really have to have a GMO tour to even get a look at the most competitive residencies.

 

[Croooz]

BO,
What I've seen is it makes you more likely to get a GMO tour. If you were an 8404 then this kiss of death an an enlisted will all but guarantee you a Marine billet as a physician.

 

[usnavdoc]

Ive seen plenty of former officers and enlisted get sent out to GMO land. All things being equal then maybe you could have an advantage over a newbie USUHS or HPSP intern. But Do not count on it especially in a more procedural field.

 

[pgg]

My question is simple: does prior service with multiple deployments and overseas PCS assignments make me less likely to do a GMO tour with the Navy? Or will I have a better chance of going straight into residency?

Yes, prior service does make you more likely to get picked up for residency straight through. The real question is, are the prior service points on your GME application enough to help you beat out GMOs applying for competitive residencies? No. Prior service alone will not put an intern straight through into a competitive residency.

The point system for determining who gets selected for GME is rigid and well-defined. Somewhere in this forum there's a link to some radiology powerpoint that gives the breakdown. Prior service does count for a couple points ... but it's not big enough to let an intern beat out a returning GMO.

IIRC, an intern with prior service AND a couple of publications is on roughly equal footing with a GMO, assuming equal grades & board scores.

 

[Monty Python]

BO,
...... If you were an 8404 then this kiss of death an an enlisted will all but guarantee you a Marine billet as a physician.

As Bohica is former USAF (Academy grad / Zoomie as well?): 8404 is the Navy Enlisted Code for a hospital corpsman with special training and qualifications as a Fleet Marine Force field medic.

 

[DeanWormer]

There is a critical shortage of GMOs and the pipeline is getting leaner thus count on two years with the green side or at best 2 with the Cbs or maybe a ship (slim).

 

[jsnuka]

Explain something to me...SOMEONE...ANYONE, why do yo guys make it sound like being a GMO/doing a utlization tour is so horrifically awful?

Is it that there is some ulterior rush to do other things, not military related e.g. by 35 I see myself being the best ped. oncologist in the state of ??????? or something like that or is it something else?

 

[usnavdoc]

Explain something to me...SOMEONE...ANYONE, why do yo guys make it sound like being a GMO/doing a utlization tour is so horrifically awful?

Is it that there is some ulterior rush to do other things, not military related e.g. by 35 I see myself being the best ped. oncologist in the state of ??????? or something like that or is it something else?

What are you kidding? Doing a GMO tour....hmmmm lets think.

1) You will be forced to practice as a Generalist and even if you want to do FP it is not the same scope of practice as a GMO. 2) pure boredom in terms of medicine. Just how many STDs, sports injuries, and malingerers do you really want to treat. I havent seen a hypertensive or diabetic in 4 years. 3) Delay in residency training towards whatever specialty you want to go into 4) Break in training results in inadequate knowledge base when returning from a GMO tour. Do you really want to return as a PGY2 in general surgery or IM and start out in the ICU after being a GMO for two years treating anything but sick people. 5) more than likely will be in an operational billet meaning you will be practicing somewhat independant with very little training. 6) In that operational billet you will find that your direct superior will be a non-medical line officer. More than a few times I have had orders that were contrary to the medical needs of a patient. I still have signed CYA letters just in case. 7) having to reapply to residency with no guarentee despite time deployed to whatever s**t Hole you were sent to 8) doing workups to go to that s**t Hole 9) actually going to that s**t Hole leaving family and friends behind 10) getting shot at, experiencing IEDs in the convoy you are in, recieving indirect fire in that s**t Hole you never wanted to go to in the first place 11) ETC....

I think thats enough reasons for you to ponder over while you re-evaluate your question.

You may think that as a BCP you will deploy also so #s 8,9, and 10 dont count. Not true. As a gmo you will be assigned to an operational unit and likely be put in a position that you have very little training for. As a BCP on deployment you are in a much more familiar environment.

 

[Croooz]

As Bohica is former USAF (Academy grad / Zoomie as well?): 8404 is the Navy Enlisted Code for a hospital corpsman with special training and qualifications as a Fleet Marine Force field medic.

Really??!!

 

[orbitsurgMD]

What are you kidding? Doing a GMO tour....hmmmm lets think.

1) You will be forced to practice as a Generalist and even if you want to do FP it is not the same scope of practice as a GMO. 2) pure boredom in terms of medicine. Just how many STDs, sports injuries, and malingerers do you really want to treat. I havent seen a hypertensive or diabetic in 4 years. 3) Delay in residency training towards whatever specialty you want to go into 4) Break in training results in inadequate knowledge base when returning from a GMO tour. Do you really want to return as a PGY2 in general surgery or IM and start out in the ICU after being a GMO for two years treating anything but sick people. 5) more than likely will be in an operational billet meaning you will be practicing somewhat independant with very little training. 6) In that operational billet you will find that your direct superior will be a non-medical line officer. More than a few times I have had orders that were contrary to the medical needs of a patient. I still have signed CYA letters just in case. 7) having to reapply to residency with no guarentee despite time deployed to whatever s**t Hole you were sent to 8) doing workups to go to that s**t Hole 9) actually going to that s**t Hole leaving family and friends behind 10) getting shot at, experiencing IEDs in the convoy you are in, recieving indirect fire in that s**t Hole you never wanted to go to in the first place 11) ETC....

I think thats enough reasons for you to ponder over while you re-evaluate your question.

You may think that as a BCP you will deploy also so #s 8,9, and 10 dont count. Not true. As a gmo you will be assigned to an operational unit and likely be put in a position that you have very little training for. As a BCP on deployment you are in a much more familiar environment.

The GMO-friendly services, particularly the Navy, are very casual (read reckless) about matters of proper supervision and assignment to incompletely trained physicians. As a GMO with only one year of GME under your belt, even from the very best internship, you will certainly not be complete in your training. I can tell you with certainty that it is possible to complete an internship at a large military medical facility with no opportunity to care for patients with an MI. Imagine that and then see yourself alone in an ER after that kind of year. Proper supervision of someone in that status anywhere in the developed world is at least a PGY-3 resident and a BC attending, anywhere except the Navy, that is.

You could easily find yourself as the sole physician after hours in a non-combat-area facility with no, or practically no technical or staff support (i.e., no lab, no x-ray) and no local backup, but in a place where significant emergency cases still come in, and where the typical standards of care and staffing are well above that for which you might expect to be able to provide with your training. And the services will irrationally, and immorally expect you to be able to deliver to that standard. You might be a resourceful, intelligent and responsible physician, but with only one year of GME, the well you are drawing from can only be so deep.

You aren't electing that kind of assignment. The service is putting you there. And you are not allowed to quit.

 

[pgg]

Explain something to me...SOMEONE...ANYONE, why do yo guys make it sound like being a GMO/doing a utlization tour is so horrifically awful?

Is it that there is some ulterior rush to do other things, not military related e.g. by 35 I see myself being the best ped. oncologist in the state of ??????? or something like that or is it something else?

Everything posted by usnavdoc and orbitsurgMD is true, or can be true.

My experience with the Marines seems to have been quite different from usnavdoc's ... for starters, he had a notoriously malignant commanding officer (who was ultimately relieved) whereas I had a fantastic CO who without exception accepted and followed my recommendations regarding treatment, duty status, deployability, etc. I was never placed in a situation where I was running an ER without help or supervision; both of my deployments were to areas that had echelon 2 care colocated with us, and I had easy access to 2nd opinions and help. The sole exception to that was a month I spent on the border of Pakistan/Afghanistan at a SF-funded free clinic that saw local nationals who were sick/injured but denied medevac by higher powers.

Some (most) people are driven to reach their BCP goal with no detours, and I can understand that. I however don't regret or resent the 3 years I spent with the Marines, going places and doing things that I never would have been able to do otherwise. Good COs know to keep their doctors out of harm's way, and there's a lot to be said for the privilege of being THE guy who there to take care of the PFC or LCPL who carries a rifle and kills the insurgents.

The biggest professional disadvantage to a GMO tour is that I've grown dumber in the last 3 years as I've treated mostly sprained ankles and minor sports injuries, URIs, psych problems, common derm issues, etc. I've had a lot of trauma experience, and perhaps a dozen serious medical illnesses (it's not all URIs) ... but there's no way I could step into an ICU as a new medicine PGY2 and not be a danger to somebody. Fortunately (?) military residencies are familiar with the whole GMO thing, and board pass rates are very high, so clearly it's not a crippling setback.

 

[usnavdoc]

Everything posted by usnavdoc and orbitsurgMD is true, or can be true.

My experience with the Marines seems to have been quite different from usnavdoc's ... for starters, he had a notoriously malignant commanding officer (who was ultimately relieved) whereas I had a fantastic CO who without exception accepted and followed my recommendations regarding treatment, duty status, deployability, etc. I was never placed in a situation where I was running an ER without help or supervision; both of my deployments were to areas that had echelon 2 care colocated with us, and I had easy access to 2nd opinions and help. The sole exception to that was a month I spent on the border of Pakistan/Afghanistan at a SF-funded free clinic that saw local nationals who were sick/injured but denied medevac by higher powers.

Some (most) people are driven to reach their BCP goal with no detours, and I can understand that. I however don't regret or resent the 3 years I spent with the Marines, going places and doing things that I never would have been able to do otherwise. Good COs know to keep their doctors out of harm's way, and there's a lot to be said for the privilege of being THE guy who there to take care of the PFC or LCPL who carries a rifle and kills the insurgents.

The biggest professional disadvantage to a GMO tour is that I've grown dumber in the last 3 years as I've treated mostly sprained ankles and minor sports injuries, URIs, psych problems, common derm issues, etc. I've had a lot of trauma experience, and perhaps a dozen serious medical illnesses (it's not all URIs) ... but there's no way I could step into an ICU as a new medicine PGY2 and not be a danger to somebody. Fortunately (?) military residencies are familiar with the whole GMO thing, and board pass rates are very high, so clearly it's not a crippling setback.

I dont think its a crippling setback either. It just forces you into an uphill battle for the first 3-6 months upon returning to GME.

I also had good experiences as a GMO. My first CO was completely opposite from my last. I didnt include the good experiences b/c the previous op's question was why do people not like the idea having to do a
GMO tour.

 

[jsnuka]

Thanx guys. I appreciate the openness and the "other side of the coin" in your answers to my questions.

 

[BOHICA-FIGMO]

Explain something to me...SOMEONE...ANYONE, why do yo guys make it sound like being a GMO/doing a utlization tour is so horrifically awful?

Is it that there is some ulterior rush to do other things, not military related e.g. by 35 I see myself being the best ped. oncologist in the state of ??????? or something like that or is it something else?

Well, I have 11.5 yrs prior USAF officer time and will be 38 when I graduate medical school. That means I will be 40-41 by the time I complete a GMO tour, and 44-46 byt the time I complete residency. That gives me only 24-25 good years in my specialty. Hence the rush ;-)

 

[jsnuka]

Well, I have 11.5 yrs prior USAF officer time and will be 38 when I graduate medical school. That means I will be 40-41 by the time I complete a GMO tour, and 44-46 byt the time I complete residency. That gives me only 24-25 good years in my specialty. Hence the rush ;-)

Ok, I can understand that concern.

 

[Portier]

Well, I have 11.5 yrs prior USAF officer time and will be 38 when I graduate medical school. That means I will be 40-41 by the time I complete a GMO tour, and 44-46 byt the time I complete residency. That gives me only 24-25 good years in my specialty. Hence the rush ;-)

I feel your pain, Bohica (bend over here it comes!)....It's not as bad for me, but....

I was Navy enlisted 10 years. I'll be 31 at Med school graduation, 34-35 at the end of GMO time, and 38 or so after residency.

I'm getting too damned old too damned quickly...

 

[NavyFP]

My question is simple: does prior service with multiple deployments and overseas PCS assignments make me less likely to do a GMO tour with the Navy? Or will I have a better chance of going straight into residency?

Honestly? No. The GME selection board looks at docs in the fleet first. You would be top of the line of interns being selected for residency, but if you are looking to do something like Ortho or Derm you will most likely be going out as a GMO.

 

[JA_Perez]

I am currently doing a DMO tour with the Navy and getting dumber every day. I don’t think it’s a big deal if I apply for Ophthalmology or any other sub-specialty. What do I know about ophthalmology anyways? But if I go back to a residency where I have to manage in-patient/primary care cases, then I would be certainly a liability. Pretty much becoming an intern once again…