Navy Internship

[gree0411]

Hi everyone. I don't know what I would do without this forum. Thank you to all those who have contributed thus far.

I am a third year HPSP recepient. I am in a quandry about what I should do for my Active Duty rotations. Should I go to a place where I want to do my residency at (EM) or does it really matter that much considering that I will most likely go on a GMO tour and they may have forgotten me by the time I would join the residency?
From my understanding I am pretty much deligated to do the GMO tour if I want a competitive residency, which I have heard EM is.
Also, what kind of internship should I do if I want to get into EM? Are the internships connected with the EM residencies in the Navy?
I would really appreciate some advice.

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[iwakuni_doc]

gree0411,

There are several different ways of doing your clinical year rotations:

1 - due to the difference in the fiscal year & the academic year, you can actually take both your 3rd yr & 4th yr active duty rotations as electives during your 4th year - one in Aug/Sep & one after Oct 1. This is what many of my classmates did since options for 3rd year rotations can be fairly limited & it allows you to hit two out of the big three - Bethesda, Portsmouth, San Diego.

2 - I knew that I wanted to end up in San Diego, so I did both rotations on the West Coast. During 3rd year, I took my mandatory OB/GYN rotation at 29 Palms - great decision. There were no residents/interns/med students & I got to catch a ton of babies and practice my surgical skills by first assisting on all of the cases - no scut since all of the staff was used to functioning on their own w/o residents/students. I also got a kick ass letter of rec from the Dept. Head for my residency application. During 4th year, I did an elective at Balboa - allowed me to work with the staff & residents where I planned on being for the following year, as well as interviewing for internship while I was out there.

As for what kind of internship to do if you're interested in EM - I would recommend either a transitional internship with a heavy emphasis on trauma/ICU/surgery rotations, or a surgery internship. While most people interested in EM have done transitional programs (they tend to be a little cushier), I did a surgery internship & truly think that was the best decision - it prepares you well for emergency medicine, as well as for GMO/FS tours.

Just my opinions, but if you have any further questions - feel free to ask.

 

[Navy Dive Doc]

I did one of the Cush transitional year programs, which are excellent internships and do prepare you well for the fleet. Yes, the surgery interns will make fun of you, they're jealous. Really, the rotations are largely the same, but with trans, you get 3 elective months, 2 weeks of psych, 2 weeks of operational med experience which can be key early in the year to get face time for DMO/FS letters, and another month of medicine. I think surgery gets one elective which must be surgery related. All Navy internships have Medicine, OB, ICU and ER months to help prepare for the fleet (yes, even the Psych interns, though I think they got out of ICU, I can't recall).
Either way, good prep for EM, especially if you add trauma into the transitional year (surgery it's integrated)

As for rotations, Iwakuni is right, do your 3rd year rotation in August or Sept and then your 4th year after 01OCT, that way they're both during the academic 4th year but different fiscal years for the Navy.

I did 2 rotations at Portsmouth Naval Hospital because I new I wanted to be a transitional there. August I did EM, both because at the time I was considering EM and because the transitional program director was an ER Doc that I would get to work with. I interviewed then, which went very well and I was told I'd be ranked favorably. I returned in October to do anesthesia, and also showed my face and confirmed my interest for transitional. All of this worked, I got my spot and am very glad I trained there, for a nnumber of reasons, too many to go into here. It's a good program, but so are most of the Navy internships. Portsmouth and San Diego are much busier, more patients, which I favored. I learn by doing, not attending rounds. We did plenty of that, too.

You might consider doing one true face time rotation where you want to go and then do something totally different for your second rotation. Go to BUD/S and PT with them while "rotating" through the clinic, find some way to do a rotation overseas, or go to a hospital where you know you don't want to do internship but a part of the country you'd like to see (Bremerton up by Seattle comes to mind, FP only internship but any rotation could be done, a letter would come out of it and you'd get to travel all expenses paid somewhere cool.) I wish I had done this in hindsight, because that first ER rotation likely sealed the deal for internship. Always take advantage of what the Navy can offer you, they will milk you for everything they can.

Yes, you will do a GMO tour if you want to be an ER Doc. Intern applications are not even looked at, there are far too many returning GMOs who wan the spots. Start looking into your GMO options now, it's never too early.

Good luck
DD

 

[iwakuni_doc]

Originally posted by Navy Dive Doc
I did one of the Cush transitional year programs, which are excellent internships and do prepare you well for the fleet. Yes, the surgery interns will make fun of you, they're jealous.

You bet I was jealous! Back in the "old days" before the 80-hr week was enforced, surg internship was quite painful at times. I agree that the transitional year can be an outstanding year with the operational medicine rotations & increased opportunities for electives. My "electives" were plastic surgery & vascular surgery - not so much electives, as selectives within the department.

If you want a little more freedom in your internship, by all means do a transitional year - I would only recommend that you use some of your elective time do some surgery rotations. Trauma surgery, plastic surgery, & neurosurgery are excellent ones that are quite applicable to life in the ER, without being too painful - or at least unnecessarily painful, since trauma & neurosurg call will always have a certain amount of pain attached.

 

[Navy Dive Doc]

Definitely do trauma if you want to be an ER Doc. Many of the transitionals do it, I wish I had done it though the ultra-cush derm rotation I did instead has served me well in the fleet. One other point to add: do a surgical internship if you think there is ANY chance that you might want to do a surgical residency of some sort after your GMO tour. The surgery year will count as the base year for any residency, but if you do transitional and then want to go surgery, the program will make you repeat some if not all of your internship, a fate worse than death. You will hate internship enough when you're still in the med-school, new graduate mode and used to abuse and scut. After being on your own in the fleet and calling the shots, to go back to the intern life would be pure misery. If surgery might be an option, suck it up and do the Surgery internship. Specialties look different when you've had some time outside the hospital to really think it over.
DD

 

[gree0411]

Thanks for the input guys. I definitely feel like I have a better grasp on the entire system now. What would be a reason for giving someone a one-year deferment? If they don't like you very much or you perform poorly on rotations? What is it?