Navy pediatric fellowships

[BScott]

I am currently getting ready to apply to medical school and am seriously considering the Navy HPSP scholarship. I am interested in doing a pediatric residency and a fellowship in critical care pediatrics. I do understand that as I go to school and do rotations my interests can change and I will maintain an open mind. However, my current question is does the Navy offer a pediatric critical care fellowship or would I have to get permission to do an out of service fellowship? Also, if I do have to do a civilian fellowship how likely is it that I can get a spot?

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[jollygoodfellow]

PM me. I did USAF HPSP. It's def a big decision.

 

[Marine to MD]

http://www.med.navy.mil/sites/nmpdc/professional-development/SitePages/ACGME Approved Positions.aspx

 

[BigRedBeta]

You'll need to check directly with your military recruiters but I know several physicians who are military that are Peds Intensivists and (more commonly in the people I know) neonatologists. There must be some mechanism to make this happen. Generally, compared to my other friends in the military, the armed forces seem to have a bit more flexibility with physicians.

As for the fellowship question. In general pediatric fellowships *somewhere* are much easier to get than adult fellowships. Competition for the top programs is undoubtedly more intense, but for the most part you should be confident that you'll be able to get a pediatric fellowship if you apply and interview broadly enough. PICU fellowships in the past few years has had a roughly equal number of available spots and applicants.

I just graduated a PCCM fellowship, feel free to PM me about it.

 

[Perrotfish]

I am currently getting ready to apply to medical school and am seriously considering the Navy HPSP scholarship. I am interested in doing a pediatric residency and a fellowship in critical care pediatrics. I do understand that as I go to school and do rotations my interests can change and I will maintain an open mind. However, my current question is does the Navy offer a pediatric critical care fellowship or would I have to get permission to do an out of service fellowship? Also, if I do have to do a civilian fellowship how likely is it that I can get a spot?

How to get a Navy Pediatric Fellowship:

1) First you match into a Pediatric Intern year. This works like the normal match, except that you're only allowed to apply to Navy programs, and you only compete against Navy applicants. Because its such a small pool of applicants the odds vary tremendously from year to year.

2) If you get an Intern year, you need to apply midway through Intern year to be allowed to train straight through. If you don't match into the rest of a Peds residency (or just want a break) you're going to go out to the fleet as a 'general medical officer' with the Marines/Ships for two years, or as a flight surgeon/undersea medical officer for three years, before you're allowed to come back to residency. Depending on the year 50-80% of Pediatricians will be allowed straight through training.

3) After residency, most Pediatricians will have to work as a general practitioners for at least two years, or as a Pediatric Chief resident for one year, before applying to fellowship. I have met one exception to that rule so far in my career (a neonatologist)

4) After your time as a general Pediatrician you can apply to any fellowship... that's available. The Navy only needs so many of a given kind of Pediatric subspecialist, so you get training if they project that someone is going to retire 3-4 years from now. For some of the larger subspecialties, like neonatology (all three big hospital have several neonatologists, and a couple of isolated hospitals have a single NICU doctor) there are usually pretty regular openings. At the other extreme, if you want to do a Child abuse fellowship there are only two of those in the Navy (I think) so its random luck if a slot opens anywhere near when you want to do that. PICU is somewhere in between those extremes with a couple of active duty intensivists at each major hospital, with many of them not staying to retirement.

5) If your fellowship is available, and you are a good applicant there are now three options
5A) You get training in service. You do a military fellowship at a military hospital. In Navy Peds I think the only option for that is Neonatology. You get your time credited towards retirement, you get active duty pay, and you work in uniform, and at the end of the fellowship you owe three years of service in addition to whatever you owed going in
5B) You get 'full training out of service', meaning the Navy pays you to do a civilian fellowship. This is how most Navy Subspecialists trained. The Navy Pays you, the civilian fellowship pays nothing, and you are basically a 'free' fellow to them that they acquire outside of the normal fellowship match. I'm not 100% clear on the mechanics of how this works but basically no one who gets FTOS doesn't get to go to a good fellowship program. Again you get your time credited towards retirement, you get active duty pay, and at the end of the fellowship you owe three years of service in addition to whatever you owed going in
5C) You get an deferral for fellowship. This means you apply for the normal fellowship match, get a civilian fellowship, and the military lets you do it. You get normal fellow pay, you're considered temporarily out of the military while you do this, you get no credit towards retirement, and at the end of the fellowship you owe whatever you owed going in. This is very hard to do for Pediatrics because the ABP fellowships generally require you to apply a year and a half before you start, and the Navy can only figure out what fellows its going to need a year in advance. It can still be done but its tough to do and requires convincing a decent number of senior people.

 

[mvenus929]

5C) You get an deferral for fellowship. This means you apply for the normal fellowship match, get a civilian fellowship, and the military lets you do it. You get normal fellow pay, you're considered temporarily out of the military while you do this, you get no credit towards retirement, and at the end of the fellowship you owe whatever you owed going in. This is very hard to do for Pediatrics because the ABP fellowships generally require you to apply a year and a half before you start, and the Navy can only figure out what fellows its going to need a year in advance. It can still be done but its tough to do and requires convincing a decent number of senior people.

There are only like 4 specialties that are still in the spring match (cards, GI, pulmonary, and heme/onc, and GI and pulm are moving to fall match for start dates in 2017). The rest have moved to a fall match, which mean you're submitting your application roughly 12 months prior to starting. Granted, you probably need some time prior to that to get your application together, but I'm not sure you need 6 months...