What's so bad about a GMO tour anyway?

[WoWdoc]

Hey guys! I've applied to my schools, and am eagerly waiting a response. I'm strongly considering the HPSP scholarship, but I've read alot of negative posts about GMO tours.

My question is are GMO tours really that bad? I understand it postpones your residency, but from what I can tell is that they can still be rewarding life enhancing experiences. Does anybody have their own GMO anecdote to share. I'm hoping to hear both positive and negative responses.

If anybody is feeling really generous a pro/con list concerning GMO tours would be awesome!

Thanks!

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[orbitsurgMD]

Hey guys! I've applied to my schools, and am eagerly waiting a response. I'm strongly considering the HSPS scholarship, but I've read alot of negative posts about GMO tours.

My question is are GMO tours really that bad? I understand it postpones your residency, but from what I can tell is that they can still be rewarding life enhancing experiences. Does anybody have their own GMO anecdote to share. I'm hoping to hear both positive and negative responses.

If anybody is feeling really generous a pro/con list concerning GMO tours would be awesome!

Thanks!

Don't bother reading any of the thousands of posts about GMO tours. Just join, take the HPSP or HSPS (whichever is the one you want) and do a GMO tour. You're right, it will probably be a great "life-enhancing" experience. Be sure to send a postcard.

 

[McCheese]

OK, I'll bite to get going on this forum:
This is a difficult one to explain to a pre-med. Sure, you'll be a licensed MD, practicing independently, often in less than optimal conditions (I wish I was talking about deployments) 1 year out of medical school. You'll be taking care of problems that may be out of your comfort zone right off the bat, depending on the type of internship you do. I guess some people might call that "challenging" and a "unique opportunity". For the most part, however, you'll be taking care of runny noses, back pain and "sad" patients, ordering and keeping track of consults to specialists for most everything else. Same thing during deployments, except that you'll live and do sick call out of a tent. None of that cool trauma stuff you see in the documentaries...
Even when you know you can take care of an even semi-complicated problem, you'll find that you won't have the equipment or ancillary staff at your disposal to do anything beyond a plain film, CBC and dipstick UA so you still end up referring out.
This will get old very fast and you'll realize that an NP or a PA is more suited to do what you're doing (and probably better qualified). Oh, and the exponential decrease in the knowledge base you'll need to retain when you continue on to your residency (surgical / gas / peds, etc.) , although overcome-able, is also something to consider.

I'll close with a positive, though. As a GMO, you really appreciate what our men and women in uniform go through day in and out at a level you probably won't experience at any point in your career. For the most part, I've enjoyed working for the Marines from a personal standpoint. Professionally, the system makes no sense and no end seems to be in sight but sure, with the right attitude a GMO tour could be "rewarding" and "life enhancing" as you put it...
Best of luck to you.

 

[pgg]

Well, the short version is that a GMO tour delayed my training by 3 years, cost me $108,000 in lost pay, and put me in a couple of situations I was barely qualified to handle.

But apart from that, I enjoyed my time with the Marines. I really mean that - I did like serving with the Marines, at the time being a GMO didn't bother me too much, and it was important work taking care of deserving patients.

But in retrospect, big picture, I'm less satisfied.

 

[MSS07]

Well, the short version is that a GMO tour delayed my training by 3 years, cost me $108,000 in lost pay, and put me in a couple of situations I was barely qualified to handle.

But apart from that, I enjoyed my time with the Marines. I really mean that - I did like serving with the Marines, at the time being a GMO didn't bother me too much, and it was important work taking care of deserving patients.

But in retrospect, big picture, I'm less satisfied.

How much do GMO's get payed? and why are you less sastisfied? Is it because of the money you lost, you said at the time you didn't mind, what's changed since then? Just curious...

 

[pgg]

How much do GMO's get payed? and why are you less sastisfied? Is it because of the money you lost, you said at the time you didn't mind, what's changed since then? Just curious...

GMOs get paid their military base pay, housing allowance, additional special pay ($15K per year), and variable special pay (depends on time in service but generally $1000 per month).

It's not that I was totally satisfied at the time - after all, I was doing primary care clinic work (which I hate) instead of working in my chosen specialty. But I made the best of it. Serving with the Marines, occasionally playing with their toys, going places with them (even if most of those places rather sucked), and being a part of an actual warfighting unit in harm's way is rewarding in its own way.

Getting away from hospitals with their cohort of maladjusted rank-heavy work-light officers (physician and non-physician) bossing me around was nice. And remember that I went to do a GMO tour after internship, which even in the 80-hour-week era is still a brutal, thankless year. Going to a unit where only the CO and XO outranked me - and actually valued my expertise - was a welcome change of pace.

What's different now is perspective. I'm better trained and look back on some medical decisions I made as a GMO that were shaky and uninformed, and it makes me uncomfortable to think about other bad decisions I may have made or things I may have missed out of ignorance. As an attending, my life doesn't suck in the ways it did as an intern, GMO, and resident, and through the retrospectoscope I now sort of resent having this good time in my life postponed by a GMO tour. To think I could have been doing what I'm doing now three years earlier ...

Also, to revisit the pay issue - 3 years as a GMO cost me $108,000 in lost ISP bonuses. It also cost me 3 years of moonlighting opportunities, which, if the last 6 months are any indication, cost me another $300,000, give or take.

As a USUHS grad, the GMO tour didn't add to my military obligation. HPSP grads who go GMO followed by an inservice residency are being funneled into extra years of obligated service, which I think is rather dishonest and shady.

And of course this is hard to percieve on an online forum, but if you knew me in person you'd know that I'm basically a happy guy who doesn't need a lot to be in a good mood. If the Navy had parked me at a weather station above the Arctic Circle I'd have found a way to not be miserable. So take the fact that I was basically happy as a GMO with a grain of salt.

But in the end, I'm still overall happy with and satisfied with going into the Navy. I was well paid and debt free through medical school, which allowed me to have kids then and remain above the poverty line ... I could be richer now if I'd stayed a civilian, but money isn't the only thing that matters.

 

[MSS07]

GMOs get paid their military base pay, housing allowance, additional special pay ($15K per year), and variable special pay (depends on time in service but generally $1000 per month).

It's not that I was totally satisfied at the time - after all, I was doing primary care clinic work (which I hate) instead of working in my chosen specialty. But I made the best of it. Serving with the Marines, occasionally playing with their toys, going places with them (even if most of those places rather sucked), and being a part of an actual warfighting unit in harm's way is rewarding in its own way.

Getting away from hospitals with their cohort of maladjusted rank-heavy work-light officers (physician and non-physician) bossing me around was nice. And remember that I went to do a GMO tour after internship, which even in the 80-hour-week era is still a brutal, thankless year. Going to a unit where only the CO and XO outranked me - and actually valued my expertise - was a welcome change of pace.

What's different now is perspective. I'm better trained and look back on some medical decisions I made as a GMO that were shaky and uninformed, and it makes me uncomfortable to think about other bad decisions I may have made or things I may have missed out of ignorance. As an attending, my life doesn't suck in the ways it did as an intern, GMO, and resident, and through the retrospectoscope I now sort of resent having this good time in my life postponed by a GMO tour. To think I could have been doing what I'm doing now three years earlier ...

Also, to revisit the pay issue - 3 years as a GMO cost me $108,000 in lost ISP bonuses. It also cost me 3 years of moonlighting opportunities, which, if the last 6 months are any indication, cost me another $300,000, give or take.

As a USUHS grad, the GMO tour didn't add to my military obligation. HPSP grads who go GMO followed by an inservice residency are being funneled into extra years of obligated service, which I think is rather dishonest and shady.

And of course this is hard to percieve on an online forum, but if you knew me in person you'd know that I'm basically a happy guy who doesn't need a lot to be in a good mood. If the Navy had parked me at a weather station above the Arctic Circle I'd have found a way to not be miserable. So take the fact that I was basically happy as a GMO with a grain of salt.

But in the end, I'm still overall happy with and satisfied with going into the Navy. I was well paid and debt free through medical school, which allowed me to have kids then and remain above the poverty line ... I could be richer now if I'd stayed a civilian, but money isn't the only thing that matters.

Thanks for the response.

 

[WoWdoc]

So I understand that just being in the military I probebly stand a greater chance of dieing young compared to the general population, but are military docs on a GMO out in the middle of the ****? I want to serve, but I don't really want to get shot at.

Also I've heard that HPSP students can incur additional time to their obligation if they have to do a GMO. Say I get into the military, and decide it's not for me and that I want out. If I get one gmo tour, could I request another just to finish up my obligation and get back out into the civilian sector?

Ideally I want to go straight through to residency and then serve the military as a board certified doc, but if the powers that be decide I should do a GMO, I don't really feel like I should be forced to serve more than my original obligation of 4 years active duty.

 

[pgg]

are military docs on a GMO out in the middle of the ****?

The short answer is no. Of course some have been killed or injured.

But I bet if someone did a study, they'd find that the mortality rate of deployed docs is actually less than that of non-deployed docs ... simply because the deployed docs don't spend their days driving on US freeways, scuba diving, flying their private planes, eating at Jack in the Box, or doing any of the not-100%-safe things we all do here every day.

 

[BOHICA-FIGMO]

Hey guys! I've applied to my schools, and am eagerly waiting a response. I'm strongly considering the HSPS scholarship, but I've read alot of negative posts about GMO tours.

My question is are GMO tours really that bad? I understand it postpones your residency, but from what I can tell is that they can still be rewarding life enhancing experiences. Does anybody have their own GMO anecdote to share. I'm hoping to hear both positive and negative responses.

If anybody is feeling really generous a pro/con list concerning GMO tours would be awesome!

Thanks!

:troll:

 

[FlyDoc34]

once you escape and do a real residency in a real facility, you'll love just how good you have it while those spoiled residents who've never done a tour of duty will simply whine and look bad to their staff.

I've got a couple of guys who work under me as GMOs and it's not a good thing intellectually or financially. What you gain in the HPSP paying for your school you'll lose in pay. Plus, as a GMO you'll be put into situations that far exceed your training capabilities. Never set a fractured radius? Well, figure it out bucko.

Take it from someone who drank the Kool-Aid, wanted to be a 'career military physician' then found out that life was much better on the outside, even for primary care.

Avoid HPSP like the plague. You can always do the FAP later if you decide it's what you want to do.

 

[WoWdoc]

I'm not trolling. I'm a pre-med awaiting to hear back from 3 medschools I've interviewed at. One of those is USUHS. Shortly after getting an acceptance I may be signing a contract with the military. In the meantime I'm trying to be proactive and gather as much information about what I'm about to get into as I can. Read my previous posts on other threads and you will see a common theme of an interest in military med being reflected.

If you have nothing to contribute to the thread, I would kindly appreciate it if you didn't post. If anything you BOHICA-FIGMO are the troll here!

 

[Segovia]

once you escape and do a real residency in a real facility, you'll love just how good you have it while those spoiled residents who've never done a tour of duty will simply whine and look bad to their staff.

I've got a couple of guys who work under me as GMOs and it's not a good thing intellectually or financially. What you gain in the HPSP paying for your school you'll lose in pay. Plus, as a GMO you'll be put into situations that far exceed your training capabilities. Never set a fractured radius? Well, figure it out bucko.

Take it from someone who drank the Kool-Aid, wanted to be a 'career military physician' then found out that life was much better on the outside, even for primary care.

Avoid HPSP like the plague. You can always do the FAP later if you decide it's what you want to do.

I'm confused. Are these meant to be negatives? I guess what I am saying is that while in the Navy (enlisted), there were situations wherein I had to improvise and just make things work. Looking back, these were positive experiences that helped me gain at least a modicum of ingenuity.

Do you mean that the infrastructure just isn't there to properly train GMO's? If you are saying that the entire continuum of training just isn't there, then I understand and agree, but if you are saying that there are times when s$*& just happens and you are forced out of your comfort zone, then I say this is not a reason to avoid HPSP.

As far as being around whiny residents that have no real understanding of scut, I think that is another positive. A grateful employee is likely to win more praise from staff, civilian or military. I would think this would be an asset professionally. Are the GMOs working under you lackluster skill-wise?

Not trying to bust your ba&&s; actually I am struggling with the idea of doing HPSP as well, but I am thinking perhaps my enlisted experience has made me a little more impervious to the gripes I am seeing about milmed thus far. I can see how a young doc with no military experience would be hating life though.

 

[Segovia]

once you escape and do a real residency in a real facility, you'll love just how good you have it while those spoiled residents who've never done a tour of duty will simply whine and look bad to their staff.

I've got a couple of guys who work under me as GMOs and it's not a good thing intellectually or financially. What you gain in the HPSP paying for your school you'll lose in pay. Plus, as a GMO you'll be put into situations that far exceed your training capabilities. Never set a fractured radius? Well, figure it out bucko.

Take it from someone who drank the Kool-Aid, wanted to be a 'career military physician' then found out that life was much better on the outside, even for primary care.

Avoid HPSP like the plague. You can always do the FAP later if you decide it's what you want to do.

Sorry, I also wanted to get your opinion (or any other experienced mil docs on this thread) about how the training is in the military residency programs after you have done your GMO. If I want to do anes or rads in the Navy, do you think my training will be adequate, or will I just suck compared to my civilian counterparts?

 

[orbitsurgMD]

I'm not trolling. I'm a pre-med awaiting to hear back from 3 medschools I've interviewed at. One of those is USUHS. Shortly after getting an acceptance I may be signing a contract with the military. In the meantime I'm trying to be proactive and gather as much information about what I'm about to get into as I can. Read my previous posts on other threads and you will see a common theme of an interest in military med being reflected.

If you have nothing to contribute to the thread, I would kindly appreciate it if you didn't post. If anything you BOHICA-FIGMO are the troll here!

Then you are lazy. Your questions have been asked and answered over and over again for years on these pages. There is even a search engine feature on this site for you to use to find them.

 

[orbitsurgMD]

I'm confused. Are these meant to be negatives? I guess what I am saying is that while in the Navy (enlisted), there were situations wherein I had to improvise and just make things work. Looking back, these were positive experiences that helped me gain at least a modicum of ingenuity.

Do you mean that the infrastructure just isn't there to properly train GMO's? If you are saying that the entire continuum of training just isn't there, then I understand and agree, but if you are saying that there are times when s$*& just happens and you are forced out of your comfort zone, then I say this is not a reason to avoid HPSP.

As far as being around whiny residents that have no real understanding of scut, I think that is another positive. A grateful employee is likely to win more praise from staff, civilian or military. I would think this would be an asset professionally. Are the GMOs working under you lackluster skill-wise?

Not trying to bust your ba&&s; actually I am struggling with the idea of doing HPSP as well, but I am thinking perhaps my enlisted experience has made me a little more impervious to the gripes I am seeing about milmed thus far. I can see how a young doc with no military experience would be hating life though.

The problem with those situations where you are forced to work beyond your level of skill and training (your comfort is something else) is that you are going to be judged by your employer as if you did have the necessary training and experience to work as you were required, even if you did not and could not have that training because you were not permitted to train beyond your internship year, a common situation of every GMO. The Navy is not particularly sympathetic to GMOs, and I am not exaggerating this.

As for the adequacy of training, consider what it might be like to be a former peds or psych intern alone in a remote ED (or an after-hours clinic that gets used as an ED) when a head trauma or suspicious chest pain (not code) rolls in the door. Oh, and lets say that your facility leaders shut down the lab and radiology facilities--no staff or money for round-the clock coverage-- at close of the day clinic but kept the ED door open. Or how would you like to handle a head/neck trauma in a three year old in the same facility after hours. I did a surgery internship at a Navy big three center and was trained at a med school with strong AI requirement at nationally renowned hospitals and I still thought this stuff was crazy, dangerous and irresponsible.

 

[2 Wycked]

The problem with those situations where you are forced to work beyond your level of skill and training (your comfort is something else) is that you are going to be judged by your employer as if you did have the necessary training and experience to work as you were required, even if you did not and could not have that training because you were not permitted to train beyond your internship year, a common situation of every GMO. The Navy is not particularly sympathetic to GMOs, and I am not exaggerating this.

As for the adequacy of training, consider what it might be like to be a former peds or psych intern alone in a remote ED (or an after-hours clinic that gets used as an ED) when a head trauma or suspicious chest pain (not code) rolls in the door. Oh, and lets say that your facility leaders shut down the lab and radiology facilities--no staff or money for round-the clock coverage-- at close of the day clinic but kept the ED door open. Or how would you like to handle a head/neck trauma in a three year old in the same facility after hours. I did a surgery internship at a Navy big three center and was trained at a med school with strong AI requirement at nationally renowned hospitals and I still thought this stuff was crazy, dangerous and irresponsible.

I'm a prior enlisted medic (Army) and current EMT who is also thinking about HPSP. How much of what you described above is Navy specific, as opposed to any other branch? It seems most of the posts are from former Navy or AF GMOs. Does anyone know how an Army GMO tour compares to the other branches? Thanks.

 

[jsmittyund03]

I have done 6 months of rotations at Army facilities, 4 different hospitals. I have encountered countless physicians who were once GMOs. I have heard NOTHING but positive experiences from them. Many said it was the best job of their lives. Understand when you hear negativity being spewed on SDN, it is with motive. I was very nervous about the possibility of GMO after reading many negative threads on it, but my personal experience with docs who have done it was the exact opposite. Good luck.

 

[orbitsurgMD]

I have done 6 months of rotations at Army facilities, 4 different hospitals. I have encountered countless physicians who were once GMOs. I have heard NOTHING but positive experiences from them. Many said it was the best job of their lives. Understand when you hear negativity being spewed on SDN, it is with motive. I was very nervous about the possibility of GMO after reading many negative threads on it, but my personal experience with docs who have done it was the exact opposite. Good luck.

Motive? Really? And your endorsement is the result of what, heresay?

Your personal experience is of hearing about what someone else thought of what they experienced, not anything that you experienced, correct? Just want to be sure of that one.

 

[Mackey]

Motive? Really? And your endorsement is the result of what, heresay?

Your personal experience is of hearing about what someone else thought of what they experienced, not anything that you experienced, correct? Just want to be sure of that one.

So, if the information comes from other doctors he has spoken to face-to-face, it is mere heresay. Meanwhile, if he forms an opinion based off someone's online persona (yours), he is doing what exactly?

Oh, this cruel cruel world of ours and the audacity of it's people who dare have conflicting perspectives than your own.

 

[WoWdoc]

Well the heresay I have to share comes from one of my interviewers at a state school I applied to. The guy was an orthopedic surgeon former Navy. Over the course of the interview when it came up that I was interested in HPSP he spoke very favorably about his GMO experience.

 

[pgg]

I have done 6 months of rotations at Army facilities, 4 different hospitals. I have encountered countless physicians who were once GMOs. I have heard NOTHING but positive experiences from them. Many said it was the best job of their lives. Understand when you hear negativity being spewed on SDN, it is with motive. I was very nervous about the possibility of GMO after reading many negative threads on it, but my personal experience with docs who have done it was the exact opposite. Good luck.

Again, being a GMO has its positive aspects. I'm not the only person who's described it as a rewardingly simple, pure practice of medicine. It's hard not feel at least some sense of pride and satisfaction after following a bunch of Marines through a dangerous deployment, witnessing their sacrifices, and taking care of them in a time of great need.

The price for the privilege of serving in that capacity is high, however. There's opportunity cost, there's a lot of enormously wasteful administrative busywork, and there's risk in sending an incompletely trained physician to a remote, austere location.

 

[pgg]

Well the heresay I have to share comes from one of my interviewers at a state school I applied to. The guy was an orthopedic surgeon former Navy. Over the course of the interview when it came up that I was interested in HPSP he spoke very favorably about his GMO experience.

Be very cautious comparing the happy GMO memories of a former Navy civilian orthopod (who was presumably a GMO in the pre-9/11 era) to what current GMOs experience.

There was a time when being a GMO was 2 hours of sick call in the morning, followed by an hour of admin work, followed by going home for lunch and not returning until the next day. Maybe a few hours moonlighting at the local doc-in-the-box that afternoon. Deployments in those days were YEARS apart and (at least on the Navy side) consisted of things like MEU cruises and port calls. Today, Navy GMOs on the green side do 60 hour weeks during deployment workups, spend another 6-8 weeks away from home for pre-deployment field training, and 30-50% of your time actually deployed.

 

[orbitsurgMD]

So, if the information comes from other doctors he has spoken to face-to-face, it is mere heresay. Meanwhile, if he forms an opinion based off someone's online persona (yours), he is doing what exactly?

Oh, this cruel cruel world of ours and the audacity of it's people who dare have conflicting perspectives than your own.

When you cite that "information," obtained face-to-face or any other way it is heresay. Sorry if that disappoints you. He wasn't relating his own experience of a GMO tour, good or bad, he was recounting someone else's account and implying that GMO assignments were a desirable and enjoyable thing because he had heard good stories about others' experiences. What is more, he was using that same story to dispute first-person accounts and assessments of GMO assignment of posters here, by people who have actually done GMO tours.

An online "persona," at least comes to you second-hand, unless you think I am making stuff up. You can decide to believe or not. I sweat that not.

As for "cruelty" of "conflicting perspectives," I can't say. I know very well of my own experiences as a GMO, and they weren't all bad but they definitely weren't all good either, and on balance, I happen to think it is a poor way to spend the amount of time that the average medical officer typically spends as a GMO. It isn't the short and enjoyable diversion that it is made to seem, in fact it is a significant end product of the HPSP program and the terminal assignment for a very large percentage of the medical students that enter the military services. The recruiters do not usually tell you that.

 

[Gastrapathy]

If you speak to me in person, I'd tell you the same thing. Why not? By that point, you're stuck doing it anyway and why would I risk telling some rotating med stud the unvarnished truth.

 

[AF M4]

I have done 6 months of rotations at Army facilities, 4 different hospitals. I have encountered countless physicians who were once GMOs. I have heard NOTHING but positive experiences from them. Many said it was the best job of their lives. Understand when you hear negativity being spewed on SDN, it is with motive. I was very nervous about the possibility of GMO after reading many negative threads on it, but my personal experience with docs who have done it was the exact opposite. Good luck.

My motive in all this, particularly in talking to pre-meds or med studs who are considering HPSP but have not yet signed, is to provide the kind of warning that I wish I had been given when I was in their shoes.

After this karmic mandate is accomplished though, I am actually quite heartened to see so many people say that I and the other folks on this forum are full of crap and go and sign on anyway. It means that the replacements for my spot in GMO-world are on their way. Bwahahaha.

(Fresh fish, FRESH FISH FRESH FISH FRESH FISH!!!!)

 

[244913]

I am an army gmo flight doc.

GMO is nuanced. Professionally it is an absolute dead end medically. Even the skills you learn in internship will rapidly atrophy. This is especially true in flight units, where almost all pathology is screened out. Your pts will be an unvarying mix of msk, pysch and a smattering of derm.

You will certainly develop your skills as a staff officer.

You will manage med readiness, do shop visits, and a thousand other admin tasks.

You get to do some really cool stuff occasionally and if you make an effort the unit will embrace you as one of their own. You will take care of a lot of genuine heroes but most of your time will be spent dealing with the flotsam and jetsam who cause a disproportionate amt of trouble.

Downrange you will likely be exposed to situations that exceed your training and capabilities.

The best thing about gmo is you get paid well, lots of time off (think 4 days) and your clock is ticking steadily. Of course if you go back into mil residency your gmo years will have availed you nothing committment wise. This is what orbitsurg is getting at when he refers to gmo as a terminal assignment for most.

Pre meds and med studs often wax poetic about gmo but you really have no idea what you are talking about until you do one. If you value being an officer more than a physician and you are willing to delay your training 3 to 4 years then gmo might be right for you. Be prepared to deploy often and train frequently while in garrison.

61N

 

[KingJamesX]

There seems like a good mix of servicemen on this thread, so i'll post this question (Yes, it has been asked before): HPSP is something I am very strongly considering, but i'm non-prior and don't have a strong committment to any one brach. Which HPSP scholarship would you suggest? I know everyone will be abit bias, but thats fine with me. I have heard that Army has the lowest GMO rate, but does that translate into better placement, or they just stick you into any residency slot?

 

[WoWdoc]

I am considering the Air Force HPSP scholarship. I am interested in military medicine, and the school I want to go to will cost me 46k a year just in tuition costs.

I understand that GMO's are given to those who do not place in residency.
Is there anyway I can possibly get some control over this. What could one do to enhance there chances of getting a military (Air Force) residency slot? Say I go to a good school, do well on step 1, and do research and try and get clinical experience in my medical field of choice. Will that help me to avoid the GMO?

 

[mdmed2012]

I am considering the Air Force HPSP scholarship. I am interested in military medicine, and the school I want to go to will cost me 46k a year just in tuition costs.

I understand that GMO's are given to those who do not place in residency.
Is there anyway I can possibly get some control over this. What could one do to enhance there chances of getting a military (Air Force) residency slot? Say I go to a good school, do well on step 1, and do research and try and get clinical experience in my medical field of choice. Will that help me to avoid the GMO?

I cannot speak specifically about how performance will impact having to be a GMO, but there are a lot of "what if's" in this scenario. Even if going to a good school, doing well on step 1, getting good grades, and research would help you avoid a GMO, there is no guarantee that everything will happen so gracefully. I think it would be a bad decision to take the HPSP banking on not doing a GMO because you will just do well enough to avoid it. I'm not here to underestimate you as a student but medical schools choose the best of the best students with high GPAs and test scores, yet there is still stratification in every class.

 

[WoWdoc]

Do you guys think the military has purposefully set the system up so that in order for an HPSP student to get residency trained, that they will most likely have to serve more than 4 years active duty?

Is this why the GMO tours exhist and are used so frequently, to trick future docs into a longer committment if they wish to recieve their training?

 

[sethco]

My motive in all this, particularly in talking to pre-meds or med studs who are considering HPSP but have not yet signed, is to provide the kind of warning that I wish I had been given when I was in their shoes.

After this karmic mandate is accomplished though, I am actually quite heartened to see so many people say that I and the other folks on this forum are full of crap and go and sign on anyway. It means that the replacements for my spot in GMO-world are on their way. Bwahahaha.

(Fresh fish, FRESH FISH FRESH FISH FRESH FISH!!!!)

You know, I kind of feel the same way, but another side of me thinks that if someone comes on here and just wants to dismiss others opinion that they originally asked for, well then they reap what they sow.

At the very least, they provide one more doc so I don't have to worry about an IRR recall. But, I guess this is a little self-centered, right?

Truth be told, I wish I had this website back in 2000 when I signed up. I would not have signed up, even given how debt-averse I am. However, I am about as neutral as they come when it comes to pros/cons of taking the HPSP.

 

[sethco]

Pre meds and med studs often wax poetic about gmo but you really have no idea what you are talking about until you do one. If you value being an officer more than a physician and you are willing to delay your training 3 to 4 years then gmo might be right for you. Be prepared to deploy often and train frequently while in garrison.

61N

This is about as true as it gets.

 

[sethco]

Do you guys think the military has purposefully set the system up so that in order for an HPSP student to get residency trained, that they will most likely have to serve more than 4 years active duty?

It depends on the particular year, the needs of the service, and the specialty you are applying to. As an example, FP/IM/Peds/OB are generally much easier to recieve straight through training for the average HPSP student. More competitive specialties such as Anesthesia, ER, Rads, Surgical specialties, etc are usually harder to get for the medical student. People that have served a "utilization tour" on active duty have a definite advantage during the JSGME match, as they accumulate more points (both for the operational tour and potential as a officer). Grades, board scores, research/publications and letters of recommendations can only take you so far. I have had friends that graduated form Hopkins, UVA, and UFlorida (off the top of my head) that have been pushed to do a flight surgery tour. I have seen people with 235+ on their boards and ranks in top portion of their class not match.

I can tell you this year (in talking to my higher-ups) that there is a push for more flight surgeons on the operational side. So, more med students will probably be pushed into a GMO tour (for at least 2 years). Whether or not it will be like that 4 years from now, nobody can tell. Who knows, maybe they will even get rid of the GMO thing. They certainly have "tried" in the past, but have been unsuccessful thus far.

 

[HollywoodCole]

Do you guys think the military has purposefully set the system up so that in order for an HPSP student to get residency trained, that they will most likely have to serve more than 4 years active duty?

Is this why the GMO tours exhist and are used so frequently, to trick future docs into a longer committment if they wish to recieve their training?

No, its because the military needs a large pool of cheap primary care physicians. Don't read any malice into it. Its an economics and numbers issue.

 

[AF M4]

You know, I kind of feel the same way, but another side of me thinks that if someone comes on here and just wants to dismiss others opinion that they originally asked for, well then they reap what they sow.

At the very least, they provide one more doc so I don't have to worry about an IRR recall. But, I guess this is a little self-centered, right?

Truth be told, I wish I had this website back in 2000 when I signed up. I would not have signed up, even given how debt-averse I am. However, I am about as neutral as they come when it comes to pros/cons of taking the HPSP.

Self-centered? Nah. Just a recognition of someone making a somewhat questionable choice that will indirectly benefit you. Given that you have given them an honest "buyer beware", well, we're all adults here and if folks still want to sign on after being given fair warning, then more power to them.

There are some pros to milmed; however a lot of them involve you being placed into a bad situation and growing to meet the difficulties of that situation. That's a benefit, but I wouldn't exactly give the .mil credit for the hard work of GMOs in overcoming the shortcomings of the situations the .mil places them in.

 

[AF M4]

It depends on the particular year, the needs of the service, and the specialty you are applying to. As an example, FP/IM/Peds/OB are generally much easier to recieve straight through training for the average HPSP student. More competitive specialties such as Anesthesia, ER, Rads, Surgical specialties, etc are usually harder to get for the medical student. People that have served a "utilization tour" on active duty have a definite advantage during the JSGME match, as they accumulate more points (both for the operational tour and potential as a officer). Grades, board scores, research/publications and letters of recommendations can only take you so far. I have had friends that graduated form Hopkins, UVA, and UFlorida (off the top of my head) that have been pushed to do a flight surgery tour. I have seen people with 235+ on their boards and ranks in top portion of their class not match.

I can tell you this year (in talking to my higher-ups) that there is a push for more flight surgeons on the operational side. So, more med students will probably be pushed into a GMO tour (for at least 2 years). Whether or not it will be like that 4 years from now, nobody can tell. Who knows, maybe they will even get rid of the GMO thing. They certainly have "tried" in the past, but have been unsuccessful thus far.

There will be more flight surgeons made from upcoming classes. My class was the feature event when they cancelled all residency deferrals and shunted everyone to FS billets. Now we've been in 2 years and I know many people are going to residencies. Next year the 3-years will punch, and after that the 4 years. We're not manned well to begin with, and that big bump they got from my class starts pouring out the door this summer.

So to anyone who's in med school right now considering HPSP, be advised that the next wave of GMO need is likely coming down the pike.

 

[2 Wycked]

61N, thanks for the army GMO info. Obviously I've never done a GMO tour, but it seems to me that the combination of quick skill atrophy plus exposure to situations that exceed your training is the most worrisome aspect. The admin/staff officer duties and dealing with sick call rangers seems like the price of practicing medicine in the army.

 

[undecided2009]

If there is a positive aspect about being sent out as a non-board certified doc as a GMO, it's that you can do your time, get out, and go train civillian and not be locked in for more time! While my civilian counterparts are training hard, I'm working up atypical chest pain in AD 28 yo's, booting them, and then doing it again, and again, and again. At least as a GMO, you can serve the time you signed up for and then leave for training elsewhere. For folks like myself who signed up to "serve," it's a bonus in that sense - great patient population that I enjoy treating, very compliant, mostly noble folks. Downside is time until you get to receive your training, but if your less interested in pulling the trigger to train straight through no matter where it is than you are in achieving your goals and attempting to land a great residency spot, then GMO time is not a bad way to go. Overall my experience with milmed has been positive - patients get good treatment overall, and there are some fantastic attendings. But the volume and acuity of patients you will deal with is far less than that at a big hospital on the outside. And if good training is directly proportional to practice, experience, and repetition instead of straight up book smarts, then the higher volume place is the place to go. You might have to wait a bit to get there, all the while getting to have some time away from the hectic life of residency training and the bs that accompanies it, but I think the wait is worth it. If I had to do it again, prolly would have waited to train on the outside then have volunteered for deployment later in my career once my training was done. There's definitely something great to be said about the docs that are in the service working hard for the people that fight to defend the US of A. The vast majority of them are fantastic, caring, knowledgeable, etc. and have given up a lot to be where they're at (i.e. financial compensation, time away from family). If you want to make that sacrifice too, consider waiting to sign up after you've completed residency - it will benefit both milmed and you as a well trained doc. Rock on...

 

[244913]

What is your experience with mil med?

 

[undecided2009]

61NOV - limited, but enough to see the pros and the cons and judge them according to what makes the most sense for me in my situation. Different strokes for different folks - my opinion is one of many. Be not swayed either way by what you read, though if I had read this forum prior to signing up I might be in a much happier place.

 

[Gastrapathy]

Be not swayed either way by what you read, though if I had read this forum prior to signing up I might be in a much happier place.

This sentence doesn't make a whole lot of sense to me.
-Yoda

 

[notdeadyet]

Be not swayed either way by what you read, though if I had read this forum prior to signing up I might be in a much happier place.

"Don't be swayed by what you read, but if I had, I'd be happier..."

Huh?

 

[orbitsurgMD]

If there is a positive aspect about being sent out as a non-board certified doc as a GMO, it's that you can do your time, get out, and go train civillian and not be locked in for more time!

. . . .

Overall my experience with milmed has been positive - patients get good treatment overall, and there are some fantastic attendings. But the volume and acuity of patients you will deal with is far less than that at a big hospital on the outside. And if good training is directly proportional to practice, experience, and repetition instead of straight up book smarts, then the higher volume place is the place to go. You might have to wait a bit to get there, all the while getting to have some time away from the hectic life of residency training and the bs that accompanies it, but I think the wait is worth it. If I had to do it again, prolly would have waited to train on the outside then have volunteered for deployment later in my career once my training was done. There's definitely something great to be said about the docs that are in the service working hard for the people that fight to defend the US of A. The vast majority of them are fantastic, caring, knowledgeable, etc. and have given up a lot to be where they're at (i.e. financial compensation, time away from family). If you want to make that sacrifice too, consider waiting to sign up after you've completed residency - it will benefit both milmed and you as a well trained doc. Rock on...

[Bolds mine.]

Written by a medical student who has done what, some rotations as a ward clerk?

Self-contradictory and written by someone who really does not have the experience to come to those conclusions. Even a USUHS student that did all of his rotations at military hospitals wouldn't have the experience to come to these conclusions.

Yeah, "rock-on" . . . .

 

[undecided2009]

Haha. Yeah, maybe English is my second language? I'd be interested in hearing what your opinion is OrbitsurgMD - most of your posts are pretty negative. Does that mean you think that whatever amount of time you served was wasted? Or did you enjoy it and think your educational experience was fantastic? Just interested in hearing your opinion. Love the digs, and I got a lesson in grammar too!

 

[HollywoodCole]

If there is a positive aspect about being sent out as a non-board certified doc as a GMO, it's that you can do your time, get out, and go train civillian and not be locked in for more time! While my civilian counterparts are training hard, I'm working up atypical chest pain in AD 28 yo's, booting them, and then doing it again, and again, and again. At least as a GMO, you can serve the time you signed up for and then leave for training elsewhere...

You might not find that getting out after four years of GMO time and seamlessly jumping into a civilian residency is as simple as you think. For instance, what if your CO won't let you take leave/TAD for all of the interviews that you will need to go to on short notice? Or what if you are deployed during the interview season? There is a significant chance that this could happen and you could need to take time off between your military medicine years and the start of residency.

If you get beyond 4 years after internship, you will run into the likely prospect of repeating your internship, retaking tests, etc. Doing four years of GMO and getting out is probably the path least taken amongst former HPSPers, so you probably aren't going to see that perspective represented too often on this board. I'm glad that you are excited to serve, but give the advice on this thread its due consideration since most of the people giving it are well beyond their clerkship days.

Bottom line--if you really wanted a civilian residency, there were much easier ways of going about it. Don't be upset during your second GMO tour when your chain of command doesn't bend over backwards to help you "get out".

 

[in motion]

Has anyone done a GMO at Ft. Hood? Can you speak to the environment at Ft. Hood. Places to live, traffic, etc. Also any thoughts on flight vs non-flight? Thanks!

 

[Homunculus]

dude. instead of necrobumping a thread just go to the one you started.

--your friendly neighborhood don't create thread zombies caveman