Which Branch for EM?

[Renaissance Man]

I read the other threads and did some research but couldn't really find the answer I am looking for. I have been accepted to medical school, and know that I want to be an EM physician. Does a specific branch offer a better chance of doing a civilian residency? What would a career as an Air Force, Navy, or Army EM doc be like?

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[TheGoose]

I read the other threads and did some research but couldn't really find the answer I am looking for. I have been accepted to medical school, and know that I want to be an EM physician. Does a specific branch offer a better chance of doing a civilian residency? What would a career as an Air Force, Navy, or Army EM doc be like?

If a civilian residency is your first question you probably shouldnt be looking into joining the military...

 

[Renaissance Man]

If a civilian residency is your first question you probably shouldnt be looking into joining the military...

Appreciate the condescending tone, if you are representative of military medicine than you are right, I shouldn't look into joining the military.

 

[teacherman84]

Appreciate the condescending tone, if you are representative of military medicine than you are right, I shouldn't look into joining the military.

To be fair he has a point, if training civilian is important for you then dont even consider HPSP, look into FAP or direct commission after youre board certified if you really want to serve. If its about the money then just take out loans, in the long run its not worth it financially if you go into anything other than primary care.

That being said the AF had 16 inservice training spots and 13 civillian deferred, so probably the better odds of training civilian (though I have no idea what the numbers are for the other branches). From what Ive been told 8 of them are active duty residents at civilian institutions (the 6 at WP and the 2 at Nellis).

As far as what its like in the AF once youre practicing, again this is based on my limited knowledge in speaking with AF EM docs, its very few high acuity/high volume EDs but a lot of over glorified Urgent Care centers. I lived by one of these and anything remotely serious, even if on base, would get rerouted to the civilian hospital a few miles away. Many, if not all, of the docs worked at local civilian EDs to actually see anything.

 

[Renaissance Man]

To be fair he has a point, if training civilian is important for you then dont even consider HPSP, look into FAP or direct commission after youre board certified if you really want to serve. If its about the money then just take out loans, in the long run its not worth it financially if you go into anything other than primary care.

That being said the AF had 16 inservice training spots and 13 civillian deferred, so probably the better odds of training civilian (though I have no idea what the numbers are for the other branches). From what Ive been told 8 of them are active duty residents at civilian institutions (the 6 at WP and the 2 at Nellis).

As far as what its like in the AF once youre practicing, again this is based on my limited knowledge in speaking with AF EM docs, its very few high acuity/high volume EDs but a lot of over glorified Urgent Care centers. I lived by one of these and anything remotely serious, even if on base, would get rerouted to the civilian hospital a few miles away. Many, if not all, of the docs worked at local civilian EDs to actually see anything.

I just got mad that he assumed I knew nothing. I have sat down with an army recruiter twice, and I know that I will have little chance of obtaining a civilian residency. However, I ask this question for some of the reasons you mentioned. IMO, good EM training include a multitude to serious cases and workups, and I didn't think you would see a whole lot of that in a military hospital. As you said, they would be transferred to civilian hospitals.

Thanks for the helpful reply, maybe I need to get into contact with an AF guy.

 

[oneyearwonder]

sat down with an army recruiter twice.

that's a good way to get misinformation, misleading information, half truths and sometimes lies. Good job on finding this Forum. questions and answers and old threads here will be way more high yield.

if you like any sense of control in your life, then don't join the military. Being subjugate-averse may be more important than being debt-averse.

 

[DocArmy]

If a civilian residency is your first question you probably shouldnt be looking into joining the military...

I didn't think Goose's response was condescending at all. If the Army recruiter that you talked to didn't tell you that the Army just doesn't really do civilian deferrals, then he is withholding information. I've been told by the head of Army GME that the only residency that has been civilian deferred with any kind of regularity for the last several years was neurosurgery. Everything else is Army residency or a gmo tour.

Rest assured that, once you sign the paperwork, they don't care that you would prefer to train at a civilian residency. This is true for all the branches. It would be a terrible mistake for you to join, thinking that you had a huge amount of input into where you train, because you don't. You apply to the military match, which happens in December. If you are hoping for a civilian deferral, you must first match into EM Civ Deferred in the military, THEN match into a civilian program (assuming that it's even a possibility, see AF vs Army).

So, as said above, if picking your training program is very important to you, then the military may not be the best fit.

 

[DeadCactus]

Appreciate the condescending tone, if you are representative of military medicine than you are right, I shouldn't look into joining the military.

No need to throw a hissy fit because your ego got butthurt; he gave you an honest and accurate answer. I really don't know wtf is wrong with the people who come asking for help and then throw a tantrum because the answers aren't all sunshine and unicorn poop.

 

[tkim]

Appreciate the condescending tone, if you are representative of military medicine than you are right, I shouldn't look into joining the military.

Not condescending at all. Check your attitude when asking for help.

 

[notdeadyet]

No need to throw a hissy fit because your ego got butthurt; he gave you an honest and accurate answer. I really don't know wtf is wrong with the people who come asking for help and then throw a tantrum because the answers aren't all sunshine and unicorn poop.

Ditto this. If your desire is to do a civilian residency, there are very few cases in which you'd be best off joining the military now. Bit the bullet and take out loans (like almost all medical students do) then take FAP in residency and pay most of them off. Or join as an attending and use your sign-on bonus to pay most of them off.

If you really care about getting the best residency for you in your particular specialty, odds are that it won't be found in the military. It's just a matter of numbers. With civilian programs having 10-50x the program offerings a particular branch of the military has, odds are you'd find a better fit for your particular goals and personality in the civilian match. Beyond that, military residencies are often average at best.

Sorry if you don't like that advice. When I was accepted to medical school, I knew that I was EM bound as well. Luckily, I did my research (of which SDN was a great tool) and found that most military EM residencies were way below average compared to my local civilian options. Through medical school, I also changed my specialty decision, as most medical students do.

The Goose gave good advice: if you want a civilian residency (and if you actually end up in EM, you'd be smart to), don't enter a program that limits your training options to a handful of programs, most of them not even at level 1 trauma centers.

 

[TheGoose]

I feel the love, guys.

Back to OP...listen to what these guys spelled out. If you want to do a civilian residency...be a civilian. It's that simple. I gave a frank answer because your very first question about military medicine was how to NOT actually do a residency IN the military. Seemed like a silly question.

To answer your question about life as a military EM...expect to be bored unless you happen to be in San Antonio (the only Level I). It seems like the EM docs do a lot of moonlighting - maybe it pays the bills, maybe they can actually manage EM cases - who knows. And by the way, EM is more competitive in the military than in the civilian sector - all that hooah hooah stuff.

 

[Renaissance Man]

Wow.....you are right I did come here for help, but before this I have also talked with a recruiter (who may or may not be looking out for my best interests), posted in the HPSP forum, and chatted with an army EM doc who did get a civilian residency. I wanted to hear from more people and from other branches, so I posted my question.

It is not my "first" question about military medicine, it is probably one of my last. I have been accepted to some affordable schools and my interest isn't about the money. I'm sorry I took offense to someone questioning if military medicine is right for me based upon a single post. But I will "check my attitude" and fix my "butt hurt" before ever posting in this jaded forum again.

 

[Renaissance Man]

I feel the love, guys.

Back to OP...listen to what these guys spelled out. If you want to do a civilian residency...be a civilian. It's that simple. I gave a frank answer because your very first question about military medicine was how to NOT actually do a residency IN the military. Seemed like a silly question.

To answer your question about life as a military EM...expect to be bored unless you happen to be in San Antonio (the only Level I). It seems like the EM docs do a lot of moonlighting - maybe it pays the bills, maybe they can actually manage EM cases - who knows. And by the way, EM is more competitive in the military than in the civilian sector - all that hooah hooah stuff.

This is what I was looking for. I appreciate the response this time, when I asked the recruiter he just says its "likely" you can get a civilian match, and if not, EM is very good in the army anyways....

 

[Charlie0318]

when I asked the recruiter he just says its "likely" you can get a civilian match, and if not, EM is very good in the army anyways....

If your recruiter told you it was "likely" that you would get a civilian match in the Army he was flat out Lying to you! The Army allows something like 2 or 3 civilian deferments per year, and only in fields that they need and don't have enough training spots for (ie not EM).

I honestly don't think it is even remotely possible that you could get civilian deferment for EM in the Army. Maybe in the AF, but still unlikely. Very unlikely in the Navy.

As has been said before, if civilian EM is what you want, HPSP is a very, very bad option. There are other ways to get into the military as a physician, and I suggest you explore those other options if you want to serve, but also want a civilian EM residency.

 

[deuist]

AF EM is extremely competitive to get a spot (military or civilian). When I went through the application process, only half of the applicants were allowed to do EM; everyone else was forced into undesirable internships along the flight surgery track. Most of those who were allowed to do EM ended up at either San Antonio or Wright Patt. The remaining got civilian deferments. As others have said, if you're dead set on going a particular route, the military is not for you.