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  1. O

    Proper Retired Title

    Retired status is different. You are not discharged or de-commissioned, you are put on the retired roll. They actually can recall you to duty if they needed you (they would more likely call you and ask you if you were interested.) What you are describing is discharge. If you are on IRR, you...
  2. O

    All Branch Topic (ABT) Possible administration discharge due to failure of ADAPT

    Unless you have performance issues associated with the discharge, you should receive an administrative discharge under honorable conditions (unless there is more you aren't telling us). The military is separating you out of their convenience; they expected to cure you of EtOH abuse with their...
  3. O

    Thinking about HPSP/USUHS? READ THIS.

    Except for the fact that the money paid per accession has never been higher, nothing about the HPSP can be said to have improved. The situation with residency training for HPSP accessions (or more correctly, the certain absence of said training) is particularly bad. I have to wonder how civilian...
  4. O

    Optic Nerve Drusen?

    You might expect to be referred for an ophthalmology evaluation. Superficial nerve drusen are fairly easily identified on ophthalmoscopy with the exception of buried drusen which may create elevation of the optic nerve and the appearance of nerve margin edema. (That is where the headache...
  5. O

    Resigning HPSP scholarship

    The recklessness with which the medical departments have embraced these radical downsizing personnel changes without thought to the nature of the training pipeline they depend on to provide the medical personnel they hope to secure ("bucket 1" generalists and specialists) ought to give anyone...
  6. O

    Read This thread was locked, why?

    It might appeal to those generally unattached with a spirit of adventure. Supposedly it is generally casual, as in uniform of the day is shorts and t-shirt, and the mode of transport is bicycle. It was treated as a one-year unaccompanied hardship billet and there was usually a "pick your...
  7. O

    Read This thread was locked, why?

    Yeah. I was told when I was there that in winter, the darkness, snow and wind can sometimes cause whiteout conditions during which you are locked down wherever you happen to be for safety. Apparently visibility can be so bad at times that even with flood lighting, it is possible to become...
  8. O

    Read This thread was locked, why?

    I don't know if you've been there, but Thule is an interesting place: wild Arctic foxes that have no fear of humans and will walk right up to you, everything built on stilts or with cold air ducts underneath to prevent melting of the permafrost and a 24-hour a day club, (the Top of the World...
  9. O

    Read This thread was locked, why?

    The commissar vanishes.
  10. O

    Thinking about HPSP/USUHS? READ THIS.

    True, but unrelated. The idea of a one-year training experience as qualification to practice independently died in about 1938.
  11. O

    Thinking about HPSP/USUHS? READ THIS.

    Most of the places that do volumes of that work are federally-subsidized clinics. This plan is going to blow up in their faces.
  12. O

    Thinking about HPSP/USUHS? READ THIS.

    This entire scheme seems to be the worst-considered and most incompetently-planned concept: so we can get some "warfighters," let's gut our medical services, destroy our training hospitals and have no explainable way of providing medical services to active duty and their families except the...
  13. O

    Thinking about HPSP/USUHS? READ THIS.

    They don't want to have to build/buy the facilities needed to support rad-onc, if I were to guess.
  14. O

    Thinking about HPSP/USUHS? READ THIS.

    In a crunch, they will stop-loss, call up RR and also IRR and then start drafting. They did it before and will do it again.
  15. O

    Starting to question military pay < civilian pay

    Actually, it appears that if you reached age 65 as of 2015, your chances of living to age 90 are 22%. That doesn't disprove your claim, but for it to be true, a large number of men, the majority, need to die before age 65.
  16. O

    Is it possible to join the NAVY post civilian FM residency solely to do FS/UMO tour?

    I am far from recent in my service, but I can say that quite a few flight surgeons were accessioned from the civilian community who had done one or more years of civilian residency training but had no Navy training or prior service obligations. In my NAMI class, there were EM, FP and...
  17. O

    “Military discount” state License = Restricted License

    They evidently don't understand the term "restricted" as concerns a state license. The fee-discounted and fee-waived licenses are not restricted as concerns scope of practice. That is all that should be relevant to the military. (Training licenses are restricted, for example.) Fee discounts...
  18. O

    All Branch Topic (ABT) So who is transferring to the Space Force?

    I have to believe there is support among the strategic missile community and others (e.g., ballistic missile defense, NRO, Geospatial Intelligence Agency) that have been sidelined in the post-SAC Air Force where the shift has gone toward air combat and special operations support. The idea is...
  19. O

    Army HPSP, good or bad choice for surgical residency/training?

    Not financially and not for a raft of other important reasons. Stay away from HPSP if you have a free-ride scholarship. Live as cheap as you can and borrow as little as you can. You will have your best opportunity at residency selection in the civilian community and if you want to do anything...
  20. O

    HPSP Medical Separation

    The HPSP contract is regular reserve, not IRR. Drilling is required, organized to take place in a 45-day period once yearly and where waivers to take school orders for the active duty training are required, otherwise orders are to an academic military facility.
  21. O

    HPSP Medical Separation

    He is already in HPSP. He already is commissioned. I suspect he has even done ACDUTRA, or at least did duty at his school. He had an accessioning physical when he applied for the scholarship and presumably passed and/or had any disqualifiers waived at the time. It seems to me this is more a...
  22. O

    What's your policy on taking back a non-compliant patient who fried you?

    You do not need to specify reasons for termination or suggest alternatives if you terminate. Some people suggest calling the local hospital physician referral line or county medical society for names of doctors accepting new patients, but you don't have to do either. When you initiate the...
  23. O

    What's your policy on taking back a non-compliant patient who fried you?

    Typically, if you are "fired" you do not have to do anything, including take the patient back if they change their mind. It is presumed when they initiate the termination that the patient has already made acceptable arrangements for followup care that they want (or don't want, whichever). The...
  24. O

    Do you see military medicine improving?

    If you believe that past performance is a useful predictor of future performance, then no. If you believe that, in general, trends regress toward the mean . . . then, yes.
  25. O

    Do you see military medicine improving?

    . . . and ortho, to a certain degree, although you won't be doing many total joints. Unless there is a war, or unless the medical departments are completely revised and retirees are brought back into the panels, there won't be any big changes coming. Budgetary pressures on medical will likely...
  26. O

    What exactly do Physicians in the CIA do?

    I was strolling through the neighborhood and came by this thread. I suppose if somewhere (not stateside) there were clandestine activities going on that had risk of combat-type injuries then it might be prudent to set up a forward medical treatment unit as part of the operation to receive and...
  27. O

    Military hospitals like DC's Walter Reed could ease national ER overcrowding, save lives

    They would be better off joining the Capital region network of trauma hospitals: MEDSTAR Washington Hospital Center, Inova Fairfax, Johns Hopkins Hospital and R. Adams Cowley in Baltimore or at least step up to a real Level II service. The nearest Level II is at Suburban Bethesda, a Johns...
  28. O

    Joining as derm with FAP or post-residency?

    Do not take HSCP. Do not apply-for or accept HPSP. Take the full ride scholarship to the state school. That is, by far, the best deal you have in hand: better than the Navy, better than Jefferson, Penn or anything else. Apply-for and take the best civilian residency you can get in the specialty...
  29. O

    Army selects new sidearm

    Sig is fine. HK would have been better, but their cost is an issue. The Glock hate is puzzling given how many LEOs carry them who have a higher probability of actually using their sidearm. The all-passive safety is easier to train and the build quality and weather-resistance are benchmark. If...
  30. O

    Why does Neuro ophthalmologists paid less than neurologists?

    Neuro-ophthalmologists come to their sub-specialty by one of two ways: as neurologists first who do a neurology residency then a neuro-ophthalmology fellowship, or as ophthalmologists first who do an ophthalmlogy residency then a fellowship in neuro-ophthalmology. Both are different from...
  31. O

    Military Medicine: Pros, Cons, and Opinions

    D.C. as well. Anymore, it is not so relevant. Without completing a residency, you can't get staff privileges, operate at an ASC, join private insurance panels, or work at many private urgent care centers. You could put up a shingle as a GP, take cash and maybe Medicare and Medicaid, but that...
  32. O

    Military Medicine: Pros, Cons, and Opinions

    This is the bitter irony of the GMO "system." Usually it is the medical graduates with interests in surgery specialties or anesthesia, radiology and other competitive non-primary care specialties who get fed into the GMO pipeline precisely because GMO duty tours have become a selection criterion...
  33. O

    Target on back

    You have a toxic work environment, which I am sure is not news. You also have a weak department leader who is not really standing up for you and in fact may be tacitly supporting the toxic accusers whose complaints are becoming disruptive of operations, giving them a free enough hand to make...
  34. O

    WPAFB hospital closing

    Those scary "contracts" are not unassailable, and they know it. Were you actually afforded the opportunity to negotiate your contract terms? (No.) Did the military recruiters make representations and promises to you that influenced your decisions on where and what to study, and did you rely on...
  35. O

    Surgical equipment

    You can benchmark Storz and Katena for almost anything, Same with Duckworth & Kent. Storz and Katena sell directly from their catalogs and at least for Storz, through Bausch & Lomb here in the USA . They may have another sales representative where you live. I recommend you contact them directly...
  36. O

    How does hospital call work?

    If there are no ophthalmologists on staff and the ED attending thinks a patient needs to see one emergently, they would be transferred to a hospital ED where that specialist was available. Usually the ED chooses, not the patient, and it is based on availability. If a patient insists on going to...
  37. O

    Insider Threat Awareness

    It depends. Do you get to have a shoe phone with a dial in the heel? Or do you have to hide in trash cans and fake 18th century paintings?
  38. O

    Bought a 20D lens to practice. Is it pretty much useless without indirect?

    Not necessarily. You can use a muscle lamp to make a coaxial beam, placing its light pipe at a point between our eyes in line with your view path, and then converge, a little trick from some visiting Russian doctors. It isn't as easy as an indirect, though. And a 20D is a great magnifier for...
  39. O

    Army HPSP for the money. Naive and future regret?

    On the money side: if you are really committed to primary care, you will be in better shape than someone undecided who might discover a specialty area that is the field for them. You may even get your whole residency done before having to practice independently, which is an enormous advantage...
  40. O

    Doing residency in crappy places and going back to desirable places --> an uphill battle?

    The first thing you need to do is get a pickup truck, nothing too fancy, but one with a diesel engine, maybe a Ram or an older Dodge, and then if you want, you can set it up as a coal roller. You'll need a "How's that Hope and Change Going for Ya? sticker and then a Bone Collector and Browning...