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GMO_52

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Our more senior members have made the point in a couple of threads that while they are the most negative about military medicine, they are also the most experienced. Both implicitly and explicitly, they are stating that their views should therefore be given more weight. While that would be valid if they were a true representation of the views of most military staff physicians, I do not believe that they are.
There are not many places in the military in which one can voice these sorts of negative opinions (hence militarymd's appropriate desire to stay anonymous) and therefore, they are quite active in what is really a student forum. Those staff physicians who are overall positive about their military experience simply a) don't know about this forum and b) share their opinions openly with students in the typical setting. I have a problem with the way these negative opinions are being characterized as "attending opinions" because, there are a lot of staff, only a few reside here, and they happen to be those individuals who need a forum like this to be able to honestly express their views.
OK, I feel better now. Back to the land of stuffy noses and well-woman exams.

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I wish I had perused this forum before signing up for HPSP. That was when I needed this advice, but it was impossible to get. I didn't know any military attendings except for one cousin (who has had a less than typical career) and a great uncle, who served in vastly different medical system, both within the military and outside of it. The recruiter had a nice story to tell, so I signed up. I didn't know the recruiter not only had never worked in medicine or been to medical school, but didn't go to college either, and only became a recruiter because of the pay bonus for recruiting.

The fact is for the vast majority of premeds considering signing up for HPSP, that they don't know what they're getting into. There are positives and there are negatives to joining the military. But the recruiters only tell you the positives! You have to find attendings to get the negatives! While militarymd and others spend great effort on sharing the negatives, you must keep in mind they only have your best interest in mind. Its true what they say, they won't benefit from sharing this information with you. They're not trying to get back at Uncle Sam. They're simply helping you make an informed decision.

The amazing thing is not that only "negative" attendings come into this forum, but that any come in at all. When they bother sharing their time with you don't dismiss their experience. I wander into this forum about once a year, and I probably won't even do that once I finish residency. But if I did, you can bet I wouldn't stick around long with people posting things about me like this.

only a few reside here, and they happen to be those individuals who need a forum like this to be able to honestly express their views.

Bull****. What do you think the military is going to do, kick them out? Give me a break. Military physicians, like all physicians, aren't afraid to talk about the things that bother them in their hospitals and health care systems. Nobody is hiding out here lest their supervisors write them up. If only a handful of attending military physicians frequent this forum, what makes you think that any of their supervisors (non-doctors by the way) come here? Newsflash....98% of the hits on these forums are from premeds and med students

Those staff physicians who are overall positive about their military experience simply a) don't know about this forum

What makes you think unhappy physicians frequent these forums at a higher rate than unhappy physicians? That's ludicrous. I would actually expect the happy ones to be in here recruiting colleagues for themselves.
 
GMO,

I'm not implying, explicitly or implicitly, that my viewpoint is more correct than anybody elses. I feel that I'm simply providing information to medical students to help them make a significant decision in their life. When I was a student, the internet did not exist, and I had no access to this kind of forum. If I did, and someone like myself was there to provide info for me, I would never have signed.

One of my jobs where I work is to teach residents, interns, and medical students. I do teaching rounds on inpatients. At times, I have up to 15 trainees round with me on my service.....and let me tell you, I'm just as vocal there, as I am here. The only difference is, the people who are rounding with me have signed already.....so my experiences and views makes no difference for them.

This is the only place where my opinion may help someone make a very major decision in their lives. Come on, why would what I have to say make you upset???
 
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I just wanted to jump into the fray... I have no military medicine experience, but I just wanted to tell you guys about a doctor I met who sees things from the other side. He was in private practice as an opthalmologist and things turned so sour for him with malpractice and managed care over the last 10 years that he gave it up to join the Air Force. He's stayed in past his commitment and doesn't plan to leave until he retires.

It's quite possible he's the exception and not the rule. I guess I won't know until I see for myself what military medicine is like. I know all of us appreciate the wisdom that militarymd and desperado have to share, but at the same time it may seem from their posts as if all military doctors hate their jobs and want to get out. Not *all* of them do.

There are a lot of factors that determine whether or not someone is going to be happy in military medicine... like specialty, post, whether or not you have a family, your temperament, what you may have expected of it. I strongly agree that people should carefully consider the decision they're making and learn what they can about it.

Can you guys maybe talk about what went wrong in your experiences, and tell us about colleagues of yours that might be happy where they are? I feel like you're trying to deter everybody from doing military medicine, as opposed to telling us what things we should consider, and who would be happy, and who wouldn't.
 
I can honestly say that only 1 of my partners in my department at work enjoy the military. He really enjoys the travel, and that's why he stays, but he has complaints too. Its just that he really enjoys the travel, and not having to stay in one place for long.

There are a few who are sticking it out for retirement because after their commitments were up, they were AD for 15 or so years, and they really feel that they can't give up the retirement. But they hate life in the mean time.

There are many who stay because they can't get jobs in the civilian world because of incompetence, laziness, etc...This is the honest truth....I think the others(desperado, mitchconnie, etc.) would concur.

And there are the exceptional few (not in my department) who stay because they love their jobs in the military and are really good at their jobs. They grin and bare the difficulties and press on. I'm sorry to say that this group really is the overwhelming minority. I had aspired to be in this group, but I just couldn't take it anymore.

If you are really interested why I'm dissatified...just search for my previous posts.
 
I've personally spoken with a few physicians who were in various branches of the military, and every one of them had good things to say about their military experience. The best thing you can do is be as well informed as possible, but don't go by a single individual's experience. Attitude is everything. If you spend your time looking at everything in a negative manner, well then you're going to be pissed off and miserable no matter where you are. Civilian or Military, there are going to be problems. As far what type of person is more likely to post here, I think someone who wants to get back at the military for whatever has a pretty big incentive. Its been stated on this forum over and over again. If you don't have an interest in the military and serving your country, then don't join because if you do you'll just be picking out every little flaw in the system to complain about and you'll be missing out on a great experience. Hell, I'm just glad I got into medical school. It's all good.
 
Originally posted by militarymd
There are a few who are sticking it out for retirement because after their commitments were up, they were AD for 15 or so years, and they really feel that they can't give up the retirement. But they hate life in the mean time.

True - I've seen plenty at Balboa, across all departments.

There are many who stay because they can't get jobs in the civilian world because of incompetence, laziness, etc...This is the honest truth....I think the others(desperado, mitchconnie, etc.) would concur.

VERY true - it's sad, really. It's always been one of my biggest criticisms of military medicine...the best & brightest always leave, while the mediocre (or worse) stay behind to get promoted & lead.

And there are the exceptional few (not in my department) who stay because they love their jobs in the military and are really good at their jobs. They grin and bare the difficulties and press on. I'm sorry to say that this group really is the overwhelming minority. I had aspired to be in this group, but I just couldn't take it anymore.

There are some truly GREAT military doctors - these are the ones who would be great no matter where they were at, but truly love the military. I've had the good fortune to work with several of these throughout my 4yrs, but they are the minority.

I've had both good & bad within my time in the Navy - overall, it's been a very positive experience & I'd recommend it for those who have a desire to serve their county - never for anyone just looking for money to pay for school. If the residencies within the Navy were stronger in emergency medicine, I would have chosen to stay in...some fields do have strong residencies, just not mine.

I'm planning on staying in the active reserves - not because of the money & in spite of a lot of the very real BS which has been mentioned by others...purely for my own sense of service. The possibility of being called up is there - that's the reason the reserves are there & that's the reason I'm staying in....
 
As I have said in other posts, I do not yet have the experience of militaryMD; I'm in a civilian EM residency s/p HPSP. However, I have spent a few months working in military clerkships. In my EM clerkship I worked with a group of good doctors, maybe 12. Only one planned to stay in until retirement. Several were very unhappy, and most had the attitude that "This isn't so bad, but there's no way I'm staying in after my commitment." The main complaints were:
1) Administrators that didn't understand medicine.
2) Deployments
3) Covering additional shifts because other members of the group were deployed (remember EDs are open 24 hours.)
4) Non-sick patients coming to the ED (I just came in to get my tylenol.)
5) Low pay
6) Lame locations
7) Having to moonlight in civilian EDs to keep skills up

I did another rotation in internal medicine. Many of the internists came in late and left early. There seemed to be very little willingness to go the extra mile for patients. Some physicians I came in contact with were clearly incompetent. The residents were not very busy, and mentioned that all their best training came during the months they were away from the home "military" institution.

I also did a rotation in Aerospace Medicine, where the director of the rotation flat out told us he stayed in the military for the health benefits for his very sick daughter. He loved his job because he didn't have to work very hard.

I also went to boot camp. Hmmm...that was useful. Nowhere near as hard as one day on a busy trauma service...yet still just as painful.

Overall my impression of military medicine is not very good. That combined with the pain in the ass of nearly not matching in my chosen specialty due to its extreme competitiveness in the military (30-40% match rate, the equivalent of dermatology in the regular match where EM has a 90-95% match rate) and topped off by the recruiter's lies....is it any wonder I'm not very excited about the 4 years ahead of me? I have yet to have a positive experience with the military. I'm sure they're out there, and I'm sure I'll have some, but it seems to me the bad will outweigh the good long before I'm done. The bummer thing is, I went to a cheap med school and probably could have gotten out with only 70K in debt.
 
Thanks, guys, for taking my post seriously. I reread it and I thought it *might* have sounded like I was instigating something. Thankfully you got me. I was particularly impressed by what you had to say, militarymd. Good thread.

~Alli
 
Just a take from a fourth-year AFHPSP med student. I go to a cheap school and I will be doing a military residency.

I took the scholarship for personal reasons that had little to do with the money. Before doing so, however, I accepted the following:

1) I might not always get to do what I want to do or where I want to do it.

2) I would have the chance to do some things while in that I could never do on the outside; some of these might be a lot of fun and some might not.

3) I would get paid enough to be comfortable but not be rich.

4) Ultimately, my boss will never be a medical guy nor will the patient always be the top priority.

5) I might not like it in the military.

In other words, like most things in life, it was a decision that involved some risk. But I figured I'd give it a shot and play my cards as best I could.

For example, I decided while a third year that if I wanted to be a surgeon (which I was seriously considering), I would do my time as a GMO, get out and then get my training. (I was worried about case load.) As it turns out, I decided on primary care and figured I'd just go ahead and get trained. Now, AF FP isn't without its problems either. But that's cool. I knew that going in.

A number of times during rotations other students who were considering either HPSP or FAP asked me for advice. I shared 1-5 above with them and I think I scared most of them away. This wasn't intentional, mind you; I was happy to join and am even more sure now that I made the right choice. But I think folks need to know what they're getting in to.

What will I think in seven years when I'm looking at things from the other end of the tunnel? I dunno. Ask me then. All anyone can say is to listen to the voice of experience; you'll learn a lot. At the same time, keep things in perspective (ie, don't ask an intern if medicine is a good career to go into or not). In the end, you make your choices and you live with them. To quote Porky from the old 'Pogo' cartoon, "don't take life too seriously; it ain't nohow permanent."

Semper gumbi.
 
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This was a great thread to start, I think a lot of good points have been made already here in one place rather than spread around various threads. I'll add a few of my own, here.

I agree that people who read these should pay attention to what the disgruntled Docs have to say. They're taking their own time to help others, with no possible benefit for themselves. Believe me, the military will get enough people to join, it's not like militarymd will single-handedly dry up the pipeline by causing potential HPSPers to really think about the cost/benefit ration. He's trying to help you people, listen. Be thankful they're here, most of us never had a resource like this, all of us had recruiters with quotas and no medical experience, that's the system. At least you folks have been warned what to watch for. Thank you militarymd and company, hopefully my colleague's attitudes will improve if more money-only types think twice before signing...my internship would have been less painful if half of my shipmates had borrowed money for medschool.

I've worked with a mix of talent, and unfortunately some of the bottom-feeders stay because they've escaped notice of their incompetence and the Navy provides a steady paycheck. These tend to be more in the outlying clinics than the major teaching hospitals, but they are practicing in those as well. I've seen worse on the civilian side, though. I've had some fantastic attendings, too. It's a mixed bag wherever you go, but I won't lie and say the military is better. And unfortunately, it seems as though the least competent clinicians often end up in the "executive medicine" track, meaning they'll be your boss. They get an MBA, punch their tickets running a clinic, etc. and then run the show not having seen a patient in 10 years. Maybe the civilian side is like this as well, I don't know.

I've tried in my posts to be objective and present facts for people who are considering Military medicine, especially the Navy, and Diving Medicine. This takes time and I gain nothing from it either. I could have used a resource like this 10 years ago, 5 years ago, during internship, etc. I still use it as a resource because militarymd and company have been where I am going. I feel that they've been quite objective in their complaints, I listen to them, though I may not completely agree. Objective is arguable for me, because I've had a great time so far in the Navy. Search my posts for details, I'm pretty positive about the experience. But I'll tell you, mine is not typical for a GMO experience. Mine can be emulated, a lot of it is doing your homework and finding out about all the options, then finding the people to help you. They're out there, I'm trying to be one of them on this forum.

I've decided to do my residency in the Navy, and thus have just reobligated myself, this time for 8 years. WIll I regret it? I doubt it, I'm a bit of a "glass half full" type. But I might, and I'll let you know. No option is perfect, as someone else stated, it's all about risk. For me, the cost/benefit ration skewed to the right, but I thought long and hard about it.

All in all, I'd do it again, but listen to those around you, at least you can look back and say you were warned. We can't.

DD
 
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excellent posts. i'm going to sticky this thread for future military physicians or potential HPSPers.

like i said when this forum was first opened, the forum is what the members make it, and the more diverse input we have the better. while i certainly may disagree with a few things here and there, i am very thankful we have resources such as militarymd, mitchconnie, navydivedoc, iwakuni, gmo_52, edmadison, desperado, etc etc. navy dive doc was right-- this forum gives opportunity for people to hear the other side of the story and make a more informed decision about their career without relying on second hand information or recruiters.

hopefully everyone will stay active here and we can get an even wider cross section of military medical experience for future students to benefit from.
 
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Originally posted by hidradenitis


I took the scholarship for personal reasons that had little to do with the money. Before doing so, however, I accepted the following:

1) I might not always get to do what I want to do or where I want to do it.

2) I would have the chance to do some things while in that I could never do on the outside; some of these might be a lot of fun and some might not.

3) I would get paid enough to be comfortable but not be rich.

4) Ultimately, my boss will never be a medical guy nor will the patient always be the top priority.

5) I might not like it in the military.

In other words, like most things in life, it was a decision that involved some risk. But I figured I'd give it a shot and play my cards as best I could.

For example, I decided while a third year that if I wanted to be a surgeon (which I was seriously considering), I would do my time as a GMO, get out and then get my training. (I was worried about case load.) As it turns out, I decided on primary care and figured I'd just go ahead and get trained. Now, AF FP isn't without its problems either. But that's cool. I knew that going in.

A number of times during rotations other students who were considering either HPSP or FAP asked me for advice. I shared 1-5 above with them and I think I scared most of them away. This wasn't intentional, mind you; I was happy to join and am even more sure now that I made the right choice. But I think folks need to know what they're getting in to.

What will I think in seven years when I'm looking at things from the other end of the tunnel? I dunno. Ask me then. All anyone can say is to listen to the voice of experience; you'll learn a lot. At the same time, keep things in perspective (ie, don't ask an intern if medicine is a good career to go into or not). In the end, you make your choices and you live with them. To quote Porky from the old 'Pogo' cartoon, "don't take life too seriously; it ain't nohow permanent."

Semper gumbi.

You have the perfect attiutde. If you have that outlook, then you will do great. I hope you have a good career!!
 
The other major part of the stay versus go argument is civilian compensation. In the military, the gap between the highest and lowest paid specialty is something like $25K, all bonuses considered. Basically, a pediatrician and a cardiothoracic surgeon have the same income. This income looks pretty good when compared to the average peds salary but starts to look a little slim when compared to the better compensated specialties. Its pretty hard to like what you are doing when you are making hundreds of thousands of dollars less than your civilian counterparts. I haven't decided what I'll do when I reach that point. I'll be 7 years from retirement, so I'll probably stick it out.

The whole point of my original post is that there are happy attendings out there, that many get out for financial reasons not because the job is so horrible and that negative views were beginning to take over the forum to the point that they painted too extreme a picture.
 
Well, I guess I might as well throw in my 2 centavos

Right off the bat, if this forum has been available 12 years ago when I was applying to med school, I would not be wearing a uniform right now -- would have scared me right off.

That being said, here's my list of pro's and con's regarding military medicine:

PRO:
1. I'm debt free. Now, in the long run, for my specialty, this is probably a breakeven proposition. But I'm just a debt-averse person, and I just prefer never having even to think about it. If I knew right out of the womb that I would for sure end up in a big bucks specialty, I'd probably not have worried about loans, but since I really wasn't sure what I'd end up as, I thought debt free was the way to go.

2. We're relatively insulated from all the medicolegal bullspit. Sure, if some patient decides to go after me they can make my life miserable for a while, but not to the point of economic ruin. This, in my mind, is probably THE BIGGEST advantage the military has to offer.

3. I know darn well that no matter how hard I work in the Army, it will NEVER be as hard as I will work in the civilian world.

4. The quality of military medicine, in my mind, is pretty darn high. I honestly have met very, very few military docs whose competence I question. The ones who really scare me are the civilians hired to fill all the slots that the Army can't find uniforms for. And while I can't speak for every military residency, mine was pretty damn good.


That's really about it for the plusses. So here, more or less in order of importance, are the reason's I'm gonna bail out as soon as I can:

1. Location, location, location. Ft Hood? Ft Bragg? Ft Lost-in-the woods? No thanks. The Army ain't got nothing for me in any place I or my wife would really want to live. One of the main attractions of medicine as a career for me (besides letting me "help people" and save the world, of course) was that I could pretty much live anywhere I wanted. That excludes most places the Army has postings for my specialty.

2. Closely related to #1: frequent moves. While some docs have apparently mastered the art and politics of "homesteading" in one place forever, I somehow doubt I'd be that lucky. I really don't want to have to relocate every 2-3 years.

3. My wife has put her career on hold to follow me around for the last 7 years. It's not fair to her to ask her to keep doing it.

4. Working environment: the Army's new marketing slogan, "An Army of One," is ironically accurate. Unless you are maybe a department chief at a major med center, forget about any kind of meaningful support staff. I currently function as my own: file clerk, receptionist, typist, transcriptionist, appointment booker, photocopier (and I have to walk halfway across the hospital to use the ONE photocopier), courier, etc, etc, etc. I could probably see twice as many patients if I had just one or two decent office staff.

5. Deployments. Nobody in the civvy world is ever going to tell me "Plane for Iraq leaves Monday. Be on it."

6. Limitations on career path and practice structure. I basically have to see what the army tells me I have to see, rather than have the option of trying to tailor my practice so I can do some of what I find to be more interesting subspecialty work.

7. After 7 years, I am so sick of wearing a uniform. I know that sounds piddling, but I find it almost depressing to have to wear the same thing day in and day out.

8. It is a big, huge bureaucracy. You really cannot change it.

9. Finally, way down at #9, is the $$$ issue. Yes, I will probably about double my salary in the civilian world. But of course, it comes at a cost, and I know I'll have to bust my butt to justify that. Nevertheless, it'll make it a bit easier to get the kids through college (I know senior docs in the Army who've had a hard time doing that on their salaries . . .)

All you who wear the uniform can comment further, no doubt.

Those of you who are thinking about it: You need to hear the bad as well as the good. I would not call myself disillusioned or disaffected or bitter or anything, but let's just leave it at this: if I had it to do over again, I probably wouldn't have.
 
Prior to re-entering the service I was asked by quite a few of my premed colleagues about the Army, and what I thought about HPSP/USUHS. I always started off with same few things:

1.) If you're doing it primarily for the money, you're doing it for the wrong reason.

2.) You must understand the primary mission of the Army is to win this country's wars, not to put you through medical school. As long as your goals and the Army's coincide, you'll probably be happy; when they diverge, the Army does not have to accommodate you.

3.) If you can't handle being both a physician & a soldier--equally--you should stay a civilian.

4.) If you don't want to deploy, don't join, regardless of what the recruiter is telling you.


I've much more respect for the physician who decides the Army is not for him/her up front and for those who can suck it up and honor their committment than I do for the disaffected ones who later on end up being liabilities to my unit because they "never signed on to be a soldier" (as has unfortunately been my experience multiple times).

That said, it is very important that the negative experiences with military service be represented here. People should know what they are getting into up front, warts and all.

FWIW,
 
First off, I'd like to jump in here and say that as an HPSPer who'll be finishing up school next year, the advice of all the military docs that have posted here (negative and positive) has been invaluable. Thanks guys - I hope I can continue to use you as a resource.

I'd also like to point out that as someone who didn't go straight through school and has spent some time in the working world, that many of the complaints:

-sh*tty pay
-incompetnent boss
-incompetent support staff
-too much beuracracy

are the exact same complaints I've had about every job I've ever heald. So, for those of you reading all this who may be turned off on the military, the moral of the story (IMHO) is that no matter who you are or where you go in life you are going to have to eat ****, or at least get some flung on you. To some extent, its going to happen no matter where you go in this world - military or not.

One thing I've encountered in my brief spells through Navy hospitals are the people that get out, then decide to come back. Almost all where people who couldn't stand the current medical-legal climate of civilian side. As someone who hates lawyers with a passion, I could definitely see myself staying in past my commitment just to avoid all the malpractice hoopla. Is there anyone that can comment on this? To me, this seems like a big plus of military medicine that hasn't been discussed too much on this board.

DB
 
Prior to re-entering the service I was asked by quite a few of my premed colleagues about the Army, and what I thought about HPSP/USUHS. I always started off with same few things:

1.) If you're doing it primarily for the money, you're doing it for the wrong reason.

There are no right or wrong reasons. This comment is like that ridiculous-but-inevitable med school interview question: "Why do you want to be a doctor?" Who cares, as long as you're a good one. If you're willing to do the job and do well by your patients, that's the bottom line. And BTW, there ARE people out there who truly couldn't afford med school any other way.

2.) You must understand the primary mission of the Army is to win this country's wars, not to put you through medical school. As long as your goals and the Army's coincide, you'll probably be happy; when they diverge, the Army does not have to accommodate you.

True, but if the Army wants to maintain a medical corps, then putting people through med school had better be a darn high priority. In case you haven't noticed, there's not a whole lot of fully trained civilian physicians out there that are waking up one morning and saying "Hey, I'm feeling kinda patriotic today ... I think I'll join the Army!" Take a walk through your MTF and ask how many docs got into the military without any kind of educational or financial obligation (HPSP, USUHS, ROTC, West Point, loan repayment, etc.) It probably borders on zero. Sure, some folks stick around after their initial payback, but the initial reason for entry is usually financial and the overall retention rate is pretty poor. The only way the military can keep its medical side going is to keep bringing in lots of new faces every year.

3.) If you can't handle being both a physician & a soldier--equally--you should stay a civilian.

The medical corps is nothing like the combat arms units. It ain't exactly civilian life either, but I have to say that I wouldn't compare what I do to what an infantry or armor office has to do -- no way, no how. Although the command structure would no doubt like it to be otherwise, the medical corps in general is not "equally physicians and soldiers."

I've much more respect for the physician who decides the Army is not for him/her up front and for those who can suck it up and honor their committment than I do for the disaffected ones who later on end up being liabilities to my unit because they "never signed on to be a soldier" (as has unfortunately been my experience multiple times).

Me too. That's exactly what I'm doing. I accept full well that I signed on the dotted line and Uncle Sam owns me for a couple years; if I don't like, that's my tough luck. But you must realize that lots of folks don't have the foggiest idea "up front" to make that decision and don't see what things are really like until they're in too deep. That's why this bulletin board is such a good thing. Keep the comments coming, pro and con.
 
I never thought my economics degree would become useful during medical school. Perhaps if the military were to pay their doctors MORE than the civilian doctors for taking additional burdens like poor leadership, deployments, incompetent support staff etc... then maybe military won't have retention problem or have unhappy military physicians warning us from joining HPSP.... Since the pay isn't and can't be high enough NOW to take that additional responsibility it is not surpising to see many negative comments from the military physicians. Thus the future HPSPer should never do it for money because you will always feel that you actually deserved to be paid MORE than civilian docs for
taking military @#$%. They should.
Bottomline, the money is the most important problem. I don't understand why it is always included as the "last reason" to leave the military. Other negative issues like poor leadership, lack of support staff, deployments, etc... are sadly inherent part of military life and only can be used as an excuse to cover up the real problem for leaving---MONEY.
 
I never thought my economics degree would become useful during medical school.
Remember that economics is a statistical/mathematical discipline that, while it may work in the aggregate, can completely break down when applied to the individual. And it is individuals, not populations, that make the decision whether or not to stay in the military.

Thus the future HPSPer should never do it for money because you will always feel that you actually deserved to be paid MORE than civilian docs for taking military @#$%. They should.
Frankly, for the amount of work I do, I'd have a hard time justifying a raise. I was pretty clear in my previous post that (regardless of the lack of support) you will never work as hard as a military doc as you would as a civilian. All other things being equal, given the same practice situation and workload (patient volume, call, etc), if I could find a civilian job that pays the me the same amount of $$ as I make now in the Army (about 95K) for the same amount of work, I'd take it. On the other hand, the Army could quadruple my salary and it wouldn't entice me to stay.

Bottomline, the money is the most important problem. I don't understand why it is always included as the "last reason" to leave the military. Other negative issues like poor leadership, lack of support staff, deployments, etc... are sadly inherent part of military life and only can be used as an excuse to cover up the real problem for leaving---MONEY.
Since I gather from your other postings that you are as yet neither a staff physician nor have any prior service in the medical corps, I suggest you not jump to conclusions about what the "real problem" is. Sure, money is an issue for some people, but for many it's NOT, as I expect you will see for yourself at some point down the road.

Those who are make good transition into military life will stay in the military for non-monetary reasons.
This is a quote of yours from another thread. It pretty much points out the fallacy of your purely economic viewpoint, because if money were truly the REAL problem, then NOBODY would stay in the medical corps, regardless of how well they "transition into military life," because salaries across the board are higher in the civilian sector. Retention rates would be zero if money were the sole motivator.
 
To R-Me-DOC: Actually it is difficult if not impossible to formulate an economic policy without understanding how an individual makes a decision. In fact, the intro level Microecomics course deals with how a certain individual and individual firms make their choice based on various factor such as income elasticity, expectation, price, opportunity cost etc... *)

While your current job may be easy for you right now in a peace environment you never know how your job will be in the future. Some military physicians are assigned to the field unit like in forward surgical team at Fort Bragg, N.C. (less cushy jobs) and their job responsibilities will be different and challenging, and to some a miserable experience as well.

I am sorry if my comments appeared shallow, but I was a prior service with considerable amount of field experience in both field (primarily) and garrisoned medical environment (preventive medicine) as a non-commisioned officer (backbone of U.S. Army) with +30 jumps out of from a perfectly good plance, expert field medical badge, air assult...w/ numerous miltary awards.

I was just trying to point that when an individual quits a job because of bad working environment it may be that he/she thinks the pay is not high enough to ignore/ accept the bad working environment. Thus economically he/she quits because of low pay.

Over 80+% military physicians leave (pre-Iraq war) after the completion of obligation. (*even higher now). I feel that increasing the pay will lower that rate for certain physicians who think that pay is too low for "living in the miltary environment." Another 20% serving beyond their obligation do think of money in other ways such as looking to retirement benefits, respect come with promotion, prior service years credited... just to name a few. For example, many USUHS grads serve beyond their obligation because many student are prior military looking forward to be paid 24th year pay after serving only 20 years. While this is certainly not only reason for their long service in the medical corps it is their best interest to retire for some...economically.

I am not saying money is the most important but it is much more important than one gives a credit from current military physicians complaing and desiring to become free from their military lifestyle.

From well transitoned military HPSP
 
give me $350,000 a year, and I 'll gladly stay, and get deployed.
 
Wow, some disgruntled physicians. It is time to move on to greener pastures.

I went to the Naval Academy, not for the education, but for the opportunity to serve my country and play with some really cool toys. I fulfilled my commitment and stayed in because I was having fun.

I went to med school on an HPSP scholarship, not for the money saved, but with plans to come back into the military because I enjoy it. I enjoy working with our troops, who bust their asses for no pay, compared to what I make. I don't like the deployment schedules, or lack of schedule, post 9-11, but we are at war. I missed my kids while I floated in the Persian Gulf this year, but was able to take care of 500 older kids on my ship. Suck it up and pay back your time. Signing a contract as an adult, may lead us to doing things that we don't enjoy, but it is only for 4 years.

Joining the military for money is foolish. Expecting to stay in one spot without going into harm's way during a career is a nice dream. I worked with good and bad physicians. Probably in the same ratio that I saw during my med school years.

Real problems
1. Getting killed in Iraq. Most didn't sign up to go to war.
2. Less than adequate pay. My bonus is the same as my friend's from 1991. Inflate it 4%/year. Still, making 100K is an adequate lifestyle. Did I mention that I matched for radiation oncology in the military? I will have a huge salary differential.
3. Administrators vs physicians. A good offficer overcomes this.
4. Increased deployments due to current world conflicts More time from family.

Pros
1. Work with genuine people..."them's good people." If you get that from your NCO, you are golden.
2. Not working for profit and having a fairly large budget. You can do things in that wouldn't be economically feasible in private practice.
3. Deployments (via ship). They can actually be fun. If I were single, I'd volunteer for another ship heading out (and tax free pay).
4. Navy has great places to live, unlike the army.
5. Hours are reasonable.

Bottom line. If you don't like your job, military or civilian, it is time to move on. You spend 25% of your week working, be happy.
 
That's exactly my point. That's why I'm moving on.....along with enough people that the powers that be came up with the CSRB last year....which was a flop.

The problem is that the recruiters don't tell it like it is.....or at least not close enough....hence I feel I need to warn those who are short on cash.....and not thinking ahead.
 
Unfortunately, the recruiters are filling quotas, and will do their best to sugar coat things. I agree with that. Look at the HPSP booklet. 30 days paid vacation in great places like HI, Japan....

Yeah, they don't tell you that you will be on your vacation for 2 years and you will take leave to come back to the states.

My intern classmates all had a decent time. The funny thing is, everyone who did flight surgery, did their best to get back to the beaches of San Diego after their 6 month course ended. They went from Pensacola, to San Diego, straight to Iraq. I'll bet they weren't expecting that.

With the numbers of physicians that come into the service via HPSP/USUHS/post-residency, it is structured so the majority get out after serving their commitments and plus a couple of years. Same with Naval Academy/ROTC. I had over 50% of my USNA class leave the service at the 5 year point. That attrition is expected.

One reason that I like where I am working (ship)....we had a blood drive today and had about 40% participation of eligible sailors. Why? They were informed that the blood received today is earmarked for Iraq. Even the dirtbags and no loads were coming out from under their rocks to give a pint for their brothers and sisters in arms.
 
First I'd like to say that it's VERY insightful to hear what all the active duty docs, residents, interns and attending alike have to say. I agree with an earlier post that there are plenty of people I have had the pleasure to work with that despite all the crap the military deals out, they are still "proud to be here, glad to serve". But militarymd poses a GREAT viewpoint, that of the opposite. In fact I would venture to say that those of you who disagree with militarymd's negative views and are unhappy with his postings, you don't realize that he is your BIGGEST advocate! Think about it, if EVERY HPSP'er, USUHS applicant read militarymd's views, then we would SIGNIFICANTLY cut down on the number of those physicians who come on AD and then spend their entire careers whining and moaning about what is wrong with mil med and now do anything about. Those of us who STILL strive on and keep the faith and work within the system will hopefully come in with eyes wide open and make this a better place to work. Nuff said about that, I agree with both sides. As I have always said there are 3 sides to every story: Yours, mine and the truth.

As for recruiters, having been in the military for the past 9 years as an ER Nurse and now starting my whole career over again by going to USUHS, I have had a unique insight as to the life of the miltary doc, intern, resident and staff alike. I have spent the last 4 years as the Medical Programs Officer in my local area in charge of recruiting medical staff into the military. Though many of you are correct that there are many recruiters out there who don't know their AS* from their elbow and often times put out bad guidance to potential applicants as to what Military medicine is like, and there are those who have no clue as to what mil med is like but act like they're the subject matter experts, and yes there are those losers who take it just because of the pay. But there are those of us that are neither. For one, officers don't get special pay to go to recruiting. Two, if you are reading this and are speaking to a recruiter, ASK to speak to a Recruiter who is a) an officer, b) a nurse or medical service officer and c) ASK to speak to an ACTIVE DUTY DOCTOR or DENTIST or whatever you are applying for. It's important you have all three in a row to ensure you get the right information.

If you have never been a recruiter, dont' be too quick to judge and chastise. These individuals have a nearly IMPOSSIBLE task to accomplish. They have to convince people to join the military in the field of health care DESPITE ALL WHAT MILITARYMD points out. A daunting task indeed. Some of you may be able to do it, however I would venture to say that most of you could not. It's very difficult, especially since we don't have the financial resources to wine and dine these applicants, but more importantly we don't have the authority to increase pay, bonuses, etc. . . as you all are aware. When I go and present to the applicants or students the last thing I say are these words "If you are not interested in a job that is professionally, personally, and FINACIALLY challenging, if you are not interested in serving your country by practicing your trade in an austere environment, if you are not interested in going in "harms way", if you are not interested in actively helping others kill the enemy in your own capacity if called upon by your country, then do not apply. The life of a military doctor is not for the faint hearted, it is not for the individual looking to get rich, it is not for the person who wants to have everything handed to them on a silver platter, and it is not for someone who is interested in being paid in the same fashion as their civilian colleagues."

"It IS for those who are interested in receiving a very healthy scholarship to pay for medical school that you otherwise may not have been able to afford, it IS for those interested in serving their country by providing the best medicine possible for those Soldiers, Sailors, Airmen, and Marines that are out on the "Tip of the Spear" and even those that remain behind to support the rear echelon, it IS for those who are interested in serving as physicians in no-traditional physician roles such as DMO, UMO, FS, SWODOC, FMF etc . . .

So I can say without a doubt that ALL of the applicants that successfully compete and matriculate into the HPSP program from my district ARE ABSOLUTELY well aware as to the pitfalls and hardships that await them in their future military medicine career. Though this does NOT make up for my unscrupulous colleagues, however at least you should all know that not ALL of the recruiters are stupid and useless. Some of us take "choosing our shipmates" very seriously.

Thanks to you all for listening . . .and militarymd, keep em coming!!!!

Jnytrama :)
 
JnyTrauma,

By info in your posting, it's obivious your Navy. I have posted elsewhere that the Navy recruiter (LT Schmeid, also from Nurse Corps) who I delt with was fantastic! Leaps and bounds more professional and honest v/s the other two branches' recruiters. From recuiting, through OIS, and continuing with my fellow Navy HPSP classmates (12+ MS1's alone at AZCOM), I am more content with my experience and decision than ever. If only all recruiters where as conscientious, there might be few applicants overall but also much fewer discontent members amonst the corps.
 
from the posted forum:
-sh*tty pay
-incompetent boss
-incompetent support staff
-too much beuracracy

Wow, the pro's and con's for mil med is compelling! Civilians like me who would like to pursue career in the military as doctors gain priceless insights on what to expect, THANK YOU!

Ok, we know what the problems are regarding military medicine. How do we deal with it and make some changes? I know civilian life is a lot different from the military personnel. Regardless, the key here is changes but the questions remain, HOW? So that the next generation of (not just the incoming physicians but anyone affected by it) the military personnel can benefit from? Can as a group voice it out and hopefully someone at the Capitol Hill listens and take some actions? I wouldn't doubt that these problems didn't come over night and I believe there are good people trying to help their peers who are affected by these. I mean, where ever we go, there are always problems. The key is how to deal with it, right?

Just a thought from a future military medicine recruit :D
 
xMD said:
from the posted forum:
-sh*tty pay
-incompetent boss
-incompetent support staff
-too much beuracracy

Wow, the pro's and con's for mil med is compelling! Civilians like me who would like to pursue career in the military as doctors gain priceless insights on what to expect, THANK YOU!

Ok, we know what the problems are regarding military medicine. How do we deal with it and make some changes? I know civilian life is a lot different from the military personnel. Regardless, the key here is changes but the questions remain, HOW? So that the next generation of (not just the incoming physicians but anyone affected by it) the military personnel can benefit from? Can as a group voice it out and hopefully someone at the Capitol Hill listens and take some actions? I wouldn't doubt that these problems didn't come over night and I believe there are good people trying to help their peers who are affected by these. I mean, where ever we go, there are always problems. The key is how to deal with it, right?

Just a thought from a future military medicine recruit :D

It seems to me that if military physicians actually communicated with one another as a group and made group decisions regarding the potential conflicts between the needs of the military and ethical medical practices they might have more of a powerful voice within the military (all branches).

It seems from my husband's experience that Air Force physicians seem to be isolated from one another - they only really know the few other physicians they have worked with (or do currently work with) on their assignments. It seems like by the time an Air Force physician has learned "the ropes" and created a wider network of other AF physicians, their time is over and they get the heck out.

Are there possibly any organizations (private ones) that are primarily composed of military physicians? My husband is part of a small group that have a yahoo! group site where they can stay in contact and inform one another on situations from base to base. Hopefully that group will grow to include all physicians in his particular specialty within the AF. It seems that the lack of information shared between physicians at various bases across the nation and a lack of organization deals a huge blow to physicians when it comes to their role as advocates for patient care as well as their own quality of life.
 
I for one am thankful that I was awarded a four year AFHPSP scholarship, because without it it would have been impossible to go to medical school (I had a family of 8 to support at the time while an unemployed full time student) without it.

But, my years spent on active duty as a GMO were miserable. There is not enough room here for me to list all the reasons why. But I will state the first and last reasons: First, I was forced to become a GMO and not allowed to enter a residency simply because I chose a transitional year. (AF policy was that all transitionals were not allowed to go on to residency.) Second, later because I did not have residency training, (and the AF supposedly wanted all the docs BE/BC), I was forced out of the Air Force (involuntarily separated). Good luck trying to figure this out.
 
I may have some bitterness about joining the Navy HPSP but as I'm applying for internships in military and civilian spots, my main goal is to get a well rounded PGY1 year and then fulfill that GMO.

I do not want it looming over my head any longer. Plus after being undecided about what field of medicine i want to join... it will give me some time to decide.

I will be applying for a civilian residency s/p GMO. By that time, I will probably have lost any desire for Surg or ER ... onto the FP/OMM spot that will land me close to 200K a year job in Hermosa Beach. :laugh:

yea right
 
This is a great thread and has provided a lot of information for me. I have applied for the Army's HSPS scholarship and have just started hearing about interviews for admission in 2005. My first interview is actually at USUHS and it is my hope that I am accepted there.

Before I started browsing SDN, I had already spoken to a lot of different people about their military experiences. I feel certain that military life is right for me and I have no apprehension whatsoever about making the necessary commitment. It meshes so well with my attitude and way of life.

However, I am not blind to the negatives associated with the military. Nothing is perfect and there will always be risks involved in whatever I do. That said, I appreciate all the time people have taken to present both sides of military medicine.
 
the negative 1 said:
However, I am not blind to the negatives associated with the military. Nothing is perfect and there will always be risks involved in whatever I do. That said, I appreciate all the time people have taken to present both sides of military medicine.

Just remember, like any public forum, those prone to complain are quick to post. So take all the posts, good and bad, at face value and as singular data points. Sounds like you're walking into to the military with the right attitude. I wish you well with your interviews.
 
Hi, thanks for the good info on all sides in this thread. I am actually a resident and considering joining the military now, I guess with something like the FAP program. Anyway, from what I understand, service post-residency is three years with this program and this seems not too terribly long if, like some of you, I decide it is not for me.

My question, though, is about deployments and assignments. If my fiance (also a resident) joins as well, is there any kind of guarantee that we will be sent to the same places? I'm guessing there's not, but is there even any kind of consideration of this in the contract? Also, how common is it to deploy physicians that have completed a residency versus GMOs?

Thanks.
 
jen628 said:
Hi, thanks for the good info on all sides in this thread. I am actually a resident and considering joining the military now, I guess with something like the FAP program. Anyway, from what I understand, service post-residency is three years with this program and this seems not too terribly long if, like some of you, I decide it is not for me.

My question, though, is about deployments and assignments. If my fiance (also a resident) joins as well, is there any kind of guarantee that we will be sent to the same places? I'm guessing there's not, but is there even any kind of consideration of this in the contract? Also, how common is it to deploy physicians that have completed a residency versus GMOs?

Thanks.

My wife and I were married for 4 years before we were stationed at the same place....both of us were active duty.....They told us they would station us together.....200 miles apart was considered "together".....exception???? maybe, but if you sign....no matter what you are told....be prepare for separation from your spouse.....there are absolutely no guarantees until you have arrived together at your duty station......then you will likely be deployed in today's climate if your specialty is a deployable specialty.
 
militarymd said:
My wife and I were married for 4 years before we were stationed at the same place....both of us were active duty.....They told us they would station us together.....200 miles apart was considered "together".....exception???? maybe, but if you sign....no matter what you are told....be prepare for separation from your spouse.....there are absolutely no guarantees until you have arrived together at your duty station......then you will likely be deployed in today's climate if your specialty is a deployable specialty.


Hmmm, so you're saying that although the military needs trained physicians, and could possibly sign up two at once, they would not be willing to offer a written contract promising to station and/or deploy them together? Is there any type of negotiating room when signing? Thanks.
 
jen628 said:
Hmmm, so you're saying that although the military needs trained physicians, and could possibly sign up two at once, they would not be willing to offer a written contract promising to station and/or deploy them together? Is there any type of negotiating room when signing? Thanks.

That's right. The military considers "co-location" to be w/in 200 miles of each other. That being said, I have PCSd (moved) x3 since residency, and my AD spouse (also in a medical field and highly deployable postition) were located at the same command. It's unlikely that you would both be placed on the same deployment platform, but it is possible. Also, if you have children, you don't want to be deployed at the same time...

A few things I've come to learn along the way in the military:
-The only constant is change
-The only guarantee is that there are no guarantees
-If you take the paycheck twice a month, you go where they tell you to.

While I do share some of the frustrations expressed by others in this string, and I will admit that I do not plan on a career in the Navy, I can honestly say that looking back I think my choice to go ahead with HPSP was a good one for me. I believe I was extremely well-trained by my military residency, I was READY for pretty-much anything when I was doing my first utilization tour. I was accepted into a highly competitive fellowship program and felt my knowledge base and prior experience was equal to or beyond that of the other incoming fellows. If you're going into medicine for the money and think HPSP is the best way to "save you money" until you're out in private practice, think again. Compared to your civilian counterparts, you won't make jack when you finish your residency and become an attending (with the exception of some highly sought after groups: surgeons, anesthesiologists, and radiologists are well-paid by the military). It seems to me that many of the frustrations of folks in this forum come from not understanding what they were getting into when they took the bait (I mean scholarship) from the military. Before you agree to anything, make inquiries to the MTFs (believe me, most of us will be candid with what we see coming in the future for the military and aren't out to recruit. We don't get any bonus if you join), find out what the USHUS folks think of their programs, etc. And finally, IF IT SEEMS TO GOOD TO BE TRUE, IT PROBABLY IS. If you are told something, and it's "guaranteed", ask for it in writing. In the military, if it isn't in writing, it never happened. Good luck to all of you!
 
I just happened across this thread site for the first time. Was actually searching the internet out of curiosity on whether current applicants were possibly more well informed than I and my colleagues were when we applied for HPSP.

You folks are fortunate! There was no such source of critical information when I applied. I can honestly say that I would not be wearing a uniform right now if I had known even a part of what I do now.

I will not waste too much time posting though, plenty of others have apparently posted plenty of what I would have said. Particularly R-Me-Doc's bit on the working environment! Couldn't have said it better.

I have to laugh about the number of high spirited military docs that are apparently around this forum though. I have honestly read more "happy" military doc stories on this forum than I have run across during my years on active duty.

Having spoken to dozens of students in the decision making stages of HPSP consideration, I have found that most have made up their mind and choose to believe only information that supports their desire to graduate from medical school "dept free." I would only propose this, four years of military service, with absolutely no guarantees, is NOT DEBT FREE!

For your reading pleasure....I put together the following fun examples of things that have occurred within my department recently in the last few months……

Some physicians in my department have found it difficult to think of themselves as contributing to the defense of their country while:

1) Attending mandatory weekly physical fitness training at all hours of the day, during which you perform group "twirling" and "exercise ball" routines in the name of physical fitness despite your recent outstanding PT test score.
2) Finding it nearly impossible to get your children in for routine scheduled immunizations or pediatric visits through the Tricare system.
4) Going multiple consecutive years without being authorized your "annual CME" funding.
5) Being authorized to participate in CME after which you pay your hefty fee only to have the military cancel your trip due to funding constraints two weeks before your departure; saying "hope you can get your fee refunded." Which of coarse doesn’t happen.
7) Being "randomly tagged" for drug testing on your way through the base gate while arriving early in the morning to perform an urgent cerebral angiogram, only to wait hours with dozens of other health care providers, similarly tagged, all lamenting over the dozens of scheduled appointments and procedures for which their patients were undoubtedly waiting, unaware of their physician's situation.
8) Watching the most qualified physicians be passed over for fellowship opportunities to make room for folks who have "been in the longest" but whom are clearly unemployable outside of the military medical system.

I could go on, but won't. I honestly don't care what an individual decides to do with regard to HPSP, so long as recruiters / propaganda pamphlets are not their only source of information.
 
What I dislike most about the military is say "Sir" or "Ma'am" to freakin' higher ranking Nurse Corps (NC) and Medical Service Corps (MSC) Officers!!! :smuggrin: I think they get a kick out of it when a doctor says it...especially those MALE NURSES!!! :mad:

I will only stay in the military if they give me the residency I want. I'm tired of doing primary care as a Flight Surgeon (FS)...don't get me wrong, I love flying and hanging out with aviators...but primary care SUCKS! I have 2 years left on my Active Duty contract, so I'm applying for Navy and Civilian Radiology residency this year. If I get Navy residency, I TAKE IT!!! If I get civilian residency, I do my time as a FS, get out of the Navy, and start my civilian residency.
 
It seems like most of the posts on here are geared towards army and navy. Do you know any specific pros/cons to going Air Force? I'm getting ready to sign (or not sign) next month, and I'm trying to get all the info I can fast. Thanks!
 
Hey. I'm just posting here, because - after reading these forums, it seems like there are a number of experienced, intelligent posters here - and I'm just looking for some opions - both on military medicine, and on practicing medicine in general. But first, let me explain where I am in life, and one avenue I've been considerng.


Right now, I'm a college physics major. I've had quite a bit of math, and physics - and I'm starting to become dissatisfied with the field, both because of the culture - and because, after finally having the maths to understand Quantum, its...well, its much less appealing actually /doing/ it - then it is reading about it. (Trust me, high-level physics is very, very boring.)

Anyways, one of the reasons I got into physics in the first place, was that I had ideas of being a theoretician, and doing something to make the world a better place then when I entered it. Now, I still have ideas along those lines, and so I've been considering medicine - possibly though HPSP or something similiar, though my application to medschool would be a /long/ way off. Here's some more details:

So, anyways - I'm currently a straight-out physics major, and I'm thinking instead of switching to a dual-degree in Literature and Biology, with minors in math and physics - then spending a year post-graduating to get my MS: Biology, whereupon I'd apply to medical school. I don't mind all the time I'll spend in education - even after graduate school, I could easily spend 10 years in education of one form or another before I can actually practice medicine (4 years med school, 4 years residency for surgery I believe, another year if I want to specialize) - fortunatly, I've always enjoyed learning: I don't think I'd be interested in a career if I suddenly had to stop learning anything new at all. Fortunatly, from what I understand - in medicine, I'd be learning new things about the field all my life.

Now, the reasons I've been considering entering into the military, post-med school (I know its a long way off, but I have a tendency to think long-term, and think ahead) - are fairly convulted. Aside from the usual 'pay for med school' issues that have been discussed on this forum - well, I'm not overly concerned with money, in terms of happiness. I come from a family that (combined income) - makes less then 30k a year, so I'm well aware that money doesn't equal happiness - and I think I could be just as satisfied as a beggar as I would be some top-level executive, as long as I had the right mental attitudes - thats all happiness is. Still, I realize that, eventually - there will come a point where I /will/ want to start securing my financial future, and I'll probably leave the military after my service obligation is up, however long it ends up being. I also don't think I'd mind traveling - I rather think I'd enjoy visiting some of the remote locations I could be sent to.

Also, I think - eventually - I'll probably try and get into politics, and some time in the military tends to be useful for that, too. Now, I'll admit - most people who are considering getting into politics at some point during there life will opt for lawschool, the traditional method (who would associate politics with med school?) - but that would 1. Probably be a second career, much later in life - and I don't think I'd enjoy being a lawyer anyways, for reasons similiar to my problems with physics.


Anyways, this is my second attempt to post this message (the forums deleted my first attempt - I had accidently not logged in, and poof) - so it may be slightly...less clear then I would prefer - but I think my basic line of thought and situation are coming clear. In short:

1. I'd like to do some good - something I can see. I'll probably specialize in surgery, when I get the opportunity.
2. I'm not overly concerned with money, though I am concened with a sense of...personal satisfaction.

Anyways, do any of my ideas sound plausible? Would you say the military-option post-medschool would be a good or poor choice for me? Am I even right to be considering medicine? I've been thinking about this possibility for a month or so, and compared to the various other careers out there - medicine seems like a fairly good choice, in terms of what I want out of life - so, essentially - I'm just seeking opinions, and I'd appreciate any you guys could offer. If some of these plans/ideas are a mistake - it would be better to know about them now, then oh so many years from now.

-Charles
 
paintingcolorbl said:
It seems like most of the posts on here are geared towards army and navy. Do you know any specific pros/cons to going Air Force? I'm getting ready to sign (or not sign) next month, and I'm trying to get all the info I can fast. Thanks!

I am Air Force. There are fewer and fewer differences between the Army and Air Force every day. The Air Force has recently adopted physical fitness standards very similar to those the Army has had for some time, they have recently increased their deployments from 3 to 5 and now to 6 months. The Army ranges between 6 and 12 months depending on your specialty. They are both deploying ground troops throughout the middle east. The Air Force deployments for physicians ARE NOT "sweeter" than the Army any more. If anyone tells you otherwise, smile and thank them for their advice, and move on knowing that they have no idea what they are talking about. The Air Force now runs one of the largest field hospitals in Iraq with nearly all Air Force personnel. They are shelled nearly daily, and some of our deployed women have been attacked by local nationals that have been hired by our government as cheap labor. You should no longer join the Air Force over the Army for a sweeter life style alone.

Honestly, only sign on at all if you are completely prepared to be treated like a pon for the duration of your contract and possibly longer. You will be a body, not a physician, not even an educated person. In the medical corps, your officer status means very little. Recently at my base, a 50+ year old full colonel and physician was even forced to comply with a new "safety regulation" along with everyone else... the regulation was that he (and everyone applying to go on leave) stand at attention next to his vehicle, holding his drivers license (to prove that it was current) and have his car inspected by an enlisted base safety representative. His tire pressures were checked, tire tread depth confirmed, seat belts tested for functionality. And car searched for contraband. All before he was allowed to take his family on vacation. His advanced medical degrees, fellowship certificate, and 20 years in service did not prevent him from having to be treated like a kindergartener having his suitcase checked by mommy before leaving for his family’s summer vacation.

Take the loans, you can't put a price on freedom. This has nothing to do with national security or being patriotic as I once thought when I signed up. Rather, it has everything to do with being treated like a child for nearly a decade when you include residency and your payback time, and there will be nothing you can do about it once you are there. Unlike most bad decisions in life, once you sign an HPSP contract, your option for a “do over” are gone.
 
I'm prior-service, going to USUHS for a variety of reasons, from a need to serve the troops to a desire to live the life less ordinary. But for those of you who are only concered with the bottom line:

I recently did a cost comparison of the USUHS route and the civilian route.
I calculated income and debt from now until age 65, using current military pay scales and average salaries for residents and general surgeons, as well as Georgetown's "student budgets" for debt figures. I discounted all future cashflows back to their present value, and summed them all together. I found that by being in the miliary, I would make about 25% more by the time I reached age 65.

Granted, I have years of service that will get me more as I go through USUSH, get me to 0-4 faster, and allow me to retire at at the end of my obilgation, upon which I will enter civilian practice. But I believe that the real factor here is the economic principle that a dollar today is worth two tomorrow. The staggering debt of medical school and the tiny salaries of civilian residents compared with the maxed out O-1 pay at USUHS and the very decent pay as a resident makes the obvious pay difference between board certified military docs and civilian docs not as important.

Of course, this is a VERY dumb reason to enter the military, but it is something to think about......
 
deegs said:
I'm prior-service, going to USUHS for a variety of reasons, from a need to serve the troops to a desire to live the life less ordinary. But for those of you who are only concered with the bottom line:

I recently did a cost comparison of the USUHS route and the civilian route.
I calculated income and debt from now until age 65, using current military pay scales and average salaries for residents and general surgeons, as well as Georgetown's "student budgets" for debt figures. I discounted all future cashflows back to their present value, and summed them all together. I found that by being in the miliary, I would make about 25% more by the time I reached age 65.

Granted, I have years of service that will get me more as I go through USUSH, get me to 0-4 faster, and allow me to retire at at the end of my obilgation, upon which I will enter civilian practice. But I believe that the real factor here is the economic principle that a dollar today is worth two tomorrow. The staggering debt of medical school and the tiny salaries of civilian residents compared with the maxed out O-1 pay at USUHS and the very decent pay as a resident makes the obvious pay difference between board certified military docs and civilian docs not as important.

Of course, this is a VERY dumb reason to enter the military, but it is something to think about......


The economics are totally specialty driven. FP, IM, Peds, etc all do better or at least as well, on average, in the military. Anes, surg, cards, etc do far worse. The difference in income between military specialties is about 20K rather than 500K.
 
I actually signed and got commissioned a few months ago but now they are telling me I need to sign the papers/contract again, since the dates are wrong!!! After running into this forum this week, I am having second thoughts about the HPSP. Plus, I have no previous exposure to the military. Is there a way to tell my recruiter and avoid resigning? I was told that I could apply for both military and civilian residency programs after med school and, if I got into the military one I had to go, but if I didn't and got into the civilian one, then I would go to the civilian training prog. Now I realize that you need to get permission for a deferment even if you get in to the civilian program? Also, I was assured that medical students or residents would not have their education or training cut short or interrupted and that 80% of HPSP students get into their residency program of choice. I thought the Army would be a good way to not only pay for school (for a family that is having economic hardships), but get some of the best training in a surgical specialty (I was told by my recruiter that military programs are some of the top 10 ranked programs--although I have no idea where the ranking is), work with experienced army physicians in a tight-knit and supportive environment, treat the people who need my skills the most (soldiers), and experience what I imagined to be the highly efficient and busy atmosphere of an army hospital. Traveling is not a huge problem, as well, although in the future, I may have a family... Reading the comments from other posters, however, causes me to question the level of experience I will have as a skilled clinician and whether the army is truly for me. Also, I am slightly anemic (on and off--not currently, however) and overweight but they let me pass the physical exam, anyway (one of the reasons I joined was I figured it would be a way to force me to stay fit :p and essentially force me to take more leadership roles). Am I going to be dissappointed in the army with these views and, if so, is there still a way out? My priority is to be a good physician and possibly have lots of exposure to different patients. I have not received any money or benefits, yet, but I have, by some miracle, a few acceptances from some great medical schools. I feel terrible about this whole ordeal because I realize that many people join the army for the "right" reasons and I am not sure I am one of those people.
 
haezi said:
I actually signed and got commissioned a few months ago but now they are telling me I need to sign the papers/contract again, since the dates are wrong!!! After running into this forum this week, I am having second thoughts about the HPSP. Plus, I have no previous exposure to the military. Is there a way to tell my recruiter and avoid resigning? I was told that I could apply for both military and civilian residency programs after med school and, if I got into the military one I had to go, but if I didn't and got into the civilian one, then I would go to the civilian training prog. Now I realize that you need to get permission for a deferment even if you get in to the civilian program? Also, I was assured that medical students or residents would not have their education or training cut short or interrupted and that 80% of HPSP students get into their residency program of choice. I thought the Army would be a good way to not only pay for school (for a family that is having economic hardships), but get some of the best training in a surgical specialty (I was told by my recruiter that military programs are some of the top 10 ranked programs--although I have no idea where the ranking is), work with experienced army physicians in a tight-knit and supportive environment, treat the people who need my skills the most (soldiers), and experience what I imagined to be the highly efficient and busy atmosphere of an army hospital. Traveling is not a huge problem, as well, although in the future, I may have a family... Reading the comments from other posters, however, causes me to question the level of experience I will have as a skilled clinician and whether the army is truly for me. Also, I am slightly anemic (on and off--not currently, however) and overweight but they let me pass the physical exam, anyway (one of the reasons I joined was I figured it would be a way to force me to stay fit :p and essentially force me to take more leadership roles). Am I going to be dissappointed in the army with these views and, if so, is there still a way out? My priority is to be a good physician and possibly have lots of exposure to different patients. I have not received any money or benefits, yet, but I have, by some miracle, a few acceptances from some great medical schools. I feel terrible about this whole ordeal because I realize that many people join the army for the "right" reasons and I am not sure I am one of those people.

You don't have to re-sign anything. A contract has been signed. They and you need to honor it as it stands.
 
Hey, I dont know about Army, but AF lets you drop HPSP before day 1 of your first year of medical school. This can even be after you go to COT, but you will have to forfeit your active duty pay. This comes from the mouth of Maj Frisco, the chief of AF HPSP. Army usually goes to OBC after 1st year, so you probably wouldn't have that problem....

So, I think you have some options, but you had better contact the Army HPSP and figure this out before you talk to your recruiter. Recruiting offices (bless them) usually dont know too much about HPSP frankly.

Before you decide, look for some other sources other than this board... talk to some AD physicians in the Army if you can, and get more info on Army GME. There are positives to go along with some of the negative (and very true) posts you have read. I will not comment on this, because I have not experienced active duty life as a physician :)

-2LT
 
I'm currently a MSI at USUHS and I was formerly a Navy MC Officer Recruiter. First of all:

I agree with Military MD that you DID sign a contract and if the Dep of the Army wanted to hold you to it, they have a right to, that sword cuts both ways, you can also hold them to the contract that you have signed. If the mistake on the contract is in your favor you DO NOT have to sign it, however if it is NOT in your favor you should sign the new contract. But REMEMBER the Army can absolutely hold you to it.

Now that we get the facts out there, we need to talk about porbability vs possiblity.

The Army will probably not hold you to your contract since you A) haven't taken any money, and B) have not gone to OBC.

The real person that will try to convince you to NOT roll out is your recruiter, your disenrolling from the program hurts his ability to do his job. So you CAN get out of your contract (Meaning it is POSSIBLE, AND PROBABLE, but final authority to do that is the Department of the Army NOT the recruiter).

Kingcer0x has GREAT advice for you. It's important that you seek out furher advice and insight from active duty physicians and their outlook on AD life as a physician is, and the quality of the GME. I know that you have so far heard some negative side of hte Army GME, but remember that there are 3 sides to every story. Theirs, yours and the TRUTH. So go and look around before you make your final decision. Because once you roll out, you're chances for EVER getting an HPSP again will be almost ZERO.

Your weight issue and anemia will work itself out, if you were truthful during your exam and they still let you enroll in the program then it must not be too problematic for them.

Just don't jump the gun too soon, it's a decision you may regret. But then again it may the best one you've made yet. . . . .

Joining the Armed Services is not like getting scholarship, this is a lifestyle that has permanent and long lasting consequences. Many of them good, some of them are not so good. However the only person that can be the judge of that is you. If you weren't absolutely sure that you wanted to join the military then you should not have signed the contract, and you should not have wasted that recruiter's time and yours. But we're past that now.

It's up to you to make decide if you did the right thing and guage your next course of action.

Good luck buddy!

Jnytrama
USUHS '08
 
GMO_52 said:
Our more senior members have made the point in a couple of threads that while they are the most negative about military medicine, they are also the most experienced. Both implicitly and explicitly, they are stating that their views should therefore be given more weight. While that would be valid if they were a true representation of the views of most military staff physicians, I do not believe that they are.
There are not many places in the military in which one can voice these sorts of negative opinions (hence militarymd's appropriate desire to stay anonymous) and therefore, they are quite active in what is really a student forum. Those staff physicians who are overall positive about their military experience simply a) don't know about this forum and b) share their opinions openly with students in the typical setting. I have a problem with the way these negative opinions are being characterized as "attending opinions" because, there are a lot of staff, only a few reside here, and they happen to be those individuals who need a forum like this to be able to honestly express their views.
OK, I feel better now. Back to the land of stuffy noses and well-woman exams.

At least in the military primary care world,anyone entering will find a substandard healthcare system with inadequate staffing and experience and docs with no authority (your clinic being run by non physicians and TRICARE) and you (the doc) will not even be an invite to the decision making meetings. You will find out that they do not need or want your input because they have you for 4 more years. Many of us have read about how in some civilian areas, primary care is in trouble....well, the USAF has joined that crowd. So, if you are heading into one of the USAF clinics, get ready for a bumpy ride and some casualties (your patients and your career). Do your best to enjoy,and realize you are doing a great service for your patients, but the military in doing a disservice to continue to look the other way and ignore the realities of our clinics).
 
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