2009 Pay

Started by Chonal Atresia
This forum made possible through the generous support of SDN members, donors, and sponsors. Thank you.
Get help with your application

Use all the free resources available to you from SDN: articles, guides, expert advising, forums discussions, and school research.

Browse articles Compare schools My application plan Read Interview Feedback
Practice for interviews Ask an Advisor
C

Chonal Atresia

Full Member
15+ Year Member
Advertisement - Members don't see this ad
Any word on when 2009 ISP rates are coming out and if bonuses will be increased this year? These bonuses have not been increased since 1991 (even adjusted for inflation) so this is long overdue. Also, will MASP, BCP and VSP still stay the same rate? I'm hoping for an increase but I'm sure it's a pipe dream. All I've heard is that MSP has increased for some specialties and the CSRB is being offered (but sparingly).

On a side note, the military obviously does not value their physicians. We are consistently underpaid (in some cases $200-300K/yr), forced to type notes on AHLTA (to avoid paying transcriptionists), deployed frequently causing our skills to atrophy (especially surgeons) and not allowed to hire/fire our clinic staff causing understaffing and incompetence.

I have personally been asked to participate in a recruitment video for the Army Medical Corps but have refused. I cannot with good conscience lie to prospective medical students about the "benefits" of military medicine.

Maybe a mass exodus of ALL specialties will take place in the next few years and we'll have some power to demand higher saaries and better work conditions.
 
Chonal Atresia said:
I have personally been asked to participate in a recruitment video for the Army Medical Corps but have refused. I cannot with good conscience lie to prospective medical students about the "benefits" of military medicine.
Click to expand...

I had a recruiter ask to bring an HPSP applicant by to talk to me. I told him I wasn't sure I would do that if I were him, but that I would be more than willing to talk to the applicant. He was smart enough not to bring him/her.
 
Chonal Atresia said:
Any word on when 2009 ISP rates are coming out and if bonuses will be increased this year? These bonuses have not been increased since 1991 (even adjusted for inflation) so this is long overdue...
Click to expand...

What do you mean increase the salary of doctors? We need more bombs and guns. Pretty soon we will have a medical corps and no military.

Sorry - couldn't resist🙂
 
Advertisement - Members don't see this ad
Based on nothing other than past experience, I would say that there is zero chance of ISP's increasing significantly. Every year for the 13 years I have been on active duty there are rumors that it will be increased and every year it stays exactly the same. Narrowly targeted bonuses like the CSRB seem to be the wave of the future moreso than any across-the-board increases. Plus, lets face it, they have you by the balls for 4-7 years and can pay you whatever they damn well please with zero consequences in the short-term.

From what I have seen, I do not believe that the DoD is particularly interested in maintaining the extensive medical programs of the past. Therefore the exodus and decreased recruitment of physicians seems to be of little concern for national decision-makers.

My feeling is that physicians should vote with their feet and then spread the word to prospective recruits. Complaints that we are underpaid with respect to our civilian colleagues have fallen on deaf ears for decades.
 
Inflation has increased the CPI by roughly 60% since 1991. So your $15K ASP, for example, would now be $24K if they had done any indexing to inflation. Each year, they value you less and less.
 
AFIM said:
Inflation has increased the CPI by roughly 60% since 1991. So your $15K ASP, for example, would now be $24K if they had done any indexing to inflation. Each year, they value you less and less.
Click to expand...

This has been a particularly disturbing and depressing aspect to military physician pays. Not to mention how low BCP is. Raising this helps everyone (most notably primary care) not in training and would be a morale booster. I have to say, my understanding is that the Navy has been the blocker as the Army and USA have pushed to increase it in prior years. I expect MSP to go up this year (that is the rumor) but I bet ISP and ASP don't change at all. Every year it seems primary care gets reamed regardless of crappy retention, whearas some specialities do ok.

If they don't raise ASP this year, I have my doubts we'll ever see it go up. This is especially true as I don't expect an Obama presidency to be interested in increasing physician pay in general and especially not military physician pay.
 
Any military ENTs out there who are moonlighting? I'm having difficulty finding locum tenens opportunities that are 10 days duration or shorter. There are plenty of jobs 1-4 months duration but this is obviously too long if you're on active duty. ERs guys and anesthesiologists have it easy - all they need to do is cover shifts. If bonus pay would increase, I wouldn't have to "bleep" myself out to make extra cash.
 
a1qwerty55 said:
If they don't raise ASP this year, I have my doubts we'll ever see it go up. This is especially true as I don't expect an Obama presidency to be interested in increasing physician pay in general and especially not military physician pay.
Click to expand...
In all fairness, 8 years of the Bush presidency hasn't exactly been a boon for military physician pay either.
 
Bonuses will not increase ...

... with the possible exception of MSP, because it's the one bonus that is available only to people at their decision-to-get-out point.

There is no reason for them to raise ASP & ISP & VSP & BCP for physicians who are in the midst of obligated service, because those physicians can't choose to leave.

Furthermore, it is all but the official policy of the US military to dissuade physicians from remaining past their obligation. Retention is an anti-goal because a lifetime of retirement benefits is very expensive.

Sub-10% retention and low pay for physicians is their goal. Of course they're not going to fix this because they don't view it as a problem.
 
Chonal Atresia said:
On a side note, the military obviously does not value their physicians. We are consistently underpaid (in some cases $200-300K/yr), forced to type notes on AHLTA (to avoid paying transcriptionists.
Click to expand...

If I am ever fortunate enough to meet the man who created AHLTA, I would lock him in a room with a rigged IED.

I would leave detailed instructions on how to defuse the bomb and its location on a computer in the room.

These instructions, however, would be in templated format on an AHLTA note, rendering them virtually unreadable. And AHLTA would crash twice in the 10 minutes he had to figure it out.

GB
 
Last edited:
There is no reason for them to raise ASP & ISP & VSP & BCP for physicians who are in the midst of obligated service, because those physicians can't choose to leave.

Furthermore, it is all but the official policy of the US military to dissuade physicians from remaining past their obligation. Retention is an anti-goal because a lifetime of retirement benefits is very expensive.
Click to expand...

I wholeheartedly agree with the above. Given the factors working against any physician pay increases, I'm surprised we make as much as we do. They could probably eliminate the bonuses altogether and the overall numbers of physicians would not be affected much for several years.

Increased retention is clearly not a goal for the reasons stated by ppg. Additionally, retention is already so low for most specialties that a marginal increase in ISP is unlikely to improve the situation. In isolated cases where increased retention IS a goal (ie AF General Surgery), massive targeted bonuses, like the CSRB, only for those eligible to leave is clearly the preferred strategy.

These sorts of pay issues also do not influence recruiting much. 80 or 100K sounds like a massive amount of money to college students signing up for HPSP, and how many are really savvy to the arcane issues surrounding ASP, VSP, ISP, and MSP? I'm guessing you could drop physician pay 30K a year without any noticable impact in recruiting. And even if decreased pay did influence recruiting, the impact would not be felt for at least 5-7 years because the training pipline is so long. And seven years is a relative eternity in a military where leadership changes every 2-3 years.

We will continue to make less and less (via inflation) for the foreseeable future, so there is really not much point in complaining. Signing up lots of college students to HPSP and accepting the fact that they will get pissed off and leave after four years of service is clearly the cheapest way to go. The only remedy that is even remotely possible is to increase moonlighting opportunities.
 
GMObound said:
If I am ever fortunate enough to meet the man who created AHLTA, I would lock him in a room with a rigged IED.

I would leave detailed instructions on how to defuse the bomb and its location on a computer in the room.

These instructions, however, would be in templated format on an AHLTA note, rendering them virtually unreadable. And AHLTA would crash twice in the 10 minutes he had to figure it out.

GB
Click to expand...

Awesome.
 
mitchconnie said:
I wholeheartedly agree with the above. Given the factors working against any physician pay increases, I'm surprised we make as much as we do. They could probably eliminate the bonuses altogether and the overall numbers of physicians would not be affected much for several years.

Increased retention is clearly not a goal for the reasons stated by ppg. Additionally, retention is already so low for most specialties that a marginal increase in ISP is unlikely to improve the situation. In isolated cases where increased retention IS a goal (ie AF General Surgery), massive targeted bonuses, like the CSRB, only for those eligible to leave is clearly the preferred strategy.

These sorts of pay issues also do not influence recruiting much. 80 or 100K sounds like a massive amount of money to college students signing up for HPSP, and how many are really savvy to the arcane issues surrounding ASP, VSP, ISP, and MSP? I'm guessing you could drop physician pay 30K a year without any noticable impact in recruiting. And even if decreased pay did influence recruiting, the impact would not be felt for at least 5-7 years because the training pipline is so long. And seven years is a relative eternity in a military where leadership changes every 2-3 years.

We will continue to make less and less (via inflation) for the foreseeable future, so there is really not much point in complaining. Signing up lots of college students to HPSP and accepting the fact that they will get pissed off and leave after four years of service is clearly the cheapest way to go. The only remedy that is even remotely possible is to increase moonlighting opportunities.
Click to expand...

Shh! They can hear you!
 
Let's pause for a moment and appreciate the fact that we have a thread in which there appears to be universal agreement... a thing of beauty.
 
Advertisement - Members don't see this ad
From the rumors I have been hearing:

1) MSP for many specialties will certainly increase this year. All 3 services have had retention issues in critical specialties and are looking to stem that tide. The current cap for this is $75K.

2) ISP will also increase for critical specialties. Although not a direct retention tool (as MSP is), keeping docs with obligations a little happier is never bad for retention. This is the pay that is supposed to close part of the gap between military and civilian doc pays. We will all agree it falls way short for many specialties, but the cap is up to $75K now, so they can come closer.

3) ASP, VSP, and BCP will not change. Ever. There is no incentive to change these pays. While they are good for overall pay of medical officers, they do not target specific specialties we need and reward those in specialties we don't.

All that said. There is a movement afoot to completely change special pays. They want to divide them into 2 categories of docs with obligations and docs without obligations and combine all of the pays. There would still be specialty differentials, but not the hodgepodge we currently have. They are supposed to implement this by 2010, but we'll have to wait and see.
 
ISP may be AUTHORIZED to increase, but this does NOT mean that the funding is there or the individual services will allow it - big difference.

Also what pisses me off is when the military-civilian pay gap is discussed. Right now there is a general agreement of a gap around 3-5% which is the reason congress routinely authorizes a bigger pay raise than does the president (who said Bush is the military's friend?). You can imagine what the gap is for physicians (10% to well over 50-60%), and line officers still complain that our "bonuses" (which are not bonuses but pay we're entitled to) are already large and that we are overpaid. They are freaking clueless. Their retirement at 20 years is 50% of their base pay where ours amounts to around 30% if you include bonuses. If it got out how young physicians actually are and the fact that the military does not care enough about it's population to retain more seasoned and experienced doctors, change might happen (along the lines of TBI, moldy barracks, etc). Making this information available to the masses is the key.
 
Chonal Atresia said:
Their retirement at 20 years is 50% of their base pay where ours amounts to around 30% if you include bonuses. If it got out how young physicians actually are and the fact that the military does not care enough about it's population to retain more seasoned and experienced doctors, change might happen (along the lines of TBI, moldy barracks, etc). Making this information available to the masses is the key.
Click to expand...

It'll never happen, but you could probably solve a big chunk of the retention problem overnight if you rolled the bonuses into the retirement picture for military docs. FWIW, I would also do this with other special pays given to pilots, special forces, etc. Now will the nation pay the 5% GDP for defense spending it will require to do this? I doubt it.
 
There seems to be a move to address the issue with critical skills retention bonuses. Check out the bottom of this page:
http://www.militarytimes.com/projects/money/pay_charts/2008/medical_dental/

What I don't understand is this: According to the webpage, if you take the CSRB, you cannot get MSP or VSP. My read of the chart is that this will actually be less money for most specialties -- am I missing something?

Frankly, I think the approach with MSP or CSRB is stupid. If I'm just a few months from getting out, am I really going to take this small amount of money and stay in? I'd love to see the stats on that one, but we know that its bad. What they should do is offer these bonuses early in the docs' careers to extend obligations.

Ed
 
edmadison said:
What they should do is offer these bonuses early in the docs' careers to extend obligations.
Click to expand...

You can do that.

If you have an existing obligation, you can sign a MSP contract and get the bonus today. The extra years are just tacked on to the end.

I'm not 100% sure why anyone would do that, but I've seen it happen. If they're planning to stay in for 20 already, and betting that the MSP rates will stay the same or go down later, I suppose it makes better financial sense to get the bonus now rather than a few years down the line.

I also think there are some circumstances where people doing FTOS fellowships can game the system and collect MSP without significantly extending their future obligations, but that ridiculous system is too complicated for me to understand.
 
Word is that the FY2009 ISP/MSP details are out now - from my understanding most people are getting a raise. I didn't get the actual memo - does anyone have the specifics on this? I am fairly certain it is in writing at this time, but don't see it on the kx website yet.
 
AFIM said:
Alright, I'm gonna answer my own question. Here's the FY09 medical pay plan! Quite a few specialties have gone up - it's about time!

http://www.health.mil/Content/docs/pdfs/policies/2008/08-011.pdf
Click to expand...

Boo! No raise for me. I don't see that anyone got a raise besides the primary care guys. As near as I can tell, this changes nearly eliminates the point of the ISP....to pay the guys in more lucrative/more needed specialties more money.

The pediatricians are already making as much or more than their civilian colleagues. If you're going to give a raise, give it to the anesthesiologists, surgeons, emergency docs and others who are going to jump ship at the first opportunity because they get paid twice as much on the outside world. You have to really love your country to do the same (or more) work for half as much pay.
 
ActiveDutyMD said:
Boo! No raise for me. I don't see that anyone got a raise besides the primary care guys. As near as I can tell, this changes nearly eliminates the point of the ISP....to pay the guys in more lucrative/more needed specialties more money.

The pediatricians are already making as much or more than their civilian colleagues.
Click to expand...

I've suppressed my urge to swear at you and erased several nasty comments I wrote. 😡

The reason the pediatric bonus went up is that our retention has been horrid. In the past two years in the Army, we've lost 35 of 41 pediatricians who were eligible to ETS, the other 6 stayed in for fellowship. There's a crisis in general peds staffing in the Army. You may say, "Who needs pediatricians? Just send the kids to the civilian sector." The problem is that we are filling a large number of operation medicine slots (hence the retention problem). Get rid of peds and you'll have to increase the number of specialists doing GMO tours. I've already seen several dermatologist and OB/GYNs doing these jobs in Iraq.

Ed
 
I agree with ActiveDuty MD. Specialists are getting screwed by the military. Are pediatricians worth only $16,000/yr less than Neurosurgeons? No one in their right mind would agree with this statement. As for the arguement that more specialists would be deployed as GMOs if more pediatricians/IMs/FPs ETS'd - this is true. However, these specialities shouldn't complain. They know full well that they are first line to fill 60A/62B slots since they don't possess the critical skills that surgeons and anesthesiologists have. This may sound elitist but it is a fact. If you don't want to get deployed get out of the military. These specialties had it made before 9/11 since their compensation was close to their civilian counterparts. Now that things have changed and the military is asking them to deploy to earn their keep, they are upset. Too bad! If you want to piss on specialists and keep their pay down, so be it. But watch the upcoming backlash in the next several years.
 
Thanks for suppressing the urge. I'd probably just swear back. One of my guys, just out of residency, just got tasked with a 179 day tour (he'll be off my schedule for 9 months) TO THE ARMY! So I'm not very happy with you guys right now at all. Fill your own damn deployments and quit calling us. 🙂

Seriously though, my argument is NOT that pediatricians shouldn't be paid more, but simply that everyone should be paid more and that if a specialty takes more time to learn or is worth more on the outside, then they should be paid significantly more. An average pediatrician makes what, $140K? An average EP makes close to twice that, yet we're only paid $6K more? What's up with that? ISPs should range from say $20K to $200K IMHO.

BTW, I'm not impressed with your retention numbers. Those look awfully similar to EVERYONE'S retention numbers. I know it is less than 5% in my specialty for instance.
 
ActiveDutyMD said:
Seriously though, my argument is NOT that pediatricians shouldn't be paid more, but simply that everyone should be paid more and that if a specialty takes more time to learn or is worth more on the outside, then they should be paid significantly more. An average pediatrician makes what, $140K? An average EP makes close to twice that, yet we're only paid $6K more? What's up with that? ISPs should range from say $20K to $200K IMHO.
Click to expand...

Much better argument than that crap spouted off by Chonal Atresia. Who acknowledged that he "may sound elitest." This discussion can be had without insulting other services just because they don't have a 5 year residency.
 
AFIM said:
Alright, I'm gonna answer my own question. Here's the FY09 medical pay plan! Quite a few specialties have gone up - it's about time!

http://www.health.mil/Content/docs/pdfs/policies/2008/08-011.pdf
Click to expand...

pgg said:
Bonuses will not increase ...

... with the possible exception of MSP, because it's the one bonus that is available only to people at their decision-to-get-out point.

There is no reason for them to raise ASP & ISP & VSP & BCP for physicians who are in the midst of obligated service, because those physicians can't choose to leave.
Click to expand...

God, I hate being right all the time. (I'm not going to call a handful of token increases in primary care physicians' ISP a significant change.)

An anesthesiologist who's eligible to get out this year and who chooses to stay would see his ISP of $36K increase to an ISP+MSP combination of $110K if he signed another 4 year contract. So essentially, they're offering a $74K/year raise to that anesthesiologist in an effort to get him to stay. Odds are the PP job he's looking at carries a pay jump closer to $150-200K.

This will have absolutely no effect on retention. The people who were going to stay anyway will remain and get paid a bit more (which is great); the people who were going to leave will still get out. Meanwhile, the people serving out ADSOs will enjoy the 18th (?) consecutive year without any of their bonuses even being adjusted for inflation.
 
Advertisement - Members don't see this ad
Chonal atresia,

You sound very angry and bitter! Just b/c you feel screwed doesn't mean you need to piss on those of us who chose primary care! Do you really think 8K more a year makes us feel anymore valuable?
 
ActiveDutyMD said:
Thanks for suppressing the urge.
BTW, I'm not impressed with your retention numbers. Those look awfully similar to EVERYONE'S retention numbers. I know it is less than 5% in my specialty for instance.
Click to expand...

You're welcome, my quarrel is not with you. Of course, I do have major problems with the civilian compensation system and the relative pay of various specialties, but I digress.

The reason you should be impressed by those numbers for pediatrics is we used to have the highest retention rate in the Army. There were (and still are, to a certain extent) tons of O-5 and O-6 pediatricians. A senior pediatrician at a MEDCEN is a great gig. We are losing all of our generalists. This is a huge problem, especially since Tricare is a horrible insurance company. When I reported to my new post (just before deployment) they told me that primary care was full and that I'd have to go to the community. They gave me a list of providers. Guess how many pediatricians on the list. ONE and he was 30 miles away. There were a few FPs and the remainder were NPs. Having lots of sub-specialists is OK, I guess. Without us, there is no reason to have the subspecialists. As I mentioned before, we have two dermatologist on my FOB doing 15 month GMO tours. What's the delay to see a derm at your MTF? I can't wait until they start putting anesthesiologists in GMO billets, or god help us, pathologists!

To paraphrase Pastor Niemöller

When they came for the pediatricians,
I remained silent;
I was not a pediatrician.

When they took the internists,
I remained silent;
I was not an internist.

When they came for the emergency physicians,
I did not speak out;
I was not an emergency physician.

When they came for the dermatologists,
I remained silent;
I wasn't a dermatologist.

When they came for me, an anesthesiologist,
there was no one left to speak out

Ed
 
Chonal Atresia said:
I agree with ActiveDuty MD. Specialists are getting screwed by the military. Are pediatricians worth only $16,000/yr less than Neurosurgeons? No one in their right mind would agree with this statement. As for the arguement that more specialists would be deployed as GMOs if more pediatricians/IMs/FPs ETS'd - this is true. However, these specialities shouldn't complain. They know full well that they are first line to fill 60A/62B slots since they don't possess the critical skills that surgeons and anesthesiologists have. This may sound elitist but it is a fact. If you don't want to get deployed get out of the military. These specialties had it made before 9/11 since their compensation was close to their civilian counterparts. Now that things have changed and the military is asking them to deploy to earn their keep, they are upset. Too bad! If you want to piss on specialists and keep their pay down, so be it. But watch the upcoming backlash in the next several years.
Click to expand...

The point is that at least there are some positive changes. You shouldn't be so bitter that you can't be happy for others who get a small, well-deserved raise. As for critical skills: for the record, we internists are manning the ICU at Balad, doing CCATT missions, and I'd say that's important to the military. And how about those FP docs and peds doing sick call and the bulk of the outpatient work in the deployed setting? Unless you want to do it, don't demean them. Keep that in mind next time you are feeling "elitist."
 
To PGG
Hey how much added income do some of the GAS docs out at your location make through moonlighting? Also any talks of increasing GAS ISP pay? You chief res yet?
The Prince
 
narcusprince said:
To PGG
Hey how much added income do some of the GAS docs out at your location make through moonlighting? Also any talks of increasing GAS ISP pay? You chief res yet?
The Prince
Click to expand...

I've never discussed moonlighting figures with any of them. I think, for the most part, that they're limited to weekends and time on leave - and nobody wants to work every day, so I'd guess most only do a few days a month. I've heard that anesthesiologists at other commands where the official workload is much less can spend more time moonlighting (without working themselves to death) and substantially augment their pay, but it's all rumor to me.

The base ISP is $36K and has been for as long as I can remember. I doubt it will go up, for all the reasons above, though the ISP/MSP combo for those who are done with their ADSO has increased recently. $110K/year if you sign a 4-year extension is substantial but even so I don't see any of the guys who are leaving for the civilian world staying for that. Every one of them is being offered more ... and the deployments, infrequent as they are for Navy gas types, aren't helping matters any.

Still, it's nice to see that the primary care guys got a raise, even if they deserved more. So maybe there's hope for some increases across the board in the future.

John & Bob are the chiefs in my class. Don't know if you met either of them, but you'd be impressed with both. The majority of my year is away from Portsmouth anyway, so my non-chiefdom, although disappointing, is probably for the best - I barely met 1/3 of the CA-1 class before leaving in August, and I won't be back until January (and that's an ASC month away from the main OR). Then gone again February-March. Some (absentee) chief I'd have been. 🙂

How's your gig treating you?
 
I am glad the primary care got a raise. They deserve it and at least someone got a raise.

I am also glad I resigned from the Navy. As usual, Urology got the shaft. If we want to talk about retention, 8/10 Urologists that were eligible to get out last year did just that. BTW with just 6 months in private practice, I am on target now to quintiple my Navy income this year!! If you think there is a shortage of physicians in the military, it is even worse on the civilian side. The amount of sick and elderly patients out here makes Navy medicine look like elementary school. I also can relish in the fact that my job is secure for the next decade, because 6/9 of the practicing Urologists in my area are over 55 years of age...😱😱
 
PGG
Gigs good haven't seen an ASA 1-2 since I have been in the building. By the way I start general anesthesia in december thats right december(running my own cases). We have a hybrid early start system and I was one of those selected to be in the first group. Also if we stay past 5:30 we get 80 an hour. Currently I am in a stepdown vent weaning unit. Plenty of s/p heart transplant, double lung transplants, and many CT pts who have been on vents for years. My first week of the month I ran a code(solo), pronounced a pt, and basically ran the unit w/o much back up. Although scary I have learned a lot through trial by fire. I would love to see a 24 y/o marine coming in for routine knee scope. Hey I can't remember what is the schedule for an attending at Portsmouth vs small hospital like Jacksonville or Bremerton. Also, with the war coming to an end how will that effect staff shortages or than the obvious? But anyway are you going to be doing a rotation in my neck of the woods?
 
Last edited:
Chonal Atresia said:
As for the arguement that more specialists would be deployed as GMOs if more pediatricians/IMs/FPs ETS'd - this is true. However, these specialities shouldn't complain. They know full well that they are first line to fill 60A/62B slots... If you don't want to get deployed get out of the military...Now that things have changed and the military is asking them to deploy to earn their keep, they are upset. Too bad! If you want to piss on specialists and keep their pay down, so be it. But watch the upcoming backlash in the next several years.
Click to expand...

No, a pediatrician is not anywhere close to a NSurgeon, and yes, everyone should have gotten increased bonuses worthy of their specialty. But the above argument about deployment is BS. It's not about the deployment. Everyone deploys, we know that. It's about keeping our skills, just like you want to keep yours. It's not just for the brand new peds graduates, but for IM and FP also. As a 62B/BDE Surg, my patient care is unfortunately minimal to non-existent. Its been spelled out to me that my job is a staff officer, not a physician.

And FP/IM/Peds aren't the only ones first in line to fill 62B slots anymore. One of the new BDE surgs with me is a brand new ER graduate out of BAMC.
 
Last edited:
narcusprince said:
Currently I am in a stepdown vent weaning unit. Plenty of s/p heart transplant, double lung transplants, and many CT pts who have been on vents for years.
Click to expand...

I'm jealous. One of the away months I scheduled this year is in a TCV SICU just to have patients with bad organs s/p surgical assault like that. As you know one of the biggest downsides to training in a military hospital is the lack of acuity, and that goes double for CCM. The ICU experience at Portsmouth is weak and I really felt like I had to go elsewhere or risk graduating without the knowledge or comfort I want with those patients. They actually merged the ICU & SDU this year because of nursing shortages, which obviously lowered the acuity even further. Plus the teams are so fat (3-4 residents, 4 interns, +/- students, 1-2 attendings) that there's not much for any one person to do for the 5-10 patients we typically had at any given time.

narcusprince said:
My first week of the month I ran a code(solo), pronounced a pt, and basically ran the unit w/o much back up. Although scary I have learned a lot through trial by fire. I would love to see a 24 y/o marine coming in for routine knee scope.
Click to expand...

That's funny; I'm living it up with my brink-o-death patients.

narcusprince said:
Hey I can't remember what is the schedule for an attending at Portsmouth vs small hospital like Jacksonville or Bremerton. Also, with the war coming to an end how will that effect staff shortages or than the obvious?
Click to expand...

At Portsmouth, staff do normal days (~0630 or 0700 until late afternoon; rarely past 1630 or 1700). They typically have 2-3 call nights per month, with an associated, rarely utilized "late stay" day before the call day. Each year they get a holiday weekend where they pull two calls.

From what I'm told, at smaller commands it's fairly common to routinely be done by early afternoon. Whether those people then go home or have moonlighting gigs I don't really know. I suspect call at smaller commands is more frequent. As it gets closer to December and they clue us in to which billets might be available, this is something I'll be asking about.

To be honest, anesthesia hasn't been hit all that hard with deployment taskings, so I don't expect that even a full withdrawal from Iraq (will believe it when I see it) would substantially effect staffing levels or call schedules. The annual summertime getting-out exodus and pre-arrival of new staff always seems to be more of a strain than the deployments. Plus, the Navy's getting a lot of outservice-trained new staff in 2009, so the Navy as a whole will be something like +30 anesthesiologists (minus however many get out next year). At any given time we only have a few anesthesiologists and CRNAs deployed. Most HPSPers deployed a single time during their payback. CRNAs pull a significant part of the deployment load, so we're not seeing anesthesiologists do multiple frequent tours the way some surgeons are.

narcusprince said:
But anyway are you going to be doing a rotation in my neck of the woods?
Click to expand...

No, we don't have any rotations there. We do our CA-3 hearts at Washington Hospital Center in DC (where I am now). Thank god for this rotation - I think last month's CA-2 doing cardiac/vascular did four hearts the entire month; I did three yesterday, two with LVADs.

Portsmouth anesthesia has its strengths - OB is solid, lots of mostly healthy peds + CHKD right next door, great regional, great pain - but it's very thin when it comes to the sick old patients with broken organ systems. Hence my CA-3 year being mostly a road trip ...
 
i know of one AF Radiology guy doing double duty as staff Radiologist and GMO/FP at KAF (Kandahar).

imo, i dont think the pay will ever be adjusted for inflation.
 
You must log in or register to reply here.

Similar threads

militaryPHYS
Navy Incentive Pay Increases
Replies
29
Views
7K
militaryPHYS
militaryPHYS
N
Pay differential
Replies
5
Views
2K
Nexus5
N
T
Board Certification Pay - Air Force Reserve
Replies
3
Views
3K
armytrainingsir
armytrainingsir
2
Pay during military residency
Replies
10
Views
8K
armytrainingsir
armytrainingsir
K
AF Reserve/Guard med school payment options
Replies
3
Views
2K
comp1
C