navdoc47

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40+ reasons not to be a military physician (please feel free to reply to my post to add more):

1-6. When you deploy for 6+ months (sometimes as long as 12 months with the Army in Afghanistan), you'll enjoy a daily schedule that will look something like...
1) No sex while your civilian counterparts enjoy a normal sex life.
2) Crappy food (though sometimes decent in large bases) while your civilian counterparts enjoy choice restaurants. For me, an MRE is
awful. Shipboard food is blah. "Tray-rats" are awful.
3) No broadband internet while your civilian counterparts enjoy whatever they want.
4) Stay in a work environment 24/7 while your civilian counterparts enjoy weekends and holidays off. Then when you go on leave
during deployment, they have the nerve to charge you despite the fact that you hadn't taken a single weekend off for months at a
time.
5) Sleep in a crappy rack/cot (it doesn't deserve the term 'bed')/crap in port-o-pottys while your civilian counterparts enjoy queen/king
sized beds and flushing toilets. The worst is sleeping on a 'isomat' on dirt - I never thought I could strain my clavicles until I slept
like that.
6) Repeat over and over, daily, for approximately 180+ days, meanwhile, the rest of society is enjoying high def television, plumbing,
broadband internet, the freedom to go out and shop/dine/romantic evenings/etc, raising a family and spending thousands of more
hours with their spouse and/or children.

But of course, if you prefer living in a tent, trying to pass time playing cards with your coworkers, then you should sign up !

7. Serve your country and expose yourself to enemy fire while celebrities and bank bonus recipients get paid millions for a lot less danger.

8. YOU LOSE BIG IF YOU TAKE AN HPSP SCHOLARSHIP: you're a sucker to take the HPSP scholarship - I like to call it a "MAFIA loan" (small short term rewards via a little more money during med school/residency, but ultra heavy payback). On the front end, you can get paid a little more as a resident (say 30K more each yr) and a little scholarship.

Clearly if you specialize, you're giving yourself a pay-rape by staying in the military.

The people whose foresight is overshadowed by their fear of carrying debt seem to enjoy getting pay-raped by the military.

9. GOODBYE AUTONOMY: kiss your right to feeling privileged as a physician good-bye. You will do what they tell you, go where they tell you, no questions asked (you can ask all you want, but it will fall on deaf ears). You may get lucky and get to live in a nice area, but you might also end up living in less cultural/popular areas like 29 Palms CA, Okinawa, Guam, Norfolk VA, Meridian MS, Ingleside TX, Camp Le Jeune NC, Guantanamo Cuba, among others. Remember you're a doctor - why subjugate yourself to a chain of command? - be all you can be - your own boss.

10. TIME IN MED SCHOOL DOES NOT COUNT TOWARDS RETIREMENT: the military doesn't respect the time you spent during medical school. You might find it interesting that it used to count: http://comptroller.defense.gov/fmr/07a/07a_01.pdf At the top of page 1-10, prior to the year 1981, time during HPSP/USUHS counted towards your pay. This matters as the pay is quite different between an O-3 with less than 2 yrs vs an O-3 with 4 years.

IT'S A SHAME THAT TIME DURING MED SCHOOL DOES NOT COUNT TOWARDS ACTIVE DUTY TIME. MSCs (medical planners) CAN GET THEIR MASTERS DEGREE IN HEALTH ADMIN AS A CIVILIAN, GET PAID AS AN E4 AS WELL AS TUITION, AND THAT TIME COUNTS TOWARDS RETIREMENT. THEY EVEN ACCRUE LEAVE. SO MEDICAL PLANNERS CAN RETIRE AT 42, BUT YOU WITH A MEDICAL DEGREE CAN RETIRE AT 46.

11. ADMINISTRATIVE JOBS: makes me laugh how one of the advertisements in military is "don't have to worry about setting up your practice". well they more than make up for it by giving you plenty of administrative duties on top of seeing patients - lol. Jump into the pyramid, climb and reach for the stars with titles like Department Head, Senior Medical Officer, and Director! If these titles turn you on, then by all means sign up !!

12. NO CHOICE IN YOUR EQUIPMENT: you can't change things like you can with your own practice. You get to enjoy folks working under you who rotate as often as you do (and therefore need constant training). don't like the old computer you're working on? well in your own practice, you can change that. In the military, you won't, unless you have that admin job.

13. YOUR EVALUATIONS: Fitness reports - this is the most comical part the military that takes away any feeling of autonomy and privilege. To make a higher rank after you've been in for awhile, your fitness reports need to be filled with bullets (stuff you've done in addition to seeing patients) - so have fun racking up the admin duties to show how good of a manager you are. Failure to do so will result in you being very frustrated at not making captain/colonel (O-6). And don't forget that lots of **** kissing can often beef up fitness reports to make you more competitive than your colleagues. Do yourself a favor - don't enter an arena you don't need to be in, and remember that NOT joining the military means you don't have to deal with the BS associated with 'competing with your peers'.

14. NO CHOICE IN FRUSTRATIONS OF INFORMATION TECHNOLOGY: Don't like your electronic records? In the military, you better get therapy to enjoy AHLTA, because it's not going to change - only you can change.

15. FIGHT FOR FREEDOM, BUT DON'T EXPECT ANY FOR YOURSELF: In the military, you're under the Uniform Code of Justice. Odds are, this won't affect you. But god help you if you've put in 10+ yrs, trying to make it a career, then you get pulled over for DUI. In the civilian world, nobody will penalize your career as swiftly as the military.

16. TRAINING: Training, training, training. First you get a taste of it at ODS - several wks of boot camp style living (early to bed, early to rise). You get to learn things that will be vital to your future success as a physician - the first thing that comes to mind is marching in formation. Your civilian friends in the meantime can stay home, enjoy their time, but suffer the consequences of not knowing how to march in formation. To get a taste of your valuable training at ODS, go to their website, look at their FAQ at http://www1.netc.navy.mil/nstc/otc/ods_faq.asp

You'll also love C4 training too - that's 10 days or so of living spartan, showering in communal showers (when you're not camping), completing your bowel movements in port-o-pottys, crappy food, the usual - kind of like conditions in a deployment.

17. REQUIRED COMPUTER TRAINING: navy knowledge online (and similar other training) - every so often, you'll get to update your computer training as you sit in front of a screen for many hrs, clicking thru outrageously slow 'learning modules'. Every year the list of required training gets longer and longer.

18. NOT ALWAYS 30 DAYS VACATION: they say you get 30 days of paid vacation per year. This isn't always the case. Also remember that leave days count even if it's the weekend. Once you report to a command, you will often have difficulty taking all 30 days of leave per year. over time this will build up, and if you carry more than 60 days of leave on the books, you can end up losing it.

19. LOST SPOUSE INCOME: those with spouses who want careers too:
The military is the absolute worst place to be, given that you have no idea where you will be in 2 yrs and the frequent moving (don't forget moving overseas). So if you join the military, if your spouse loses out on a good job making decent $$$/benefits, then you just intentionally killed thousands of $$$ of potential earnings. If your spouse does not work or works for very little, then the military won't hurt.

20. CONTRACTED PHYSICIANS. The best physician jobs are being taken by contracted physician jobs. This means those who are left in the military get stuck on deployment, or are in the worst jobs. If you want a nice job in a military hospital, work under contractual agreement. As a civilian specialist, you'll get paid way more, never deploy, and you have your pick of location. Every time i see a civilian getting a contracted position, I'm more convinced that the way to go is civilian. In the worst places, like Guantanamo Bay Cuba, they can't find any civilians willing to work on a contractual basis: but they can find you if you're in the military :)

21. HIGH TURNOVER: the military finds that it is cheaper to have high turnover (don't give many incentives to keep people in, but make up for it in recruiting those who are naive). This is very true for specialists. For primary care, you may have a tough time in the civilian world, but an even tougher time in the military. What's the retention rate for deploying specialists (ortho, ER, surgery, anesthesia) - almost zero unless they're close to that 20 yr retirement. If specialists are leaving by the droves, is this the career for you?

22. NOT SO GREAT RETIREMENT: your retirement pay is the same as any officer who didn't go to medical school (less if you count the fact that officers entering the service straight out of undergrad will end up retiring 4 yrs sooner than you). Remember that retirement pay is based on 'base pay'. So all those bonuses you made as a doctor don't get factored into retirement pay. Hence you end up with retirement pay equal to a nurse.

23. EDUCATION FOR YOUR CHILDREN. If you're stationed overseas with children, your children will be taught by teachers contracted abroad (and no, these teachers are not typically Philips Exeter material). I have heard good things about overseas schools however. But if for some reason you don't like the school system in Okinawa or wherever, what private school choice do you have? - nothing. Want your kids to enjoy the advantages of having private lessons in music or sports? - good luck finding them abroad or in desolate areas such as LeMoore, CA, 29 Palms, or El Centro, CA.

24. FINANCIAL LOSS WHEN MOVING: DLA (dislocation allowance) - approx $2K for officers to help off-set the cost of your move every 2-3 yrs. This is laughable considering that civilian mid-level managers/consultants are paid 70K or more to move, to include guarantees that the company pick up the tab if their house loses value.

25. LOST HOME INVESTMENT. The #1 investment in America is your home. However with moving every few years, don't expect your home to be your investment. Most people in the military rent, very few go thru the trouble of keeping their home long-term.

26. SLAVE LABOR. remember that when you sign a contract, there is no limit to the hours you can work. Not always abused to the extreme, or else everyone would leave. However it is abused from time to time, like when you deploy. Imagine what the military would have to pay a family physician to go 6+ months in a war zone, in a wonderful place like Afghanistan - upwards of 500K I'm guessing? The Pentagon gets one hell of a deal if you sign up :)

27. GREAT FOR PRIVATE PRACTICE. For every year spent in the military, that is a year lost in building up your practice.

28. MOVING (an experience you'll learn to love). I guarantee that with every single move, the movers will f*ck up your furniture. They routinely mark that it is scuffed, scratched on every side of the furniture, even if the furniture is brand new. So only with the most obsessive photo-history will you get compensated.

28. FAIR RETIREMENT. Stay in for 20 yrs so you can earn a retirement that is equivalent to what a nurse would earn for the same amount of time. Oh actually your retirement is less - remember, a nurse can retire at age 42 whereas you start at age 46.

29. MORE INTERVIEWS. Your civilian buddies get to interview typically once to get into residency. Join the military and you'll get to
interview 3, 4, maybe even 5 times! You'll interview once to get into internship. Then interview again for pgy-2 while you're an intern. Then when you don't get into pgy-2 cause you have to play GMO (as is the case for 2/3 of navy interns), then while you're a GMO, you get to interview for PGY-2 yet again. And if that PGY-2 spot is tough to get (ie dermatology), expect to interview yet again after GMO tour #2.

30: PERSONAL DEVELOPMENT: personal reasons to join the military as a physician (in addition to what the recruiter tells you):
a) you enjoy spending time away from your family.
b) the thought of being away while your child is born is appealing (for males) - this happens often, given deployment schedules.
c) if you're single, you like to stay single (kind of hard to develop a relationship if you're in middle of nowhere or on deployment or stationed in Okinawa, Diego Garcia, or Guam).

31. Sometimes you have the opportunity to be a guinea pig. Just ask the folks who previously tried refusing the anthrax vaccine. I think it's unfortunate that the British military is smart enough to not require their folks to get shot for anthrax and smallpox, but we in the US military are too dumb to follow suit.

32. Non-physicians in higher administrative positions: I roll with laughter when a non-physician congratulates one of the physician staff for having the highest RVUs (a point measurement system that measures productivity from IDC codes). A certification of "congratulations" - lol - what a friggin joke - physicians becoming the new 'employee of the month'.

33. When you're getting close to finishing your time with your commitment, don't expect to be around stateside to interview for residency. What's convenient for you has ABSOLUTELY no bearing on whether you get deployed to the sandbox. And to top it all off, by the time you finish your commitment, your civilian classmates will be ATTENDINGS while you're back to playing resident-slave.

34. Odds are (since 2/3 do GMO), you'll do your 4 yrs of GMO, and get out to do residency while your CIVILIAN CLASSMATES are now ATTENDINGS, getting their life and practices together. Perhaps you're not envious now as a medical student, but you may very well be just a whee bit put off when your civilian friends are happy they're done with training. Oh and don't forget, some specialty programs might require you to re-do your internship, and wouldn't that be lovely as well? Also this situation can make a little wrinkle in your life: you do your 4 years commitment (HPSP), and if you want a residency that is competitive (ie more than foreign MDs want it), you may be told to re-do your internship since "it's been awhile." However since you already did an internship, your program might not get funding for you to re-do your internship (so guess what, they might not pick you!). And remember - when you're applying for PGY2 - who do you think has more clout - the medical student who has been there doing a rotation, or you the applicant who looks good on paper? If you find yourself overseas (oh and btw don't forget to apply ONE YEAR EARLIER for PGY2 - some folks get burned by forgetting that little tidbit), good luck trying to finish your residency in any place other than ones that are vacant or are filled with foreign MDs.

35. I think one of the biggest reasons why people don't stay beyond their commitment is the fact that they don't factor in the stress on their family with regards to deploying or moving. They think, "i can handle a deployment to iraq, a ship, afghanistan, move overseas, etc". But when they complete all of these events, they find that things take a greater toll than they had expected with regards to their family. Thoughts include, "hmmm...my son or daughter missed a lot of time with me...don't need to do that to them again". Then off to the civilian world they go :)

36. If you're a pet lover, you'll want to keep your pets down to 2 cats or dogs (or 1 of each). If you go overseas, you will have restrictions. Go to Japan, and enjoy following a whole list of stuff to bring them over (you may have to keep them quarantined for 6 months). All in all, a big headache.

37. If you're single, you're going to have a very rough time trying to fix your love life with the click of a mouse button. Your match.com pursuits will be very challenging when you write back saying you can't go on a date for the duration of your deployment :p

38. You think you can enjoy seeing the world in the military? Most married people, when traveling abroad, don't seem to enjoy their travels as much when their spouse isn't around. To further complicate things, you will enjoy all sorts of restrictions when you're out on 'liberty'. These include having a 'liberty buddy' (they don't want you exploring by yourself) as well as Cinderella curfews. If you stay overnight in a hotel (at your own expense), you'll enjoy calling at 6am to 'check in'.

39. GMO PENALTY. Increasingly, many of us after internship are completing 4 yrs of GMO so we can get out as fast as possible. It is also unfair to those who complete 4 yrs of GMO who then stay in the military to complete a residency. Here's how: if you're part of the 33% who go straight thru to complete residency, you'll spend (let's say a 4 yr residency) 8 yrs in the military (4 yrs residency, then 4 yrs concurrent payback). If you do 4 yrs of GMO and therefore delay residency, you spend 11 yrs in the military (1 yr internship plus 4 yrs GMO plus 3 yrs residency plus 3 yrs residency payback). And because you end up owing more yrs (11 instead of 8), if you choose to stay in beyond, you're delaying by 3 yrs all the incentive specialty pay retention bonuses, which range from roughly 30K/yr for primary care on up. In other words, a 4 yr GMO person misses out on 90K+ of specialty pay if they stay beyond their commitment when compared to their colleague who didn't do GMO.

40. Docs are deployed to war zones. Pity the person who receives a disabling injury, for I hear it's tough to perform procedures if you've lost a limb.

41. For people already in the military: transitioning to the field of medicine from another military job is insulting given the loss in rank. If you change jobs as an officer from Surface Warfare to Intel (or nukes or pilot or NFO, etc), you don't lose rank or time in rank. Only in the HPSP programs does an officer lose rank and/or time in rank !!! There's no reason why someone should make O-4 later than their ROTC/OCS/Academy classmates, just because they went from one officer job to becoming a military physician.

42. Not all physicians get promoted to O-5. If you're not board certified when you're up for promotion to O-5, you're probably not going to make it. Now it's reasonable to think one should be board certified prior to making rank as a Senior Officer. But think about this: nurses don't need to be board certified to make O-5.

43. Email and social networking sites will not work when you're at work. So no gmail, yahoo mail, hotmail, myspace, facebook, etc, etc. You'll find the military does a wonderful job preventing you from going to plenty of 'time-wasting' sites. But of course as a civilian, you can CHOOSE to check your email. Not so in the military. Your only escape is if you own an I-phone or equivalent.

44. A new bonus for physician assistants puts their pay higher than a GMO.

45. Canadian physicians make a lot more. http://cdn.forces.ca/_PDF2010/PhysicianOpportunities_en.pdf

Canadian physicians are paid 50% of their entire pay for retirement (not 50% of a subset of their pay, ie "base pay" like US physician suckers)

After 25 yrs of service (the 4 yrs in medical school count towards the 25 yrs), Canadian physicians receive 50% of their entire pay (roughly 50% of 220K). So their retirement pay in today's dollars is 110K.

That's approximately double of what their nurses get in retirement.

Work 20 yrs in the US Military so that you can receive the SAME pension as a nurse !!!!
 
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militarymd

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Navydoc....tell us a little about yourself.
 
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Galo

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Welcome.

Be ready to have your personality judged by pro-military fanatics who just do not understand what being a doctor is, or pre-med, or med students with prior service who think the military can do no wrong.

Just venting from the latest attempt to quell physicians who have something bad to say about their military medicine experience. I'm sure you'll catch on.

We appreciate your input.
 

BiGArKDoC

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Does this exist anymore? As bad as you make it out to be, is it any more sacrifice than the 19 year old marine?
 

USAFdoc

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Does this exist anymore? As bad as you make it out to be, is it any more sacrifice than the 19 year old marine?

it depends on the circumstances of the situation. Are the troops over in IRAQ sacrificing more than I did during my time at a "broken" USAF Primary Care clinic? ABSOLUTELY

the questions you have to ask is why is a "sacrifice" being made, how is the "sacrifice" being made etc.....

As a physician in the military, I expected to have a certain amount of "lost autonomy" in the military system. What I never imagined is that the people calling the shots would have designed and manned a system so poorly to the point where things become simply too reckless, too unacaceptable, and too caustic for any physician committed to excellence, integrity etc. to continue to be a part of.

I commend the 19 year old marine fighting on the front line for all of us. But if that marine loses his/her life or becomes injured not because of what he/she has done, but because our "admin" deliberately game them faulty equipment, deliberately did not send enough troops to safely do the job, deliberately lied about the situation, etc...then SHAME on our leadership.:mad:

What is going on in military medicine is shameful, and SHAME on our leadership that has been told for years about serious problems and continues not only to ignore them, but to claim they do not even exist.:thumbdown:
 

DropkickMurphy

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Selfless patriotism is a stupid idea, and a fallacy. No one sacrifices themselves for anything that is not going to further their own beliefs. As one of my WWII veteran friends (a very highly decorated 101st Airborne vet) put it, "Dying gloriously in battle is about the dumbest thing I've ever heard. Death, is death, and patriotism is a lousy reason for sacrificing yourself."
 

MedicalCorpse

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Galo

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Post of the year. Well stated. This one belongs in a sticky moderators.


Placed a link to it on the con thread. I doubt this by itself will be made a sticky, someone might take homunculus' club and hit him with it if he did.
 

BOHICA-FIGMO

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However cynical your points are, most of them are true. I think most people know this (or ought to!) before joining the military. However, I must disagree with several of your points:

24. SKETCHY EDUCATION FOR CHILDREN. Actually, the DoD school system is one of the best publically funded school systems in the U.S.


25. FINANCIAL LOSS WHEN MOVING I've never known anyone to LOSE money during a move. If you plan properly you can actually make out like a bandit

26. LOST HOME INVESTMENT I personally have never owened a home in the military because I'm single and the hassle factor you mention. However, those willing to put up with the hassle of selling a home every 3 yrs or so, often make out QUITE well.

Just my two cents.
 
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8744

34 reasons not to be a military physician (please feel free to reply to
my post to add more):

(edited content of quote for easier forum reading-- homunculus)

CONCLUSION: suck it up and borrow the money. you'll make less in
residency, but once you're board certified, you will be so glad you're
free to work as you wish.

My wife and I ran the numbers both for the HSPS before medical school and for the FAP before residency. Either way, the numbers just don't make sense. Even for the low-paying specialties, I doubt you would even break even considering that most federal student loans can be consolidated at a ridiculously low rate which for us amounts to about $500 bucks a month until I die (and at 43 I might be dead before I finish paying it back).

I'm perpetually surprised at how scared people are of debt. Granted, a 50,000dollar credit card balance for personal watercraft and hooker sandwiches is probably a bad idea but the couple hundered thousand investment in human capitol represented by medical school loans pays big dividends and is just the cost of doing business.

I can see your point about most of the items on your list. Still, I don't understand the trouble people have with one through six. Isn't that the whole point of military medicine, to deploy with the troops?
 

Banlioch

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I can't help but notice that #23 and #30 are the same.

Also, #1-7, 9, and 15 are simply to be expected in the military. Are doctors in the military supposed to get a civilian structure for some reason? What did the former and current docs expect when they joined the military? It seems that this thread should be "34 Reasons Not to Join the Military... especially as a physician/medstudent"

Service through the Army will not require a GMO tour unless you can't get into a residency or decide to drop out of the residency you're in. Therefore, the deleterious effects of the GMO won't affect aspiring Army docs.

Regarding the slur against Ingleside/NAS Corpus Christi, I lived in Corpus for six years while my dad was stationed there. It's a really nice area, pretty and full of culture. I will admit that Kingsville to the south is awfully barren, though.
 
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The White Coat Investor

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Service through the Army will not require a GMO tour unless you can't get into a residency
.

I'm not sure you understand the frequency with which this occurs. The percentage of applicants not getting into a specialty of their choice is significant, even in the army, and is the biggest downside of the HPSP program.

The lack of sex on deployments is easily number two, at least for those of us for whom sleeping with co-workers or hookers isn't an option.

The lack of broadband is also a huge irritation, but could be easily fixed through satellite technology.

I can handle the food, I can handle the tent, I can handle the mortars, I can handle the trauma. Just let me have a little sex, a little sleep, and a high speed connection during my down time and I can do anything.

And obviously, the thread applies to physicians/med students. I am a firm believer that military service is a very good thing, both financially and personally, for people joining directly out of high school.
 

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However cynical your points are, most of them are true. I think most people know this (or ought to!) before joining the military. However, I must disagree with several of your points:

24. SKETCHY EDUCATION FOR CHILDREN. Actually, the DoD school system is one of the best publically funded school systems in the U.S.


25. FINANCIAL LOSS WHEN MOVING I've never known anyone to LOSE money during a move. If you plan properly you can actually make out like a bandit

26. LOST HOME INVESTMENT I personally have never owened a home in the military because I'm single and the hassle factor you mention. However, those willing to put up with the hassle of selling a home every 3 yrs or so, often make out QUITE well.

Just my two cents.


You need to come sell your home in california right now...If you bought in the last year or two and have to move... say a two year move... you will lose money and have horrible stress in the time to sell your house... if you bought in 2000 or 2001 and moved in 2004 you made a ton of money. All things out of your control
 

MedicalCorpse

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34 reasons not to be a military physician (please feel free to reply to
my post to add more):

35 (related to #9: Goodbye Autonomy): BE COMMANDED BY A NONPHYSICIAN:

Nurses, pharmacists, physical therapists, and other non-physicians now routinely command physicians; they wield the fearsome power of the UCMJ
over docs like the Sword of Damocles:
http://forums.studentdoctor.net/showpost.php?p=4060532&postcount=12

Other appalling...er, appealing aspects of military medicine in 2006 and beyond:

Have your written doctor's orders regarding critically-ill post-op patients in a deployed setting countermanded by a clipboard-carrying nurse. When you object, be threatened with an Article 15 for disobeying orders: http://www.medicalcorpse.com/doctorssuggestions.html

Have a nurse remove a blood pressure cuff from a VIP, AD FP M.D., while you are injecting her epidural with potentially-lethal 2% lidocaine. Have the Charge Nurse tell you that the O-3 nurse's judgment regarding her patient's discomfort with the BP cuffing going up and down (per standard of anesthesiologic care) trumps your O-4 medical judgment. Have the Army perinatologist without any line authority look the other way, so as not to alienate "his" OB nurses: http://forums.studentdoctor.net/showpost.php?p=4192710&postcount=20

If you like those possibilities, you'll love being commanded by a CRNA when you're a board-certified anesthesiologist physician.

Lots more in my posts referenced above (18 and 17 Reasons Not to Join Military Medicine)...this is one reason that *must* be emphasized to anyone even thinking about joining the (soon to be unified) Military Medical Corpse.

--
R
Ex-LtCol, USAF, MC
http://www.medicalcorpse.com
 
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8744

I'm not sure you understand the frequency with which this occurs. The percentage of applicants not getting into a specialty of their choice is significant, even in the army, and is the biggest downside of the HPSP program.

The lack of sex on deployments is easily number two, at least for those of us for whom sleeping with co-workers or hookers isn't an option.

The lack of broadband is also a huge irritation, but could be easily fixed through satellite technology.

I can handle the food, I can handle the tent, I can handle the mortars, I can handle the trauma. Just let me have a little sex, a little sleep, and a high speed connection during my down time and I can do anything.

And obviously, the thread applies to physicians/med students. I am a firm believer that military service is a very good thing, both financially and personally, for people joining directly out of high school.


Apropos of nothing, when I was deployed in the eighties and early nineties, email was almost unheard of in the military. The nearest thing we had was the "MARS" radio-telephone service which I never used but which I understood to involve a couple of amateur HAM radio operators listening to intimate conversations between husbands and wives.

Mail call was very important. It was great to get twenty letters from my girlfriend (now my wife) at one time. On my first deployment I never got any mail which kind of sucked. I don't know if I'd like always being in touch while deployed. I kind of like writing letters which you don't haveto do if you can pick up a phone or send an email.
 
8

8744

35 (related to #9: Goodbye Autonomy): BE COMMANDED BY A NONPHYSICIAN:

Nurses, pharmacists, physical therapists, and other non-physicians now routinely command physicians; they wield the fearsome power of the UCMJ
over docs like the Sword of Damocles:
http://forums.studentdoctor.net/showpost.php?p=4060532&postcount=12

Other appalling...er, appealing aspects of military medicine in 2006 and beyond:

Have your written doctor's orders regarding critically-ill post-op patients in a deployed setting countermanded by a clipboard-carrying nurse. When you object, be threatened with an Article 15 for disobeying orders: http://www.medicalcorpse.com/doctorssuggestions.html

Have a nurse remove a blood pressure cuff from a VIP, AD FP M.D., while you are injecting her epidural with potentially-lethal 2% lidocaine. Have the Charge Nurse tell you that the O-3 nurse's judgment regarding her patient's discomfort with the BP cuffing going up and down (per standard of anesthesiologic care) trumps your O-4 medical judgment. Have the Army perinatologist without any line authority look the other way, so as not to alienate "his" OB nurses: http://forums.studentdoctor.net/showpost.php?p=4192710&postcount=20

If you like those possibilities, you'll love being commanded by a CRNA when you're a board-certified anesthesiologist physician.

Lots more in my posts referenced above (18 and 17 Reasons Not to Join Military Medicine)...this is one reason that *must* be emphasized to anyone even thinking about joining the (soon to be unified) Military Medical Corpse.

--
R
Ex-LtCol, USAF, MC
http://www.medicalcorpse.com

Hey R, we got off to a bad start and I'd like to apologize. I love your website, by the way, and in a strange way some of the crap you have to put up with reminds me a lot of my recent experiences at Duke.

Are military residents subject to the ACGME work hour rules? It seems to me that for reasons peculiar to the military, they would not be.
 

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Hey R, we got off to a bad start and I'd like to apologize. I love your website, by the way, and in a strange way some of the crap you have to put up with reminds me a lot of my recent experiences at Duke.

Are military residents subject to the ACGME work hour rules? It seems to me that for reasons peculiar to the military, they would not be.
This is yet another reason why I respect you Panda. :thumbup:
 

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Are military residents subject to the ACGME work hour rules? It seems to me that for reasons peculiar to the military, they would not be.


yes. they're all accredited through the ACGME. we have to submit work hours regularly (our program does a decent job of complying btw)

JHACO on the other hand, we do as a service. supposedly even if we fail our inspections they can't shut us down. at least that's what the rumor mill has told me, lol.

--your friendly neighborhood 80 hour abiding caveman
 

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This is yet another reason why I respect you Panda. :thumbup:

i was a little taken aback at panda's reception in the forum. he calls it like he sees it, and has the sack to say so. not to mention, he's braved the everyone forum as a rational conservative . . . he likes to walk on the edge, lol.

--your friendly neighborhood ever watching caveman
 

MedicalCorpse

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Hey R, we got off to a bad start and I'd like to apologize.

Thanks. That's very gracious of you. Apology accepted. For my part, if I was somewhat "over the top" defending myself, I apologize, as well. As you go forward with your military career, please keep us all posted (literally!) regarding your experiences. Nice segue into...

I love your website, by the way, and in a strange way some of the crap you have to put up with reminds me a lot of my recent experiences at Duke.

Re: Website: Thanks! Everyone else seems to suffer retinal damage from the white text on black background, as well as my, er, liberal use of Air Force Blue and Danger, Will Robinson Red. I had always hoped, in true Iron Chef fashion, that the flavor and originality of my offerings would prove more important than the presentation.

Re: Experiences: Pray give details...several of my anesthesiologist colleagues on active duty went to Duke. Very strong program...especially with regard to advanced regional techniques (continuous lumbar sympathetic/psoas-sciatic blocks, etc.). Sadly, their extremely excellent training set them up for disappointment in the military, for many reasons which perhaps you, better than I, could explain...

Are military residents subject to the ACGME work hour rules? It seems to me that for reasons peculiar to the military, they would not be.

Yes, and this leads to a sick/hilarious side effect. Let us say I was the anesthesiologist on call for Saturday/Federal Holiday. I was in the middle of a 24 hour shift, often up the entire time starting epidurals, doing C-sections, and starting IVs on the ward (easily 40% of all pages on call were from techs and RNs to start IVs on ward/E.D./NICU/OB patients). The intern would walk in fresh as a daisy at 1900 to stay overnight. When I was paged regarding a malfunctioning/almost out continuous interscalene catheter (part of the MARAA initiative, wherein Army docs started catheters on patients downrange, then told the patients to hide the infusion pumps loaded with a lethal dose of ropivacaine from the Air Force puke flight nurses/M.D.s, because the Army didn't do the work to get the pumps approved for use on board aircraft), I asked the intern what the deal with her patient was. Did she know about this pump? What was the plan for her patient?

"How should I know, I just came on duty. I'm just getting report." At 1900. When I had been at work since 0700-0800, and was scheduled to be on duty until 0800 the following day. Thus, it devolved to me to liaison with the General Surgeon in charge of the patient (who knew nothing about the pump), and the Flight Surgeon in charge all RON patients (who knew less than nothing about the pump).

As a result of mandatory RRC rules regarding adherence to ACGME standards, it was not unusual for the most excellent thoracic surgeon and MGMC chief of general surgery, Major (Dr.) R., to be on duty at 0200 holding the Attending Surgeon pager, the WRAMC Resident pager, and the intern pager, so that he could respond to the ED to r/o appy, respond to the ICU to up a propofol drip, and respond to the ward to get Mrs. Smith more medicine for her chronic constipation.

As I have said, (creaky voice), when I was an intern/resident, the max number of hours I could work/week = 168 = 24x7 (/creaky voice).
Enjoy your time in residency. Even as a 'tern, I never worked as many hours as I did as staff after 9/11 (qod call for three months, including late scheduled O.R.s until 1930+, which gives the lie to those who claim that military ORs *always* shut down at 1530. This used to be the case. Not any more...because there are more surgeons than anesthesia folks by several multiples, so we can't run as many ORs in parallel; thus, 2 ORs are run with cases in series until the middle of the night, not infrequently).

Bottom line: there are no ACGME rules for attendings. Something to look forward to...

Again, thanks for your graciousness. Hopefully, we can start off anew.

Later,

--
Rob
http://www.dreamquencher.com
 

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2) crappy food

7. serve your country while the CEOs of defense companies and
contractors (Halliburton) are serving themselves richly. okay this
doesn't help, but I like to make fun...
The one positive thing I'll say about Halliburton is that the meals they served in Afghanistan and Iraq (probably to the tune of $8,500 per plate :rolleyes: ) were outstanding. The menus got repetitive after a while, but the food was good.

At least, compared to the bowl o' cereal, plate o' pasta, granola bar & a coke kind of meals I'm capable of preparing for myself 2-3x/day at home.

Panda Bear said:
Are military residents subject to the ACGME work hour rules?
Yes.
 
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8

8744

...As you go forward with your military career, please keep us all posted (literally!) regarding your experiences....

Good Lord. I'm not going into the military. I was only a little pissed off at you because I thought you were tarring the entire military with the same brush. I completely believe everything you say about Air Force medicine and by extension the other services.

I was thinking about the Navy a while back but as they didn't seem to keen on me (maybe it's my age) and my wife, who owns my medical degree and expects a payback goddamit, rejected the idea. (I left a perfectly good structural engineering career to go to medical school and my wife is coming to the end of her tolerance for our unaccustimed poverty.)
 

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Service through the Army will not require a GMO tour unless you can't get into a residency or decide to drop out of the residency you're in. Therefore, the deleterious effects of the GMO won't affect aspiring Army docs.

Yes it will. Just because the Army doesn't send you on a GMO tour after internship doesn't mean they won't after your residency. Many freshly trained Army docs are GMOs right now, especially FP, IM, and Peds.
 

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MedicalCorpse

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Good Lord. I'm not going into the military. I was only a little pissed off at you because I thought you were tarring the entire military with the same brush. I completely believe everything you say about Air Force medicine and by extension the other services.

Glad we got *that* cleared up.

Peace,

--
Rob
 

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...not to mention SEVERAL adverse discharge codes, including HLC, HLL, HMB, HRC, HWL, and, of course, the infamous JRC. :laugh:

--
R

That post sure sounds bad to my ears. I can't believe one with such high moral standards such as you would laugh at it. Can you imagine if it read "That would be cross burning, but it would be "cool" if you lived in Alabama." Doesn't sound so innocent anymore does it.
;)
(To those reading this thread who wonder WTH that came from, it was in response to a post by Corpse on another thread.)
 

MedicalCorpse

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That post sure sounds bad to my ears. I can't believe one with such high moral standards such as you would laugh at it.

Sigh. To paraphrase the Professor in the Chronicles of Narnia, what *are* they teaching children nowadays in school? Logic...where's the instruction in logic?

Ethics is not the same thing as morals. I have very high ethical standards. When it comes to the question of *morals*, that's where religion rears its (often) ugly head. I must especially point out the puritannical, homophobic, missionary-position-only nature of both the UCMJ and a huge chunk of Bible thumping Christians.

I am not Christian. The "morals" you speak of are based on narrow-minded interpretations of a very BAD translation of a selected subset of screeds allegedly penned by authors who lived *before Rome fell*. If we based our medical treatment on books nearly two millennia old, we would probably get the same BAD results we have seen repeatedly when religious "morals" are intermixed with politics (cf. English Civil War, Spanish and German and English Inquistions, Thirty Years' War, Balkan Civil War, Iraq Civil War [ongoing], etc.).

I am Pagan. I abide by the Wiccan Rede: An None Be Harmed, Do As Thou Wilt. This means that the bizarre and uniquely American desire to legislate the bedroom behaviors of consenting adults seems, well, bizarre to me. When children in our cities and countryside are dying from malnutrition, I personally don't see the need to get all worked up about "Same Sex Marriage". Jeez, how "sanctified" is marriage nowadays with a 50% divorce rate, anyhoo?

There are many "moral" people who are unethical. There are some ethical people who would seem immoral in the eyes of religious zealots of whatever stripe (e.g., my wife drives a car and does not cover her hair in public. She and I often hold hands while walking in the mall with our three boys. This would seem severely immoral to some in certain parts of the world. I could be flogged for this "immorality", which has zero to do with ethics).

Can you imagine if it read "That would be cross burning, but it would be "cool" if you lived in Alabama." Doesn't sound so innocent anymore does it.
;)

Have you ever heard of a "Straw Man". You just gave a textbook example.

"Oh, yeah! Sure! Laugh at treating colds with narcotics! You probably would let a baby die from strep throat because you don't like to prescribe ANY meds!"

Logic. Logic. Logic.

Your cross burning scenario is a Federal Crime, as well as a State crime in any state of the union. It harms the psyches of its innocent victims; it violates the law; and it harms the Earth (fire hazard, smoke, etc.).

Same sex relations with appropriate precautions among consenting adults harm no one. They are only illegal under the (antiquated, puritannical, bizarre) UCMJ, which *also* sets down guidelines about how married heterosexual couples can do the wild thing. I assert that every single married military couple has violated the UCMJ behind closed doors. Does that make all of us "unethical"? Apples and oranges, sir, apples and oranges.

If we bottled and sold all the energy wasted in America fighting homosexuality (which has been part of the story of our species for all of recorded history, and probably long before), we could run all of our vehicles for a year. Better that we use the energy to hunt down, prosecute, convict, and incarcerate (or execute) child molesters like that guy on the news. THAT would be a fine outlet for religious, "moral" outrage, IMHO.

Next.

--
R
http://www.medicalcorpse.com
 

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MedicalCorpse,
While I don't agree with everything you say because I can't....I haven't done time as a military physician only a corpsman. I can say that it does my old bones good seeing someone else wondering where the logic went and giving a quick class in "Intro to Logic" of "PreLogic". :thumbup: Most times I think I'm sitting in a stream by a crop field with all the red herrings and strawmen that I see. :cool:
 

MedicalCorpse

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I can say that it does my old bones good seeing someone else wondering where the logic went and giving a quick class in "Intro to Logic" of "PreLogic". :thumbup: Most times I think I'm sitting in a stream by a crop field with all the red herrings and strawmen that I see. :cool:

Thanks,

--
Rob
...who highly recommends: Dies the Fire, By S.M. Stirling, for entertainment while sitting near your stream by a crop field
watching while GUNPOWDER doesn't work any more, and Wiccans are repopulating the Changed Earth:
http://www.amazon.com/Dies-Fire-Roc-Science-Fiction/dp/0451460413
 

The White Coat Investor

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, I personally don't see the need to get all worked up about "Same Sex Marriage".

Your cross burning scenario is a Federal Crime, as well as a State crime in any state of the union. It harms the psyches of its innocent victims; it violates the law; and it harms the Earth (fire hazard, smoke, etc.).

Same sex relations with appropriate precautions among consenting adults harm no one. --
R
http://www.medicalcorpse.com

Where'd the homosexual thing come from? I thought we were talking about Polygamy? Illegal in Utah and certainly frowned upon by the vast majority of Utah residents, I thought it was a pretty good comparison to another serious crime...that of cross burning.
 
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MedicalCorpse

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Where'd the homosexual thing come from? I thought we were talking about Polygamy? Illegal in Utah and certainly frowned upon by the vast majority of Utah residents, I thought it was a pretty good comparison to another serious crime...that of cross burning.

"What's all this I hear about Eagle Rights? Next thing you know pigeons will want rights, then there will be sparrow talks and crow uprisings! Oh. Equal Rights... Never Mind..."

--Rosanne Rosannadanna

--
R
P.S. FYI: Polygamy (up to four wives) is cool and "moral" for about a billion people who follow a certain religion. Not that there's anything wrong with that (Seinfeld)
 

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Yes it will. Just because the Army doesn't send you on a GMO tour after internship doesn't mean they won't after your residency. Many freshly trained Army docs are GMOs right now, especially FP, IM, and Peds.

That's what I used to think. But so far I haven't heard of a single one of the many army docs I know that finished residency recently getting sent out as GMO's. One did, but that was by choice (partially b/c she wants to moonlight a lot). Perhaps that army has gotten a bit smarter over the past couple years . . . or maybe most of their older residency trained docs quit, who knows.
 

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That's what I used to think. But so far I haven't heard of a single one of the many army docs I know that finished residency recently getting sent out as GMO's. One did, but that was by choice (partially b/c she wants to moonlight a lot). Perhaps that army has gotten a bit smarter over the past couple years . . . or maybe most of their older residency trained docs quit, who knows.

In talking with an Army Derm resident, there are a number of Dermatologists in the sandbox as GMOs and only one true Derm spot. And listening to Homunculus, it seems Army Peds is in a similar predicament.
 

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That's what I used to think. But so far I haven't heard of a single one of the many army docs I know that finished residency recently getting sent out as GMO's. One did, but that was by choice (partially b/c she wants to moonlight a lot). Perhaps that army has gotten a bit smarter over the past couple years . . . or maybe most of their older residency trained docs quit, who knows.


they aren't specifically called "GMO" spots like they are for the navy.. they dress them up and call them flight surgeon or brigade/battalion surgeon slots. basically when we get deployed as non-pediatricians it's a general medical slot. lately there has been a few peds docs get deployed as peds docs, but that is the exception by far. we staff the BAS and level II's out there, with the occasional CSH thrown in.

like i said-- we allow (and even encourage) this system to justify keeping our GME programs around. "we support the warfighting effort, give us some residents!!". has worked so far, but as the retention rates plummet, something is going to give.

--your friendly neighborhood battle pediatrics caveman
 

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Even if Army docs eventually play a general role outside of their residency-specialization, the time for that is most likely after completion of residency. In this case, you are safe from the extension of commitment. The GMO is actually an effective part of your payback. (intern + GMO + residency + payback from residency) > [residency + GMO + (payback from res - GMO)]
 

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Reason #643 . . .

Because it's not just the doctors who get screwed for doing their job . . .


http://www.msnbc.msn.com/id/15189555/


X-RMD Never thought I'd sympathize with a lawyer . . .



This is amazing.............NOT. TO think that someone who did their job in an excellent manner, to the best of their ability, and got screwed in the end by the military, is just business as usual. Clearly one can see this is not just a medicine issue. You bite the hand, and you;re out.

About the promotion issue, up until Nov of 03 I think, docs were using that loophole like a greased pig. That is now closed. If you do not get promoted, but you still owe time, you're there till you finish.

How can any military lover justify this????????????????? I'd love to hear it.
 

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34 reasons not to be a military physician (please feel free to reply to
my post to add more):

1-6. when you deploy for 6+ months (sometimes as long as a year in
afghanistan), you'll enjoy a daily schedule that will look something
like...
1) no sex
2) crappy food
3) no broadband internet
4) stay in a work environment 24/7
5) sleep in crappy rack (it doesn't deserve the term 'bed')/crap in port-o-pottys
6) repeat over and over, daily, for approximately 180+ days,
meanwhile, the rest of society is enjoying high def television, plumbing,
broadband internet, the freedom to go out and shop/dine/romantic
evenings/etc, raising a family



8. YOU LOSE BIG IF YOU TAKE AN HPSP SCHOLARSHIP: you're a sucker to
take the HPSP scholarship (small short term rewards via a little more
money during med school/residency, but ultra heavy payback). on the
front end, you can get paid a little more as a resident (say 30K more
each yr) and a little scholarship (100K tuition plus 50K of stipend
over 4 yrs).

So let's consider on the high end, as an orthopedic surgeon...
from tuition(100)/stipend (50)/residency(150), that's a total of
gaining roughly 300K

9. GOODBYE AUTONOMY: kiss your right to feeling privileged as a
physician good-bye. you will do what they tell you, go where they tell
you, no questions asked (you can ask all you want, but will fall on
deaf ears). you might get lucky and get to live in a nice area, but you
might also get to live in less cultural/popular areas like 29 Palms CA
(middle of desert, east of palm springs), Guam, Norfolk VA, Meridian
MS, Pascagoula MS, Ingleside TX, Camp Le Jeune NC, Guantanamo Cuba,
among others. Remember you're a doctor - why subjugate yourself to a
chain of command? - be all you can be - ie your own boss.



1-6.) For me 4 years of college has been like this, so no big deal..


8.) Yeah thats right, everyone who goes to med school gets to be an orthopedic surgeon. Majority of med students will end up in some facet of primary care...


9.) No different that the first 18 years on ones life..
 

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1-6.) For me 4 years of college has been like this, so no big deal..


8.) Yeah thats right, everyone who goes to med school gets to be an orthopedic surgeon. Majority of med students will end up in some facet of primary care...


9.) No different that the first 18 years on ones life..

I agree with many of your thoughts above. Yes, we all busted ass during med school and residency. The problem with Primary Care in the USAF is NOT that you will bust your ass even more than you did (for the past upteen years of your life). The major problem is that you and I were/are committed to excellence. That is how we got the grades we did. You and I are committed to people. That's why we volunteered as a Big Brother/Sister, why we chose medicine to begin with.

Well, as a physician in the USAF Primary care you will find that NONE OF THAT MATTERS!!!!!!!!!!!!!!!!! All that admin wants is for their "Metrics" to look good. They could care less if the clinic is manned at 10%. Thet could care less if the overworked 18 yo admin techs are shredding unfiled lab results. They could care less if you separate at your DOS. For any physician still holding on to the ideals of USAF Core Values, committed to excellent safe care for patients, committed to reasonable treatment of staff, committed to a professional environment; todays military medicine is simply UNACCEPTABLE.:mad:
 

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1-6.) For me 4 years of college has been like this, so no big deal..


8.) Yeah thats right, everyone who goes to med school gets to be an orthopedic surgeon. Majority of med students will end up in some facet of primary care...


9.) No different that the first 18 years on ones life..


1-6) Yes...... say that after you've been in it for awhile

8) I'm a internist, it's a pay cut..

9) very VERY different than the first 18 years of life. If you got arrested for smoking pot it would not end your career, and get you a discharge that would make it impossible for you to work in government service ever again. Which is important for Doctors, VA hospitals are a source of potential employment. Hell most of the docs at the VA ARE pot smoking folks!!! This is a bit of a tongue in cheek example but you are sacrificing your freedom and your decision making ability as a physician completely
 

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i updated to reflect 36 reasons (too bad i can't change the title - heh). ty galo for providing reason #35 - lol. ty usafdoc for reminding me of reason #36. ty to previous poster who provided below msn link.

for now, i'll keep details of my own professional life a secret. would be inconvenient to end up like the military lawyer who didn't make O-5 since he beat the Bush administration in his representation of the Gitmo prisoner (how messed up is that? he's asked to take on that job...but someone from higher in his chain of command forgot to tell him to do a crappy job?). i'm sorry but making O-5 is not a big deal for professionals (MD/DO, JD, etc) - so he got personally screwed. what a way for the current leadership to illustrate "honor, courage, commitment".

http://www.msnbc.msn.com/id/15189555/
 

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i further refined reason #38.

But as an aside...will Navy Medicine (and military medicine in general) make a comeback, now that the Dems have won back Congress?
 

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My wife and I ran the numbers both for the HSPS before medical school and for the FAP before residency. Either way, the numbers just don't make sense. Even for the low-paying specialties, I doubt you would even break even considering that most federal student loans can be consolidated at a ridiculously low rate which for us amounts to about $500 bucks a month until I die (and at 43 I might be dead before I finish paying it back).

I'm perpetually surprised at how scared people are of debt. Granted, a 50,000dollar credit card balance for personal watercraft and hooker sandwiches is probably a bad idea but the couple hundered thousand investment in human capitol represented by medical school loans pays big dividends and is just the cost of doing business.

So we are in the midst of running the numbers as well. And while everyone says "the numbers don't work", I really have a hard time believing that. I've run dozens of net-present-value (NPV) scenarios - with in-state tuition, a cheap cost of living at the civilian schools I'm looking at, and the GI Bill to supplement our income for the first couple of years vs. the higher cost of living in DC for different specialties. The difference is small provided I get out when my commitment is first complete.

A NPV discount rate of 6% (current Stafford loan repayment rate) gives choosing USUHS a higher NPV at 15 yrs by about 7% than instate for family practice - and I don't take into account civilian malpractice insurance because I just can't find any numbers to use.

A larger difference occurs with surgical subspecialties (civilian NPV is 30% larger at end of commitment estimated as 17 yrs). But again, I'm not counting malpractice insurance and that is with an incredibly cheap tuition and two yrs of stipend - not the norm. So what I'm saying is that my conservative estimate that should have pushed USUHS way back in the financial area didn't pan out. Any thoughts? What am I missing here?
 

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Your calculations may be accurate, but the central point you are missing is that money is the absolute wrong reason to join the military. Also consider the fact that you will have no control over your life during your hitch.
 

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So we are in the midst of running the numbers as well. And while everyone says "the numbers don't work", I really have a hard time believing that. I've run dozens of net-present-value (NPV) scenarios - with in-state tuition, a cheap cost of living at the civilian schools I'm looking at, and the GI Bill to supplement our income for the first couple of years vs. the higher cost of living in DC for different specialties. The difference is small provided I get out when my commitment is first complete.

A NPV discount rate of 6% (current Stafford loan repayment rate) gives choosing USUHS a higher NPV at 15 yrs by about 7% than instate for family practice - and I don't take into account civilian malpractice insurance because I just can't find any numbers to use.

A larger difference occurs with surgical subspecialties (civilian NPV is 30% larger at end of commitment estimated as 17 yrs). But again, I'm not counting malpractice insurance and that is with an incredibly cheap tuition and two yrs of stipend - not the norm. So what I'm saying is that my conservative estimate that should have pushed USUHS way back in the financial area didn't pan out. Any thoughts? What am I missing here?

NPV may be the simplest model, but it is defective in several ways that rule for and against USUHS. Stafford loan rate is not the only rate applicable, and there are indeterminate rates--probably negative--that should be considered in a NPV for practice income dependent on Medicare reimbursements which have been cut due to the "sustainable growth rate" limitations in Medicare law that amounts to "we're not going to pay you more even if you do more work".

Malpractice insurance should be seen as a practice expense and not as an element of personal income. Net physican income should not include the value of malpractice premiums. While it is true that military physicians don't have this expense, they also don't have rent, staff salaries, business taxes and fees, equipment leases and professional membership fees to pay either. Malpractice premiums are just another operating expense to pay from gross collections.
 

runningmom

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Your calculations may be accurate, but the central point you are missing is that money is the absolute wrong reason to join the military. Also consider the fact that you will have no control over your life during your hitch.

:) I have three children, I haven't had control over my life in a long long time.

Your point is well taken, but that isn't the reason for my (re)joining. I just wanted to put it out there that running the numbers to show that the military route isn't a financial benefit is just a myth. And yes, I'm ducking for cover now in prep for the coming flames.
 
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