40 (and counting) Reasons Not To Join

[BomberDoc]

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Your point is well taken, but that isn't the reason for my (re)joining.

No flames from me. The fact that you are prior service speaks volumes. You've been there, done that and have a good idea of the baseline military BS. Military medicine, however, comes with its own huge pile of additional BS. Making an informed decision is the smartest thing you can do. I wish I had this forum several years ago when I thought I was making a good decision that focused too much on money and debt aversion. Best of luck.

 

[Spaceman Spiff]

Many of your 34 reasons are valid, but I think overall you and others complain too much. 🙄 Maybe it's therapeutic to vent. I would say that 1) you don't join the military to make money, you do it to serve; 2) you don't join, expecting not to be deployed, because you will be; 3) you don't join so you can drive drunk and pick-up hookers; I think the UCMJ is a great thing for the most part, it holds people to a higher standard of behavior, and in my experience, it's usually only applied to the most grevious of transgressors. Anyhow, I think you and others make some great points about the current state of military medicine, I would like to suggest that maybe all you complainers get together and do something constructive, like writing a position statement you could give to whatever persons or organizations might do the most good in effecting a change. Just a thought, I'm sure there are many other possibilities.

 

[orbitsurgMD]

Many of your 34 reasons are valid, but I think overall you and others complain too much. 🙄 Maybe it's therapeutic to vent. I would say that 1) you don't join the military to make money, you do it to serve; 2) you don't join, expecting not to be deployed, because you will be; 3) you don't join so you can drive drunk and pick-up hookers; I think the UCMJ is a great thing for the most part, it holds people to a higher standard of behavior, and in my experience, it's usually only applied to the most grevious of transgressors. Anyhow, I think you and others make some great points about the current state of military medicine, I would like to suggest that maybe all you complainers get together and do something constructive, like writing a position statement you could give to whatever persons or organizations might do the most good in effecting a change. Just a thought, I'm sure there are many other possibilities.

Hey Spiff, you're a med student. What would you know about military medical practice? Why should anyone care what you think? And just exactly what is "your experience" anyway?

Here's an idea. Let's have an open forum where those who have experience from having actually practiced as physicians in the military give their impressions of what is right and not right about the system. Let anyone who wants to read and think and decide for themselves whether the military is right for them. If the military finds itself unable to attract prospective doctors when its activities are revealed in the light of day, then so be it. If the reverse is true, then likewise.

Sorry, but speaking for myself only, the military wasn't much interested in hearing what I thought when I was on active duty, and I wrote more than one "white paper". Why should I think they want to hear from me now? Drafting a position paper as a civilian is a waste of my time. I would rather tell the things I know to be true. Let those who want to hear listen.

 

[dpill]

Here's an idea. Let's have an open forum where those

... who want to voice their opinion can without being flamed.

 

[island doc]

Military medicine needs to be exposed to public scrutiny, or the "light of day" as said here. Could it withstand? Civilian oversight of the military, though constitutionally mandated, is not embraced enthusiastically.

There was an effort along this line with the DoD HQIRP (Dept. of Defense Healthcare Quality Initiative Review Panel) a decade ago, but I don't think many of the panel's recommendations were implemented. I know for a fact that the panel's recommendation to eliminate the utilization of GMO's and other "one-year-wonders" was not, because here it is ten years later and GMO's and one-year flight surgeons are still casting their ominous shadow over military medicine.

By the way, the DoD HQIRP came about as the result of the Pulitzer Prize winning articles by the Dayton Daily News, "Dangerous Medicine", about military medicine.

 

[navdoc47]

christmas bump...

 

[navdoc47]

i just updated to increase the number to 41. i still haven't figured out how to change the title to reflect the appropriate number.

anyone know why there's only 2 pages showing for the forum in general?

 

[tkim]

i just updated to increase the number to 41. i still haven't figured out how to change the title to reflect the appropriate number.

anyone know why there's only 2 pages showing for the forum in general?

I changed your title, but you need a mod to edit titles.

 

[navdoc47]

thanks for updating the title 😀

 

[navdoc47]

updated 🙂

 

[West Side]

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?

As noted, you shouldn't include malpractice, as that's taken out before a doctor's net income is reported. It's the equivalent of a business reporting sales as earnings: think of malpractice as your personal SG&A.

I think if there's anything that's not making the numbers work, it's possible that you've grossly underestimated the spread between military medicine pay and civilian pay, and the growth rates thereon. Further, you probably haven't run any scenarios including some of the debt repayment programs private hospitals are offering (I assume for specialties). Finally, I would bet for FP that the spread isn't as dramatically large, leaving your NPV probably pretty close. At that point, it's a crapshoot, and you're left to the vagaries of your growth assumptions on the private side, which are a finger in the wind. most importantly for this analysis, if the NPV's are almost the same, why not have the option of autonomy? Shouldn't they be paying you SIGNIFICANTLY more for giving up your flexibility?

But good on you for running these sensitivities before going in.

 

[orbitsurgMD]

As noted, you shouldn't include malpractice, as that's taken out before a doctor's net income is reported. It's the equivalent of a business reporting sales as earnings: think of malpractice as your personal SG&A.

I think if there's anything that's not making the numbers work, it's possible that you've grossly underestimated the spread between military medicine pay and civilian pay, and the growth rates thereon. Further, you probably haven't run any scenarios including some of the debt repayment programs private hospitals are offering (I assume for specialties). Finally, I would bet for FP that the spread isn't as dramatically large, leaving your NPV probably pretty close. At that point, it's a crapshoot, and you're left to the vagaries of your growth assumptions on the private side, which are a finger in the wind. most importantly for this analysis, if the NPV's are almost the same, why not have the option of autonomy? Shouldn't they be paying you SIGNIFICANTLY more for giving up your flexibility?

But good on you for running these sensitivities before going in.

You should apply a risk premium (discount) to your calculation on the military side. If you don't do that, you value freedom of choice for residency ranking and decision to apply to fellowships at zero. It is worth more.

 

[West Side]

You should apply a risk premium (discount) to your calculation on the military side. If you don't do that, you value freedom of choice for residency ranking and decision to apply to fellowships at zero. It is worth more.

Risk premium is probably a misnomer (job security vs. getting sent to the Green Zone...is the military riskier or less risky?), but we're arguing semantics.

Suffice to say, that the calculation is even close for the lowest paying of residency directions (while including all of the possible military's financial benefits while ignoring most of the civilian financial benefits) underscores that she's not capitalizing all of the lifestyle upside of civilian life.

 

[navdoc47]

bump - hate to think that this info isn't widely available without a bump 😎

 

[navdoc47]

updated.

 

[Founder]

All this sounds so depressing... hopefully something will be fixed in 4 years...?

 

[Tiger26]

not fixed yet, I'm sitting at obc right now (reserve=2 week obc🙂) and while it's the easiest army course i've ever done, it still amazes me how stupid the army management style is--just a real waste of time

 

[dentalOH]

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

43. I almost forgot to mention. When you deploy, you don't get weekends off. So imagine you were deployed to Afghanistan for 18 months...that's a lot of weekends to miss out on. The only time you would get off, in that situation, is leave time of 30 days per year (and yes, weekends do count during leave !!!). Oh, and your travel time out and back into Afghanistan would deduct leave if you were to visit your folks in the US or wherever.

Does the Navy really charge you for travel time while on R&R? If so, that's crazy.

In the Army, your chargeable leave doesn't start until the day after you land in the states and ends the day before you are to fly back. Also, if your military flights are delayed, it isn't charged to your leave. I was delayed leaving Kuwait and leaving Dallas to go back to Kuwait. I spent a total of 21 days out of theater and was only charged 15 days.

 

[navdoc47]

I had heard that transit time was charged for leave. But perhaps it is not given what you mentioned. So I updated and deleted the line regarding transit time being charged for leave.

To all the HPSP folks about to enjoy increases in their stipend and bonus (i wish we had that): I look forward to the day when the difference between HPSP and USUHS pay is nil, except for the 4 vs 7 yr commitment 🙂

"Chug, Chug, Chug, Chug !!!!"

*party on*

 

[navdoc47]

updated.

what info can i place to make this thread controversial?
(i'm jealous of USAFDoc's much more popular thread)

I'm the only one keeping it within the first 2 pages of threads...I hope it's educational.

Any folks lately consider a scholarship but decided for/against after reading my thread?

 

[elderjack21]

From what I have gleaned from shadowing military docs both in garrison and in combat, most of the posts are true. (could argue about the education for children, but hey, not a bad list overall)

The bottom line is this. Perhaps you didn't research out your decision to join the military enough before you signed up?

Sometimes I want to ram my head into a wall, numerous times for signing that initial ROTC contract. But, in the end, when I visit family, friends, and the like..are in awe of my service and the things that I have to go through being a member of the armed forces, it makes me extremely proud of the time I have put in.

Ironically, I think that it has really been a huge boost to my medical school application as well. I have average stats, but am doing fairly well in getting interview invites (understanding that interview does not always equal accept...but it is in the right direction_

I guess the sad ending to that is when I look at the costs of school and supporting a family throughout it, using the military to pay for it all seems to be the least stressful way of doing it. Especially since I don't see myself going into any high paying speciality.

I would be interested to know what former military doctors are really making on the outside.

 

[USAFdoc]

From what I have gleaned from shadowing military docs both in garrison and in combat, most of the posts are true. (could argue about the education for children, but hey, not a bad list overall)

The bottom line is this. Perhaps you didn't research out your decision to join the military enough before you signed up?

Sometimes I want to ram my head into a wall, numerous times for signing that initial ROTC contract. But, in the end, when I visit family, friends, and the like..are in awe of my service and the things that I have to go through being a member of the armed forces, it makes me extremely proud of the time I have put in.

Ironically, I think that it has really been a huge boost to my medical school application as well. I have average stats, but am doing fairly well in getting interview invites (understanding that interview does not always equal accept...but it is in the right direction_

I guess the sad ending to that is when I look at the costs of school and supporting a family throughout it, using the military to pay for it all seems to be the least stressful way of doing it. Especially since I don't see myself going into any high paying speciality.

I would be interested to know what former military doctors are really making on the outside.

156K with bonus for productivity (made 15 K bonus this year) and some times moonlight urgent care at 70$/hr

this is all outpt work (no hospital) 4 1/2 days a week family medicine/midwest

 

[elderjack21]

156K with bonus for productivity (made 15 K bonus this year) and some times moonlight urgent care at 70$/hr

this is all outpt work (no hospital) 4 1/2 days a week family medicine/midwest

That sound perfect. I am no gunner and would enjoy a decent schedule to allow time to play with the family.

 

[The White Coat Investor]

That sound perfect. I am no gunner and would enjoy a decent schedule to allow time to play with the family.

I am looking at a moonlighting gig paying $150-175/hour. I figure I make ~60/hour with the military, ~50/hour my last year (unless I sign on for more time via the ISP stunt they pulled over on us.)

 

[biggejac]

I'm a med student considering the AF and Army, and have read through many of the threads on the site (I feel like I've really come to know a lot of you!).
First of all, Thanks!
It's crazy because what I read here is so at odds with everything that the Army and AF recruiters say. I even ask my recruiters pointed questions about the deterioration of military medicine... financial and personnel-wise... and all I get is blanket praise of the military. I've come to realize they don't even really know... it's not like they visit the hospitals, and even if they did they wouldn't really be able to tell the quality.
One thing that they are up-front about is the fact that I *could* end up anywhere, for residency as well as active duty placement, and considering where some of the bases are located, that scares the living hell out of me! Not only because I love civilization (in Boston now), but because I worry my training may suffer.
I've had a hard time getting a straight answer from anyone as to how often people get screwed over. Say if I wanted a surgery or EM residency at Lackland (which I hear is the biggest for the AF and in a decent area), what are the chances I might end up in the middle of nowhere.
A related concern is this whole GMO business. It's why I'm not considering the Navy, but I gather from some post's that it happens throughout the military. Again, anyone have any clue as to the *chances*.
I realize these are extremely subjective questions, but I think some of you are in a position to judge a lot better than me or anyone I've talked to.

Thanks in advance,
wide-eyed first year (1st anatomy lab tomorrow!)

 

[The White Coat Investor]

I'm a med student considering the AF and Army, and have read through many of the threads on the site (I feel like I've really come to know a lot of you!).
First of all, Thanks!
It's crazy because what I read here is so at odds with everything that the Army and AF recruiters say. I even ask my recruiters pointed questions about the deterioration of military medicine... financial and personnel-wise... and all I get is blanket praise of the military. I've come to realize they don't even really know... it's not like they visit the hospitals, and even if they did they wouldn't really be able to tell the quality.
One thing that they are up-front about is the fact that I *could* end up anywhere, for residency as well as active duty placement, and considering where some of the bases are located, that scares the living hell out of me! Not only because I love civilization (in Boston now), but because I worry my training may suffer.
I've had a hard time getting a straight answer from anyone as to how often people get screwed over. Say if I wanted a surgery or EM residency at Lackland (which I hear is the biggest for the AF and in a decent area), what are the chances I might end up in the middle of nowhere.
A related concern is this whole GMO business. It's why I'm not considering the Navy, but I gather from some post's that it happens throughout the military. Again, anyone have any clue as to the *chances*.
I realize these are extremely subjective questions, but I think some of you are in a position to judge a lot better than me or anyone I've talked to.

Thanks in advance,
wide-eyed first year (1st anatomy lab tomorrow!)

The chances are specialty, service, and year specific. The year I applied in AF EM, there were 8-10 people taken at Lackland, another 4 at Wright-Patterson and around 12 deferrals. There were 50 people who wanted to do EM that year. So the odds to successfully match were ~50%, to match at lackland, ~18%. Not very good. But like I said, it is different every year.

You're lucky to realize your recruiter knows nothing. Not all of us did in time.

 

[Galo]

I'm a med student considering the AF and Army, and have read through many of the threads on the site (I feel like I've really come to know a lot of you!).
First of all, Thanks!
It's crazy because what I read here is so at odds with everything that the Army and AF recruiters say. I even ask my recruiters pointed questions about the deterioration of military medicine... financial and personnel-wise... and all I get is blanket praise of the military. I've come to realize they don't even really know... it's not like they visit the hospitals, and even if they did they wouldn't really be able to tell the quality.
One thing that they are up-front about is the fact that I *could* end up anywhere, for residency as well as active duty placement, and considering where some of the bases are located, that scares the living hell out of me! Not only because I love civilization (in Boston now), but because I worry my training may suffer.
I've had a hard time getting a straight answer from anyone as to how often people get screwed over. Say if I wanted a surgery or EM residency at Lackland (which I hear is the biggest for the AF and in a decent area), what are the chances I might end up in the middle of nowhere.
A related concern is this whole GMO business. It's why I'm not considering the Navy, but I gather from some post's that it happens throughout the military. Again, anyone have any clue as to the *chances*.
I realize these are extremely subjective questions, but I think some of you are in a position to judge a lot better than me or anyone I've talked to.

Thanks in advance,
wide-eyed first year (1st anatomy lab tomorrow!)

If you're concerned about what training you go into, and the quality of that training, you should really reconsider. Did you read the AFGME post in the stickies?
http://forums.studentdoctor.net/showthread.php?t=298854

It has real data and info about what can happen if you do not match.

The reality is once you sign, you are a body to be placed where the military needs you, and you have no choice.

I recommend you keep reading, stay away, get educated well, in the field of your choice, and then see what the climate is in the military.

 

[navdoc47]

I posted a similar post on the Military Dentistry forums, with appropriate adjustments 🙂

 

[bricktamland]

In the military, incompetent leaders aren't fired, they just get reassigned, and then wreak havoc and spread misery elsewhere:

I'd like to share with you a little anecdote. When I was deployed as a Battalion Surgeon with a Marine infantry unit to Iraq, we had this complete psycho of a Regiment Surgeon overseeing us. I've never met anybody like him before. This guy was the most ego-maniacal, power hungry freak of nature I've ever encountered.

We're in the middle of a war zone, and all this guy cares about is bolstering his numbers so he can advance his career. He makes up some arbitrary rule about HIV readiness, making our entire battalion's HIV status out-of-date. Somehow, he convices the Regimental CO that Marines will be dying left and right if we don't get their HIV status current. So my CO gets super pissed, chews me out with all sorts of F-bombs, and orders us to get blood draws on the entire battalion. Remember, we're in the middle of a war zone, with Marines spread out all over the AO. Obviously, the military medical system in Iraq wasn't designed with the intention of doing HIV draws.

The whole thing was a tremendous fiasco. First off, we had to beg for extra medical supplies from other units, pissing them off in the process. Next, we risked many peoples lives--mainly the Corpsmen--sending them over IED-laden roads to remote outposts just so they could draw an HIV sample. Eventually, through unbelievable efforts, we collected the HIV for every single person in the whole battalion. We sent the samples off to the lab. Guess what happened? The transit time from the middle of Iraq all the way to a lab in the US was way too long, and over 90% of the samples had to be destroyed. Lives risked, time wasted, money wasted. All for one person's selfish gain.

Higher ups in the medical system heard about this and got pissed. There was an investigation. But guess what the fallout was? Nothing. This Regimental Surgeon, who actually has a real medical degree (believe it or not), suffered no repercussions. He was merely transferred to another billet.

What pisses me off the most, is that he put people's lives at risk for his own selfish gain. Clearly, he wanted to put on his Fit Rep that all the BAS's under his supervision went from 0-100% medical readiness due to his superior leadership. We were in a combat zone!!! He could have done something useful, like taught airway managment to the Corpsmen. But instead, we spent the entire 7-month deployment dealing with that crap.

Sadly, people like him are all too prevelent in the military. Often, they are the career military folks whose only concern is picking up rank. They could care less who they have to stab in the back to get there, and seem to take a perverse pleasure in wasting resources.

That being said, I have met plenty of kind, selfless career military doctors who are genuine heros. They are truly inspirational. But unfortunately, they seem to be in the minority.

For anybody reading this and considering a career as a military doctor, please realize you will have plenty of colleagues like this guy. And no matter how ruthless and incompetent they are, they just seem to continue climbing the ladder.

 

[navdoc47]

thanks for the insight, bricktamland.

In case anyone is wondering what sort of tasty meals you can enjoy while on deployment, below is a photo of a trayrat.



bon appetit !

 

[NavyFP]

thanks for the insight, bricktamland.

In case anyone is wondering what sort of tasty meals you can enjoy while on deployment, below is a photo of a trayrat.



bon appetit !

Looks better than the tray rats I ate for 6 straight weeks a decade ago.

 

[Homunculus]

thanks for the insight, bricktamland.

In case anyone is wondering what sort of tasty meals you can enjoy while on deployment, below is a photo of a trayrat.



bon appetit !

i especially like how the mixed fruit juice is running into the chili-mac. was that from the care they take in dishing it out or do you like your chili-mac a little grape-ey and pineapple-ey?

--your friendly neighborhood food network watching caveman

 

[pgg]

In case anyone is wondering what sort of tasty meals you can enjoy while on deployment, below is a photo of a trayrat.

Oh man, there's plenty of deployment-related stuff to complain about, but the food sure as hell isn't one of them. Most places in Iraq and Afghanistan have mess halls run by KBR. I'm sure they're charging the US Government $40/plate or something even more obscene, but they deliver.

I had daily fresh pineapple, mangos, avocados, not-great but still pretty-good steaks at least once/week, salad bars, etc ... all at relatively small compounds with either a dirt runway (or no runway) a few miles from the Pakistani (or Syrian) border. I can only imagine what kind of meals get served at larger bases where they have volleyball courts, swimming pools, massage parlors where you can chill out after your Pizza Hut meal, rec centers with rows of bigscreen TVs and videogame consoles, DJs for "Salsa Night" dancing ...

No, it wasn't a restaurant with a snooty waiter in a tuxedo and $60 entrees ... but it was still pretty good. 🙂

The USMC served me far worse in the US. The slop they produced at 29 Palms out in that half-buried beer can structure they called a mess hall ... I think that was 2 parts Vietnam-era leftovers and 1 part mud spooned from the puddle downhill from the handwashing stations.

 

[a1qwerty55]

Yes, the food is soo bad that our number one heathcare issue in redeploying soldiers is...... Obesity. Yes it is true, 20-30 weight gains aren't at all unusual.

 

[NavyFP]

Yes, the food is soo bad that our number one heathcare issue in redeploying soldiers is...... Obesity. Yes it is true, 20-30 weight gains aren't at all unusual.

That's weird. I always lose weight on deployments.

 

[West Side]

i especially like how the mixed fruit juice is running into the chili-mac. was that from the care they take in dishing it out or do you like your chili-mac a little grape-ey and pineapple-ey?

--your friendly neighborhood food network watching caveman

Are those pineapples or potatoes?

The fun part: the person eating it probably doesn't know! Whee!!

 

[alpha62]

I think a soldier burns more calories kicking in doors on dismount duty than your average Fobbit.

Maybe more time torching the ville and less time at Pizza hut in the FOB might do the trick, but then we'd have higher body count and that's not acceptable. As long as we can say we've got 170,000 in country, that's what counts.

Also, they've managed to deploy just about every menopausate and Syndrome X old fart in the inventory and that shifts the numbers..

 

[FlameBoy]

From Navdoc47:
(47. 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.

But of course, the best reasons to work in the military are that you're not self-serving, you don't mind working a lot more (lose countless weekends during deployments) for less pay, you don't mind risking your life or limb, and you love the idea of working in the military. Most people are great to work with, and that's the best quality i can think of (but people are great to work with in civilian world too).

CONCLUSION: suck it up and borrow the money (you'll have much more "sucking it up" down the road if you take an HPSP scholarship). 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. Plus, you can take a job at a military hospital and smile at your military colleagues who will worry about having to deploy, where they will live next, all the while you're making more than them )

Sniveling from a misguided squid, likely no one told him he would be serving Marines.
Bottom line - serving is just that, serving the med and women that risk getting killed or maimed in service to their country. If you don't feel the calling to take care of them look elsewhere.
- De oppresso libere.

 

[navdoc47]

a few minor updates. also a bump would probably do good for the new crop of HPSP takers...

 

[navdoc47]

Reason #48 added.

 

[MaximusD]

Reason #48 added.

A bleak picture indeed, but I think I'll be able to live it for three years even with all the negatives you listed.

Thank you very much for taking the time to bring these issues to light. At least now I know what I'm facing up-front.

 

[navdoc47]

added the final paragraph concerning IAs (individual augments). a wonderful opportunity for personal enrichment...ROFL.

 

[SF49ers Fan]

Reason #48 added.

Reason #49:
You have to spend years of your life serving and protecting the good citizens of Berkeley, CA. Even though you are risking life and limb for them, you will be unappreciated. 😡

http://www.cnn.com/2008/US/02/07/berkeley.protests/index.html

Gotta love hippies


(BTW this is a sarcastic post)

 

[Galo]

Reason #49:
You have to spend years of your life serving and protecting the good citizens of Berkeley, CA. Even though you are risking life and limb for them, you will be unappreciated. 😡

http://www.cnn.com/2008/US/02/07/berkeley.protests/index.html

Gotta love hippies


(BTW this is a sarcastic post)

Quite true. However, you may find yourself having lost life or limb to then be underappreciated, undertreated and left aside by your own goverment. It's a sad irony.

 

[grotto]

I have been an active duty line officer for 4 years, so reading this is both informative and funny. I am an academy guy, so from day one I was taught just to suck things up and wait for tomorrow. This discussion makes me wonder exactly how different things are in the rear ("the rear" being analogous with "support" and not a diss) from the line. That being said, in my career I have found that the military (in my case the Navy) usually does a pretty good job of selecting high ranking officers. Yes, there are some outliers and woe by the guy who gets stuck with one of those, but I have been pretty happy overall with leadership - though I have not always been happy about their decisions. The great leaders talk to their officers and use the feedback loop to make better decisions the next time, in fact the best officers I have ever seen are also the most humble men and women I have ever met. They admit their mistakes and look to be team builders instead of show and go individuals. The bad ones disappear, the good ones you hope to see again.

Having been in charge of people and things all of my adult life, I wonder if a lot of people here are discounting the fact that if you are not a leader you will not succeed in the military - doctor, pilot, shipdriver, whatever. Being a leader means that you make decisions in the order of (forgive my Navy slant) : ship, shipmate, and self. That meaning that the welfare of the organization and the mission always comes before individuals. This concept seems diametrically opposed to the mission of an individual doctor (shipmate-patient, self training and expertise, then organization and mission) and causes a great deal of conflict within military health organizations.

Frankly, outside of sickcall and health inspections, the line has no idea what the medical side of the business is even doing. In four years at sea I never saw a doctor for treatment, and if I wasn't feeling well I would just go down to my IDC and get some motrin. When I was at the academy I had two ankle surgeries by navy physicians, and they were simply the best doctors I have ever dealt with. I have sent many a sailor to the doctor though, and I have been in charge of getting ready for many a health inspection. They are just a great asset when your hurting or a pain in the *** when you are trying to do a mission and you need an inspection to get going. From my (very limited so far) experience with military medicine, I have noticed that the leadership training is limited, and that those in the management side, Med corps, nurse corps, etc are the ones making the call - a point of contention for physicians. Physicians are somewhat like pilots in my view - highly trained at individual, very difficult tasks but not asked to be leaders from day one.

As I hope to be a physician, and will probably be a military physician - I wonder if my impressions are accurate or if I am mistaken by the little I have seen. Frankly, sometimes I wonder if it is a good idea to take fresh college kids right out of med school and strap LT bars on them. I know it is neccessary for numbers, but it seems like a lot of these problems people have would be addressed by a little more experience with the operational military before signing that HPSP or USUHS contract.

 

[Mirror Form]

I have been an active duty line officer for 4 years, so reading this is both informative and funny. I am an academy guy, so from day one I was taught just to suck things up and wait for tomorrow.

That's what I was taught in ROTC, and it definitely made sense when I was out on field exercises or getting chewed out. But in medicine things are completley different. We're taught from day one that patient care trumps everything else.

The biggest folly I see on these boards is pre-meds that want to do HPSP soley for finacial reasons. However, a close second would have to be the line officers that think they have a good idea about what military medicine is like based on their prior service. Sorry, but doctors aren't just all complaining b/c they're pampered whiners who got a bad assignment.

That being said, in my career I have found that the military (in my case the Navy) usually does a pretty good job of selecting high ranking officers.

On the line that may be the case. But in the medical world I'd have to disagree with you. In medicine, you occasionally get stuck with leaders from MSC which are a nightmare. They don't have a single clue about what patient care entails. All they do is get obsessed with beefing up some random "metric" that will make their resume look good. Nevermind that doing so doesn't do anything positive for patient care (and more often than not can hamper it). Your next option is dealing with nurse leaders, who are sometimes just as bad as MSC. If you're at a large medical center then you'll be lucky enough to have an actual physician in charge of you, which is much better. However, the best physicians do not go into admin because that requires them to stop treating patients. So you're still not dealing with great leaders by any means. Lets not forget about General Kylie who slashed 14 million dollars of much needed money from Walter Reed's budget so that he could get another star pinned on.

 

[SF49ers Fan]

As I hope to be a physician, and will probably be a military physician - I wonder if my impressions are accurate or if I am mistaken by the little I have seen. Frankly, sometimes I wonder if it is a good idea to take fresh college kids right out of med school and strap LT bars on them. I know it is neccessary for numbers, but it seems like a lot of these problems people have would be addressed by a little more experience with the operational military before signing that HPSP or USUHS contract.

Good post. I have been wondering this as well. Maybe some of the guys who have done GMO tours can answer these questions for me.

1. Do you think that you had a tight leash with your responsibilities because they didn't trust your leadership skills?
2. Were you given many opportunities to lead?
3. Do you think that you were prepared properly for this?
4. How fast was your learning curve?
5. Do you think having the opportunities you had on your GMO tour made you a better leader?

 

[Mirror Form]

Good post. I have been wondering this as well. Maybe some of the guys who have done GMO tours can answer these questions for me.

1. Do you think that you had a tight leash with your responsibilities because they didn't trust your leadership skills?
2. Were you given many opportunities to lead?

It's not often that you hear someone asking about opportunities to lead in medicine. What kind of leadership opportunities are you looking for as a GMO? Are you hoping to be in charge of a hospital someday? Regardless, after you finish residency training, it's unlikely that any previous things you did as a GMO will be considered very important to the medical community (unless it was scientific research).

 

[Galo]

That's what I was taught in ROTC, and it definitely made sense when I was out on field exercises or getting chewed out. But in medicine things are completley different. We're taught from day one that patient care trumps everything else.

The biggest folly I see on these boards is pre-meds that want to do HPSP soley for finacial reasons. However, a close second would have to be the line officers that think they have a good idea about what military medicine is like based on their prior service. Sorry, but doctors aren't just all complaining b/c they're pampered whiners who got a bad assignment.



On the line that may be the case. But in the medical world I'd have to disagree with you. In medicine, you occasionally get stuck with leaders from MSC which are a nightmare. They don't have a single clue about what patient care entails. All they do is get obsessed with beefing up some random "metric" that will make their resume look good. Nevermind that doing so doesn't do anything positive for patient care (and more often than not can hamper it). Your next option is dealing with nurse leaders, who are sometimes just as bad as MSC. If you're at a large medical center then you'll be lucky enough to have an actual physician in charge of you, which is much better. However, the best physicians do not go into admin because that requires them to stop treating patients. So you're still not dealing with great leaders by any means. Lets not forget about General Kylie who slashed 14 million dollars of much needed money from Walter Reed's budget so that he could get another star pinned on.

Excellent points!!!!!!!!!!!!!!!!!!

This is something that cannot be emphasized enough.

 

[orbitsurgMD]

Good post. I have been wondering this as well. Maybe some of the guys who have done GMO tours can answer these questions for me.

[Bolds mine]

1. Do you think that you had a tight leash with your responsibilities because they didn't trust your leadership skills?

There is a tremendous mismatch between responsibilities and training to meet those responsibilities. Most GMOs start work as doctors with a single year of hospital-based training. In the real world--outside that world created by the military services and their fantasies of bygone days--that training makes you qualified for your next year of supervised training, and nothing else. Civilian hospitals would not allow you to practice independently with so little training, they have gone well beyond the 1930s model the services so irrationally refuse to give up.

What the military needs is to keep a tighter leash on your responsibilities, one that keeps you in a setting where senior residents and attending faculty are watching what you are doing.

2. Were you given many opportunities to lead?

Yes. My department in squadron. I was a department head.

3. Do you think that you were prepared properly for this?

I had as much training as the doctor I replaced and the one who replaced me. Which is to say, not enough.

4. How fast was your learning curve?

I deployed immediately on reporting. Fast. Steep.

5. Do you think having the opportunities you had on your GMO tour made you a better leader?

Difficult question to answer. Probably yes, but not by the usual standards of the medical profession. In medicine, leadership presupposes a developed knowledge base, completed training and the ability to demonstrate and convey that knowledge to your colleagues and juniors. The military does not really give you the opportunity for that when it cuts you out of the training pipeline.

I don't recommend this as a good way to prepare medical leaders; the GMO concept is really very outdated and inappropriate for modern medical practice in or out of the military. It is morally and professionally bad for the doctors and it does no good for patients either. The fact that it exists at all is indefensible. Arguments about preserving it as a "peculiar" need of the military only begs comparison to other odious and "peculiar" practices thankfully long gone from our nation.