A few tired questions that won't go to sleep.

[Chemguync]

Hello all. I've got a few questions about military (specifically Army) medicine that weren't really answered at all by the recruiter I spoke with. I'm sure these've been asked a dozen times over, but I'll give 'em a shot anyway..

I just got accepted to UNC for the '08 class, and am seriously considering going the Army route. My concerns are thus: When do I start accruing time toward retirement? I'm not talking promotion and pay raises, but when do I start working toward that 20 year mark? I've heard it's as soon as I'm commisioned, I've heard it's after med school, and I've heard it's after residency. That's a pretty big time span there of uncertainty.

Secondly, has anyone actually figured out how military salary compares with civilian? I'm talking after deducting civilian over-head costs of running the practice and paying malpractice and all that good business major stuff. I know money isn't everything, but it would be plain dumb to not consider that before signing up for such a commitment.

Thirdly, let's suppose the spouse does not want a career, but wants to be a stay-at-home mom.. How does this work out? Can she come with me when I get a free 2 year vacation to BFE, or does she have to stay at the home base and develop a taste for liquor? Can I afford a stay-at-home wife (really depends on concern #2 I suppose)?

Fourth..ly..Regarding residency. Let's suppose I don't match in any of the Army Anes. spots, is it recommended I take a civilian spot provided I match? Or would it be possible/better to do a GMO tour to gain browny points for the next application cycle? Are the Army specialty spots generaly more or less competitive than civilian spots (meaning getting a match at all., not comparing Harvard to Walter Reed or anything).

I guess that's all I can think of for now, though I'm sure I can think of more unanswered questions. I like to be in the know before jumping into something.

Thanks for your help
-Chem

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[Navy Dive Doc]

I'll try to answer a few of the questions, though Army GME I'll leave to someone who can speak directly.

1. Time in service for retirement begins the day you start internship getting paid active duty salary. If you get a civilain deferment (not full time outservice), your time starts after you show up and start working for the military.

2. For primary care specialties, the incomes are pretty close, for subspecialties like anesthesiology or radiology, they aren't even close. There are more specific posts already, so I won't go into all of the detail. Whenever you see average physician salaries listed anywhere, they are after expenses such as office overhead and malpractice.

I made $81000 last year as a DMO. I work Mon-Thurs 0700-1600, Fri 0700-1200. I did not deploy, I have mandatory physical training everyday from 0730-0900, I have done diving in Key Largo, the Monitor recovery and more ships than I care to remember. I've shot grenade launchers, machine guns, been around explosions that could be felt 1/2 mile away. I've rappeled, fast roped and SPIE rigged out of Helos. I've been at test depth in a submarine, even been involved in a collision at see while submerged (not recommended). I don't want to sound like a recruiter, but I've had some experiences that cannot be found in the civilian sector for any price. These are the things I will remember and are the intangibles that people talk about with the HPSP scholarship. Plus, I've worked with the finest people I've ever known. Don't do it for the money alone, you will be frustrated.

That said, when I return to residency this summer, I'll make $64k for the year (the annual bonus and dive pay go away on return to residency). WHen I put on O-4 in a year or so, my pay goes back up to $84K. As a resident, this is a lot better than civilian life, and one of the reasons I didn't get out.
When I graduate as a radiologist, I'll make $135,000 a year. Look at the posted salaries for civilian Rads and obviously I'm not making the bank I could in the civilian sector. But, the Navy paid me very well for what I do now, much better as a resident and not too bad as an attending. Plus, $140,000 for school that I don't have to pay back (including interest).

For a high paying specialty, it's probably economically better to pay your own way, especially to a state school. But I'll have had more fun and more experience...I figure I have my whole life to be a radiologist.

3. A spouse at home is the easiest type to have in the military, because their jobs are by definition portable. Wherever you get orders, your family comes with you (with a few "unaccompanied" exceptions). However, when you deploy she's left at home for 6 months or so. I have a wife and 3 kids, and I can afford it without any trouble. I'd much rather be in the Navy for residency for that reason, I was unwilling to take the pay cut to leave and go civilian for training.

As always, look at everything in this forum, especially my dour counterpart, MilitaryMD. He'll give you the other side of the story. I've had an unusual but not unique experience, but my opinion is colored by a great time. Informed consent...

 

[militarymd]

If you are thinking about anesthesiology as a specialty, then without a doubt, DO NOT sign. Call up any anesthesia department in the military, AF, Army, Navy, and talk to the individual anesthesiologists and ask them about what they think, I think the answer will be unanimous about staying out.

Talk to the department heads, or those who have multi year commitments and you'll get a different story, because they need people to sign up so they deploye them Iraq or other undesirable places.

 

[Chemguync]

Thanks for the input. I'll be sure to speak w/ current army gassers before signing the dotted line. Still interested though, but not if everyone in the job I want is miserable.

 

[r90t]

The majority that I know, do their time and get out because of the salary differential. Most navy docs don't match straight thorugh for this specialty and have a chance to get out and do a civilian program. It is hard to go back to resident salary after you have been "working." I'll make just over 105K as a GMO with prior service. About equal to primary care docs. World events are very fluid and you could possibly deploy as any specialty/primary care physician.

As MilMD said, talk to the gas passers at the army medical centers if you are thinking about going that route. They can give you the low down of the US Army morale.

 

[Masonator]

Army anesthesiologists are not deployed, nurse anesthetists get deployed.

 

[GMO_52]

Umm, everybody can deploy. There are no rules. Gas passers of all kinds and branches definitely deploy.

 

[Masonator]

Originally posted by GMO_52
Umm, everybody can deploy. There are no rules. Gas passers of all kinds and branches definitely deploy.

All of the anesthesiologists I talked to at WRAMC said that they don't deploy. By deploying I mean go to Iraq, Bosnia or hardship tours. Maybe I am misusing the terminology, or maybe they were lying. There might have been a leak on their enflurane line.

 

[Mirror Form]

Originally posted by Masonator
All of the anesthesiologists I talked to at WRAMC said that they don't deploy. By deploying I mean go to Iraq, Bosnia or hardship tours. Maybe I am misusing the terminology, or maybe they were lying. There might have been a leak on their enflurane line.

Hmm, maybe those particular ones are senior enough or are in a privaledged position so that they don't have to deploy. But I would hope that there would be some aneshesiologists deployed along w/ the CRNA's. I don't have any experience here though, just trying apply logic where it might not exist.

 

[Navy Dive Doc]

1. I would assume that you will be deployed as an anesthesiologist, because to assume otherwise and join with that as a factor is a recipe for disaster.

2. However, don't assume that because CRNAs are deployed there must be anesthesiologists. At least in the Navy, CRNAs were given equivalent provider status a long time ago, and don't technically need supervision. They can even be department heads, the boss of the MDs. Just another example of the DOD letting Nurses run the medical show, and a huge source of angst for active duty physicians. Executive medicine is open to any "medical" type, MC,NC,DC or MSC. Sorry, I digress...


The reason CRNAs were granted equal practice privileges? SO MDs wouldn't have to deploy, so we did it to ourselves. The CRNAs have long been using the military as an example of "we're just as good, see" PAs are next.

Just my $.02 as someone who almost did anesthesia.
DD

 

[Homunculus]

Originally posted by GMO_52
Umm, everybody can deploy. There are no rules. Gas passers of all kinds and branches definitely deploy.

i was told there is only one deployable pathologist in the Army, and he's in some kind of environmental response team or something. it's actually a selling point for them that they are never deployed.

 

[VentdependenT]

Originally posted by Navy Dive Doc
1. I would assume that you will be deployed as an anesthesiologist, because to assume otherwise and join with that as a factor is a recipe for disaster.

2. However, don't assume that because CRNAs are deployed there must be anesthesiologists. At least in the Navy, CRNAs were given equivalent provider status a long time ago, and don't technically need supervision. They can even be department heads, the boss of the MDs. Just another example of the DOD letting Nurses run the medical show, and a huge source of angst for active duty physicians. Executive medicine is open to any "medical" type, MC,NC,DC or MSC. Sorry, I digress...


The reason CRNAs were granted equal practice privileges? SO MDs wouldn't have to deploy, so we did it to ourselves. The CRNAs have long been using the military as an example of "we're just as good, see" PAs are next.

Just my $.02 as someone who almost did anesthesia.
DD

Aww man that sucks! I was wondering why the military trained CRNA I worked with in Washington State was so friggen good. Congrats on rads, its a great field.