Look, I'll be the first to say that you should not view my experience and opinions as Gospel. However as is typically the case with online forums, most people who take the time to post are those that are not happy with their experiences and want to vent about it. I just wanted to give an alternate view and let those looking into the program know that there ARE in fact people that have had great experiences with doing military medicine and some that even want to make it a career. Is it for everyone, obviously not, but I remember from my time as a pre-med student on these forums, a lot of the older people on here have very negative opinions on things.
You know what I'm not going to take your troll bait. I think the people who read this forum can decide for themselves what to think and who to believe. You elegantly made my point for me. Considering I am currently on active duty and actually a part of the system first hand, I'll leave it to the people reading to decide who better has a handle on the current state of military medicine.
There are definitely programs that are available for people to join the military after residency that help with loan payback. As far as disaster relief goes, its a little hit or miss. In most deployments you do get some experience with humanitarian work, but if you want to focus on that I would second the suggestion for doctors without borders or some other non-profit once you are board certified.
Ok I lied, I will take the bait.
The notion that I'm turned loose with no supervision to practice on unwitting Marines is ludicrous. There is still most certainly a hierarchy in place with senior medical officers, chart reviews, and instant communication with both the local Naval Hospital and the specialists at NAMI. I'm not sure where/how Gastro practiced as a medical officer but he makes it sound like GMO's were missing things left and right...this is simply not the case. If we trust PAs and Nurse Practitioners to practice mid level primary care then why exactly does Gastro think its unethical and dangerous for an MD with 1-2 years of post graduate training to do the same.
I again challenge you to produce evidence of the epidemic of injured military personnel caused by "untrained" medical officers. I'll say it again, the bulk of my patients have issues that can be treated with OTC medications and rest. For those that are outside my comfort level I simply walk two steps across the hall to the MAG surgeon who is a board certified FP with years if civilian practice under his belt. I see no difference between what I do and what a NP or PA does. If I view military medicine through rose colored glasses then you view it through sunglasses. Is it perfect? Of course not, but to make it sound like it consists of a bunch of dangerous untrained residency dropouts is absurd and couldn't be farther from the truth.
Not true at all...at least not in the Navy. I do flight physicals daily. As long as you are correctable to 20/20 you can be a flight surgeon. Also both LASIK and PRK are waiverable so that is an option as well.Just an FYI: you can't become a FS if you have terrible eyesight. I'm correctable to 20/20 in both eyes, but the military doc said after a certain power, you're prohibited from things like that.
I'm in the process of applying to the Army HPSP. Hopefully my packet goes before the boards later this month
I'm not qualified to have a comfort level? You are nuts. I'm not sure what school you went to but most US medical graduates can handle basic midlevel primary care issues and can certainly decide when something is outside their comfort level. Have you worked with any NPs or PAs? They are most definitely independent practitioners who don't run their patient's by anyone. You contradict yourself by railing against me because I am supposedly a dangerous unethical doctor that practices whatever level of medical care I happen to feel like but then complain because in reality I, along with the Navy, consider myself at this point in my training to be similar to a midlevel provider. As far as "while many GMOs will seek out more support, it isn't required", do you actually practice in a teaching hospital? How many senior residents, or any residents for that matter run every patient decision by you as the attending? Of course there are the rare nut job GMO's that try to do things they aren't credentialed or trained to do, but that goes for all physicians across all fields and levels of training. Are interns and residents allowed to have a comfort level? As a surgical intern I was trusted to make decisions on the floor regarding patient care and fluids/feeding/vent settings while in the SICU, yet suddenly I'm outside the hospital and I can't make a comfort level call because I haven't done 2 more years of OBGYN, geriatrics, and peds rotations for a FP residency? Finally, I'm a little unclear as to what GMO's find themselves completely alone with no phone/email/senior MO. Where did you deploy to again? I'll leave it up to the people who read this forum to make the judgment call on who is closer to reality here. Your posts do make an excellent teaching point though. You will all come in contact with negative attendings in your future life as med students and residents. Just remember to try and seek out positive people to balance the negative. Being a doctor is awesome! Practicing safe responsible primary care in the Navy is awesome! Being a Flight Surgeon is super awesome!
There I was, arguing with orbitsurgMD. He was right, I was wrong.
I'm not going to get defensive or angry but I'm still not sure what the point either of you are trying to make. The military uses multiple independent providers to care for the huge number of service members. These include IDCs, NP, and PA's. All of which can and do practice independently with some occasional physician oversight. Would you suggest they are replaced by board certified physicians? Your inability to know when and how to seek guidance or a referral doesn't mean the whole system is broken, it means someone should have done a better job teaching you how to be a GMO. I am privileged and credentialed for a select set of skills, if I practice outside those skills I am breaking the law. This is no different than if a PA decides to do something outside their scope of practice. You practicing outside your scope on the locals, however well intentioned, is most definitely unethical and wrong, as would I be if I did the same on my Marines. I operate within a set of rules and guidelines, those that don't certainly don't prove the system is wrong, but rather that person is mistaken. I'm still unsure exactly what population you both saw on a daily basis that was loaded with House type pathology that you missed. It doesn't take a board certified doctor to do a thorough H&P, lab/X-ray, treatment and realize that if something doesn't fit you need backup. If a NP can operate in this setting why can't an internship trained MD? My 3rd and 4th year rotations at least equal a PA's clinicals, especially since I see no children, elderly, or OB...why is that so hard to believe? Where exactly were you deployed with no communication capabilities whatsoever? And if you were indeed in such an austere environment for long periods of time, I'm sure your patients were glad to have a doctor vs no doctor or a corpsman only. In an ideal world every patient would have access to a board certified doctor, but that is not only unrealistic it's absurd. That will never happen even in the civilian world. No offense, but I'll also point out that both of you chose to specialize but now criticize a system for not manning all billets with primary care docs. Your negative and skewed comments in this venue will also only work to dissuade future students from joining which will have the end result in ensuring more of our troops will be cared for by non-MD/DOs of any level of training.
So let me get this straight, you feel that having operational billets staffed by internship trained MD/DOs is so unethical and dangerous that you plan on dissuading pre-meds from joining in an effort to force the military to re-evaluate how they man their billets. Sounds like a great plan, meanwhile overall recruiting numbers drop and not only are the billets not manned by board certified doctors they aren't manned by doctors at all. You really need to re-evaluate your motives and methods as real people pay the price.
So at the time you were a GMO you felt comfortable and confident enough to not only finish your tour but extend and voluntarily stay to do more. Why didn't you go back to training ASAP if you were constantly left alone with no resources and practicing outside your scope? I'm confused at what point you came to realize your 3 years as a GMO was a negative and dangerous experience?
In.
I like this thread.
Hearing major defense of the GMO system, when somehow the Army gets by without it.
You're right, I don't get it. As a graduate of a US medical school you weren't able to realize when something was outside of your comfort level and/or scope of practice? As a lowly intern there were plenty of times when I knew I was out of my depth and needed backup. Why would I suddenly become this careless, clueless doctor when they tell me I'm a GMO. Exactly what FP residency would require their second year residents to formulate a plan, pass it by the attending, and have the attending examine the patient for a cough and runny nose? We handled that type of patient on our own as 3rd year med students. We are talking about minor sick call issues here, not open heart surgery. How much more pure outpatient medicine would I get doing another 2 years of FP residency once you take out all the OBGYN, PEDS, INPATIENT, ICU, etc...all of which I not only do not do, but am not licensed or credentialed to do. I'm starting to think you are deliberately trying not to understand. I practice at the level of a NP, PA, or IDC what part of that don't you understand? If these mid-level providers can practice independently then why the heck can't I with an MD and one year of internship? Will I possibly miss things, perhaps, but you try and make it sound like once you have a couple more years of FP residency you are infallible. Do you not think that both you and Gastro will miss things as new attendings that you wouldn't have after 5-10 years of practice? Should we make you pass your decisions by a senior attending?
