Am I making a bad decision?

[HeadMed]

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Hi, I am new here and I was hoping I could solicit some honest advice.

I am a 1st year med at Harvard (hopefully Big Brother isn't watching) and I am looking to enlist in the military. Although I have been reasonably focused on medicine the last several years, I have never been able to shake my interest and passion for the military. However, I also am not an idiot and I realize much of what I know about military life is romanticized by the media and military recruiter propaganda. The latter is the reason that I am posting here, as I would prefer to receive honest and complete answers to my questions.

My main interests in the military: ultimate patriotism, awesome brotherhood/camaraderie, my father's satisfaction (for many years) with his service as a Colonel in the AF (family doc).

Detractions: Horror stories of surgeons receiving dreadfully low case loads, hierarchy frequently not based on skills but longevity, inability to leave a bad working environment, too much information is intentionally hush-hush such that you won't know about it until it is too late.....oh and my father eventually retired because he could no longer handle the structure of AF medicine and the fact that he was unable to institute changes that he knew were needed

I realize that all of these questions have probably been addressed either partially or completely somewhere, but after ample searching for answers to my questions, I think I will bare the hating and just ask them again. So, sorry.

1. What factors and variability go into determining entering rank and pay? That is does marriage, degree, fitness level, etc. play a role or does every medical student enter as a 2LT?

2. How does the Health Loan Repayment Program work? I was told that they cover up to a certain amount of debt given that you "serve" at least 3 years. Is it really that simple? Are there not strings attached somewhere?

3. If I want to do a civilian surgical sub-specialty residency, what role will my affiliation with the military play? Can it limit my choices? Can I get pulled out during this residency to serve as a GMO or another role?

4. Am I better off waiting until later in life to get involved with the military? That is, should I delay this until after residency such that I can make a shorter commitment or perhaps contract with the military to fill a void for a given time? This way if I can't stand something about the situation I am more free to bolt.

I realize that ultimately this is a personal decision, but there are not many people around here considering this path that I can talk to about my concerns (again, recruiters do not count).

Thanks for any and all help and advice.

 

[colbgw02]

Hi, I am new here and I was hoping I could solicit some honest advice.

I am a 1st year med at Harvard (hopefully Big Brother isn't watching) and I am looking to enlist in the military. Although I have been reasonably focused on medicine the last several years, I have never been able to shake my interest and passion for the military. However, I also am not an idiot and I realize much of what I know about military life is romanticized by the media and military recruiter propaganda. The latter is the reason that I am posting here, as I would prefer to receive honest and complete answers to my questions.

My main interests in the military: ultimate patriotism, awesome brotherhood/camaraderie, my father's satisfaction (for many years) with his service as a Colonel in the AF (family doc).

Detractions: Horror stories of surgeons receiving dreadfully low case loads, hierarchy frequently not based on skills but longevity, inability to leave a bad working environment, too much information is intentionally hush-hush such that you won't know about it until it is too late.....oh and my father eventually retired because he could no longer handle the structure of AF medicine and the fact that he was unable to institute changes that he knew were needed

I realize that all of these questions have probably been addressed either partially or completely somewhere, but after ample searching for answers to my questions, I think I will bare the hating and just ask them again. So, sorry.

1. What factors and variability go into determining entering rank and pay? That is does marriage, degree, fitness level, etc. play a role or does every medical student enter as a 2LT? It's mostly just time. All new physicians enter as O-3s (Captains, or senior grade LT for the Navy), and all medical students are O-1s (2LTs or ensigns). Getting promoted is almost exclusively determined by how long you've been in. You can get some credit if you have another degree, like a masters. At the upper ranks, you must check certain blocks, but you're a long way from there.

2. How does the Health Loan Repayment Program work? I was told that they cover up to a certain amount of debt given that you "serve" at least 3 years. Is it really that simple? Are there not strings attached somewhere? This program isn't very popular, at least not in the Army. There is also the FAP program whereby they supplement your income in exchange for service. And yes, you had better believe there are strings attached.

3. If I want to do a civilian surgical sub-specialty residency, what role will my affiliation with the military play? Can it limit my choices? Can I get pulled out during this residency to serve as a GMO or another role? Your military affiliation will not only play a role, it will be the principal deciding factor. You should count on completing your GME in the military. This topic has been covered ad nauseum here. Suffice it to say that this is a bread-and-butter issue that you absolutely must understand before making any decisions.

4. Am I better off waiting until later in life to get involved with the military? That is, should I delay this until after residency such that I can make a shorter commitment or perhaps contract with the military to fill a void for a given time? This way if I can't stand something about the situation I am more free to bolt. This is a popular suggestion on these boards because it allows you to retain control over the timing and location of your specialty of choice. In reality, I can tell you that there are very few people who are already board-certified and unaffiliated with the military who decide to join. Those that do are typically in the lower-paying specialties where they have to bust their butt to make ends meet.

I realize that ultimately this is a personal decision, but there are not many people around here considering this path that I can talk to about my concerns (again, recruiters do not count).

Thanks for any and all help and advice.

See bold comments above. You really should spend some time reading this forum. There's nothing you're asking that hasn't already been answered.

 

[Perrotfish]

No active duty experience here, but:

You should definitely refer to the thread on FAP, a program which supplements your residency pay in exchange for a military obligation. If you're worried about the military affecting your choice of specialty/subspecialty (which you should be, especially with the options you're going to have coming from Harvard) go with FAP.

Also if you do choose the military, don't go AF just because your Dad went AF. The consensus here seems to be that AF has a relative surplus of the problems associated with Military medicine.

 

[The White Coat Investor]

Hi, I am new here and I was hoping I could solicit some honest advice.

I am a 1st year med at Harvard (hopefully Big Brother isn't watching) and I am looking to enlist in the military. Although I have been reasonably focused on medicine the last several years, I have never been able to shake my interest and passion for the military. However, I also am not an idiot and I realize much of what I know about military life is romanticized by the media and military recruiter propaganda. The latter is the reason that I am posting here, as I would prefer to receive honest and complete answers to my questions.

My main interests in the military: ultimate patriotism, awesome brotherhood/camaraderie, my father's satisfaction (for many years) with his service as a Colonel in the AF (family doc).

Detractions: Horror stories of surgeons receiving dreadfully low case loads, hierarchy frequently not based on skills but longevity, inability to leave a bad working environment, too much information is intentionally hush-hush such that you won't know about it until it is too late.....oh and my father eventually retired because he could no longer handle the structure of AF medicine and the fact that he was unable to institute changes that he knew were needed

I realize that all of these questions have probably been addressed either partially or completely somewhere, but after ample searching for answers to my questions, I think I will bare the hating and just ask them again. So, sorry.

1. What factors and variability go into determining entering rank and pay? That is does marriage, degree, fitness level, etc. play a role or does every medical student enter as a 2LT?

2. How does the Health Loan Repayment Program work? I was told that they cover up to a certain amount of debt given that you "serve" at least 3 years. Is it really that simple? Are there not strings attached somewhere?

3. If I want to do a civilian surgical sub-specialty residency, what role will my affiliation with the military play? Can it limit my choices? Can I get pulled out during this residency to serve as a GMO or another role?

4. Am I better off waiting until later in life to get involved with the military? That is, should I delay this until after residency such that I can make a shorter commitment or perhaps contract with the military to fill a void for a given time? This way if I can't stand something about the situation I am more free to bolt.

I realize that ultimately this is a personal decision, but there are not many people around here considering this path that I can talk to about my concerns (again, recruiters do not count).

Thanks for any and all help and advice.

Not sure why you want your own thread for the most routine questions we get, but hey, here you go:

1) Time, whether or not you have a DWI, and whether or not you sleep with the general's daughter. Mostly time. 2LT as med stud, Cpt as resident and until 6 years out of med school, then Major. Pretty much automatic. No one cares about your fitness level, degree, or spouse in the med corps.

2) HPSP: You get tuition, fees, equipment, tuition and a monthly stipend paid for 3 years. Then you go through the military match (no choice) where you are chosen either to just do an internship then a GMO tour, to train in your chosen specialty (usually not a subspecialty) in the military, or deferred to train in your chosen specialty in the civilian world. What the odds are for that are year, service, and specialty specific. For some specialties, it can even be slightly easier in the military, but for many, it is impossible to do a civilian residency and very hard to match into your specialty at all. You do 4-6 weeks of active duty time each year, are paid slightly more than your usual stipend.
You: You lose control of your match and where you will live for the 6-10 years after med school. You will be deployed to random locations at random times with random amounts of notice. You will have to work in the military medical system with its unique problems and issues. There will be bureaucratic paperwork and problems. You will do 3 years of active duty, then owe 5 years of individual ready reserve (they can always call you back.) You will also be exposed to a phenomenon called "stop-loss" where the military can tell you what to do, even if you've done your commitment. You will probably be paid significantly less than your civilian counterparts, even when you add in the money and its time value that you were given years ago.

3. A big role. Yes. Yes, but once you're in they usually wouldn't pull you out. Getting in is usually the issue.

4) Yes. I would be surprised if you still joined later, but that option never goes away and usually comes with a big signing bonus, higher rank etc.

 

[BomberDoc]

If you want truly honest answers to your questions, thoroughly read this forum and pick out a few people to PM. Either give them your phone number or just ask via the PM.

I am thrilled to see people in your situation actively seeking information.

 

[HeadMed]

Again, sorry for asking questions that have been answered in other places. I had no doubt that my questions were not original, I just had a difficult time finding relevant posts using the 'search' function.

With that said, I spent several hours perusing the sticky's and several other posts referenced from the sticky's. Any positive aspects of military medicine that I once believed have been completely obliterated. For every positive post that I read, there was a flurry of jaded responses based upon FIRSTHAND experiences. In fact with only a couple exceptions, the only endorsements of military medicine came from premeds or med students.

So.....thanks to everyone that has provided honest accounts of experiences on this forum as I am now completely against the idea of enlisting. I would love to serve my country, but not at the price of all of the negative aspects that numerous residents and attendees have documented here. There are just too many articulate, persistent, and seemingly non-hysterical people saying not to do this. If it were only a single bad apple recounting a series of bad experiences it would be one thing but.......I just can't shake the fact that these veterans of military medicine are so unhappy that they take the time to post of this forum repeatedly. Thank you again to all of these people because the picture they have painted is dramatically different than the one I saw from the recruiters and media propaganda.

 

[Galo]

Again, sorry for asking questions that have been answered in other places. I had no doubt that my questions were not original, I just had a difficult time finding relevant posts using the 'search' function.

With that said, I spent several hours perusing the sticky's and several other posts referenced from the sticky's. Any positive aspects of military medicine that I once believed have been completely obliterated. For every positive post that I read, there was a flurry of jaded responses based upon FIRSTHAND experiences. In fact with only a couple exceptions, the only endorsements of military medicine came from premeds or med students.

So.....thanks to everyone that has provided honest accounts of experiences on this forum as I am now completely against the idea of enlisting. I would love to serve my country, but not at the price of all of the negative aspects that numerous residents and attendees have documented here. There are just too many articulate, persistent, and seemingly non-hysterical people saying not to do this. If it were only a single bad apple recounting a series of bad experiences it would be one thing but.......I just can't shake the fact that these veterans of military medicine are so unhappy that they take the time to post of this forum repeatedly. Thank you again to all of these people because the picture they have painted is dramatically different than the one I saw from the recruiters and media propaganda.

If you truly have read this forum you surely have seen my name and posts not only describing my experience as an active duty surgeon for 6 years, but actually having to defend my myself, refuting mental illness, hating my country, being incompetent, etc etc, from premeds, med students, residents, and one particularly malignant current active duty "officer." These are the type of people that will be your bosses.

My aim is to give prospective physicians a glimpse of what I know, and how bad military medicine has become. I always no matter what, always tell you to call up active duty bases and talk to as many physicians as you can. Avoid physicians who are head of departments, Lt Col, and Col, as in my experience with few exceptions, they have bought what military medicine offers, and thrive in it. Show your dad some of these posts, and see what he thinks.

I think you are making a wise decision, and when you are a trained physician, you will at least be able to see what the military climate is like at the time, and chose how to best serve your country.

Feel free to PM me if you want.

 

[Standard Dev]

Look into the uniformed aspect of the Public Health Service. All the benefits of the uniformed services (mainly the military) with the ability to be assigned to some great locations in the US or to be assigned as a physician in the Coast Guard. Since the PHS does not have a training hospital per se, you will be competitive for any civilian residency since the PHS will pay the hospital for you to train there.

 

[HeadMed]

If you truly have read this forum you surely have seen my name and posts not only describing my experience as an active duty surgeon for 6 years, but actually having to defend my myself, refuting mental illness, hating my country, being incompetent, etc etc, from premeds, med students, residents, and one particularly malignant current active duty "officer." These are the type of people that will be your bosses.

My aim is to give prospective physicians a glimpse of what I know, and how bad military medicine has become. I always no matter what, always tell you to call up active duty bases and talk to as many physicians as you can. Avoid physicians who are head of departments, Lt Col, and Col, as in my experience with few exceptions, they have bought what military medicine offers, and thrive in it. Show your dad some of these posts, and see what he thinks.

I think you are making a wise decision, and when you are a trained physician, you will at least be able to see what the military climate is like at the time, and chose how to best serve your country.

Feel free to PM me if you want.

HAHA. Yes I did run across your name frequently. In fact I spent at least an hour following your first huge post (at least I think it was your first) where you posted those .doc's. I read them and then forwarded them to my father. After he read your documents he called me back and we talked for a couple hours about aspects of his experience that he had never shared with me before. Although, as a FP doc, he never had issues filling his time, he did have quite a bit to say about daily quotas. Something along the lines of delivering a baby or calling back a lab both counting equally as a single "contact". Apparently he had to deal with docs with seniority trying to call back 20 labs and calling it quits for the day leaving the junior docs earning their 20 contacts doing the real work. (I am sure my lingo is off here, but I think you get the gist).

Although I know my father was always open to suggestions from the docs under him, he still is upset about the fact that his superiors continually restricted him from making significant (even if totally warranted) changes.

He doesn't regret his decision, but he definitely sympathizes with everything you mentioned. Luckily for him he was not a surgeon looking to develop and maintain proficiency through a diverse and steady case load. Also on the up side, his experience "managing" the AF hospital has helped him develop a very successful private practice. Not sure if it is purely coincidence, but all 4 of the other docs he has hired to work for him served in the military as physicians (so there is something to be said for networking).

 

[sethco]

Look into the uniformed aspect of the Public Health Service. All the benefits of the uniformed services (mainly the military) with the ability to be assigned to some great locations in the US or to be assigned as a physician in the Coast Guard. Since the PHS does not have a training hospital per se, you will be competitive for any civilian residency since the PHS will pay the hospital for you to train there.

Maybe I am wrong, but doesn't the PHS mandate that you enter into a Primary Care specialty? Am I thinking of something else?

 

[a1qwerty55]

With that said, I spent several hours perusing the sticky's and several other posts referenced from the sticky's. Any positive aspects of military medicine that I once believed have been completely obliterated. For every positive post that I read, there was a flurry of jaded responses based upon FIRSTHAND experiences. In fact with only a couple exceptions, the only endorsements of military medicine came from premeds or med students.

So.....thanks to everyone that has provided honest accounts of experiences on this forum as I am now completely against the idea of enlisting. I would love to serve my country, but not at the price of all of the negative aspects that numerous residents and attendees have documented here.

I'm sorry about your decision. I might question the wisdom of making a decison based on a internet forum, but that is your call.

I can say that many of us, have vastly different and far more positive experiences to tell. Most of my colleagues are horrified by the excessively negative posts on this forum and agree that the many of the complaints and examples are hyperbolic. Most of us plan on leaving after our committments are up, but we aren't leaving as with as much anger and hatred as those who post on this forum. We did our payback and it is time to move on. Others stay for a career, usually because they feel they are making positive change and not because they can't compete in the civilian world as some would assert.

Few of my coworkers and friends who have left look back on their Army time as a waste, or regret it.

I'd ask you to look at alternate sources of info, not from the board, and not from recruiters. Look into doing a military rotation as a 3rd or 4th year. I'm sure you could find a military hospital which would accept you even if you are not affiliated with the military.

If you really want to serve and it isn't just some fuzzy concept, you should. One major beef I have with Americans is this belief that somehow service comes without sacrifice.

I would also note that there is an overwhelming preponderence of disgruntled former and current USAF personnel on this board.

For an blunt appraisal of service in the Army as a physician, feel free to PM me.

 

[Galo]

I'm sorry about your decision. I might question the wisdom of making a decison based on a internet forum, but that is your call.

I can say that many of us, have vastly different and far more positive experiences to tell. Most of my colleagues are horrified by the excessively negative posts on this forum and agree that the many of the complaints and examples are hyperbolic. Most of us plan on leaving after our committments are up, but we aren't leaving as with as much anger and hatred as those who post on this forum. We did our payback and it is time to move on. Others stay for a career, usually because they feel they are making positive change and not because they can't compete in the civilian world as some would assert.

Few of my coworkers and friends who have left look back on their Army time as a waste, or regret it.

I'd ask you to look at alternate sources of info, not from the board, and not from recruiters. Look into doing a military rotation as a 3rd or 4th year. I'm sure you could find a military hospital which would accept you even if you are not affiliated with the military.

If you really want to serve and it isn't just some fuzzy concept, you should. One major beef I have with Americans is this belief that somehow service comes without sacrifice.

I would also note that there is an overwhelming preponderence of disgruntled former and current USAF personnel on this board.

For an blunt appraisal of service in the Army as a physician, feel free to PM me.

So you have one overwhelmengly positive position from a person who says is getting out as soon as his commitment is up.

Note that this "disgruntled" former USAF physician also, (and always), gave the advice to call up as many current active duty physicians from all 3 branches, to get alternate opinions from people currently in the field. Are we telling you to make your decision based on what I or others experienced? We are giving you a glimpse of what seems to be an all too common experience in military medicine. Sure, it may be branch specific, and specialty specific, and commander specific, yet it happens to so many. Regardless, if you did call up places, it would be interesting (if you're even still reading this thread), what you were told by current physicians on active duty.

 

[73BARMYPgsp]

2) HPSP: You get tuition, fees, equipment, tuition and a monthly stipend paid for 3 years.

Tuition AND tuition? Man that's a great deal. Sorry, had to do it.

 

[Heeed!]

If you want "awesome brotherhood/camaraderie," look at working on the line (aviation)...DEFINITELY not a whole lot of that in the hospital.

 

[The White Coat Investor]

Tuition AND tuition? Man that's a great deal. Sorry, had to do it.

Yup, that's the way it works. No matter how many times they bill you for tuition, you can send the bill to the military!

 

[73BARMYPgsp]

Yup, that's the way it works. No matter how many times they bill you for tuition, you can send the bill to the military!

What is funny about that is there is some truth to it. Not much oversight on Federal Tuition Assistance either. You could probably create fake invoices for a lot of things and get the money.

*discaimer--this is illegal and the poster in no way endorses such activity.

 

[bliss72]

Be specific. GMO tours are Navy by policy. Not HPSP in general. I know people can only speak about their experiences but , there are people who have no idea about the differences in the way each of the services applies their residency policies and they will think ALL services do the same thing. At least state what service you represent.

 

[bliss72]

Just wanted to say Hi to Galo, although disgruntled, I've rather enjoyed alot of his posts. Everyone's experience is different so I always take heed to the negative as well as the positive. I respect the physicians here, even the disgruntled ones for posting their views.

 

[IgD]

Be specific. GMO tours are Navy by policy. Not HPSP in general. I know people can only speak about their experiences but , there are people who have no idea about the differences in the way each of the services applies their residency policies and they will think ALL services do the same thing. At least state what service you represent.

All the services have GMOs in some form or another. Are you suggesting otherwise?

 

[pokerslut]

I joined the Army Reserve when I was 17 years old. The first part of my training was 2 years because of my extensive training as a medic and lab technician. 12 years total. 6 Active and 6 Reserve.

Random thoughts:

One of my most memorable moments was in basic training. It was 0500 hours; and we were in formation in the rain. I was feeling so sorry for myself. It was cold and I was soaking wet. Did I mention that it was 5 a.m.? Later when the run started things changed. The drill sergeant had a nice pace going and was singing cadence. Soon I found myself singing cadence at the top of my lungs. Rain continued to pour, but I didn't care. At the risk of sounding overdramatic I felt like electricity was flowing through my veins. I felt that I could accomplish anything. I think this is when I realized that attitude and perseverence means everything. Cliche I know.

One of my worst memories is having to work under a hypocrite. But this is not unique to military.

In my opinion you would have a harder time finding the comradarie in a military hospital setting as a physician.

The Inspector General at a North Carolina base told me something that I will not forget. You can serve you country in other ways without being in uniform/military-- something to keep in mind.

I'm a second year medical student hoping to match in Physical Medicine and Rehabilitation. Making the decision to do FAP or not would be a very difficult one because there are so many pros and so many cons. Good luck with your decision.

Sorry about the choppy post but I'm multi-tasking right now. Feel free to drop me a line with any questions based on my experiences. Never been to Iraq but pretty much everywhere else.

 

[ILUvRVUs]

With that said, I spent several hours perusing the sticky's and several other posts referenced from the sticky's. Any positive aspects of military medicine that I once believed have been completely obliterated. For every positive post that I read, there was a flurry of jaded responses based upon FIRSTHAND experiences. In fact with only a couple exceptions, the only endorsements of military medicine came from premeds or med students.

Exactly! I was once a bright eyed med student excited for the many opportunities offered by the Navy! Now as a seasoned GMO I know better. They can always hurt you more, and they do. I will save you the details about my diabolical clinic but share this; my friends and colleagues on the line/flight or ex-Mil are disgusted by the way we(doctors) are treated.

Feel free to pm me.