Any concerns over Navy training diversity?

[AdverseAffinity]

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So, let's see if I can get off to a better start this time.

It seems like there's a good bit of Navy guys on here, not quite as many Army guys talking about training (maybe I'm missing some threads of the Army guys). It seems like overall the Navy would be a better fit for us, but the Army certainly touts a lot more diversity in potential training opportunities. Their fellowship grid on their GME site is quite extensive, and the official Navy GME site that I found only lists like 10. How common are the FTOS spots in the Navy for less common residencies/fellowships? I honestly have no idea what field of medicine will appeal to me which is why I'm not sure how to go about approaching choosing between these branches given the above conundrum. Navy guys, was this a part of your consideration when choosing USUHS/HPSP? Was there much concern over falling in love with a field but the Navy not offering it (like neonatology or something pretty specific like that)?

Thanks guys.

 

[DrMetal]

So, let's see if I can get off to a better start this time.

It seems like there's a good bit of Navy guys on here, not quite as many Army guys talking about training (maybe I'm missing some threads of the Army guys). It seems like overall the Navy would be a better fit for us, but the Army certainly touts a lot more diversity in potential training opportunities. Their fellowship grid on their GME site is quite extensive, and the official Navy GME site that I found only lists like 10.

that's true. Army GME is bigger and (I think) better managed.

How common are the FTOS spots in the Navy for less common residencies/fellowships?

Depends on the specialty, depends on the year. It's hard to predict what things are going to be like next year, let alone what they'll be like in 10 years when you'll be applying for fellowships.

I honestly have no idea what field of medicine will appeal to me which is why I'm not sure how to go about approaching choosing between these branches given the above conundrum. Navy guys, was this a part of your consideration when choosing USUHS/HPSP? Was there much concern over falling in love with a field but the Navy not offering it (like neonatology or something pretty specific like that)?

Thanks guys.

It should be a huge concern. Many people in my class didn't match into the pgy1 spot that they wanted (and I'm talking about good people), and will have to do something else, will then probably have to go GMO and reapply. that's all well and good, if you're patient. And even after doing a GMO, there's no guarantee that you'll get what you want, b/c the number of spots (as you've correctly discovered) as few for certain specialties.

If you know you want to do something primary care-related (IM, FM, Peds), you could probably join now as a medical student and hope to get that (you probably will, exactly where/when is TBD, but you should get it, as these are in high demand).

If you think you might want to do something more sub-specialized (especially the surgical sub-spects, like Ent, ortho, etc), I'd consider going the civilian route and delaying your entrance into the mil. If you're unsure, I'd advise you in the same way.

 

[AdverseAffinity]

Thanks DrMetal. I know that most people here are larger supporters of FAP or direct entry after all training. But if I choose a specialty that the military doesn't "need," then I assume that essentially eliminates most possibilities of serving as a physician in the military?

 

[DrMetal]

But if I choose a specialty that the military doesn't "need," then I assume that essentially eliminates most possibilities of serving as a physician in the military?

So be it. It's more important that you pick a specialty that you like and are good at, than picking one just for the sake of joining the military.

Now, having said that, the military does need physicians from almost every specialty. I seriously doubt they would turn you away from all forms of service (consider the reserves as well), if you're a fully trained XXXXX.

Anyway, your choice of specialty is more important. There are many ways to serve, and you can always find one later that works for you. So if you're really concerned about choice-of-specialty (which is a very valid concern), I'd advise against joining now as a student.

 

[Perrotfish]

So, let's see if I can get off to a better start this time.

It seems like there's a good bit of Navy guys on here, not quite as many Army guys talking about training (maybe I'm missing some threads of the Army guys). It seems like overall the Navy would be a better fit for us, but the Army certainly touts a lot more diversity in potential training opportunities. Their fellowship grid on their GME site is quite extensive, and the official Navy GME site that I found only lists like 10. How common are the FTOS spots in the Navy for less common residencies/fellowships? I honestly have no idea what field of medicine will appeal to me which is why I'm not sure how to go about approaching choosing between these branches given the above conundrum. Navy guys, was this a part of your consideration when choosing USUHS/HPSP? Was there much concern over falling in love with a field but the Navy not offering it (like neonatology or something pretty specific like that)?

Thanks guys.

This was part of my consideration in choosing Navy vs. Army. I think that you're right that vs the Army the Navy seem to rely more heavily on FTOS fellowships vs. inservice fellowships, which can be frustrating because unlike their inservice fellowship the Navy has more freedom to change the number of people the select for FTOS from year to year, and might not select anyone in your particular fellowsihp when you are applying for it.

One thing balanced against that, for me, is that I feel the Navy's GMO system is much more protective of providers who choose not to subspecialize. By shunting all of the operation work onto their GPs rather than making basically every Intern in the service do a single opperational tour as a GMO I feel that the Army elimintates one of the biggeset advantages of military medicine: a better than civilian enviornment to practice primary care.

Of course, since you want the real military experience, maybe it would be best just to do your GMO time and worry about fellowship when your contract is up and you're back to being a civilian again? Intern year --> 2 year GMO --> finish residency --> 2 year utilization tour is a common path, gets you the real military experience from a couple of angles, and leaves civilian fellowship options wide open.

One other FYI: neonatology is actually one of the Navy's most in demand subspecialists. Marines make a lot of babies and all Navy MTFs maintain relatively large, mederately high acuity NICUs.

 

[AdverseAffinity]

This was part of my consideration in choosing Navy vs. Army. I think that you're right that vs the Army the Navy seem to rely more heavily on FTOS fellowships vs. inservice fellowships, which can be frustrating because unlike their inservice fellowship the Navy has more freedom to change the number of people the select for FTOS from year to year, and might not select anyone in your particular fellowsihp when you are applying for it.

One thing balanced against that, for me, is that I feel the Navy's GMO system is much more protective of providers who choose not to subspecialize. By shunting all of the operation work onto their GPs rather than making basically every Intern in the service do a single opperational tour as a GMO I feel that the Army elimintates one of the biggeset advantages of military medicine: a better than civilian enviornment to practice primary care.

Of course, since you want the real military experience, maybe it would be best just to do your GMO time and worry about fellowship when your contract is up and you're back to being a civilian again? Intern year --> 2 year GMO --> finish residency --> 2 year utilization tour is a common path, gets you the real military experience from a couple of angles, and leaves civilian fellowship options wide open.

One other FYI: neonatology is actually one of the Navy's most in demand subspecialists. Marines make a lot of babies and all Navy MTFs maintain relatively large, mederately high acuity NICUs.

Thanks for this.

The reason I mentioned neonatology is because it's listed on Navy.com but didn't see it on the navy GME site.

 

[IlDestriero]

I'd be more concerned with Navy GME quality myself. If you're a superstar, and interested in specialization, you're probably selling yourself short.

 

[AdverseAffinity]

I'd be more concerned with Navy GME quality myself. If you're a superstar, and interested in specialization, you're probably selling yourself short.

Is that suggesting the army is better or that civilian is better?

 

[IlDestriero]

Is that suggesting the army is better or that civilian is better?

Civilian.