APMC. AMA

[armytrainingsir]

Reserve doc. I've been in APMC for the last few years. Ask away.

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[Gastrapathy]

What’s APMC?

 

[USArmyHPSP]

Armed Professional Medical Command? That's the only time I've seen it used...

 

[TheEarDoc]

What’s APMC?

You belong to medical command. Often times doing this you are left to yourself to do drill usually by working in a civilian facility wearing your uniform. These volunteer type days are used for your drill points. You don't actually usually go drill with a unit although you can. This is the way I've heard it go at least. Perhaps this reservists can tell us more.

I had no desire to do APMC for my field because part of joining the reserves was wanting that feeling of belonging to a group of people and doing drills together and getting out and meeting new people, but for some it sounds like a sweet gig especially if you don't have any medical units near you and you are highly motivated to do everything on your own.

 

[armytrainingsir]

AMEDD Professional Management Command

You are assigned to a unit that has a slot for you.
But, often for specialists, that slot is across the country, so there is no practical way to drill.
So, you are attached to APMC (in greater Atlanta area) for all your admin stuff.

For drill, you are required to drill on your own so to speak. This also includes 'volunteering' at a local civilian facility if you are > 90 miles from a reserve unit that can use you. When you drill, you have someone sign off on your 1380 that just says you where there and did something. You are required to drill with your unit during their 2 week AT. At first, this was only for every other year, now it is every year since money is supposedly available now. My unit was cool with me not coming out and I was able to do CGSC via TASS over an 18 month period. Much better than distance learning.

If you are prior active duty, it can be awesome. You truly are an army of one. Nobody messes with you. Downside? You are an army of one. No one is gonna give you a heads up on anything. It can be lonely as was alluded to above. For folks that have never been in the .mil, I think it is a bad idea. Because you don't even know what to ask.

APMC is staffed mostly by DoD civilians. Processing my 1380s for pay has never been an issue. Credentialing folks are pretty decent too. But if you have a problem or questions that falls out of the ordinary monthly processing, it is a quagmire. About 20% of voicemails are returned. 50/50 if your first email is answered. One question per email. Any others are ignored. Email on Monday, get a response by Thursday. Any other followup or clarifications? Sorry. Send a new email next week. Very little back and forth conversation. And sadly, they are very slow to offer any advice. If you don't ask, they most certainly won't volunteer the information. Very frustrating.

I had to get my ORB fixed for my promotion board last year. APMC did absolutely nothing. Fortunately, by unit fixed all my problems incredible quickly.

My one key if you go APMC is to get to know your unit via email and phone. Most APMC folks don't. I only was able to drill with my unit once, three years ago. It has paid off immensely. I know our UA and he is sharp. Some issues are limited as to what he can do but still pretty awesome at helping me if and when he can.

Looking forward to deploying with them in the near future as a 90 day bogger. It will be my first and very likely last deployment.

 

[DMBandFan86]

One of the best parts of the APMC is that they will constantly loose your height/weight/APFT. About every month or two you will get an email that you are delinquent on your bi-annual performance evaluation. Doesn't matter how many times you send it in. Doesn't matter if you are physically present at the APMC to have an APFT. They will loose all records and tell you that you are delinquent.

 

[244913]

My question: why does this program even exist

 

[armytrainingsir]

My question: why does this program even exist

Because the chances of a specialist that’s willing to be in the army reserve living near unit that needs that specialist is close to zero. This is a mechanism to link willing physicians to empty slots regardless of geography

 

[Perrotfish]

Because the chances of a specialist that’s willing to be in the army reserve living near unit that needs that specialist is close to zero. This is a mechanism to link willing physicians to empty slots regardless of geography

Yes, but do we really need a reserve of physicians so subspecialized that no one outside of a major MTF knows what to do with them? We barely know what to do with all the hyper subspecialized docs we have on active duty.

Something is usually better that nothing, so this probably doesn't hurt, but I think you could make a strong argument that this money would be better spent on incentives for family docs to join the reserves.

 

[244913]

This program sounds like a total waste of money, even with our unnecessarily bloated military budgets. Reminds me of that old National guard scam/boondoggle where a bunch of Rambos served out their entire commitment in med school and residency- when they were non-deployable and entirely useless to operational units and the .Mil as a whole. Yeah, doing PHA's at a drill weekend doesn't count.

Get rid of useless programs like this and use the money to incentivize experienced AD specialists and sub-specialists to stay in.

- ex 61N

 

[Perrotfish]

. Reminds me of that old National guard scam/boondoggle where a bunch of Rambos served out their entire commitment in med school and residency- when they were non-deployable and entirely useless to operational units and the .Mil as a whole.

I remember that program, and knew someone in it. I hope they don't call themselves veterans.

 

[usma05]

Isn't APMC a mechanism to fill short critical wartime specialties such as Anesthesia, Gen Surg, Ortho, Neurosurg, etc? That's the impression I've been given in the past. With what shortages we have in certain specialities and no way to catch up by incentivizing, that doesn't seem like such a waste to me. Sure, don't fill these guys in battalion/brigade slots but line them up for their jobs in role II/IIIs downrange. We're going to need if it we actually go to war with a near-peer.

 

[DMBandFan86]

The APMC isn't a program, it is a unit. Any army reserve physician, dentist, veterinarian, audiologist, certain nursing, students, etc is either assigned to this unit or attached to this unit.

They also manage all reserve soldiers who are students that are currently in a stipend program. Once they finish their training program the soldier gets pushed to a local reserve unit, but they will still have a connection to the APMC for credentialing purposes and mission purposes. If the reserve soldier gets assigned to unit that is very far away from where the live then they will either continue to drill/train with a closer unit or do their drill another way. So therefore, a family physician can drill with a local infantry reserve unit, but not deploy with them for an infantry mission.

The APMC's purpose has nothing to do with super specialized docs. And it has nothing to do with a discontinued NG program. Without the APMC you would have a very fragmented reserve medical corp and wouldn't be getting reserve docs to fill needed deployment spots.

 

[Dr. Wexler]

Are you prior active duty? If so, why are you doing this? The pension?

 

[notdeadyet]

As of 2010 I saw, of Army servicemembers who deployed, 60% were active Army and 40% were Reserve Corps. I thought I'd read that this RC percentage was even higher when limited to AMEDD (but never saw actual data).

For the ARNG-side, almost every doc in my state is a Field Surgeon and deploys as such (some repeatedly). APMC makes sense for folks either in specialties that can't backfill for 62B. You could make the argument that we shouldn't recruit for those specialties and I'd support it. I was part of the ASR scam/boondoggle that 61November referred to back in the day; he's right that the majority involved did their time and got out while in residency (though in fairness, I recruited 5 docs into the Army ARNG, 2 of whom are still serving, as am I). If I had any input, I'd get rid of MDSSP entirely, focus STRAP heavily, and divert funds to the Accession Bonus.

The RC side feels a bit like being a fire extinguisher. The threads during hot and heavy deployment years focus on "why would you join the Reserve Corps? You could get torn away from your practice q2 years..." and in the absence of these deployments the threads turn to "why do we need them?"

The problem isn't with the RC, it's with Army recruiting assets we don't need. Which is true with active as well as RC. We recruit medical students because by the time someone is a fully trained, they have much less interest in military service. I'd love to see a trial of wiping away all pre-residency recruitment schemes (including HPSP) and offering a big fat Accession Bonus to get exactly who we want, but this is not to be.

 

[armytrainingsir]

Yes, but do we really need a reserve of physicians so subspecialized that no one outside of a major MTF knows what to do with them? We barely know what to do with all the hyper subspecialized docs we have on active duty..

I wouldn't call general orthopods, ENTs, neurosurgeons and ophthalmologists 'so subspecialized'.

A better complaint is why does the .mil let AD urologists do a Peds fellowship?

This program sounds like a total waste of money, even with our unnecessarily bloated military budgets.......

Get rid of useless programs like this and use the money to incentivize experienced AD specialists and sub-specialists to stay in.

- ex 61N

Tough crowd.
I thought the problem on AD now is skill rot and no challenging cases for AD surgeons? Why do we want to keep them if there is nothing for them to do?

 

[armytrainingsir]

One of the best parts of the APMC is that they will constantly loose your height/weight/APFT. About every month or two you will get an email that you are delinquent on your bi-annual performance evaluation. Doesn't matter how many times you send it in. Doesn't matter if you are physically present at the APMC to have an APFT. They will loose all records and tell you that you are delinquent.

I have found that a healthy dab of Loctite on my APFT cards keeps them tight. YMMV.

 

[244913]

As of 2010 I saw, of Army servicemembers who deployed, 60% were active Army and 40% were Reserve Corps. I thought I'd read that this RC percentage was even higher when limited to AMEDD (but never saw actual data).

For the ARNG-side, almost every doc in my state is a Field Surgeon and deploys as such (some repeatedly). APMC makes sense for folks either in specialties that can't backfill for 62B. You could make the argument that we shouldn't recruit for those specialties and I'd support it. I was part of the ASR scam/boondoggle that 61November referred to back in the day; he's right that the majority involved did their time and got out while in residency (though in fairness, I recruited 5 docs into the Army ARNG, 2 of whom are still serving, as am I). If I had any input, I'd get rid of MDSSP entirely, focus STRAP heavily, and divert funds to the Accession Bonus.

The RC side feels a bit like being a fire extinguisher. The threads during hot and heavy deployment years focus on "why would you join the Reserve Corps? You could get torn away from your practice q2 years..." and in the absence of these deployments the threads turn to "why do we need them?"

The problem isn't with the RC, it's with Army recruiting assets we don't need. Which is true with active as well as RC. We recruit medical students because by the time someone is a fully trained, they have much less interest in military service. I'd love to see a trial of wiping away all pre-residency recruitment schemes (including HPSP) and offering a big fat Accession Bonus to get exactly who we want, but this is not to be.

The .Mil will never do away with HPSP. It provides a never ending supply of indentured servants who often stay a lot longer than 4 years after they do their residencies.

Whether .Mil GME should exist at all, is another story. My opinion- they don't do it right, and should just get out of the business. Maybe retain primary care/psych but get rid of specialty training-OR- send all these people to the community for training and then bring them back on AD when complete.

But then you deal with skill rot etc.

The real question is, do we need a standing army > 100K at this point in time, and I would say we don't. The geopolitical "threats" which currently exist are either entirely manufactured (Russia/NK) studiously ignored (China) or shamelessly exploited in the interests of a middle eastern Ethno state with a blood citizenship test and a big wall over it's southern border.

- ex 61N

 

[armytrainingsir]

Are you prior active duty? If so, why are you doing this? The pension?

I was AD for 10 years. Got out because I could, but always had finishing out my 20 in the back of my mind. So, kids out of the house, a practice situation that allows it, and I am back in.

To steal the term from someone else here in another post, I had a Forest Gump military career on AD. And my AD time was in the time of retirees able to get care, none of the mandatory powerpoint training, etc. Straight to a MEDCEN out of residency, And a couple of years there, I was a clinic chief at a MEDCEN, doing as big a case as I wanted. No pushback from Admin on what we did, and my 'chief' title gave me a parking space close to the side door of the hospital. None of the meetings briefings yada yada that seems to be the norm now. So while I was happy to ETS, I had a good time on AD. YMMV.


But I do recognize that AD vs Reserves are two entirely different beasts. My unit administrator said it best. "The Army has two games. Active duty and the reserves. Pick one, learn the rules, pay your money, and take your chances."

To be honest, Obamacare was the straw that broke the camel's back that pushed me into calling a AMEDD recruiter.. BCBS for my family bumped up to $1500 per month with $75 copays and a $7500 deductible. Tricare Reserve Select is $220 per month, with a $150 deductible.

The reserves are a pretty good gig, esp when you compare it to the AD side.

Upside:
Yearly bonus, 25K/yr
Tricare Reserve Select vs commercial- $15000 savings/yr, which is money in my pocket.
05 drill pay, about 1K per month, 12Kper year.
I am currently employed by a hospital system that pays my salary during the 2 weeks of summer AT. About 5K/yr because I am 'double dipping' for those two weeks.
APFT- Keeps you from getting fat.

That is about 57K per year.

Downside:
Army BS. Really depends on your unit and your situation. Ranges from great to crappy.
Deployment. 90 BOG policy really was/is an improvement. Can they change that? Sure. Life is full of risks. Being gone has an huge intangible business burden as well. Careful planning can mitigate how severe, but you will take some sort of hit. But when I hit 18 years, no way they will deployment me due to the Title X sanctuary provisions. Heck, at 16 years, they start tracking you to make sure they don't deploy you inadvertently.
Drill. It sucks up a weekend a month. But APMC makes drill very flexible. Still sucks.


I get the hate. While I never 'hated' my time on AD, I was very happy to ETS.
And it is not for everyone. Get burned like some most certainly have, and army becomes a four letter word.


Furthermore, I do recognize that AD vs Reserves are two entirely different beasts. My unit administrator said it best. "The Army has two games. Active duty and reserves. Pick one, learn the rules, pay your money, and take your chances."


But finally, to quote the great soldier, PFC Chico Escuela, "Army been berry berry good to me".


YMMV

 

[Perrotfish]

I wouldn't call general orthopods, ENTs, neurosurgeons and ophthalmologists 'so subspecialized'.

A better complaint is why does the .mil let AD urologists do a Peds fellowship?

So now I'm just confused. The guys who are too subspecialized to drill includes general orthopedic surgeons? The Army Reserves can't figure out somewhere for ortho to drill for 2 weeks per year? In the Navy reserves these guys appear in our hospitals all of the time. They are very helpful for making PCS season and TAD skill maintenance work for the AD guys. Also there is a certain minimum amount of contact with the military you need to retain your knowledge base for the computer systems and bureaucracy that you need to navigate. The Army doesn't think is worth paying for two weeks in a hotel to make sure their docs actually know how to use Essentris/Genesis/whatever?

 

[Apollyon]

who often stay a lot longer than 4 years after they do their residencies.

Isn't retention <10% after ADSO is fulfilled? I would be hard pressed to call less than 1 in 10 "often".

 

[TheEarDoc]

The APMC isn't a program, it is a unit. Any army reserve physician, dentist, veterinarian, audiologist, certain nursing, students, etc is either assigned to this unit or attached to this unit.

They also manage all reserve soldiers who are students that are currently in a stipend program. Once they finish their training program the soldier gets pushed to a local reserve unit, but they will still have a connection to the APMC for credentialing purposes and mission purposes. If the reserve soldier gets assigned to unit that is very far away from where the live then they will either continue to drill/train with a closer unit or do their drill another way. So therefore, a family physician can drill with a local infantry reserve unit, but not deploy with them for an infantry mission.

The APMC's purpose has nothing to do with super specialized docs. And it has nothing to do with a discontinued NG program. Without the APMC you would have a very fragmented reserve medical corp and wouldn't be getting reserve docs to fill needed deployment spots.

Bingo. Most of these slots are either in backfill units or readiness units. So basically active duty doc gets sent to Germany. His slot opens up CONUS. They pull the other docs in that specialty in back fill units and they call them up to fill that CONUS slot so someone is there while active duty doc is overseas.

So it serves a purpose.

 

[Dr. Wexler]

So now I'm just confused. The guys who are too subspecialized to drill includes general orthopedic surgeons? The Army Reserves can't figure out somewhere for ortho to drill for 2 weeks per year? In the Navy reserves these guys appear in our hospitals all of the time. They are very helpful for making PCS season and TAD skill maintenance work for the AD guys. Also there is a certain minimum amount of contact with the military you need to retain your knowledge base for the computer systems and bureaucracy that you need to navigate. The Army doesn't think is worth paying for two weeks in a hotel to make sure their docs actually know how to use Essentris/Genesis/whatever?

I think there are few instances where it make sense to have a doc doing a job for 2 weeks (even a month). Surgeons see a patient in clinic, arrange the surgery, also tell the patient "btw we hope this goes perfectly because at most I'll be around for your initial follow-up". Surgeons who have shown up for a month do almost no actual surgery.

Even for anesthesiology, radiology, and EM where care is more episodic it takes a while to figure out the system and actually get all the logons, badge, etc, etc, etc. They do one week of actual work. And then they're gone. And then a month later there is an issue and no one can get a hold of them because to discuss the care they rendered when the risk management meeting is held. It's more trouble than it's worth.

It works okay if they are there for 3 months at a time. Not great. Might meet the local standard of "this place stinks so we'll take whatever locum we can get for a few months" that is the reality around MTFs in undesirable locations. But not the care you would desire if you had any choice in the matter.

If the army wants to pay medical professionals to do no medical work for the army but be on call to deploy or backfill I think that is fine. They can learn Essentris when they actually have work to do.