Are HPSP doctors on the ground with troops?

[Chlorophyll Oracle]

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Hello everyone,

I have a question about the role of MD/DO physicians in the military. If I was to join the military through the HPSP program would I be able to be on the front lines with troops, moving with their squadrons like traditional corpsmen? I am a bit confused from the posts I've read as to whether MD's fill these roles or whether the MD's are perpetually stuffed in a hospital. If I was to join the military as a physician it would be to serve along side the troops, not be locked away in hospital doing essentially the same job as my civilian counterparts. I am curious if any current or former military docs would shed some light on this for me.

 

[maundy]

If you are an officer rank, specifically a medical officer you will not be doing combat patrols.

You might do some civic action, but usually that will be nurses or dentists for once overs, who may then be brought back to you for specialist attention or taken back to the dental facility.

And that will be in safe zones, or they will come to you.

Your surgeon skills aren't able to be utilized to their full extent as a combat medic, and you are providing greater support and assistance in a hospital with modern equipment you have the training and experience to use. A corpsman is not practical to have on standby for a dysentery outbreak, and a surgeon is overqualified and wasted in a casualty evacuation role.

 

[Lee]

Hello everyone,

I have a question about the role of MD/DO physicians in the military. If I was to join the military through the HPSP program would I be able to be on the front lines with troops, moving with their squadrons like traditional corpsmen? I am a bit confused from the posts I've read as to whether MD's fill these roles or whether the MD's are perpetually stuffed in a hospital. If I was to join the military as a physician it would be to serve along side the troops, not be locked away in hospital doing essentially the same job as my civilian counterparts. I am curious if any current or former military docs would shed some light on this for me.

As a battalion or brigade surgeon in a light infantry unit like 82D or a doc with an SF group you may find yourself in combat on very rare occasions.

However this is by far the exception to the norm. Per the Geneva Conventions, doctors are not trained to be engaged in anything more than unexpected defensive engagements with small arms, which means doctors are a liability to troops in combat.

You’re best employed and trained for work at an aid station or CSH. Those will definitely give you the experience you’re after.


Sent from my iPhone using SDN mobile

 

[deleted480308]

If you really want to run around with a rifle, you can be a medic but it is a “waste” of your medical training

 

[psychbender]

Do you want to be a doctor, or a soldier? If you want to run around and shoot bad guys, then don't bother going to medical school, just join and select infantry. If you want to be a doctor, then go to school, and stop fantasizing about being GI Joe.

Sent from my SM-G930V using SDN mobile

 

[notdeadyet]

You will be locked away in a hospital essentially doing the same job as your civilian counterparts.

Your question is like asking the county hospital if you will be going out on an ambulance all the time or if you'll have to work in the hospital. Sure, they may let you go out with lights and sirens now and again, but your job is to be a physician, not a medic.

 

[grumbo]

The answer is generally no, but it does depend on your specialty (ER and FM are most likely) and what unit you're assigned to (SOF units have the best chance). In general, you're not needed very far forward as you don't have the equipment to utilize your training. However, you don't have to be stuck in a hospital indefinitely. As a battalion surgeon, you have the best shot going forward. There are a couple of very specialized units that push very far forward but usually they only take ER and Gen surg. If you really wanted to ensure you go far forward and do medicine, go SF and be an 18D. I've seen a couple of physicians on the civilian side who went through the Q course and are 18D in the guard just for the reasons the OP asked. If you really want it, there are ways to make it happen.

 

[vitamorior]

Lee put it well.
Plenty of profus docs on my deployments, though yeah you stick to the aid station.

 

[militaryPHYS]

As the other posts have stated it depends on what specialty you choose and what kind of op tempo is going on. At a physician, for the most part you will not be on the front-lines at all.

From a surgical standpoint (ortho, general surgery) you can be put anywhere from a role II (just off the battlefield) all the way back to a tertiary care center (landstuhl or stateside at Walter-Reed/Bethesda in D.C.). Either way it is very unlikely you will be out on patrols with the units, but you will work side by side with those units on the FOB (forward operating base)...you just wait to support casualties if they occur while the patrols/missions are outside the walls of the base.

Look up "Fighting for Life". Its a video put together to show the role of a military physician during the height of OIF/OEF. Things are slowing down immensely now. OIF/OEF taught us a lot but we are likely at a turning point between the old wars and an unknown situation in the future. Don't sign up to be a doc because you will be on the front lines. Your services are needed off the battlefield to save the lives of those pushed far forward.

 

[244913]

As the other posts have stated it depends on what specialty you choose and what kind of op tempo is going on. At a physician, for the most part you will not be on the front-lines at all.

From a surgical standpoint (ortho, general surgery) you can be put anywhere from a role II (just off the battlefield) all the way back to a tertiary care center (landstuhl or stateside at Walter-Reed/Bethesda in D.C.). Either way it is very unlikely you will be out on patrols with the units, but you will work side by side with those units on the FOB (forward operating base)...you just wait to support casualties if they occur while the patrols/missions are outside the walls of the base.

Look up "Fighting for Life". Its a video put together to show the role of a military physician during the height of OIF/OEF. Things are slowing down immensely now. OIF/OEF taught us a lot but we are likely at a turning point between the old wars and an unknown situation in the future. Don't sign up to be a doc because you will be on the front lines. Your services are needed off the battlefield to save the lives of those pushed far forward.

I wouldn't consider Role II's "just off the battlefield" in the non-linear modern battlefield environment. They should change the name from forward surgical team to "surgical team placed at slightly smaller Hesco enclosed ****hole with smaller gym." So maybe call them SSHESSG's instead of FST's. For anyone who lives inside the wire, your only exposure to "combat" will be the occasional dollop of indirect fire, which comes in different flavors and varying intensity. Or maybe a truck bomb. You're not out at the little COPs getting small arms fire poured into the perimeter. We overflew FSTs constantly on MEDEVAC missions to drop guys off at the Role 3. The FST surgeons I knew were extremely bored and frustrated for the most part, especially if the nursing "talent pool" wasn't up to snuff on their base (Air Force RN's definitely tops in the looks department). They all got into the best shape of their lives though during that 6 months.

To the OP- yes MD's can be involved. It varies depending on the unit you are assigned to, your Commander's attitude towards Docs and your own personal motivation. I flew 400 combat missions as a flight surgeon on both MEDEVAC and Air Assault missions supporting JSOC. Most of the MEDEVAC missions were point of injury, some to "hot" LZ's, not just FOB-hopping. Some Marine Battalion surgeons do mounted patrols regularly, or at least they did a few years ago. It's rare for MD's to go on dismounted patrols but I've known a few guys who did that too with some regularity, there was a poster on here who went by "Ultimate DO" who had a few posts about that. That is more common in the specialized light infantry units like 82nd and 101st ABN, maybe 10th MTN.

JSOC is a different story- these guys are usually prior service Ranger qualified or long tabbed- and I know the Ranger regiment surgeons often went out with their guys because we would fly them. SF did too but with lesser frequency because of the nature of their missions and the composition of the A team which includes a very qualified PA equivalent in the 18D.

So to answer your question, MD's can be involved very "far forward" but it isn't that common. Whether any of this is a good idea is another story altogether.

- ex 61N

 

[HighPriest]

It's really uncommon. I knew one guy who was out with an SF team, and he was SF before he ever went to med school. One guy. And I know a lot of general surgeons.

I also agree that it would be a waste of your medical expertise, especially if you were a surgeon. The amount you can do for a bleeding patient in a ditch vs. the amount you can do in an OR simply isn't comparable. I'm not saying that what happens in the ditch isn't important. I am saying that you can train a boat load of guys to do the right thing in a ditch in the time it takes to train one small class of surgeons who can do much more - with the proper equipment.

 

[d2305]

Watch The Hurt Locker, and you will find out what happens to medical officers who stray away from their assigned duty.

 

[MusicDOc124]

Read the book "On Call in Hell" by Dr. Jaddick. He's a former Marine officer who became a DO and deployed as a GMO as a Navy Physician with the Marines. He was in fallujah for the push. That is the closest you might ever come. He did see combat as a physician, but was still well-protected and rarely involved. Keep in mind, this took place over 10 years ago, and he started out as a Marine already who requested to get back out there - and even that was the closest he could get.

It's a relatively short and easy read, too, so even if you're busy, you can finish it within a weekend.

 

[Gastrapathy]

At that time there were some inexperienced Marine O5s who thought docs should patrol. Really stopped being a thing by 2005. We are a hazard to the young marines because they feel obligated to keep us safe.

 

[Perrotfish]

I feel like I might be reading the OP differently than you guys. I think he means that he wants to do things 'in a warzone' more than specifically 'under fire

Hello everyone,

I have a question about the role of MD/DO physicians in the military. If I was to join the military through the HPSP program would I be able to be on the front lines with troops, moving with their squadrons like traditional corpsmen? I am a bit confused from the posts I've read as to whether MD's fill these roles or whether the MD's are perpetually stuffed in a hospital. If I was to join the military as a physician it would be to serve along side the troops, not be locked away in hospital doing essentially the same job as my civilian counterparts. I am curious if any current or former military docs would shed some light on this for me.

So I feel like I am reading two questions here:

1) Are there opportunities to feel like you're really in the military and not just doing a normal hospital job? Yes. You can take on the role of a battalion, flight, or dive surgeon. These are the docs who directly or indirectly command corpsmen. You get some basic training relevant to your job (more fun for flight surgeons) and might have the opportunity to add on a few more weeks of military short courses while in garrison. In a warzone you will see primarily sick call, but may stabilize some trauma as its on its way from the actual fighting (where your Corpsmsen work) to a higher level of care. FWIW most physicians run screaming from these jobs when they actually get to do them, because they involve so few of your very perishable medical skills. If you are one of the rare docs who discovers he enjoys planning out the medical side of the warfighting military there are opportunities to move up to SMO/regiminal surgeon/brigade surgeon/division surgeon later in your career. Those jobs parallel the role of senior line officers; lots of meetings, lots of forms, lots of supervision and planning, and very little of anything else

2) Are there opportunities to fight on the front lines? No. See above. There actually are a few opportunities, but they are vanishingly rare because that's not what military docs do. That's what Corpsmen and medics do. Just assume the answer is no.

 

[deuist]

I knew one guy who was out with an SF team, and he was SF before he ever went to med school.

I also heard of the reverse: A physician who enlisted in the Army and became an 18D.

 

[Gastrapathy]

I also heard of the reverse: A physician who enlisted in the Army and became an 18D.

There were/are? a couple MD PJs too

 

[astrostellar]

Don't join the AF.

 

[Apollyon]

I also heard of the reverse: A physician who enlisted in the Army and became an 18D.

I read about that here on SDN, and then forgot, and asked about it a few years ago, and someone recalled. Didn't that guy get KIA?

 

[DrMetal]

Read the book "On Call in Hell" by Dr. Jaddick.

Read "Paradise General"....it's a more realistic account.

Don't join the AF.

Well said!

 

[Chlorophyll Oracle]

I feel like I might be reading the OP differently than you guys. I think he means that he wants to do things 'in a warzone' more than specifically 'under fire



So I feel like I am reading two questions here:

1) Are there opportunities to feel like you're really in the military and not just doing a normal hospital job? Yes. You can take on the role of a battalion, flight, or dive surgeon. These are the docs who directly or indirectly command corpsmen. You get some basic training relevant to your job (more fun for flight surgeons) and might have the opportunity to add on a few more weeks of military short courses while in garrison. In a warzone you will see primarily sick call, but may stabilize some trauma as its on its way from the actual fighting (where your Corpsmsen work) to a higher level of care. FWIW most physicians run screaming from these jobs when they actually get to do them, because they involve so few of your very perishable medical skills. If you are one of the rare docs who discovers he enjoys planning out the medical side of the warfighting military there are opportunities to move up to SMO/regiminal surgeon/brigade surgeon/division surgeon later in your career. Those jobs parallel the role of senior line officers; lots of meetings, lots of forms, lots of supervision and planning, and very little of anything else

2) Are there opportunities to fight on the front lines? No. See above. There actually are a few opportunities, but they are vanishingly rare because that's not what military docs do. That's what Corpsmen and medics do. Just assume the answer is no.

Thank you everyone for the replies. I appreciated any wisdom you guys have because I can guarantee that you know more about the ins and outs of military medicine than I do myself. After reading the responses I realized that my wording was a bit unclear. Perrotfish understood best what I was trying to convey. My main question was whether or not as a military physician I would be in positions where I could feel active in the military. I would love to be involved in trauma cases and stabilization of injuring soldiers. Not fighting along side the soldiers, but close enough to help them when they've sustained injuries. My fear is joining the military and being trapped for the entirety of my service dealing with stuffy noses and fevers, which is important to the day to day lives of the soldiers, but not how I would want to spend my active years in service to my country.

 

[WernickeDO]

Thank you everyone for the replies. I appreciated any wisdom you guys have because I can guarantee that you know more about the ins and outs of military medicine than I do myself. After reading the responses I realized that my wording was a bit unclear. Perrotfish understood best what I was trying to convey. My main question was whether or not as a military physician I would be in positions where I could feel active in the military. I would love to be involved in trauma cases and stabilization of injuring soldiers. Not fighting along side the soldiers, but close enough to help them when they've sustained injuries. My fear is joining the military and being trapped for the entirety of my service dealing with stuffy noses and fevers, which is important to the day to day lives of the soldiers, but not how I would want to spend my active years in service to my country.

If you train in a specialty that will call for that spectrum of care (surgery, EM) then theoretically you could. Thankfully casualties are pretty low these days but at the height of OEF/OIF you better believe that mil docs were treating traumas and stabilizing combat injuries.

 

[schmoob]

Thank you everyone for the replies. I appreciated any wisdom you guys have because I can guarantee that you know more about the ins and outs of military medicine than I do myself. After reading the responses I realized that my wording was a bit unclear. Perrotfish understood best what I was trying to convey. My main question was whether or not as a military physician I would be in positions where I could feel active in the military. I would love to be involved in trauma cases and stabilization of injuring soldiers. Not fighting along side the soldiers, but close enough to help them when they've sustained injuries. My fear is joining the military and being trapped for the entirety of my service dealing with stuffy noses and fevers, which is important to the day to day lives of the soldiers, but not how I would want to spend my active years in service to my country.

Thank you for your patriotism. It seems these days that many folks just want the HPSP for the free ride and a cushy few years of payback.
Everyone in the military has a job to do. The 18D's, PJ's, SFIDC's, Field Medics, MARSOC Corpsmen, etc, are trained to provide advanced field trauma on the X. They have lots of training that support that specific mission and are much better suited handling casualty care in the middle of a TIC. They are better utilized outside the wire. For example, Marcus Luttrell (Lone Survivor) was a Corpsman, but he was also a Sniper.
A physicians role is better suited in the hospital utilizing the resources they were trained to use. There they can perform the advanced care the wounded troops need. Think of it this way: say you had a combat medic in the hospital working alongside you providing advanced care to a trauma patient (not helping you, working in a similar role as you). Do you think they would be the best person for that job? Or do you think they would be a liability?
Also as Lee mentioned, the Geneva Conventions come into play. Physicians are not Line Officers - they are non-combatants, similar to Chaplains. Depending on where physicians deploy, they will get weapons qualified and have them issued. It was quite common to see the docs carrying their weapons on the FOB.
If you want to get as close as possible to a theater of operations, it's possible. The folks who answered previously have provided solid advice.

 

[Perrotfish]

Thank you everyone for the replies. I appreciated any wisdom you guys have because I can guarantee that you know more about the ins and outs of military medicine than I do myself. After reading the responses I realized that my wording was a bit unclear. Perrotfish understood best what I was trying to convey. My main question was whether or not as a military physician I would be in positions where I could feel active in the military. I would love to be involved in trauma cases and stabilization of injuring soldiers. Not fighting along side the soldiers, but close enough to help them when they've sustained injuries. My fear is joining the military and being trapped for the entirety of my service dealing with stuffy noses and fevers, which is important to the day to day lives of the soldiers, but not how I would want to spend my active years in service to my country.

I think that you are, basically, saying you want to do a Navy GMO tour (in between internship and the rest of residency). That makes you the medical officer for a ship, battalion, wing, or one of the various groups that dive medicine docs take care of. The people who are really motived to do this kind of thing tend to gravitate towards flight and dive medicine, because they include more 'real military' experiences as part of the training and work. Most docs find that a single GMO tour (2-3 years) scratches that itch, and they then can go on to complete residency and finish out their time in a physician's job. A handful find out that, similar to scabies, no amount of scratching is going to make their itch go away. They tend to go on to do either the residency in aerospace medicine, an adolescent fellowship, or a wilderness med fellowship and then spend at 30 year career doing operational stuff.

Unsolicited advice: if you are going to do this at all, do it as a GMO tour (in between internship and the rest of residency),. Medical skills degrade rapidly, particularly if you stop using them immediately after residency before they have had a chance to solidify. If you have finished your training, you want to spend at least the next three years in a hospital, and ideally moonlighting on the side, to make yourself the best doctor you can be.

Finally: please understand that, if you don't like stuffy noses and low grade fevers, you might be disappointed in the kind of medicine you practice as a GMO. Remember that you job, on most days, will be to provide primary care to a healthy group of adolescents who are allowed to skip work if you say that they're sick. Expect malingering, common colds, sprained ankles, and a handful of serious sports medicine and psych cases. A GMO tour will usually involve no more than one deployement and even if you deploy somewhere 'real' odds are you will have at least 10 days without a trauma for every day where you manage a real injury. Every other day is going to be urgent care medicine, occupational medicine, and sports medicine.

 

[HighPriest]

Thank you everyone for the replies. I appreciated any wisdom you guys have because I can guarantee that you know more about the ins and outs of military medicine than I do myself. After reading the responses I realized that my wording was a bit unclear. Perrotfish understood best what I was trying to convey. My main question was whether or not as a military physician I would be in positions where I could feel active in the military. I would love to be involved in trauma cases and stabilization of injuring soldiers. Not fighting along side the soldiers, but close enough to help them when they've sustained injuries. My fear is joining the military and being trapped for the entirety of my service dealing with stuffy noses and fevers, which is important to the day to day lives of the soldiers, but not how I would want to spend my active years in service to my country.

Agree with Perrotfish.

No matter what you do in medicine, unless you're very, very subspecialized, the majority of your day is going to be dealing with simple problems that aren't very interesting. If you are very, very subspecialized in the military, you're still going to spend most of your time dealing with simple problems that aren't very interesting because there just isn't enough volume of high acuity cases to fill most of your time.

You can definitely deal with war-related injuries in the military. But it will not represent even a significant fraction of your work. Even if you're a GMO, most of what you're going to deal with would be the stuffy noses, fevers, and ankle sprains of soldiers who are out doing what soldiers do. Most visits to the TMC aren't guys with shrapnel protruding from their chest. It's the clap, rashes, and head colds. But you can be the guy getting those soldiers/sailors/marines back to their job.

If what you want is the rush of dealing with high acuity trauma, don't join the military. Do a civilian surgery residency in a major metro area.

If what you want is to make sure soldiers are taken care of, and to make sure that they can do their job even if it means taking care of minor, nuisance problems - or taking care of their family members so that there is one less thing they have to worry about while they're out getting shot at - then military medicine is a good place to be.

Most of my job is literally taking care of stuffy noses, but in the Army a lot of them were trauma-related. Not every war injury is a severed foot. Also - I've found that dudes are a lot more thankful if you're the guy that made them breathe better with a small surgery than if you're the guy who helped hack off a limb. I mean, I'm sure they're still thankful, but it's a harder pill to swallow.

 

[schmoob]

Something to also consider is a reverse approach. If Old Glory is really calling, you can apply for a commission in your branch of choice doing the high speed stuff. You would get incredible training and experience. And then you can go to medical school after you're done. The great thing about this path is you would have your VA benefits to pay for med school if you choose not to return to the military, you won't need to depend on the chance of HPSP.
The pay for a new college grad as an O-1 is pretty good. It would also wouldn't hurt your medical school application when you apply, it will definitely help you stand out.

It's a more unconventional approach, and not for everyone. But based on what you're looking for, I would give it some serious consideration.

 

[Perrotfish]

Something to also consider is a reverse approach. If Old Glory is really calling, you can apply for a commission in your branch of choice doing the high speed stuff. You would get incredible training and experience. And then you can go to medical school after you're done. The great thing about this path is you would have your VA benefits to pay for med school if you choose not to return to the military, you won't need to depend on the chance of HPSP.
The pay for a new college grad as an O-1 is pretty good. It would also wouldn't hurt your medical school application when you apply, it will definitely help you stand out.

It's a more unconventional approach, and not for everyone. But based on what you're looking for, I would give it some serious consideration.

I don't know. Medical school and residency are undignified, expensive, and isolating. To the extent that it is ever a good time to go through that, it makes the most sense when you are young and haven't yet built up a family/home/sense of dignity for that process to tear down.

I realize some people decide they want to be a physician later in life, and that's fine, but I would never advise someone who already knows he wants medicine to wait to get started.

 

[grumbo]

From my Army perspective, there are two very distinct types of medicine out there: clinical and operational. The clinical is very similar to what you'd get in the civilian world with lower pay and more bureaucracy. Operational medicine is all about supporting the war fighters in some way or another. Operational medicine can further be divided into conventional Army and Special Operations. The higher the unit you are in, the more meetings and paperwork and powerpoints you will do. The lower/small unit you are in, the more likely you are to do interesting things. Brigade/Division surgeons rarely have any time to see even clinic and are often doing admin things and briefing their superiors and preparing admin stuff. Battalion level jobs are more sick call/ clinic and then training. Physicians are assigned to battalion jobs only in units that are aviation, special operations, OCONUS, and deployed units (profis). Other than that, the battalions are covered by PAs only. You can go to flight surgeon school, dive school, ranger, SERE, infectious disease courses, trauma courses, airborne, air assault, mountain medicine, and a number of other courses if you want to do something outside of the hospital. You'll go to ranges, rucks, field training exercises, JRTC/NTC, staff exercises, and other training events. Many of those things are not fun, but are outside of a hospital and interesting. I've personally done many of the things listed here and I found most of it fun. I've deployed twice and had some really good experiences. I've practiced medicine on 4 continents. I've jumped out of planes, flew 100+ hours with medevac, worked with local national doctors, seen hundreds of humanitarian cases, run trauma beds and mascals, and worked with some incredible people along the way. It does come at a cost clinically, and I have had to moonlight regularly and volunteer at the MEDCENs in order to keep up some clinical skills. As a family med doc, I've found it fun, interesting, and professionally rewarding. As a civilian FP doc, I would never have done half the stuff I've gotten to do in the Army and I was very glad to be able to do it.