Army HPSP advice

YayPudding

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    Hi all,

    If I am accepted for Army HPSP I am looking for any and all strong reasons against accepting. In this case, I feel that the best choices can be made with guidance from the strongest voices for and against. I have my personal reasons such as national service, interest in unique opportunities, leadership training and a feeling that I would be a good fit in the team. Naturally lack of debt is great but I could manage to take the hit from loans and have family support. I have no strong drive for any particular specialty yet. Does anyone really regret taking it or have specific negative information regarding Army medical service?

    Thanks in advance.
     
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    DatInterviewDood

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      (I'm also accepted army HPSP and am considering my options)

      If you're aiming for a speciality like ENT/ortho/EM, matching can be harder through the military than in the civilian world.

      Officer training (ODS) between ms1 and ms2 prevents time for research during that summer. Though, on another thread someone suggested that ODS could be completed after ms4.

      After our intern year, post medical school, we might be shipped off somewhere as a general medical officer (GMO) for 1-2ish years. We could be in a dangerous place and killed. This also delays residency training completion, but GMO years count towards service payback so some people just do 4 years of GMO and then complete residency training as a civilian.
       
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      YayPudding

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        (I'm also accepted army HPSP and am considering my options)

        If you're aiming for a speciality like ENT/ortho/EM, matching can be harder through the military than in the civilian world.

        Officer training (ODS) between ms1 and ms2 prevents time for research during that summer. Though, on another thread someone suggested that ODS could be completed after ms4.

        After our intern year, post medical school, we might be shipped off somewhere as a general medical officer (GMO) for 1-2ish years. We could be in a dangerous place and killed. This also delays residency training completion, but GMO years count towards service payback so some people just do 4 years of GMO and then complete residency training as a civilian.
        Congratulations and all the best with arriving at a decision. Can I ask what motivated you to pursue the program? Beyond the important points you highlighted, I would like to hear from anyone who decided to make a career out of it. Does this happen frequently or does the work cause most to get out once able? I think getting a feeling for % who stay vs. leave would be informative.
         
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        HighPriest

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          Read the forum. There are plenty of arguments for and against HPSP, and while some people don't mind rewriting their opinions every year (because there are multiple posts like yours every year), you'll get more breadth by looking at older threads. You don't have to go back to 2003, just look at the sticky threads and back maybe a year or so.
          But since I'm posting: HPSP is crap. At least in the Army, I've found it to be one hell of a Faustian deal for a variety of reasons.
           
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          YayPudding

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            Read the forum. There are plenty of arguments for and against HPSP, and while some people don't mind rewriting their opinions every year (because there are multiple posts like yours every year), you'll get more breadth by looking at older threads. You don't have to go back to 2003, just look at the sticky threads and back maybe a year or so.
            But since I'm posting: HPSP is crap. At least in the Army, I've found it to be one hell of a Faustian deal for a variety of reasons.
            cheers!
             

            sonofva

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              Congratulations and all the best with arriving at a decision. Can I ask what motivated you to pursue the program? Beyond the important points you highlighted, I would like to hear from anyone who decided to make a career out of it. Does this happen frequently or does the work cause most to get out once able? I think getting a feeling for % who stay vs. leave would be informative.
              My consultant gave a lecture the other day saying there is currently a 40% retention rate to 20 years (retirement) Army widd. The primary reason people stay, per him, is that they get contractually locked in via required years of payback to around the 14 year mark. Then most people just stay until 20 years because of the retirement check.

              For example, people do USUHS and a residency and a fellowship, and then after paying it all back have 15 years time in service. At that point, for most specialties, its a better deal to just stay until retirement.

              Take that for what it's worth...

              Sent from my SM-G930V using SDN mobile
               
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              DatInterviewDood

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                Read the forum. There are plenty of arguments for and against HPSP, and while some people don't mind rewriting their opinions every year (because there are multiple posts like yours every year), you'll get more breadth by looking at older threads. You don't have to go back to 2003, just look at the sticky threads and back maybe a year or so.
                But since I'm posting: HPSP is crap. At least in the Army, I've found it to be one hell of a Faustian deal for a variety of reasons.

                I would love to hear your reasons/insight :)
                 

                colbgw02

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                  Hi all,

                  If I am accepted for Army HPSP I am looking for any and all strong reasons against accepting. In this case, I feel that the best choices can be made with guidance from the strongest voices for and against. I have my personal reasons such as national service, interest in unique opportunities, leadership training and a feeling that I would be a good fit in the team. Naturally lack of debt is great but I could manage to take the hit from loans and have family support. I have no strong drive for any particular specialty yet. Does anyone really regret taking it or have specific negative information regarding Army medical service?

                  Thanks in advance.

                  As far as I can tell, of everything bolded, the only one that means anything is the first one. To me, desire to serve is requisite, but not always sufficient. The last three are quite vague - to the point that it's something you'd hear in a recruiting pitch or on a brochure. You need to ask yourself, and be specific, what unique opportunities and leadership positions will military medicine offer that you can't easily or reasonably find elsewhere. How exactly would fitting in with milmed benefit you in ways that fitting in with civilian medicine won't? If you can't answer those questions, then they're really not reasons to join at all.
                   
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                  Homunculus

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                    My consultant gave a lecture the other day saying there is currently a 40% retention rate to 20 years (retirement) Army widd. The primary reason people stay, per him, is that they get contractually locked in via required years of payback to around the 14 year mark. Then most people just stay until 20 years because of the retirement check.

                    For example, people do USUHS and a residency and a fellowship, and then after paying it all back have 15 years time in service. At that point, for most specialties, its a better deal to just stay until retirement.

                    Take that for what it's worth...

                    Sent from my SM-G930V using SDN mobile

                    and yet, i know people getting out at 14, 14 and 12 years. the pendulum is already swinging back to a higher optempo, as trump has ceded troop numbers over to the pentagon and the generals always want more troops deployed. always. i doubt it will get to the Afghanistan 100k numbers of the past but "trying to get the Taliban to discuss terms" is going to take far more people than we have there now. BDE surgeon positions are as onerous as ever, and now there are even "field surgeons" on many BDE staffing models that can utilize another GMO. promotion to O6 has been a succession of moving goalposts-- no longer is it sufficient to do your job well. now you must have ILE, a 60A admin job, operational or deployment experience ,etc-- and even then can get passed over. 6-7 years may not seem like that long, but in the army they can seem an eternity.

                    As far as I can tell, of everything bolded, the only one that means anything is the first one. To me, desire to serve is requisite, but not always sufficient. The last three are quite vague - to the point that it's something you'd hear in a recruiting pitch or on a brochure. You need to ask yourself, and be specific, what unique opportunities and leadership positions will military medicine offer that you can't easily or reasonably find elsewhere. How exactly would fitting in with milmed benefit you in ways that fitting in with civilian medicine won't? If you can't answer those questions, then they're really not reasons to join at all.

                    this is a great point. before asking others about HPSP you really need to drill down on what exactly you are looking for. "leadership positions" are largely a mirage-- you aren't leading as much as taking orders and figuring out how to get your minions to willingly obey. keep the boxes green is your leadership goal. you are afforded little in the way of independence to solve problems, and have even less power to implement any changes you may think are advantageous. the more "leaders" i run across in the military the more jaded i become. there are exceptions of course-- some brilliant people who i would charge the hill for, but the majority are in leadership positions to avoid deployment, pass the time to retirement, or homestead. you will have far more leadership powers as a civilian. one of the common "battered spouse" type things the military attempts to pull is the "you can't do this anywhere else" sort of thing. the military does not have a monopoly on leadership or leader development. as a matter of fact, the military scrambles to copy the latest fad/trend in the civilian corporate world, never learning that the military may look like a corporation from 10,000 feet but no corporation has the turnover or rules/regulations and general inefficiency the military does. it's closer to a banana republic at times.

                    "unique experiences"-- sure, but "unique" doesn't always mean good.

                    i have more but i think having your answers to the above would be a good start for discussion.

                    --your friendly neighborhood crapping in a burnout sh*tter is "unique" caveman
                     
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                    DatInterviewDood

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                      Can I ask what motivated you to pursue the program?
                      • service to the USA
                      • debt-free
                      • I'm a journey over destination kind of person
                      • pride (both parents served)
                      • I may want to go into primary care, in which case HPSP might make more sense. Though I'm also thinking anesthesia.

                      Not sure if my reasons are great, though. And this forum makes me question myself. HBU?
                       
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                      YayPudding

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                        • service to the USA
                        • debt-free
                        • I'm a journey over destination kind of person
                        • pride (both parents served)
                        • I may want to go into primary care, in which case HPSP might make more sense. Though I'm also thinking anesthesia.
                        Not sure if my reasons are great, though. And this forum makes me question myself. HBU?
                        I have the same reasons except relatively few in my family have served in the military. Kind of a leap in that sense - I have no military background nor anyone in my immediate family!
                         

                        HighPriest

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                          I would love to hear your reasons/insight :)
                          I've written them multiple times in this thread.
                          In specific reference to your reasons for joining:

                          -service to the US
                          That is the best reason to join. That being said, I can honestly say that I don't feel like I really provided any service to my country that I couldn't have provided more efficiently as a civilian who accepts Tricare or works in a VA. I never deployed, and most in my specialty never do, so that could be a part of it. Plus, if you join the Army and get sent to a brigade surgery spot as a surgeon, the way you'll serve your country is by sacrificing your skill set on the altar of poor resource utilization. You do get to treat soldiers and their families, and that is great. Hopefully it's enough. The biggest sacrifice I made for the US was not climbing a bell tower due to the inordinate amount of idiocy I had to wade through each and every day. It wasn't exactly what I had hoped it would be when I signed up. But, that's life.

                          Debt Free
                          Yeah, sure. Of course in more than a couple of specialties you'll end up behind your civilian peers financially before you get out. I still argue that, save for maybe primary care, you'll get your debt cleared one way or another. As evidenced by the majority of physicians who do not take HPSP and yet still survive. Then there are things like the military reclaiming chunks of your pay when they decide to alter their pay scheme, and charging you interest on it.

                          Journey over destination
                          I would actually say this is a reason -not- to join. At the destination, if you're lucky, you'll have an experience to look back on and be proud of. The journey is a straight $#!tstorm start to end. Inefficiency, incompetence, poor management, zero value placed on your clinical acumen, you're just a tool in a toolbox, no more educated or capable than a 17 year old pfc. until something goes wrong, and then it's entirely on you. You'll have to fight your own people every single day of your career just to try to do your job. At first it will be because you really thought the point was to take care of people. Then you'll start to do it because you'll be fearfully watching your skills fade away from lack of use. All that, and you may be doing it in the least interesting place you can imagine, like KS or OK. That journey -sucks-.

                          Pride
                          I have a lot of green in my gene pool too. But looking back, I'd have been equally as proud just being a physician. That was an accomplishment. I don't consider my military service an accomplishment any more than that I survived it professionally. And I did it to myself. So it would be akin to taking pride in paying off a gambling debt.

                          If you pick primary care, you'll be better off in many ways than you would be on the civilian side. If you pick anesthesia? Well, I'm no anesthetist, but the few physicians I've actually met (and keep in kind I do surgery every week, it's just that 99% of the anesthetists are CRNAs) all more than doubled tgeircpay by moonlighting. The exception being a civilian contractor. But you will definitely not be expected to do a ton of cases...at least not in the Army. Good if you aren't interested in working. Bad if you want to do mostly cardiac.

                          Trust me when I say that most of my reasons for joining mirrored your own. Back before I actually spent time as a physician in the Army. In fact, my reasons mirrored yours until about 3/4 of thecway through my residency, when the veneer started to chip off what the Army was. Ask guys who have been in a long time - more than 12-15 years. I've been making it a point to do that. At least in the Army, the results are fascinating in their similarity. They all say things have continuously become worse since they joined.
                           

                          DatInterviewDood

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                            I've written them multiple times in this thread.
                            In specific reference to your reasons for joining:

                            -service to the US
                            That is the best reason to join. That being said, I can honestly say that I don't feel like I really provided any service to my country that I couldn't have provided more efficiently as a civilian who accepts Tricare or works in a VA. I never deployed, and most in my specialty never do, so that could be a part of it. Plus, if you join the Army and get sent to a brigade surgery spot as a surgeon, the way you'll serve your country is by sacrificing your skill set on the altar of poor resource utilization. You do get to treat soldiers and their families, and that is great. Hopefully it's enough. The biggest sacrifice I made for the US was not climbing a bell tower due to the inordinate amount of idiocy I had to wade through each and every day. It wasn't exactly what I had hoped it would be when I signed up. But, that's life.

                            Debt Free
                            Yeah, sure. Of course in more than a couple of specialties you'll end up behind your civilian peers financially before you get out. I still argue that, save for maybe primary care, you'll get your debt cleared one way or another. As evidenced by the majority of physicians who do not take HPSP and yet still survive. Then there are things like the military reclaiming chunks of your pay when they decide to alter their pay scheme, and charging you interest on it.

                            Journey over destination
                            I would actually say this is a reason -not- to join. At the destination, if you're lucky, you'll have an experience to look back on and be proud of. The journey is a straight $#!tstorm start to end. Inefficiency, incompetence, poor management, zero value placed on your clinical acumen, you're just a tool in a toolbox, no more educated or capable than a 17 year old pfc. until something goes wrong, and then it's entirely on you. You'll have to fight your own people every single day of your career just to try to do your job. At first it will be because you really thought the point was to take care of people. Then you'll start to do it because you'll be fearfully watching your skills fade away from lack of use. All that, and you may be doing it in the least interesting place you can imagine, like KS or OK. That journey -sucks-.

                            Pride
                            I have a lot of green in my gene pool too. But looking back, I'd have been equally as proud just being a physician. That was an accomplishment. I don't consider my military service an accomplishment any more than that I survived it professionally. And I did it to myself. So it would be akin to taking pride in paying off a gambling debt.

                            If you pick primary care, you'll be better off in many ways than you would be on the civilian side. If you pick anesthesia? Well, I'm no anesthetist, but the few physicians I've actually met (and keep in kind I do surgery every week, it's just that 99% of the anesthetists are CRNAs) all more than doubled tgeircpay by moonlighting. The exception being a civilian contractor. But you will definitely not be expected to do a ton of cases...at least not in the Army. Good if you aren't interested in working. Bad if you want to do mostly cardiac.

                            Trust me when I say that most of my reasons for joining mirrored your own. Back before I actually spent time as a physician in the Army. In fact, my reasons mirrored yours until about 3/4 of thecway through my residency, when the veneer started to chip off what the Army was. Ask guys who have been in a long time - more than 12-15 years. I've been making it a point to do that. At least in the Army, the results are fascinating in their similarity. They all say things have continuously become worse since they joined.

                            Thanks for this response. I know it's probably very annoying/boring because people like me come asking the same questions every year, but I really appreciate your insight.

                            May I ask what type of surgery that you do? And are you still serving your ADSO?
                             
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                            Homunculus

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                              ...

                              Trust me when I say that most of my reasons for joining mirrored your own. Back before I actually spent time as a physician in the Army. In fact, my reasons mirrored yours until about 3/4 of thecway through my residency, when the veneer started to chip off what the Army was. Ask guys who have been in a long time - more than 12-15 years. I've been making it a point to do that. At least in the Army, the results are fascinating in their similarity. They all say things have continuously become worse since they joined.

                              @HighPriest speaks the truth. obviously not everyone goes on the same "hero's journey" in the military-- and there are exceptions to every rule. some people seem to get screwed at every turn, others are like forrest gump and things just work out for them. for the vast majority, however, the above path is pretty true.

                              in my army experience, you start your career knowing the negatives but wanting to believe in the good parts, and hoping those horror stories are anecdotal. then as you progress you either get out with a slightly positive to slightly negative experience (for short termers) or you decide to subspecialize (or if you have a longer obligation) you begin to see patterns and understand some of what occurs behind the curtain is a systemic problem. I have been lucky enough to experience some great leaders-- people I'd "charge the hill" for or do whatever menial task they ask because of mutual respect and my trust that they genuinely work to do what's best for everyone. unfortunately this is not the norm. the longer I am in the more I distrust leadership, and the the higher they are the less I trust them. I have accepted I am simply a cog and a means to an end, which is best illustrated by the name they give for looking at staffing-- "human capital distribution." we are a commodity like everything else. once you've accepted that we are essentially pawns they move around a board the decisions that upper echelons of leadership make start to make sense. they attempt to appease the masses for the most part with lip service, while simultaneously keeping us split and in the dark while they sacrifice us to the altar of the combatant commands under the guise of "readiness." they talk about "readiness" like it's the end all be all (because that's what plays well with their combatant audience) but really want everything and are unwilling to let dependent/retiree care go. most are so far removed from real clinical medicine they don't even know the questions to ask. never once has my OIC asked me "what can I do to help you do your job better?"

                              around the 12-14 year mark chances are good your opinion of military medicine has changed significantly from when you first joined. goalposts have been moved-- "standards" that you assume the military is built on change, and things your mentors (through no fault of their own) have told you no longer are relevant. promotions, duty stations, deployments, operational assignments, administrative assignments-- all of these are subjective to the whim of the service. you see that some people and specialties are more equal than others. you see non-deployable docs working 8 hours days due to "fibromyalgia." it's quite literally death by a thousand cuts. ultimately at the 13-15 year mark there is a significant branch in the path. you either "drink the Kool-Aid" and learn to live with it and accept your fate as a function of wanting the retirement, or you decide that the constantly changing landscape and rules are not worth the next 6 years and you either get out entirely or join the reserves/guard. you can tell the "kool aid" folks because they minimize all the things they previously were passionately against and start rationalizing everything as "readiness" and "why we wear the uniform" and "enabling commanders to accomplish missions" and such. I get it- without rationalizing it this way, they'd have to admit they're institutionalized and are trading lower workload and army headaches for a retirement. that's fine. but guess who happens to be in charge of making decisions that impact deployments, assignments, promotions, etc? those same people, who for the large part are now insulated from whatever policy changes they make. how quickly they forget their past.

                              Thanks for this response. I know it's probably very annoying/boring because people like me come asking the same questions every year, but I really appreciate your insight.

                              May I ask what type of surgery that you do? And are you still serving your ADSO?

                              it's not annoying/boring as much as it is such a complex issue it requires a lengthy answer. I'm not a 100% "military sucks!!" person at all. I would have considered a career of it (and still might I guess) had assignments and my experiences been different. I think with the right tweaks it can be a great system, but this would require some tough decisions to be made, and no one likes making tough decisions because they are chasing a star or are deathly afraid of being "wrong" since culturally the military always needs someone to blame. the result is a slowly dying system no one wants to intervene on.

                              I know you didn't ask me but I'm a medical subspecialty and will be finishing my ROTC/HPSP/fellowship ADSO summer 2018. will hit the 13 year mark soon.

                              --your friendly neighborhood slow day at sick call caveman
                               
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                              HighPriest

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                                Thanks for this response. I know it's probably very annoying/boring because people like me come asking the same questions every year, but I really appreciate your insight.

                                May I ask what type of surgery that you do? And are you still serving your ADSO?
                                As homonculus said, it's not annoying, it just takes time to repeat myself. A lot of people don't even bother looked my into the older threads, and there's plenty of good information in them. Getting into HPSP is a big decision, and it warrants the extra hours-worth of effort to read a bit.
                                I'm still finishing my ADSO. For another 50 days. With regards to the type of surgery, let's just say it's not gensurg, ortho, or urology. If it were the former two, I would have certainly deployed. If it were the latter, I'd have to touch a lot of penises, and I'm not that guy.
                                 

                                ilovekitkat

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                                  I did the Army HPSP. I will have served 4 years and some days... I had a great experience.

                                  As for specialty... i find that it is more difficult to get into an Army specialty program. There are fewer spots for applicants that apply. They are highly competitive while also being nice that they are fully funded and you get paid officer pay.

                                  Army HPSP is a great experience, you truly get to serve the soldiers. It just depends on what you are looking for. If money isn't an issue and you want complete freedom I would say do not join the Army, you lose your freedom as a solider. As a civilian dentist you can still serve.. through public/community medicine/dentistry

                                  I have a blog... but it is about Army HPSP - Dental... I am not sure if it would relate to you.

                                  Good luck with your decision.
                                   
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                                  ilovekitkat

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                                    Hi all,

                                    If I am accepted for Army HPSP I am looking for any and all strong reasons against accepting. In this case, I feel that the best choices can be made with guidance from the strongest voices for and against. I have my personal reasons such as national service, interest in unique opportunities, leadership training and a feeling that I would be a good fit in the team. Naturally lack of debt is great but I could manage to take the hit from loans and have family support. I have no strong drive for any particular specialty yet. Does anyone really regret taking it or have specific negative information regarding Army medical service?

                                    Thanks in advance.

                                    I went to USC Dental School, which is the most expensive dental school in the world. Army HPSP paid for school, while also paying me captain's pay to practice my first few years out of school (In the Army). I had very good leadership which made my Army experience wonderful... but then I also had HORRIBLE leadership which made life hell. The thing is someone eventually leaves. I think the most difficult thing about educated professionals in the military is that you have to deal with hierarchy, stupid rules, and you are owned by the US Army. You lose your freedom in the Army. For years we are taught that your education gives us freedom in life... but in the Army you just have some liberties taken away... It is just the price you pay for freedom.

                                    I hope that makes some sense.
                                     
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                                    WernickeDO

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                                      I did the Army HPSP. I will have served 4 years and some days... I had a great experience.

                                      As for specialty... i find that it is more difficult to get into an Army specialty program. There are fewer spots for applicants that apply. They are highly competitive while also being nice that they are fully funded and you get paid officer pay.

                                      Army HPSP is a great experience, you truly get to serve the soldiers. It just depends on what you are looking for. If money isn't an issue and you want complete freedom I would say do not join the Army, you lose your freedom as a solider. As a civilian dentist you can still serve.. through public/community medicine/dentistry

                                      I have a blog... but it is about Army HPSP - Dental... I am not sure if it would relate to you.

                                      Good luck with your decision.
                                      Out if curiosity, how common is it for dentists to get pulled out of clinic and pushed into an admin job against their will?
                                       

                                      ilovekitkat

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                                        Out if curiosity, how common is it for dentists to get pulled out of clinic and pushed into an admin job against their will?
                                        Yes it is common and can occur at any moment. You have to remember "Mission First." If the mission needs you to do a fully admin job, then that is what you will do. If the mission needs you to do an admin job such as run a clinic, but you can still practice at that clinic then most likely your 5 day work week will have you taking one day off that week to do admin stuff. It all depends... It doesn't matter what YOU want... it is what the ARMY(Your commander) and mission needs....

                                        Generally if you want to be chair side the Army will allow this. There are some dentists that graduate from school and don't want anything to do with clinical work. This guy or girl will volunteer for admin jobs and do everything to try to evade chair side time...
                                         

                                        WernickeDO

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                                          Yes it is common and can occur at any moment. You have to remember "Mission First." If the mission needs you to do a fully admin job, then that is what you will do. If the mission needs you to do an admin job such as run a clinic, but you can still practice at that clinic then most likely your 5 day work week will have you taking one day off that week to do admin stuff. It all depends... It doesn't matter what YOU want... it is what the ARMY(Your commander) and mission needs....

                                          Generally if you want to be chair side the Army will allow this. There are some dentists that graduate from school and don't want anything to do with clinical work. This guy or girl will volunteer for admin jobs and do everything to try to evade chair side time...
                                          Okay so it can happen, but generally doesn't? Are you saying that if a dentist wants to remain clinical then they are allowed to do so, while admin jobs are more for people who volunteer or are looking to climb the monkey pole?
                                           
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                                          HighPriest

                                          Specialized in diseases of the head holes
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                                            "Mission first" is a real line term that MEDCOM (and dental apparently) like to apply to situations in which poor leadership and poor planning results in gross misuse of resources and manpower. If the mission requires that I deploy or treat an SRP patient first or be a departmental OIC or move me to a $#!thole because they need me, those are appropriate causes. But in no way does the mission -require- that I spend two years without any sort of real patient contact, thereby destroying the skillset that the Army spent hundreds of thousands of dollars to procure, when there are hundreds of equally qualified MSC officers, PAs, NPs, or primary care providers who could do the job instead. That's not "Mission First," that an idiot making idiotic decisions based upon poor planning and a need to follow the letter of a regulation without regard for or understanding of its intent.

                                            If the Army told you to leave clinic and dig a hole in the ground using a blanket when there were five unused shovels laying about, it wouldn't be "mission first." It would be poor leadership. It's not that they couldn't make you do it, it's just that making you don't it is contrary to your mission, not supportive.

                                            I hate it when terms like that are used as blinders, to ignore a broken system. There's nothing wrong with the term, but it's purpose isn't to be used as a patch-all for every poor decision.
                                             
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                                            HighPriest

                                            Specialized in diseases of the head holes
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                                              Dental definitely pulls similar crap. We had a poor SOB who was an oral pathologist. He had a normal dental clinic, plus he was the OIC of that clinic, plus he was attached to the pathology department (all of which is mission first, I can buy that). But then our pathologists decided that because we happened to work in the mouth, he should be responsible for 100% of our path specimens. So oral disease, yes. But also metastatic neck disease, skin cancers, thyroids, ear specimens, sinonasal masses, etc. of his own admission, he wasn't trained to do that much. And we were the busiest surgical service in the hospital (not that we always sent specimens, but still). We had eight regular pathologists - one of whom was a thyroid specialist - who wouldn't lift a finger to help him, because it was his assignment. (Or at least, not without a fight). He was consistently overwhelmed. Our specimens were always exceedingly late (3-4 weeks for a routine biopsy was common) and when we did get them back, 80% of the time he wasn't able to provide a diagnosis at all, and had sent the specimen out (which delayed things 1-2 additional weeks). THAT isn't "mission first." That's poor leadership.
                                               
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                                              ilovekitkat

                                              Dr. Katherine Loi, DDS
                                              10+ Year Member
                                              Army
                                              Dec 27, 2006
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                                              www.GetYourDentistOn.com
                                              1. Dentist
                                                "Mission first" is a real line term that MEDCOM (and dental apparently) like to apply to situations in which poor leadership and poor planning results in gross misuse of resources and manpower. If the mission requires that I deploy or treat an SRP patient first or be a departmental OIC or move me to a $#!thole because they need me, those are appropriate causes. But in no way does the mission -require- that I spend two years without any sort of real patient contact, thereby destroying the skillset that the Army spent hundreds of thousands of dollars to procure, when there are hundreds of equally qualified MSC officers, PAs, NPs, or primary care providers who could do the job instead. That's not "Mission First," that an idiot making idiotic decisions based upon poor planning and a need to follow the letter of a regulation without regard for or understanding of its intent.

                                                If the Army told you to leave clinic and dig a hole in the ground using a blanket when there were five unused shovels laying about, it wouldn't be "mission first." It would be poor leadership. It's not that they couldn't make you do it, it's just that making you don't it is contrary to your mission, not supportive.

                                                I hate it when terms like that are used as blinders, to ignore a broken system. There's nothing wrong with the term, but it's purpose isn't to be used as a patch-all for every poor decision.

                                                I never thought about the term "Mission First." Thank you for bringing this up. Now looking back on it the only time that it really affected me came from bad leadership. It is a cop out or reason to make you do something that you don't want to do. Usually the person stating it is doing so to reinforce that your opinion, and wants don't matter. It IS usually stated when there is poor... very poor planning.

                                                The system works.... I just believe their are poor leaders... as well as good leaders. When you get good leadership life is great. When you get bad leadership you feel trapped and because you are in the Army this is mentally draining which can lead to other problems...
                                                 

                                                ilovekitkat

                                                Dr. Katherine Loi, DDS
                                                10+ Year Member
                                                Army
                                                Dec 27, 2006
                                                79
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                                                CA
                                                www.GetYourDentistOn.com
                                                1. Dentist
                                                  Dental definitely pulls similar crap. We had a poor SOB who was an oral pathologist. He had a normal dental clinic, plus he was the OIC of that clinic, plus he was attached to the pathology department (all of which is mission first, I can buy that). But then our pathologists decided that because we happened to work in the mouth, he should be responsible for 100% of our path specimens. So oral disease, yes. But also metastatic neck disease, skin cancers, thyroids, ear specimens, sinonasal masses, etc. of his own admission, he wasn't trained to do that much. And we were the busiest surgical service in the hospital (not that we always sent specimens, but still). We had eight regular pathologists - one of whom was a thyroid specialist - who wouldn't lift a finger to help him, because it was his assignment. (Or at least, not without a fight). He was consistently overwhelmed. Our specimens were always exceedingly late (3-4 weeks for a routine biopsy was common) and when we did get them back, 80% of the time he wasn't able to provide a diagnosis at all, and had sent the specimen out (which delayed things 1-2 additional weeks). THAT isn't "mission first." That's poor leadership.

                                                  Agreed. That's poor leadership. It is a shame that people are allowed to be so lazy. In my experience the more a person kisses up to leadership the more they can get away with. I know a person that is "out processing" for month. He is literally sitting on a computer and doing nothing. He says that he is "bored" but in reality he is just lazy and evading any time of chair side work. The leadership lets him get away with this because he kisses their a$$es and they cannot see clearly.
                                                   

                                                  ilovekitkat

                                                  Dr. Katherine Loi, DDS
                                                  10+ Year Member
                                                  Army
                                                  Dec 27, 2006
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                                                  www.GetYourDentistOn.com
                                                  1. Dentist
                                                    Okay so it can happen, but generally doesn't? Are you saying that if a dentist wants to remain clinical then they are allowed to do so, while admin jobs are more for people who volunteer or are looking to climb the monkey pole?
                                                    You will be kept as a clinical dentist a majority of the time.... if you want to practice they will of course let you practice. However, if you are needed for something else because your commander needs you to do a special project then you won't be doing dentistry. I would say 75% of time you are doing dentistry, 25% admin. Of course this is all based on what is needed of you at the time....
                                                     

                                                    HighPriest

                                                    Specialized in diseases of the head holes
                                                    10+ Year Member
                                                    Army
                                                  • Jan 1, 2008
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                                                    1. Attending Physician
                                                      I never thought about the term "Mission First." Thank you for bringing this up. Now looking back on it the only time that it really affected me came from bad leadership. It is a cop out or reason to make you do something that you don't want to do. Usually the person stating it is doing so to reinforce that your opinion, and wants don't matter. It IS usually stated when there is poor... very poor planning.

                                                      The system works.... I just believe their are poor leaders... as well as good leaders. When you get good leadership life is great. When you get bad leadership you feel trapped and because you are in the Army this is mentally draining which can lead to other problems...
                                                      The system works depends upon the definition of "works." It hasn't collapsed, so by that definition it is working. But with regards to efficiency, patient outcomes, skill maintenance, resource utilization....I'd say the system is barely functional - really only kept alive by will and a constant influx of cash.
                                                      I can't speak for DENTAC. I work with mostly oral surgeons quite often, and they always leave me with the impression that all things compared, dental is a better-run organization. At least at the posts where I have worked.
                                                       
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                                                      jabreal00

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                                                      1. Attending Physician
                                                        I was in the Army for 11 years. I had a 3 year HPSP. I had added time for fellowship through the Army. I had no regrets about joining the military. I got decent training. Met some good people. Came out debt free and had considerable savings (living below my means). However I did not hesitate to get out when my obligation was up after 11 years of service. I am more professionally satisfied in my civilian practice. More breadth of patients. More ability to expands one's repertoire from a procedural standpoint. I felt like I was spinning my wheels while I was in the military doing the same bread and butter stuff on generally healthy patient populations. No way I could have stayed an additional 9 years for a career given all the antics and administrative buderns foisted on MEDCOM.
                                                         
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                                                        Kibe3143

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                                                        Dec 14, 2016
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                                                          I did the Army HPSP. I will have served 4 years and some days... I had a great experience.

                                                          As for specialty... i find that it is more difficult to get into an Army specialty program. There are fewer spots for applicants that apply. They are highly competitive while also being nice that they are fully funded and you get paid officer pay.

                                                          Army HPSP is a great experience, you truly get to serve the soldiers. It just depends on what you are looking for. If money isn't an issue and you want complete freedom I would say do not join the Army, you lose your freedom as a solider. As a civilian dentist you can still serve.. through public/community medicine/dentistry

                                                          I have a blog... but it is about Army HPSP - Dental... I am not sure if it would relate to you.

                                                          Good luck with your decision.

                                                          Link to the blog? I'm going to Herman Ostrow in the fall myself.

                                                          FIGHT ON!!!
                                                           

                                                          ilovekitkat

                                                          Dr. Katherine Loi, DDS
                                                          10+ Year Member
                                                          Army
                                                          Dec 27, 2006
                                                          79
                                                          58
                                                          CA
                                                          www.GetYourDentistOn.com
                                                          1. Dentist
                                                            Link to the blog? I'm going to Herman Ostrow in the fall myself.

                                                            FIGHT ON!!!
                                                            My blog GetYourDentistOn.com can be googled or you can go to it directly. I am not suppose to promote it on SDN. I have no financial gain in getYourDentistOn i did it to help predents and dental students that are going into dentistry or Army dentistry. I an currently our processing from the Army... Please let me know if you have any questions. Good luck!

                                                            I hope everyone is having a nice summer and doing productive things!
                                                             
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