Army Neurosurgery

[cycletank]

I am an Army HPSP MS1 and I am interested in surgery and potentially neurosurgery. I saw the 2017 Army GME slideshow posted a few weeks ago and it states that there were 2 Army slots for neurosurgery.

Additionally, there was a slide about VA sponsored-civilian partnerships for training at University of Florida (1 slot, WRNMMC website) and UT San Antonio (1 slot according, WRNMMC website) and a note that in the 2019 Match Baylor will be an option. [According to the WRNMMC website it sounds like these slots are open across all three services]

Given that the only military neurosurgery residency is at Walter Reed and they have one slot a year across all three services, do many Army neurosurgery residents do civilian deferments or are there only ever 2 slots for entering Army neurosurgery residents? Additionally, if the VA sponsored-civilian partnerships was offered previously does that guarantee it will be offered in the future?

A motivating factor as to why I am interested in neurosurgery is that I would like to practice in a large academic hospital as opposed to the smaller Army community hospitals and potentially become involved in medical education. I noticed that neurosurgery clinics are only found at Tripler, BAMC, Walter Reed and Landstuhl. If there are any Army or military neurosurgeons out there that could add to my understanding of this field and the military that would be great.

---

Members don't see this ad.

 

[Atlas Shrugged]

I (speaking as someone not remotely interested in neurosurgery) would absolutely not do neurosurgery in the military.

It will not ensure you will work a a “large, academic” hospital. Ask the two that are working at LRMC.

The infrastructure and the trained personnel is not there. How many Army hospitals have a neuro ICU?




Sent from my iPhone using SDN mobile

 

[cycletank]

I (speaking as someone not remotely interested in neurosurgery) would absolutely not do neurosurgery in the military.

It will not ensure you will work a a “large, academic” hospital. Ask the two that are working at LRMC.

The infrastructure and the trained personnel is not there. How many Army hospitals have a neuro ICU?




Sent from my iPhone using SDN mobile

I appreciate your reply. I’m also interested in orthopedics and general surgery but I’m a little turned away by the fact that there is a large possibility that I may be practicing in a small community army hospitals such as at Ft. Irwin or Ft. Wainwright* after my residency. I doubt that surgeons there have a robust schedule and I imagine my future skills would deteriorate. My reasoning for neurosurgery was that at least BAMC, Tripler and Walter Reed (maybe even LRMC) are larger than the Ft. Irwin size hospitals that I may end up at if I go ortho or general surgery.

*I use these hospitals as an extreme example of an isolated small hospital where moonlighting at a nearby medical center may be limited.

 

[WernickeDO]

I appreciate your reply. I’m also interested in orthopedics and general surgery but I’m a little turned away by the fact that there is a large possibility that I may be practicing in a small community army hospitals such as at Ft. Irwin or Ft. Wainwright* after my residency. I doubt that surgeons there have a robust schedule and I imagine my future skills would deteriorate. My reasoning for neurosurgery was that at least BAMC, Tripler and Walter Reed (maybe even LRMC) are larger than the Ft. Irwin size hospitals that I may end up at if I go ortho or general surgery.

*I use these hospitals as an extreme example of an isolated small hospital where moonlighting at a nearby medical center may be limited.

Just so you know, there are more NS clinics than the ones you have listed.

If you have a very specific specialty and practice goal in mind that requires a fair amount of volume to maintain then you are almost always better off staying civilian. You will be subject to low volumes and low acuity in the military, as well as having difficulty obtaining the training you want. I'll make a thousand dollar bet that you change your mind from NS by MS4 but know that the Army takes very few applicants for NS. You may find yourself in a TY despite being qualified for NS. Food for thought.

 

[cycletank]

Just so you know, there are more NS clinics than the ones you have listed.

If you have a very specific specialty and practice goal in mind that requires a fair amount of volume to maintain then you are almost always better off staying civilian. You will be subject to low volumes and low acuity in the military, as well as having difficulty obtaining the training you want. I'll make a thousand dollar bet that you change your mind from NS by MS4 but know that the Army takes very few applicants for NS. You may find yourself in a TY despite being qualified for NS. Food for thought.

All very good points. I don’t have the option to go civilian as I’ve already signed on the dotted line. I knew coming in that I’d have low volumes and other limitations in military medicine. I think at the end of the day I’m going to pick my specialty on what I want to do not only in the military but afterwards as well. I sort of view my future military obligation as a service with sacrifices along the way.

 

[WernickeDO]

I think at the end of the day I’m going to pick my specialty on what I want to do not only in the military but afterwards as well. I sort of view my future military obligation as a service with sacrifices along the way.

You've got the right idea. Good luck.

 

[HighPriest]

Keep in mind with neurosurgery: the opportunity for intracranial cases is very limited in the military. You'll do plenty of spine, and you'll be competing with your ortho colleagues for cases. You'll do plenty of periperal neural stuff (decompression, what-have-you), but there's just not that much intracranial stuff. Our neuro-otologist used to do acoustics by himself, without neurosurgery support (in part because there was never a guarantee that we'd have a neurosurgeon available to support those cases), and when we did have a NS, they'd come ask us to be involved in those cases just so they weren't so sparse.