Jun 29, 2009
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I know, I know. I'm a (almost) PA and shouldn't be posting in the Medicine forum. Bear with me please.

I wanted some insight on how PAs are used in the military. Maybe a little day in the life from your perspective. I'm mainly interested in the safety aspect. I'm fully aware that being in the Army is dangerous by nature, but relative to all other military jobs what are we talking about?

If you know of any military medicine blogs I would love to hear about them.

I've come to you guys cause there are many more of you than at physicianassistantforum.com
 

pgg

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I'm mainly interested in the safety aspect.
Your safety as a PA is not something I'd really worry about, unless you deliberately seek out and are qualified for specific billets with SF units. The great majority of PAs, like physicians, are not placed in positions where they are at significant risk of being wounded or killed. It's not as safe as working at Kaiser here in California - there are helicopter rides, the occasional convoy (IEDs don't discriminate), and unpredictable but generally inaccurate mortar/rocket fire. Almost all of your deployed time will be spent on a well secured base doing the things that PAs do.

I don't have a lot of first hand experience with military PAs, and I'm a Navy guy anyway. The only Army PA I ever worked with was attached to a SF unit and he did a lot of higher risk operational work with them. His job was not typical though.
 
Jun 29, 2009
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Thank you for answering the question and not talking about the prereqs of being in the military! This is the first useful answer I've gotten.
 

DoctaJMa

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Thank you for answering the question and not talking about the prereqs of being in the military! This is the first useful answer I've gotten.
Im not sure what other forum you have been on and been jerked around by a troll but Military Med is usually pretty good about answering questions regardless of where you are in your training. A lot of the people that post here are not finished with med school or PA school once and awhile they arent even finished with undergrad. So feel free to post questions...sorry I cant help you out with your original question tho.
 
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It wasn't any one place that people were unhelpful. This was the only time I ask SDN. I got a lot of "in order to consider the military you first have to be willing to get shot and die" answers. Those aren't helpful or reasonable answers.

I also don't listen to anyone that doesn't directly mention their experience or sources (or recruiters for the matter...).
 

a1qwerty55

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Your safety as a PA is not something I'd really worry about, unless you deliberately seek out and are qualified for specific billets with SF units. The great majority of PAs, like physicians, are not placed in positions where they are at significant risk of being wounded or killed. It's not as safe as working at Kaiser here in California - there are helicopter rides, the occasional convoy (IEDs don't discriminate), and unpredictable but generally inaccurate mortar/rocket fire. Almost all of your deployed time will be spent on a well secured base doing the things that PAs do.

I don't have a lot of first hand experience with military PAs, and I'm a Navy guy anyway. The only Army PA I ever worked with was attached to a SF unit and he did a lot of higher risk operational work with them. His job was not typical though.
A completely uninformed reply.

Wrong- not to embellish the risk but PA's are at higher risk of dying than doctors - why?

Because most are deployed at Battalion level and go with their units during missions. If you are an Infantry BN, PA (same is true for Armor, artillery whatever) you go with your troops during missions. This usually means a lot of time outside the wire (less so now that we are hunkering down in Iraq but still more than you would lead the OP to believe. Actually your chances of getting killed with an SF unit are probably lower since they move faster and have a smaller footprint.

The risk of dying in the big scheme of things is fairly low, but low is relative. I feel for the PA's at BN level - they have a very hard an in my opinion dangerous and often thankless job.
 

Gastrapathy

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A completely uninformed reply.

Wrong- not to embellish the risk but PA's are at higher risk of dying than doctors - why?

Because most are deployed at Battalion level and go with their units during missions. If you are an Infantry BN, PA (same is true for Armor, artillery whatever) you go with your troops during missions. This usually means a lot of time outside the wire (less so now that we are hunkering down in Iraq but still more than you would lead the OP to believe. Actually your chances of getting killed with an SF unit are probably lower since they move faster and have a smaller footprint.

The risk of dying in the big scheme of things is fairly low, but low is relative. I feel for the PA's at BN level - they have a very hard an in my opinion dangerous and often thankless job.
Do you know of any PAs that were KIA?
 
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A completely uninformed reply.

Wrong- not to embellish the risk but PA's are at higher risk of dying than doctors - why?

Because most are deployed at Battalion level and go with their units during missions. If you are an Infantry BN, PA (same is true for Armor, artillery whatever) you go with your troops during missions. This usually means a lot of time outside the wire (less so now that we are hunkering down in Iraq but still more than you would lead the OP to believe. Actually your chances of getting killed with an SF unit are probably lower since they move faster and have a smaller footprint.

The risk of dying in the big scheme of things is fairly low, but low is relative. I feel for the PA's at BN level - they have a very hard an in my opinion dangerous and often thankless job.
I can't speak to how things are actually done in theater currently. However, current Army doctrine for setting up a Battalion Aid Station--composed of two units--assigns the PA to the Forward Aid Station closer to combat, while the physician mans the Main Aid Station in the rear. I've been told the rationale behind this is that PAs traditionally come from a combat medic background giving them some sort of advantage when triaging casualties and dealing with care under fire situations as compared to most physicians.

http://en.wikipedia.org/wiki/Battalion_Aid_Station
The Battalion Aid Station belongs to, and is an organic component of, the unit it supports. It may be split into two functional units for up to 24 hours, the Main Aid Station consisting of the medical doctor and three 68W combat medics or corpsmen and a Forward Aid Station consisting of the Physician Assistant and three more 68Ws or corpsmen. This allows the section to support more than one unit or care as the unit advances or withdraws.
This is also how we trained at AMEDD OBLC last summer. Additionally I have heard anecdotally from several E-6, E-7 medics that PAs are much more overworked in a combat role as compared to physicians. Take this with a grain of salt; you could always end up being on a FOB like most physicians and nurses.
 
Jun 29, 2009
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Thanks guys for the insight into unit breakdown in terms of Main and Forward operating bases. This actually corresponds very accurately to what an Army PA recruiter told me the other day. ("You're responsible for the well being of about 500-1000 soldiers")

From the stuff I've read I haven't heard much about PAs going out on missions. They obviously do, but it just doesn't sound that common. Anyone else have insight into this?

Another naive question:
Is it taken into account whether a PA has had previous military experience? In my scenario I would have never gone through basic training just the basic officer training. Would the same be expected of me as another PA with previous experience?
 
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pgg

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A completely uninformed reply.

Wrong- not to embellish the risk but PA's are at higher risk of dying than doctors - why?

Because most are deployed at Battalion level and go with their units during missions. If you are an Infantry BN, PA (same is true for Armor, artillery whatever) you go with your troops during missions. This usually means a lot of time outside the wire (less so now that we are hunkering down in Iraq but still more than you would lead the OP to believe. Actually your chances of getting killed with an SF unit are probably lower since they move faster and have a smaller footprint.

The risk of dying in the big scheme of things is fairly low, but low is relative. I feel for the PA's at BN level - they have a very hard an in my opinion dangerous and often thankless job.
Enh ... most GMOs are deployed at the battalion level too. That's what GMOs do. Their risk is also low.

In the USMC there are two physician GMOs at each infantry battalion. One of them typically mans the "forward BAS" during ops.

The truth is that in the 14 months I was deployed with USMC infantry I went along on a number of ops but only once or twice felt at risk. And by "went along on" I mean my ass was parked a couple miles from whereever anything dangerous was going on.

Outside the SF community, docs and PAs are not carrying long guns and packs and participating in raids or kicking in doors or even watching others do this from across the street. (And if they are, they're generally being misused by clueless commanders.)

The forward BAS has become largely irrelevant and unused. With the rapid air transport times, significant casualties almost exclusively bypass forward aid stations and go straight to echelon 2 or higher. Forward casualty collection points are typically run by senior corpsmen or medics.

Again though, as I noted in my first post, I'm not in the Army. From what I observed of colocated Army units at 8 or 10 FOBs in Afghanistan and Iraq though, from 2004-2006, the PAs were generally not at substantially higher risk than GMOs.

Final points -
- YMMV, every unit and every billet is different
- It's not as safe as working for Kaiser
- Overall risk is not that high IMO