Ask Me Anything: Military Medicine

[militaryPHYS]

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Right, I get what it is. Our ship sup was a GMO, though she had a shore billet (both of them, actually, since I was on two small buoys). I’m just wondering how hard it is to get orders to an amphib or a carrier as a general GMO.

Not too hard. Just start early with your requests to your detailer. Like I said, usually they aren't the most sought-after billets in the milmed community, therefore you have a good chance of getting it if you start early and make your preferences known

 

[lancecorpsman]

Are you a prior Lance Corporal who then transitioned to a corpsman and now becoming a physician? Ironically that is my exact pathway since 2003. Congrats on the adventure thus far!

Anyway, very easy to get green side orders if you want them in the Navy. After internship you can request to do a GMO tour (not always everyone's first option therefore you will have prime pickings) and you can request a green-side billet from your detailer. If your plans change and you don't necessarily WANT to go out for a GMO tour, you may have the opportunity to go straight through in to residency. If this is the case, and you are still interested in green side work, your specialty really needs to be primary care (ideally FP or ER). There are members of every specialties who have green side billets these days (we even have ortho green-side billets), but they are not necessarily your "operational billets" that GMO's and primary care can fill.

If I can offer my two cents... Don't focus on just one thing, especially if you are entering a pathway through military medicine. Your interests, passions and life can change along the way and you should let that happen naturally. Initially I was in the same boat -- I wanted to be primary care, green side, Oorah doc. I then realized a surgical pathway suited me best and then I realized ortho was where I fit. Still, I was highly considering requesting a FMF billet as a GMO. I landed my ortho internship and was then offered to go straight through in to residency. An offer like that you can't turn down (you can, but it would be a very personal decision). For me it was a career decision, family decision and life decision to finish ortho residency as fast as possible. If you truly want to do something you can almost always make it happen after you are specialized and with more rank on your collar (i.e. if I still want to ground pound with a green-side medical billet I could, even as an orthopedic surgeon).

Hope that helps!

Being a physician in the military isn't that high up on the list. The only part I like about my military experience is being with division. I've been blue side and with MLG, hated every single second of it. If I had the option of working at Balboa vs. permanently in the field at 29 Palms, I would pick the latter lol.

In all seriousness, I would probably only join as a physician after completing a civilian residency. If I ever became an orthopedic surgeon, active duty pay would be out of the question. I would rather cruise on my own yacht and fly on private jets...

Do you know anything about the physicians in the reserves? I've met a physician who is attached to a reserve infantry battalion. He is in EM and a professor at Stanford. He was one of the most moto individuals I've encountered and it seemed like he has the best of both worlds. When not deployed, he is working at a high speed ED.

 

[Matthew9Thirtyfive]

If I had the option of working at Balboa vs. permanently in the field at 29 Palms, I would pick the latter lol.

I’m totally the opposite lol. I’m looking forward to being a ship’s surgeon.

 

[militaryPHYS]

I've been blue side and with MLG, hated every single second of it. If I had the option of working at Balboa vs. permanently in the field at 29 Palms, I would pick the latter lol.

Hey, it isn't for everyone. Just make sure you aren't jaded by the classic "evil blue side" mantra of every green side corpsman known to man. Milmed does have its flaws, but sometimes the worst rap it can get is from marines or green side corpsman who have been raised on the evils of the blue side. Believe me, I was one of them. If you are considering coming back in anyway once you are done with training then at least take your uniform off, shadow a physician you respect in the hospital and make sure you really want to take a break in service and give up on those years counting for you in your retirement years.

If I ever became an orthopedic surgeon, active duty pay would be out of the question. I would rather cruise on my own yacht and fly on private jets...

The income gap is real, but not to the extent everyone thinks. Over the last few years it has been closing as opposed to expanding given the changes in our healthcare system. It also doesn't factor in lifestyle which, to me, is most important. You'll live comfortably either way. Lavishness is a personal preference.

Do you know anything about the physicians in the reserves?

I honestly don't know a whole lot about the reserves. From the little I do know, the ideal way to utilize it is to bridge a small gap you may have if you don't want to stay until 20 active duty years as a military physician but want to continue serving to reach retirement benefits. Doing it as a side gig during your primary earning years will add some unknown and uncertainty to life and practice, but sometimes that is what people are searching for.

 

[MD#6]

I'm curious if you (or anyone else in Mil Med) has had any experience with co-location ~ specifically if I should anticipate that co-location will be more difficult (or potentially not possible) given that my spouse will be AD - special operations... ALSO is co-location possible during residency?

--incoming USUHS student

 

[militaryPHYS]

I'm curious if you (or anyone else in Mil Med) has had any experience with co-location ~ specifically if I should anticipate that co-location will be more difficult (or potentially not possible) given that my spouse will be AD - special operations... ALSO is co-location possible during residency?

--incoming USUHS student

I have direct experience with co-location. Things that make co-location easier are: Same Service (navy-navy), milmed-milmed, and of course officer-officer. If there are residency spots and duty stations for you, as a military physician, that are close to spots your spouse is able to go too then it is a good possibility you can make it work. One (or both) of you will usually have to sacrifice something in terms of location, but sometimes it can be a win-win.

PM me if you want to discuss specifics and likelihood.

 

[John1513]

Greetings, question about Sports Medicine with your perspective of military Ortho.

1) do ortho docs get annoyed when they are sent cases that aren’t surgical? Do they see non-surgical mgmt of injuries as beneath them?

2) if an MTF isn’t near a SMART clinic (or large MedCen) it doesn’t appear patients can be sent to Sports Medicine. There isn’t even a drop down option for Sports Medicine in AHLTA’s referrals tab. Only Orthopedics.

3) I see you have mentioned that you got into Sports Med fellowship, congrats! Thus, what is your view point on FP Sports Med docs in Military medicine?

4) is it frowned upon to send ortho a patient without MRI/imaging?

Thank you for your time. Thanks for being OCONUS

 

[militaryPHYS]

Some Ortho guys get upset when they see too many non op injuries but that is not universal. I don’t have any objective data. In the military we make the same amount no matter what we do. Therefore I try to remember that getting the member back to full duty is the primary objective (surgical or not); funding my boat payment or second home is not.

Sometimes you have to talk to your local CHCS/AHLTA people to fix referral dead ends if you know the service should exist.

FP sports med guys are great. Often times we get the best (already worked up completely) consults from them. Only issue arises when they try to use unverified data to treat injuries when it hasn’t been validated. Then we see the member for the first time on their 5th month of their second period of LIMDU. I’d rather get crappy consults then see members get limped along for months and months before seeing a surgeon...and yes, they should always have appropriate imaging ahead of time (at least plain films)

 

[John1513]

Some Ortho guys get upset when they see too many non op injuries but that is not universal. I don’t have any objective data. In the military we make the same amount no matter what we do. Therefore I try to remember that getting the member back to full duty is the primary objective (surgical or not); funding my boat payment or second home is not.

Sometimes you have to talk to your local CHCS/AHLTA people to fix referral dead ends if you know the service should exist.

FP sports med guys are great. Often times we get the best (already worked up completely) consults from them. Only issue arises when they try to use unverified data to treat injuries when it hasn’t been validated. Then we see the member for the first time on their 5th month of their second period of LIMDU. I’d rather get crappy consults then see members get limped along for months and months before seeing a surgeon...and yes, they should always have appropriate imaging ahead of time (at least plain films)

Thank you for your reply!! Do you mean prolotherapy or PRP in the unverified data?

 

[nosoddy]

I was an 0311 - taking a Navy slot this year at USUHS. Thanks for the info folks, been slightly dreading meeting the green weenie again.

 

[John1513]

I was an 0311 - taking a Navy slot this year at USUHS. Thanks for the info folks, been slightly dreading meeting the green weenie again.

What does the green weanie mean? I can’t figure it out

 

[John1513]

😱 Also, I just found out that there is a fee for the No-Fee gov’t/military passport for OCONUS PCS. It is 35 dollars processing fee, and an additional 15 bucks if you don’t have a passport photo.

 

[Matthew9Thirtyfive]

I was an 0311 - taking a Navy slot this year at USUHS. Thanks for the info folks, been slightly dreading meeting the green weenie again.

Welcome aboard lol.

 

[MedicalDoge]

Hello! Thank you for taking the time to answer questions.

I am woefully ignorant on the subject of military medicine, so I hope I don't sound too naive.

I am entering a top 25 civilian med school this Fall, and didn't apply HPSP, but I hear you can apply one year into med school as well. Military service and medicine has always intrigued me, and deep down I feel a call to serve somehow.

My main career interest right now is Infectious Disease. I have heard that ID would be a very translatable specialty into military medicine, and that you would see a plethora of "cool" cases/diseases working in the military abroad as compared to civilian medicine.

Anyway, my main question is what would be the best path/branch to take if I decide to do the HPSP after the first year (after I do a lot of program research first of course)? To your knowledge, do ID docs in the military make much less than their civilian counterparts?

 

[Gastrapathy]

Not too hard. Just start early with your requests to your detailer. Like I said, usually they aren't the most sought-after billets in the milmed community, therefore you have a good chance of getting it if you start early and make your preferences known

Not accurate. These billets let people homestead where they did internship in many cases and are open to women.

 

[Matthew9Thirtyfive]

Not accurate. These billets let people homestead where they did internship in many cases and are open to women.

So you think if a gmo tour is necessary, it’s not a sure thing to get a ship billet? I kind of figured those would be the least desirable.

 

[Gastrapathy]

So you think if a gmo tour is necessary, it’s not a sure thing to get a ship billet? I kind of figured those would be the least desirable.

Women have limited options. Lejeune and 29 Palms suck. For the non flight or dive people, it’s greenside or a ship. Like everything elss, it depends on the year. There aren’t actually that many ship billets and they open every 2-3 years. If you’re trying to homestead in Norfolk or SD, those jobs can suddenly look desirable.

That said, SWOs are not pleasant people. Give me a Marine unit any day of the week.

 

[Matthew9Thirtyfive]

Women have limited options. Lejeune and 29 Palms suck. For the non flight or dive people, it’s greenside or a ship. Like everything elss, it depends on the year. There aren’t actually that many ship billets and they open every 2-3 years. If you’re trying to homestead in Norfolk or SD, those jobs can suddenly look desirable.

That said, SWOs are not pleasant people. Give me a Marine unit any day of the week.

Good to know. SWOs are a mixed bag. I’ve had some awesome ones and some collossal dbags.

 

[Melchizedek]

I'm glad I found this thread! I just started exploring this option, so bear with me if I say something ridiculous.

1. The impression I got from some of the threads/websites I read is that if you take the HPSP for any of the branches, you should have a desire to be a part of the military first, which would come before a desire to be in medicine. Would you say this is true?

2. What residencies in the military match have programs comparable in training/equal in prestige of top to mid ranked residencies in their civilian match counterparts?

3. How often do people do gen surg or IM, serve their commitment, and then apply for civilian fellowships? How successful are these applicants at obtaining top to mid ranked fellowships?

EDIT: Adding a 4th question
4. I looked at the GPA/MCAT Requirments for each branch's HPSP. How flexible are those requirements? (i.e. well above requirement MCAT but below requirment GPA) and how do Post bacc/SMP GPA's figure into that minimum requirement?

Thanks in advance.

 

[Melchizedek]

Bueller? Bueller....?

 

[militaryPHYS]

Bueller? Bueller....?

First off, if you need immediate answers try private messaging or Twitter. SDN doesn't give me alerts on my phone and I'm pretty busy lately.

1. The impression I got from some of the threads/websites I read is that if you take the HPSP for any of the branches, you should have a desire to be a part of the military first, which would come before a desire to be in medicine. Would you say this is true?

If you are pursuing medicine then medicine is and likely always will be your primary life goal. The key is realizing that when you sign up for the military it is not just a free-ride through medical school. Once you sign the line your primary responsibility is to the military, not necessarily your prestigious medical education depending on current global events.

2. What residencies in the military match have programs comparable in training/equal in prestige of top to mid ranked residencies in their civilian match counterparts?

Overall, all active duty residencies provide excellent education, diversity to military/civilian practice and produce a great specialist. There is nothing prestigious about them and if you are looking for "prestige" then you're in the wrong place. Military residencies are focused on education, literature and caring for our active duty members. We would need more specifics about branch of service and specialty desired to provide any further info as there are many residencies and they all have their positives and negatives.

3. How often do people do gen surg or IM, serve their commitment, and then apply for civilian fellowships? How successful are these applicants at obtaining top to mid ranked fellowships?

Many serve their commitment and get out. If you put-out during residency and contribute as a provider and leader as an attending then military service will help your application to any civilian fellowship. If you coasted, did nothing during your time paying back a commitment and have nothing to show for your time in service then that reflects negatively on your application...not the military itself. You are responsible for how your CV looks, not the military.

4. I looked at the GPA/MCAT Requirments for each branch's HPSP. How flexible are those requirements? (i.e. well above requirement MCAT but below requirment GPA) and how do Post bacc/SMP GPA's figure into that minimum requirement?

This is service specific and dependent on your supporting application. Unfortunately, just like civilian med schools, if your numbers are below a certain cutoff then you may not even get a first look just because there are so many applicants.