Connollyr

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Jul 28, 2011
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Hi everyone. I am a current med school applicant and I am also applying for HPSP. While researching military GME, I came across this austere wilderness medicine fellowship for Emergency docs at Madigan. I would be interested in any information about what this fellowship is and what it would mean for an army doc's career opportunities. I of course don't know what residency I will choose yet and I am not asking for advice in this discussion about whether or not to join the military. Let's also stay away from any posts about HPSP in general because it has been discussed to death. Unless the discussion somehow manages to legitimately connect HPSP to austere wilderness medicine in some way. So, is there anybody out there who has been through this program, is currently in it, or knows anything about it? Thanks in advance.
 
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DocRGR

It's generally geared toward EM docs with a strong interest in being operationally focused throughout their careers. The intention for fellows graduating the program would be a follow on assignment with a unit. Current Fellowship Director is COL Ian Wedmore who is also the EM consultant for the Army. Cool program, just know if you did it you are sort of declaring a focus on medicine outside of the hospital.
 

Perrotfish

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How to practice Wilderness Medicine, by service:

Army:
Step 1) Get a 240+ on your step 1, ace your rotations, and match into one of the Army's insanely competitive EM slots
Step 2) Show outstanding clinical acumen and military bearing in your two year utilization tour after residency.
Step 3) Apply to, matriculate in, and complete an Austere Wilderness Medicine Fellowship.

Navy:
Step 1) Be an Ob-Gyn Intern
Step 2) Fail to match into the rest of Ob-Gyn residency
Step 3) Get shipped to the wilderness as a GMO

Air Force:
Wilder-what?
 
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Connollyr

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Jul 28, 2011
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It's generally geared toward EM docs with a strong interest in being operationally focused throughout their careers. The intention for fellows graduating the program would be a follow on assignment with a unit. Current Fellowship Director is COL Ian Wedmore who is also the EM consultant for the Army. Cool program, just know if you did it you are sort of declaring a focus on medicine outside of the hospital.
When you say operationally focused, am I correct in assuming this means these physicians will spend most of their time in the field? Or do you mean to say that most of their time will be spent in managerial positions. I have seen the term used both ways on this site.
 

teacherman84

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How to practice Wilderness Medicine, by service:

Army:
Step 1) Get a 240+ on your step 1, ace your rotations, and match into one of the Army's insanely competitive EM slots
Step 2) Show outstanding clinical acumen and military bearing in your two year utilization tour after residency.
Step 3) Apply to, matriculate in, and complete an Austere Wilderness Medicine Fellowship.

Navy:
Step 1) Be an Ob-Gyn Intern
Step 2) Fail to match into the rest of Ob-Gyn residency
Step 3) Get shipped to the wilderness as a GMO

Air Force:
Wilder-what?
I was just discussing this with an Army friend, its also available to FM and IM
http://www.mamc.amedd.army.mil/gme/Residencies_Fellowships/austereWilderness.HTM
 

teacherman84

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Interesting... so I guess you don't need to get one of those "insanely competitive EM slots" after all. Although at this point I have to admit I do find Emergency Medicine very attractive...
I did too...until I stepped into an ED as a third year.
 

colbgw02

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When you say operationally focused, am I correct in assuming this means these physicians will spend most of their time in the field? Or do you mean to say that most of their time will be spent in managerial positions. I have seen the term used both ways on this site.
Both, but mostly the latter. I won't bother to explain the specifics, but there are MTOE units and then there are TDA units. For MTOE, think an infantry battalion; for TDA, think Walter Reed.

Most Army physicians spend the large majority of their career at TDA units. They have plenty of administrative and often managerial positions, but they're still working at a medical treatment facility.

People who spend their career on the "operational" side of things are often an organic part of MTOE units, serving as a battalion, brigade, or division surgeon for example. They train with the unit, go on FTXs with the unit, deploy with the unit, etc.. In garrison, they're either largely or exclusively staff (read: administrative) positions, particularly higher up the food chain.
 
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Connollyr

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Jul 28, 2011
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Both, but mostly the latter. I won't bother to explain the specifics, but there are MTOE units and then there are TDA units. For MTOE, think an infantry battalion; for TDA, think Walter Reed.

Most Army physicians spend the large majority of their career at TDA units. They have plenty of administrative and often managerial positions, but they're still working at a medical treatment facility.

People who spend their career on the "operational" side of things are often an organic part of MTOE units, serving as a battalion, brigade, or division surgeon for example. They train with the unit, go on FTXs with the unit, deploy with the unit, etc.. In garrison, they're either largely or exclusively staff (read: administrative) positions, particularly higher up the food chain.
Thank you. This was extremely helpful.
 

orbitsurgMD

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Can't you just get a t-shirt that says "deploy me" on the back? It seems that having done that fellowship would have a similar, career-long effect.
 

Connollyr

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Can't you just get a t-shirt that says "deploy me" on the back? It seems that having done that fellowship would have a similar, career-long effect.
I would assume that most people considering the program would be interested in deploying regularly. What would be the point of developing the skill set if you weren't intending to use it?
 

Connollyr

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Does anyone know what the academic program actually looks like? I know that it is one year in length but it is very hard to find much more information than that. Do you spend most of your time training in the field or are you in the hospital seeing patients and attending lectures?
 

colbgw02

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I would assume that most people considering the program would be interested in deploying regularly. What would be the point of developing the skill set if you weren't intending to use it?
Your question is a great one. As it turns out, military medicine excels at spending lots of money training personnel to acquire skills that then go underutilized, misutilized, or unused.
 

Connollyr

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Your question is a great one. As it turns out, military medicine excels at spending lots of money training personnel to acquire skills that then go underutilized, misutilized, or unused.
This is a complaint I have read more than once on SDN. It is a little bit scarry but from my limited management experience it seems that you have to work with what you have. Is that what is going on here or are we talking about something more pervasive?
 

deuist

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This is a complaint I have read more than once on SDN. It is a little bit scarry but from my limited management experience it seems that you have to work with what you have. Is that what is going on here or are we talking about something more pervasive?
It's pervasive in that the military spends loads of money moving and training people for job skills they don't need. I still don't know why the person who takes my ID card picture is a tech sergeant. That's quite a bit of money spent on basic training, tech school, and assignments (plus the costs of moving and healthcare) just to click a button.

Just look at the training needed for Air Force flight surgeons. Can anyone tell me why six weeks are needed in Ohio? Couldn't that training be distributed among multiple bases since the goal is to sit through PowerPoints?
 

62A

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Does anyone know what the academic program actually looks like? I know that it is one year in length but it is very hard to find much more information than that. Do you spend most of your time training in the field or are you in the hospital seeing patients and attending lectures?
Does anyone know what the academic program actually looks like? I know that it is one year in length but it is very hard to find much more information than that. Do you spend most of your time training in the field or are you in the hospital seeing patients and attending lectures?
Curriculum:
playing in the outdoors: rope work, climbing/repelling, rescue, skiing/snowshoing, hiking, austere medicine
~4 staff shifts/month
teaching a lot of AWLS course (http://awls.org/) across the country (and occasionally international)

most of the past fellows were already well established in the operational world (special ops in particular).

this year there are two fellows at MAMC, one EM and the other FM

hope that helps.
 

Connollyr

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Jul 28, 2011
153
39
Yonkers yo... Yonkers.
Status
Medical Student
Curriculum:
playing in the outdoors: rope work, climbing/repelling, rescue, skiing/snowshoing, hiking, austere medicine
~4 staff shifts/month
teaching a lot of AWLS course (http://awls.org/) across the country (and occasionally international)

most of the past fellows were already well established in the operational world (special ops in particular).

this year there are two fellows at MAMC, one EM and the other FM

hope that helps.
Exactly what I wanted to know. Thank you.
 

Connollyr

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most of the past fellows were already well established in the operational world (special ops in particular).
Does that mean people who get to do this fellowship have usually served before med school? Or is this something that could potentially be achieved by a regular HPSP student.
 
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