Can the military force you to do a residency you don't want?

[IgD]

10 USC 2122 (http://www.law.cornell.edu/uscode/html/uscode10/usc_sec_10_00002122----000-.html)

(b) The Secretary of Defense may require, as part of the agreement under subsection (a)(2), that a person must agree to accept, if offered, residency training in a health profession skill which has been designated by the Secretary as a critically needed wartime skill.

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[BigNavyPedsGuy]

10 USC 2122 (http://www.law.cornell.edu/uscode/html/uscode10/usc_sec_10_00002122----000-.html)

(b) The Secretary of Defense may require, as part of the agreement under subsection (a)(2), that a person must agree to accept, if offered, residency training in a health profession skill which has been designated by the Secretary as a critically needed wartime skill.

Sadly, I think you answered your own question. For the most part, HPSP students haven't/don't get forced into residency spots they down't want. They frequently get internships they don't want, do 4 years as a GMO and get out. At least that's how it goes down in the Navy.

 

[NavyFP]

10 USC 2122 (http://www.law.cornell.edu/uscode/html/uscode10/usc_sec_10_00002122----000-.html)

(b) The Secretary of Defense may require, as part of the agreement under subsection (a)(2), that a person must agree to accept, if offered, residency training in a health profession skill which has been designated by the Secretary as a critically needed wartime skill.

Sadly, I think you answered your own question. For the most part, HPSP students haven't/don't get forced into residency spots they down't want. They frequently get internships they don't want, do 4 years as a GMO and get out. At least that's how it goes down in the Navy.

I have a couple of big problems with this thread.

1) Yes, the law says the military can force you to do a residency. No, they won't do it. Making phyisicians train in an area they do not want is stupid. All you will get out on the other side is a poorly trained, unmotivated, bitter specialist that I wouldn't want working on the enemy much less our guys. Add to that the hugely negative impact it would have on recruitment and you have a perfect storm against this idea. I would expect a draft first. The option to decline GME 2 positions is intact and will remain intact.

2) The VAST majority of graduating student get an internship in an area they wish to train. This year in the Navy, 12 students fell through the match and ended up in something they did not initially list. 12/260 = 4.6% Seventy-five percent got their first choice and 91% got in their top 3.

It really gets aggravating when posters insinuate that the military deliberately goes out of its way to make people's live miserable. It doesn't.

Can we complain about Administration in the Navy? Yep. Can we complain the the current OP-tempo suck? Yep. Can we complain about all the extra duties and obligations we have based upon the fact that we wear a uniform? You betcha. My current beef is that the pharmacy at NNMC is pathetically slow. But let's get off this boat that nobody( or more don't than do) gets what they want.

 

[Galo]

I have a couple of big problems with this thread.

1) Yes, the law says the military can force you to do a residency. No, they won't do it. Making phyisicians train in an area they do not want is stupid. All you will get out on the other side is a poorly trained, unmotivated, bitter specialist that I wouldn't want working on the enemy much less our guys. Add to that the hugely negative impact it would have on recruitment and you have a perfect storm against this idea. I would expect a draft first. The option to decline GME 2 positions is intact and will remain intact.

2) The VAST majority of graduating student get an internship in an area they wish to train. This year in the Navy, 12 students fell through the match and ended up in something they did not initially list. 12/260 = 4.6% Seventy-five percent got their first choice and 91% got in their top 3.

It really gets aggravating when posters insinuate that the military deliberately goes out of its way to make people's live miserable. It doesn't.

Can we complain about Administration in the Navy? Yep. Can we complain the the current OP-tempo suck? Yep. Can we complain about all the extra duties and obligations we have based upon the fact that we wear a uniform? You betcha. My current beef is that the pharmacy at NNMC is pathetically slow. But let's get off this boat that nobody( or more don't than do) gets what they want.

I don't think anyone has stated the military deliberately chooses something you dont want. It's the nature of the beast, and that's what people need to understand. There is no "man" singling anyone out to screw their life's, (that comes later). But with the recent results of the match, you have to be a little skewed to say that the VAST majority got what they wanted. Is that a factual statement or opinion? How many med students set out to become GMO's or Flight surgeons for 1-2 yrs, to then only add to their commitments when it comes time to try for a residency of their choice? In the AF, for the last two years it has been about a third (someone correct me if I'm wrong) that are "forced" into gmo/fs slots. Why would anyone in their right mind take their 2nd or 3rd choice?? Do you think in the civilian match there is such a high percentage of people interupting their training for up to two years?

The message most of us who went through military medicine are trying to get out, is that it's a system designed to work for itself with you as a distant second. That means that there is a significant chance (???30%) that you may end up not getting to train in what you want, and have to do 2-4 yrs as an untrained physician. As far as numbers are concerned, they're there, it may just be difficult to find out the actual % of people who got what they wanted, as the military is no longer publishing that data.

 

[NavyFP]

I don't think anyone has stated the military deliberately chooses something you dont want. It's the nature of the beast, and that's what people need to understand. There is no "man" singling anyone out to screw their life's, (that comes later). But with the recent results of the match, you have to be a little skewed to say that the VAST majority got what they wanted. Is that a factual statement or opinion? How many med students set out to become GMO's or Flight surgeons for 1-2 yrs, to then only add to their commitments when it comes time to try for a residency of their choice? In the AF, for the last two years it has been about a third (someone correct me if I'm wrong) that are "forced" into gmo/fs slots. Why would anyone in their right mind take their 2nd or 3rd choice?? Do you think in the civilian match there is such a high percentage of people interupting their training for up to two years?

The message most of us who went through military medicine are trying to get out, is that it's a system designed to work for itself with you as a distant second. That means that there is a significant chance (???30%) that you may end up not getting to train in what you want, and have to do 2-4 yrs as an untrained physician. As far as numbers are concerned, they're there, it may just be difficult to find out the actual % of people who got what they wanted, as the military is no longer publishing that data.

Concur with that. I would agree that most who end up in GMO land are not there as their first choice. On the other hand, if you join the military, you need to be prepared for that eventuality and if you go straight through, consider that a windfall. I recognize that recruiters will play down the GMO possiblity and applicants should beware of promises made by recruiters, but in the end it is what we should expect when we join. The system is designed to work for itself, but it is in the systems best interest to keep as many people happy as possible. As to taking the 2nd or 3rd choice? How many in the civilian match get their first choice?

 

[Galo]

Concur with that. I would agree that most who end up in GMO land are not there as their first choice. On the other hand, if you join the military, you need to be prepared for that eventuality and if you go straight through, consider that a windfall. I recognize that recruiters will play down the GMO possiblity and applicants should beware of promises made by recruiters, but in the end it is what we should expect when we join. The system is designed to work for itself, but it is in the systems best interest to keep as many people happy as possible. As to taking the 2nd or 3rd choice? How many in the civilian match get their first choice?

Good question. Perhaps someone out there has the answer for us.

Also, I think we see almost weekly a question about which service is best to join to be a "X" kind of doc, as if it is that simple. I really think you said it correctly that the chance of being not selected for your choice is played down by the recruiters, and perhaps people just do not think it will happen to them, but to someone with less brain or grade, etc... Problem is they just do not understand. The smartest person could be applying for something that just does not exist a need for that year, and they're a GMO.

Thanks

 

[IgD]

I posted this because I surprised by what the law said. I agree I've never seen anyone forced into a residency. In fact I've seen some residents leave their programs and join another in the middle of their PGY2 year without have to match.

I would really like to see retention and recruiting go up. I think my recent posts reflect a hypothesis I have that if the matching system was tweaked and brought more in line with NRMP retention and recruiting would go up. What do you think?

 

[BigNavyPedsGuy]

I posted this because I surprised by what the law said. I agree I've never seen anyone forced into a residency. In fact I've seen some residents leave their programs and join another in the middle of their PGY2 year without have to match.

I would really like to see retention and recruiting go up. I think my recent posts reflect a hypothesis I have that if the matching system was tweaked and brought more in line with NRMP retention and recruiting would go up. What do you think?

They changed the Navy match system for intern selection to a computer based match similar to the civilian match. It got rave reviews. I also think that as GMO billets are whittled down, there will be a lot less disgruntled folks hanging around.

I think the reason recruiting has gone down is the evening news. My year was the last to fill. I signed up when the War in Iraq was 3 weeks old and most people thought it would last 6 months. As the war has persisted, the idea of signing up has gone from "you'll go with the Marines and do some training X" to "you'll go to Iraq or Afghanistan". That's enough to tip the casual pre-med in a different direction.

Retention is a different ballgame all together. That varies by specialty.

 

[BomberDoc]

Retention is a different ballgame all together. That varies by specialty.

Absolutely. Recruitment and retention are very different problems and no single approach will do much for either. Recruitment problems have a lot to do with the long term wars, news coverage, and fear of going to the sandbox or to the mountains to get killed by an IED. The more informed student also worries about getting residency training, quality of training, spending less time being a doc than being a paper pusher/box checker. There are many others.

Retention also suffers from the wars (high optempo), getting residency trained (from the angry GMO crowd), docs getting treated like s#it by management (usually nurses), and the pay gap. We are getting paid LESS every year because bonuses aren't indexed for inflation. Each year you stay in the military as a doc, you earn LESS spending power. There are many others.

Unfortunately the system has been so broken for so long that very few remember it any other way. Those who think of milmed in a positive way typically fall into 3 camps:
Too dumb to know it is broken. Too incompetent to survive in the civ world.

Management who doesn't care because they are climbing over the bodies of subordinates to make the next rank. Usually the biggest cheerleaders.

Retired ex-mil docs who remember the Reagan years. Should spend a week practicing in my clinic.


Fixing it would require re-working the entire system from top to bottom. It will never happen. If you already made the mistake and signed your life away, get out ASAP and help to spread the truth. If you haven't made the biggest mistake of your life yet, don't. Read and learn from the mistakes of others.

 

[Galo]

Absolutely. Recruitment and retention are very different problems and no single approach will do much for either. Recruitment problems have a lot to do with the long term wars, news coverage, and fear of going to the sandbox or to the mountains to get killed by an IED. The more informed student also worries about getting residency training, quality of training, spending less time being a doc than being a paper pusher/box checker. There are many others.

Retention also suffers from the wars (high optempo), getting residency trained (from the angry GMO crowd), docs getting treated like s#it by management (usually nurses), and the pay gap. We are getting paid LESS every year because bonuses aren't indexed for inflation. Each year you stay in the military as a doc, you earn LESS spending power. There are many others.

Unfortunately the system has been so broken for so long that very few remember it any other way. Those who think of milmed in a positive way typically fall into 3 camps:
Too dumb to know it is broken. Too incompetent to survive in the civ world.

Management who doesn't care because they are climbing over the bodies of subordinates to make the next rank. Usually the biggest cheerleaders.

Retired ex-mil docs who remember the Reagan years. Should spend a week practicing in my clinic.


Fixing it would require re-working the entire system from top to bottom. It will never happen. If you already made the mistake and signed your life away, get out ASAP and help to spread the truth. If you haven't made the biggest mistake of your life yet, don't. Read and learn from the mistakes of others.

Very nicely said. I would venture to add a fourth minority camp. Those few competent physicians who through hard work, and excellent politics have made a difference in the environment around them, and despite multiple opposition think that they can make a difference. The ones that seem to be waiting 14-16 yrs to then realize the mistake they've been making, and just get out.

Also waiting the barrage of insults and name calling for those in the 3 other camps who may have taken offense to your clear pointing out. Haven't seen a flair up in a while.

 

[Sir Buckethead]

Is it possible to sign up for a hitch after you've already done a residency? (and thus have greater control over what you would be doing?)

 

[Galo]

Is it possible to sign up for a hitch after you've already done a residency? (and thus have greater control over what you would be doing?)

Absolutely. Its called FAP, and there are people on this forum with much more knowledge about it that me. However, unless you are very specific about what you want to do, you will just become another nameless body. Make sure you really look at the reasons you want to join. Also, besides FAP, you can just go into active duty. You have to do an abreviated Officer Indoctrination Camp, and then you are in. Likely go in as a major or above depending on experience, and their need.

Good luck