Change from GMOs to board cert primary care docs

[IgD]

When I went through HPSP, there was information that congress directed the military to replace GMOs with fully trained physicians. I recall getting HPSP newsletters that said GMO tours were getting phased out. Obviously this didn't pan out.

I'm noticing that similar information is re-circulating today. Is there an actual DoD or service specific policy that says there are to be no more GMO tours?

Maybe such a policy would improve the marketability of the HPSP scholarships.

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[NavyFP]

When I went through HPSP, there was information that congress directed the military to replace GMOs with fully trained physicians. I recall getting HPSP newsletters that said GMO tours were getting phased out. Obviously this didn't pan out.

I'm noticing that similar information is re-circulating today. Is there an actual DoD or service specific policy that says there are to be no more GMO tours?

Maybe such a policy would improve the marketability of the HPSP scholarships.

There is no directive. VADM Robinson has mandated the conversion and the Chief of the Medical Corps is working with BUPERS to make it happen. The key will be when you see the Navy start to offer continuous contracts like the Army does.

 

[Perrotfish]

Continuous contracts?

 

[NavyFP]

Continuous contracts?

Means your given orders for the entire residency vice just the intern year.

 

[Out in 2008]

Ha I remember reading the One Striper saying the same thing just before I signed on the dotted line in 1998. Well into my 4th year of GMO hell now....

 

[NavyFP]

Ha I remember reading the One Striper saying the same thing just before I signed on the dotted line in 1998. Well into my 4th year of GMO hell now....

I remember it too, but the impetus for change is greater now.

 

[Out in 2008]

I remember it too, but the impetus for change is greater now.

I agree as before the impetus came from Congress I believe and ADM Arthur made the case for keeping the GMO. Now BUMED is the driving force.

 

[bricktamland]

I've spent 3 years as a GMO with the Marines. To stick a board-certified primary care doctor in these billets is a travesty. I can think of few other places where your skills and knowledge base can deteriorate faster. I would be unbelievably pissed to have worked so hard for three years perfecting my mangement of complicated diabetics, working up chest pain, etc, to come here and spend all morning seeing PFPS, sprained ankles, and sore throats, and spend every afternoon doing mind-numbing final physicals.

On the other hand, it's frankly irresponsible to throw an intern out to the wolves to operate totally unsupervised. Sure, as a GMO you mature and grow at an incredible pace, but at what cost to the patients? Obviously, that's why Congress has elected to staff these positions with a fully-trained physician.

IMO, these billets should be staffed by experienced PAs, who have been trained in the military with specific preparation for an operational billet. It would be the perfect fit. An intern is undertrained, and a board-certified doctor is overkill. A PA, with a few years of experience, good handle this job easily. It would definitely save the military some money and keep a lot of military doctors happier. Can you imagine having a job in the military where you get to do what you were actually trained for?

The military should ramp up some sort of Corpsman to PA program. That would be the perfect population to draw from.

 

[elderjack21]

IMO, these billets should be staffed by experienced PAs, who have been trained in the military with specific preparation for an operational billet. It would be the perfect fit. An intern is undertrained, and a board-certified doctor is overkill. A PA, with a few years of experience, good handle this job easily. It would definitely save the military some money and keep a lot of military doctors happier. Can you imagine having a job in the military where you get to do what you were actually trained for?

The military should ramp up some sort of Corpsman to PA program. That would be the perfect population to draw from.

You should send that up the channels...sounds like a great plan.

 

[The White Coat Investor]

I've spent 3 years as a GMO with the Marines. To stick a board-certified primary care doctor in these billets is a travesty. I can think of few other places where your skills and knowledge base can deteriorate faster. .

I feel this way about my regular billets. The main problem is the military desires to have a high level of capability, even though they don't actually need it 99% of the time. For example, I am currently deployed with a mobile forward surgical team (an orthopod, a general surgeon, an anesthesiologist/nurse anesthetist, a scrub nurse, and an emergency doc with 600 lbs of stuff in 5 backpacks designed to be up and operating anywhere in the world with 24 hours notice.) We do outprocessing paperwork and see athlete's foot and URIs hundreds of miles from anyplace where any bullets are being fired. The commanders like to know that if for some crazy reason the **** hit the fan, they've got something around to clean the **** off the walls with. The problem is the wall-cleaners forget how to clean walls when they never clean walls. It is like keeping pilots sitting in cockpits on the flightline but never letting them take off, for years at a time, until one day you need a mission flown, then expecting them to fly it perfectly.

 

[Galo]

I feel this way about my regular billets. The main problem is the military desires to have a high level of capability, even though they don't actually need it 99% of the time. For example, I am currently deployed with a mobile forward surgical team (an orthopod, a general surgeon, an anesthesiologist/nurse anesthetist, a scrub nurse, and an emergency doc with 600 lbs of stuff in 5 backpacks designed to be up and operating anywhere in the world with 24 hours notice.) We do outprocessing paperwork and see athlete's foot and URIs hundreds of miles from anyplace where any bullets are being fired. The commanders like to know that if for some crazy reason the **** hit the fan, they've got something around to clean the **** off the walls with. The problem is the wall-cleaners forget how to clean walls when they never clean walls. It is like keeping pilots sitting in cockpits on the flightline but never letting them take off, for years at a time, until one day you need a mission flown, then expecting them to fly it perfectly.

I love this comparison, and its so applicable that I have often used it myself. This compares much to the AF way of training and keeping current trauma surgeons. By letting go to a major trauma center, Baltimore shock trauma, and work as a second year resident for 30 days, but not abiding by the RRC guidelines and making us stay up 24-36 hours drawing blood, doing H&P's, transporting patients, and holding retractors. Another fiasco that earned some "leader" his kudos.

 

[almostfamous]

You should send that up the channels...sounds like a great plan.

Navy is ramping it up. Taking HMCs and HMCS, promoting them to officers and putting them through the NSHS PA school. Most of the ones I've talked to are headed to Marine units in late fall.