Civilian --> Military Career

[Dr Gradus ad Parnassum]

I am an IM-certified community hospitalist. I’ve strongly considered a medical career in the military for many years, but due to health reasons feared there was a good chance I wouldn’t pass the physical requirements to be accepted.

I enjoy but am not completely fulfilled with my career in private practice. My experience treating veterans in a VA setting in medical school and residency was very brief, but my memories were very fond. Veterans were the best patients, and even now when I take care of them in a non-VA setting it is rewarding work. I know that the VA is resource-limited, but I appreciated their mission to provide the best level of care possible at minimal or no expense to the veteran. Differing insurance coverage for patients, prior authorizations, peer-to-peers, etc are major factors driving patient care in my current job, and I have optimism that all of these barriers would be less significant if practicing in the US military.

I’m giving serious thought again to pursuing the military career; if they accept me great, or if their health/physical requirements disqualify me then it is what it is and I will just continue practicing civilian medicine (of note, my health has not impacted my ability to perform my current job duties at all, though there is no “boot camp” where I have to run an obstacle course or scale a wall). However, reading through this forum, I do fear that my impression of military medicine may be naïve or unrealistic because I do notice a number of people with multiple years of experience who seemed unhappy. I wanted to ask a few questions people with first-hand experience with military medicine:


1. Is it likely I would be able to live or practice in my home state, or would I most likely be moved around the country, overseas or both frequently?

2. Is there much role for hospital medicine physicians in the US military? With my license and certification I can practice outpatient general IM, which I’m fine with, though most of my experience is inpatient

3. Would you recommend one particular branch over another (Army, Navy, Air Force, etc)?

4. I fully understand that the pay in military medicine will be less than the private sector. However, do you find other aspects of the job (treating veterans, support from medical staff and leadership, not dealing with insurance companies, possibly less fixation with metrics and volume) more rewarding?

5. Any other pieces of advice you might recommend regarding things I may have lacked the knowledge to even ask about?

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[DrMetal]

I am an IM-certified community hospitalist. I’ve strongly considered a medical career in the military for many years, but due to health reasons feared there was a good chance I wouldn’t pass the physical requirements to be accepted.

I enjoy but am not completely fulfilled with my career in private practice. My experience treating veterans in a VA setting in medical school and residency was very brief, but my memories were very fond. Veterans were the best patients, and even now when I take care of them in a non-VA setting it is rewarding work. I know that the VA is resource-limited, but I appreciated their mission to provide the best level of care possible at minimal or no expense to the veteran. Differing insurance coverage for patients, prior authorizations, peer-to-peers, etc are major factors driving patient care in my current job, and I have optimism that all of these barriers would be less significant if practicing in the US military.

I’m giving serious thought again to pursuing the military career; if they accept me great, or if their health/physical requirements disqualify me then it is what it is and I will just continue practicing civilian medicine (of note, my health has not impacted my ability to perform my current job duties at all, though there is no “boot camp” where I have to run an obstacle course or scale a wall). However, reading through this forum, I do fear that my impression of military medicine may be naïve or unrealistic because I do notice a number of people with multiple years of experience who seemed unhappy. I wanted to ask a few questions people with first-hand experience with military medicine:


1. Is it likely I would be able to live or practice in my home state, or would I most likely be moved around the country, overseas or both frequently?

2. Is there much role for hospital medicine physicians in the US military? With my license and certification I can practice outpatient general IM, which I’m fine with, though most of my experience is inpatient

3. Would you recommend one particular branch over another (Army, Navy, Air Force, etc)?

4. I fully understand that the pay in military medicine will be less than the private sector. However, do you find other aspects of the job (treating veterans, support from medical staff and leadership, not dealing with insurance companies, possibly less fixation with metrics and volume) more rewarding?

5. Any other pieces of advice you might recommend regarding things I may have lacked the knowledge to even ask about?

What state are you in? What kind of medical condition (can you run 2 miles, do push ups, planks?)?

Don't join the Active Duty medical corps. Consider the Reserves, it makes more sense for folks like you.

 

[armytrainingsir]

Agree with Dr Metal. Don’t go AD.

5. Have you considered the VA?

IMO, VA + Reserves is the best gig given what you’ve told us.

 

[Dr Gradus ad Parnassum]

Thank you so much for your feedback. I have definitely given thought to the reserves; my concern was balancing the one weekend monthly/2 weeks yearly requirement on top of my already fairly busy civilian job. I figured instead of trying to balance both simultaneously (and potentially do neither well), it might be best to just fully commit my time solely to the military through active duty.

I've also considered just working at a VA facility but not joining the military. I figured the only advantage of this vs active duty was guaranteeing where I could live (and the ability to leave if I did not like the job), but it would come with the comparative low salary of VA medicine without the additional benefits (health, retirement, etc) of joining the military.

If you don't mind me asking, what is the reason that you wouldn't recommend active duty to someone in my position? Again, salary is not a big factor to me. I know that there is a bureaucracy in the military (as exists everywhere), but I was hopeful that the military would be a good environment to take care of veterans with perhaps less focus on metrics and insurance. While remaining in the US and a stable home area would be ideal, I acknowledge to moving and deployment is a possibility.

 

[SirGecko]

I think the priorities that your questions indicate make it seem like VA or reserves would be better. I’m not IM but AD isn’t the place to be a hospitalist who wants to homestead in one location. Pretty much everyone has to do clinic and the way the DHA metrics work it’s kind of all they judge you guys on. Also the military will definitely move you and I’d expect with current manning levels that the ability to dictate where you want to be is only going to get worse not better in the foreseeable future. The ideal person to join the military as an active duty physician is flexible above all else. (Flexible in duty location, flexible in type of work or amount of work asked to do, able to be told to come back with form 2b stamped by a specific contractor who only works on Tuesday from 1330-1400 without popping an aneurysm, etc) A VA job with reserves tacked on top would let you self direct a lot more. (Type of work, location, etc)

That said if you want to know if it’s possible to stay in your home state you might get more specific answer if we know what state/service. Some places are easier to homestead than others. I wouldn’t anticipate being able to do the majority of your career in one location though.

 

[JerryMouse]

Find a VA job. If you can tolerate it, consider joining the reserves while staying at the VA job. The VA offers lots of leave, including military leave, which will make the time commitment of the reserves easier. If you have never worked for the government, joining as active duty will be miserable. Inefficiency and bureaucracy abounds. A VA job will give you a small taste of what that may look like.

 

[comp1]

What benefits were you thinking that the DoD offered that the VA did not? Free ammo? My understanding is that the benefits are quite similar, if not superior, in the VA as opposed to the DoD.

 

[pgg]

What benefits were you thinking that the DoD offered that the VA did not? Free ammo? My understanding is that the benefits are quite similar, if not superior, in the VA as opposed to the DoD.

Don't forget the free travel!