Civilian residency after GMO advice

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j4pac

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If you’ve found this thread looking for advice on how to match to a military residency, this is the wrong thread. The intent of this thread is to help military docs prepare for applications to the civilian match. A decent percentage of those who do HPSP decide to pay their time back as a GMO and get out for civilian residency. The problem is that there is VERY little help in regards to the planning that takes place to match. I am going to do my best to give a timetable for you to work with. I will also give valuable resources that you can use to make yourself the best civilian applicant you can be.


FIRST YEAR INTO GMO/FS/UMO TOUR

STEP 1. Determine the date of the end of your military commitment
-If you are signed up for a 4-year HPSP, like most people, it will be four years after the end of your internship.

STEP 2. Determine the competitiveness of your specialty, in context to your resume and degree type
-Not everyone was made for Dermatology, Neurosurgery, and ENT. You need to research the competitiveness of your specialty to determine the likelihood of you matching. I would go to the NRMP Charting Outcomes to get that information. http://www.nrmp.org/wp-content/uploads/2014/09/Charting-Outcomes-2014-Final.pdf. Your degree type does matter. DOs are at a significant disadvantage when applying to particular residency types. IM, EM, FM, OB/GYN, Peds, Psych, Neuro, Path, Anesthesia, and PM&R tend to be more DO-friendly. Rads and Gen Surg are typically somewhere in the middle. Surgical subspecialties, Rad-Onc, and Derm tend to be DO-unfriendly. Also realize that many ACGME program types require USMLE. PM&R does NOT, but not having USMLE will hurt you while applying to most other specialties.

STEP 3. Educate yourself on the types of civilian residency programs
-The military match is very simple to understand. You match in December, and you show up the next Summer to start training. It’s not that simple for civilian programs. The reason is that there are multiple program types. Here is a brief overview on the residency types:
Transitional: PGY-1 only; starts the Summer after the match
Advanced: PGY-2 through completion of training; starts two summers after the match (assumes you will complete a transitional year prior year)
Categorical: PGY-1 through completion of training; starts summer after the match
Physician: PGY-2 through completion of training; starts summer after match (assumes you have completed PGY-1)

STEP 4. Determine the type of program you will apply
-I am going to assume that you have completed your internship, so that takes transitional programs off the table. That leaves advanced, categorical, and physician spots. There are advantages and disadvantages to each, but I personally believe that advanced programs have far less risk than other programs. Here’s the reason. You will later read that you have to get your resignation paperwork in about a year prior to separation. You match two years in advance for “advanced” programs, and therefore you will find out whether or not you have matched before you have to submit your resignation papers. You will not be able to do that with categorical and physician slots because you match only a few months prior to your resignation. So if you fail to match to an "advanced" program, oh well…you keep your military job and you don’t starve to death. You could try to reapply civilian the following your or apply military…life goes on. Not matching after you have submitted your resignation paperwork is a life altering event. It is NOT easy to pull back resignation paperwork. In my opinion, the only times you should apply categorical or physician is if your specialty doesn’t have advanced spots, if you get a military deferment or full-time out-service for the following year, if you are applying to a specialty that requires you to repeat an internship for lapses in training, or you are entering a completely different field than your internship (medicine to surgery, or instance). There is no one single resource available with that updated information, so you may need to do some legwork to better educate yourself about your desired specialty’s process. Obviously, going physician only would be preferable to categorical because you won’t have to repeat an internship (assuming you have a qualifying PGY-1 under your belt), but the problem with physician spots is that there are FAR fewer of them available each year. Have I sold you on applying to advanced programs yet? Good. Now let’s move on.


28 MONTHS PRIOR TO SEPARATION

STEP 1. Communicate with your clinical education department
-You know those awesome LORs you received in medical school? In all likelihood, your clinical education department got rid of them over the years. The LORs that were uploaded into ERAS years ago have disappeared into cyberspace. You will need to notify your clinical education department about your intent to apply to civilian residency for a particular match season and for them to expect to see LORs sent their way. They will be responsible for giving you your ERAS token (when ERAS opens), submitting your LORs, and submitting your Dean’s Letter (which will likely still be on file).

STEP 2. Collect Letters of Recommendation
- Understandably, you may not be able to get a new specialty LOR for an obscure specialty during your fleet tour. You can use medical school recommendations, but at the very least I would get your letter writers to update the dates on their letters. A program may have a tough time taking a recommendation seriously if it is 4-5 years old. I would encourage you to get “grown-up LORs”. A strong LOR from your internship program director and your senior medical officer will likely have more importance than a random non-specialty med school LOR.

STEP 3. Set your application season budget
-Figure out the cost of applications, lodging, and travel for the number of interviews you anticipate attending. KEEP TRACK OF ALL OF YOUR EXPENDITURES. YOU CAN ITEMIZE ABSOLUTELY EVERYTHING FOR TAX PURPOSES.


24 MONTHS PRIOR SEPARATION

STEP 1. Write personal statement
-I would recommend not using your internship PS. You can try to amend your prior PS to include more updated information, but you really run the risk of it not being a flowing prose. After a strong introduction, I prefer a chronological personal statement. When you get to your fleet experience, be sure to tie in how your fleet experience has prepared you to enter the residency you desire. An example could also be helpful in putting it over the top. Most medical school resumes look very similar. The personal statement of a GMO has a very good opportunity to stand apart. Do NOT underestimate the power of a strong personal statement.

STEP 2. Discuss residency plan with your commanding officer
-You must have your CO’s support to go on leave and/or TDY for the number of interviews you will need to attend to match. If you CO is concerned about giving you that many days off, I would recommend printing out the NRMP Charting Outcomes for your speciality to show how many programs you need to have a 90% probability of matching. I would request No-cost TDY, but if they are unwilling at bare minimum you should be able to land cost-TDY so you don’t have to eat into your leave.

STEP 3. Discuss coverage plan with other providers
-Self-explanatory. You need to have a general coverage plan.


MONTH OF MAY, YEAR PRIOR TO YOUR SEPARATION

STEP 1. Gain access to ERAS
-You may need to create a new ERAS account if you have forgotten your log-in information. At minimum, you will need your AAMC number, ACGME number, AOA number (if DO), and ERAS token. This can be acquired from your medical school’s clinical education department, and if they don’t have it you will need to contact AAMC/ACGME/AOA.
-ERAS opens in late May. Having access to ERAS is very helpful because you can very quickly search program information. For instance, you can look up advanced FP programs and it will spit out the entire list of them at you. This will allow you to focus your search on where you want to apply and how many applications you want to put out. The number of applications depends largely on the specialty you are applying and the competitiveness of your application. I would recommend applying to as many programs as your budget allows. You do NOT want the reason you didn’t match to be because you didn’t apply broadly enough.


MONTH OF JULY-SEPTEMBER, YEAR PRIOR TO YOUR SEPARATION

STEP 1. Submit applications.
-I would have EVERYTHING ready to go with ERAS weeks before invitations are sent out. ERAS will slow considerably in the days before the opening day for invites.
-Submit your application on opening day. Interviews are often issued on a first come, first served basis. For AOA, applicants can start applying in July. For ACGME, applicants can start to apply in September.


MONTH OF JANUARY-FEBRUARY PRIOR TO YOUR SEPARATION

STEP 1. Certify rank list on NRMP.
-Ensure you have selected the appropriate program type (as in advanced) and correct program.
-Try to cope with the longest 2 or so months of your life.


CONGRATS, YOU HAVE MATCHED! WHAT’S NEXT? WHILE THE OTHER FOLKS WHO MATCHED TO YOUR ADVANCED CLASS GO THROUGH INTERNSHIP, YOU CONTINUE YOUR DAY JOB, WHILE GETTING A FEW THINGS ACCOMPLISHED.


14 MONTHS PRIOR TO SEPARATION


STEP 1. Determine your GI Bill status
-Were you given incorrect counseling regarding your Montgomery GI Bill benefits? If you will be attending residency in a location with a low BAH, now is the time to contest your Montgomery GI Bill benefits. The appeals process can take a year, so you want to get started. Read my post here to see more details on how to do that: http://forums.studentdoctor.net/threads/important-info-for-new-accessions-gi-bill.485739/page-4


12 MONTHS PRIOR TO SEPARATION

STEP 1. Submit your resignation paperwork
-You will need to submit the following three documents on command letter head through your admin department to the appropriate authority (Navy is SECNAV): unqualified resignation from active duty, first endorsement for unqualified resignation from active duty, reason for submission of request. Speak to your detailer or admin department for more details. Ask someone who has gone through this before for a template. I’m Navy and I don’t mind sending anyone a template.

STEP 2. Talk to your command counselor
-They will give you information on TAPS (or the other branches equivalent transitions course) along with filling out paperwork you will need.


6-12 MONTHS PRIOR TO SEPARATION

STEP 1. Attend TAPS
-They will provide you more information on your GI Bill benefits, get you signed up for E-benefits, and talk about disability. You could be exempt from a portion of TAPS with your residency program letter of assignment.


6 MONTHS PRIOR TO SEPARATION

STEP 1. Have Separation physical
-This can’t be done until 6 months prior to separation. I would do it promptly at the 6-month mark, especially if you have any service connected disability

STEP 2. Request GI Bill benefits on E-benefits
-It will take time for the VA to mail you a letter saying that you are all set. At that time you will get instruction to contact a certifying official at the program you will be attending. This is usually handed by the medical school and NOT the residency program. Eventually you will need to get your certifying official a copy of your DD-214 which you receive at the time of getting your resignation orders.

STEP 3. Speak with your local AMVET representation
-If you have service connect disability, you will want someone to walk you through the process. There are lots of forms to fill out and stay on top of. You can’t afford to make a mistake on the forms and delay yourself lots of time. Get a representative. If you are married, you will need a copy of your marriage certificate. If you have children, you will need copies of their social security cards.

STEP 4. Contact resignation authority
-For the Navy it is PERS-834F to ensure that your request for resignation has been approved. They will unlikely write you your resignation orders right away due to budget constraints, but the key at this point is that they have been received and approved.


3-4 MONTHS BEFORE SEPARATION

STEP 1. Ensure that your residency program has contacted you
-They at the very least should give you instruction on filling out paperwork for your state medical licensure
-Also, look into the perks of the company that will employ you…you’ll be surprised. There are sometimes hospital specific classifieds where you can find a place to live. You can also look into medical, dental, insurances, etc. Get that stuff squared away to get an idea of your post-military budget

STEP 2. Get your resignation orders and DD-214
-They are your ticket to completing your disability claim, getting household goods scheduled, along with having the ability to separate.
-Waiting for order sucks. Assuming that they have been approved, you will get them. If you DO NOT receive your orders (very rare), they can be produced within a week by contacting your service's resignation authority (PERS-834F in the Navy)...so don't sweat it.
-After you receive your orders (you will likely get them from your personnel authority or command), you will need to notify your command career counselor. He/she will then organize a meeting with PSD (or your personnel support detachment "pay people" equivalent) who will go over your separation itinerary including travel and your DD-214.
-Your DD-214 may be required to apply for your medical licensure for civilian residency, and will be required for you to submit for disability. It is not essential to process your MGIB/P911GIB but your residency program will request a copy in case they get audited.

STEP 3. Start talking to your detailer and commanding officer to see if your replacement is in line.
-Who wants to be grinding up until the time you get into residency? It's also a nice thing to do for your command.


AFTER THAT YOU SHOULD HAVE COMPLETED EVERYTHING YOU NEEDED TO GET ACCOMPLISHED BEFORE RESIDENCY. SIT BACK AND DO YOUR BEST TO RELAX.

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If you’ve found this thread looking for advice on how to match to a military residency, this is the wrong thread. The intent of this thread is to help military docs prepare for applications to the civilian match. A decent percentage of those who do HPSP decide to pay their time back as a GMO and get out for civilian residency. The problem is that there is VERY little help in regards to the planning that takes place to match. I am going to do my best to give a timetable for you to work with. I will also give valuable resources that you can use to make yourself the best civilian applicant you can be.


FIRST YEAR INTO GMO/FS/UMO TOUR

STEP 1. Determine the date of the end of your military commitment
-If you are signed up for a 4-year HPSP, like most people, it will be four years after the end of your internship.

STEP 2. Determine the competitiveness of your specialty, in context to your resume and degree type
-Not everyone was made for Dermatology, Neurosurgery, and ENT. You need to research the competitiveness of your specialty to determine the likelihood of you matching. I would go to the NRMP Charting Outcomes to get that information. http://www.nrmp.org/wp-content/uploads/2014/09/Charting-Outcomes-2014-Final.pdf. Your degree type does matter. DOs are at a significant disadvantage when applying to particular residency types. IM, EM, FM, OB/GYN, Peds, Psych, Neuro, Path, Anesthesia, and PM&R tend to be more DO-friendly. Rads and Gen Surg are typically somewhere in the middle. Surgical subspecialties, Rad-Onc, and Derm tend to be DO-unfriendly. Also realize that many ACGME program types require USMLE. PM&R does NOT, but not having USMLE will hurt you while applying to most other specialties.

STEP 3. Educate yourself on the types of civilian residency programs
-The military match is very simple to understand. You match in December, and you show up the next Summer to start training. It’s not that simple for civilian programs. The reason is that there are multiple program types. Here is a brief overview on the residency types:
Transitional: PGY-1 only; starts the Summer after the match
Advanced: PGY-2 through completion of training; starts two summers after the match (assumes you will complete a transitional year prior year)
Categorical: PGY-1 through completion of training; starts summer after the match
Physician: PGY-2 through completion of training; starts summer after match (assumes you have completed PGY-1)

STEP 4. Determine the type of program you will apply
-I am going to assume that you have completed your internship, so that takes transitional programs off the table. That leaves advanced, categorical, and physician spots. There are advantages and disadvantages to each, but I personally believe that advanced programs have far less risk than other programs. Here’s the reason. You will later read that you have to get your resignation paperwork in about a year prior to separation. You match two years in advance for “advanced” programs, and therefore you will find out whether or not you have matched before you have to submit your resignation papers. You will not be able to do that with categorical and physician slots because you match only a few months prior to your resignation. So if you fail to match, oh well…you keep your military job and you don’t starve to death. You could try to reapply civilian the following your or apply military…life goes on. Not matching after you have submitted your resignation paperwork is a life altering event. It is NOT easy to pull back resignation paperwork. In my opinion, the only times you should apply categorical or physician is if your specialty doesn’t have advanced spots (unlikely), or if you get a military deferment or full-time out-service for the following year. Obviously, going physician only would be preferable to categorical because you won’t have to repeat an internship (assuming you have a qualifying PGY-1 under your belt), but the problem with physician spots is that there are FAR fewer of them available each year. Have I sold you on applying to advanced programs yet? Good. Now let’s move on.


28 MONTHS PRIOR TO SEPARATION

STEP 1. Communicate with your clinical education department
-You know those awesome LORs you received in medical school? In all likelihood, your clinical education department got rid of them over the years. The LORs that were uploaded into ERAS years ago have disappeared into cyberspace. You will need to notify your clinical education department about your intent to apply to civilian residency for a particular match season and for them to expect to see LORs sent their way. They will be responsible for giving you your ERAS token (when ERAS opens), submitting your LORs, and submitting your Dean’s Letter (which will likely still be on file).

STEP 2. Collect Letters of Recommendation
- Understandably, you may not be able to get a new specialty LOR for an obscure specialty during your fleet tour. You can use medical school recommendations, but at the very least I would get your letter writers to update the dates on their letters. A program may have a tough time taking a recommendation seriously if it is 4-5 years old. But I would encourage you to get “grown-up LORs”. A strong LOR from your internship program director and your senior medical officer will likely have more importance than a random non-specialty med school LOR. Your medical school’s clinical education department is responsible for

STEP 3. Set your application season budget
-Figure out the cost of applications, lodging, and travel for the number of interviews you anticipate attending.


24 MONTHS PRIOR SEPARATION

STEP 1. Write personal statement
-I would recommend not using your internship PS. You can try to amend your prior PS to include more updated information, but you really run the risk of it not being a flowing prose. After a strong introduction, I prefer a chronological personal statement. When you get to your fleet experience, be sure to tie in how your fleet experience has prepared you to enter the residency you desire. An example could also be helpful in putting it over the top. Most medical school resumes look very similar. The personal statement of a GMO has a very good opportunity to stand apart. Do NOT underestimate the power of a strong personal statement.

STEP 2. Discuss residency plan with your commanding officer
-You must have your CO’s support to go on leave and/or TDY for the number of interviews you will need to attend to match. If you CO is concerned about giving you that many days off, I would recommend printing out the NRMP Charting Outcomes for your speciality to show how many programs you need to have a 90% probability of matching. I would request No-cost TDY, but if they are unwilling at bare minimum you should be able to land cost-TDY so you don’t have to eat into your leave.

STEP 3. Discuss coverage plan with other providers
-Self-explanatory. You need to have a general coverage plan.


MONTH OF MAY PRIOR TO YOUR SEPARATION

STEP 1. Gain access to ERAS
-You may need to create a new ERAS account if you have forgotten your log-in information. At minimum, you will need your AAMC number, ACGME number, AOA number (if DO), and ERAS token. This can be acquired from your medical school’s clinical education department, and if they don’t have it you will need to contact AAMC/ACGME/AOA.
-ERAS opens in late May. Having access to ERAS is very helpful because you can very quickly search program information. For instance, you can look up advanced FP programs and it will spit out the entire list of them at you. This will allow you to focus your search on where you want to apply and how many applications you want to put out. The number of applications depends largely on the specialty you are applying and the competitiveness of your application. I would recommend applying to as many programs as your budget allows. You do NOT want the reason you didn’t match to be because you didn’t apply broadly enough.


MONTH OF JULY-SEPTEMBER PRIOR TO YOUR SEPARATION

STEP 1. Submit applications.
-I would have EVERYTHING ready to go with ERAS weeks before invitations are sent out. ERAS will slow considerably in the days before the opening day for invites.
-Submit your application on opening day. Interviews are often issued on a first come, first served basis. For AOA, applicants can start applying in July. For ACGME, applicants can start to apply in September.


MONTH OF JANUARY-FEBRUARY PRIOR TO YOUR SEPARATION

STEP 1. Certify rank list on NRMP.
-Ensure you have selected the appropriate program type (as in advanced) and correct program.
-Try to cope with the longest 2 or so months of your life.


CONGRATS, YOU HAVE MATCHED! WHAT’S NEXT? WHILE THE OTHER FOLKS WHO MATCHED TO YOUR ADVANCED CLASS GO THROUGH INTERNSHIP, YOU CONTINUE YOUR DAY JOB, WHILE GETTING A FEW THINGS ACCOMPLISHED.


14 MONTHS PRIOR TO SEPARATION

STEP 1. Determine your GI Bill status
-Were you given incorrect counseling regarding your Montgomery GI Bill benefits? If you will be attending residency in a location with a low BAH, now is the time to contest your Montgomery GI Bill benefits. The appeals process can take a year, so you want to get started. Read my post here to see more details on how to do that: http://forums.studentdoctor.net/threads/important-info-for-new-accessions-gi-bill.485739/page-4


12 MONTHS PRIOR TO SEPARATION

STEP 1. Submit your resignation paperwork
-You will need to submit the following three documents on command letter head through your admin department to the appropriate authority (Navy is SECNAV): unqualified resignation from active duty, first endorsement for unqualified resignation from active duty, reason for submission of request. Speak to your detailer or admin department for more details. Ask someone who has gone through this before for a template. I’m Navy and I don’t mind sending anyone a template.

STEP 2. Talk to your command counselor
-They will give you information on TAPS (or the other branches equivalent transitions course) along with filling out paperwork you will need.


6-12 MONTHS PRIOR TO SEPARATION

STEP 1. Attend TAPS
-They will provide you more information on your GI Bill benefits, get you signed up for E-benefits, and talk about disability. You could be exempt from a portion of TAPS with your residency program letter of assignment.


6 MONTHS PRIOR TO SEPARATION

STEP 1. Have Separation physical
-This can’t be done until 6 months prior to separation. I would do it promptly at the 6-month mark, especially if you have any service connected disability

STEP 2. Request GI Bill benefits on E-benefits
-It will take time for the VA to mail you a letter saying that you are all set. At that time you will get instruction to contact a certifying official at the program you will be attending. This is usually handed by the medical school and NOT the residency program. Eventually you will need to get your certifying official a copy of your DD-214 which you receive at the time of getting your resignation orders.

STEP 3. Speak with your local AMVET representation
-If you have service connect disability, you will want someone to walk you through the process. There are lots of forms to fill out and stay on top of. You can’t afford to make a mistake on the forms and delay yourself lots of time. Get a representative. If you are married, you will need a copy of your marriage certificate. If you have children, you will need copies of their social security cards.

STEP 4. Contact resignation authority
-For the Navy it is PERS-834F to ensure that your request for resignation has been approved. They will unlikely write you your resignation orders right away due to budget constraints, but the key at this point is that they have been received and approved.


3-4 MONTHS BEFORE SEPARATION

STEP 1. Ensure that your residency program has contacted you
-They at the very least should give you instruction on filling out paperwork for your state medical licensure
-Also, look into the perks of the company that will employ you…you’ll be surprised. There are sometimes hospital specific classifieds where you can find a place to live. You can also look into medical, dental, insurances, etc. Get that stuff squared away to get an idea of your post-military budget

STEP 2. Get your resignation orders and DD-214
-They are your ticket to completing your disability claim, getting household goods scheduled, along with having the ability to separate.
-Waiting for order sucks. Assuming that they have been approved, you will get them.

STEP 3. Start talking to your detailer and commanding officer to see if your replacement is in line.
-Who wants to be grinding up until the time you get into residency? It's also a nice thing to do for your command.


AFTER THAT YOU SHOULD HAVE COMPLETED EVERYTHING YOU NEEDED TO GET ACCOMPLISHED BEFORE RESIDENCY. SIT BACK AND DO YOUR BEST TO RELAX.
Thank you very, very much!!
 
Can somebody speak some about the ability to pursue this route among the different branches? My Army recruiter led me to believe that this route is much less common in the army.
 
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First of all, thank you very much for this informative guide.

Is it difficult to set aside time while as a GMO to work on the residency applications? Also, is it easy to take leave to go for interviews?

Thanks
 
First of all, thank you very much for this informative guide.

Is it difficult to set aside time while as a GMO to work on the residency applications? Also, is it easy to take leave to go for interviews?

Thanks

It can be. This is HIGHLY dependent on the unit in which you are assigned. You can be very busy as a GMO/FS/UMO, and you could be on a deployment cycle. But if your desire is to get into civilian residency, you have to make it work. A big part of the reason of why I made this guide is because it took a network of people who are in the same situation as me, and hearsay, to figure it all out. The situation can be complex and it requires timing. I can't tell you how many people that I have spoke with that did not know that they had to apply two years in advance before separation. More often than not, it was too late. That's sad. They had to extend a year.

I think that it is important to consider deployment as a possibility. If you are set to be deployed between September and January, you will NOT be able to interview and match during that season. You may need to extend a year to make the time work. You may even need to transfer to a different command after your deployment in order to make it work.

You need to have support from your command. If you are a POS doc...your command won't help you achieve your career goals. My CO was more than willing to give me the time I need to interview...very supportive. The most difficulty I had was making it work with my wife's schedule for childcare, and trying my best not to require too much clinic coverage. Not because I couldn't get the clinic coverage, but more so because I felt bad about it.
 
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If you’ve found this thread looking for advice on how to match to a military residency, this is the wrong thread. The intent of this thread is to help military docs prepare for applications to the civilian match. A decent percentage of those who do HPSP decide to pay their time back as a GMO and get out for civilian residency. The problem is that there is VERY little help in regards to the planning that takes place to match. I am going to do my best to give a timetable for you to work with. I will also give valuable resources that you can use to make yourself the best civilian applicant you can be.


FIRST YEAR INTO GMO/FS/UMO TOUR

STEP 1. Determine the date of the end of your military commitment
-If you are signed up for a 4-year HPSP, like most people, it will be four years after the end of your internship.

STEP 2. Determine the competitiveness of your specialty, in context to your resume and degree type
-Not everyone was made for Dermatology, Neurosurgery, and ENT. You need to research the competitiveness of your specialty to determine the likelihood of you matching. I would go to the NRMP Charting Outcomes to get that information. http://www.nrmp.org/wp-content/uploads/2014/09/Charting-Outcomes-2014-Final.pdf. Your degree type does matter. DOs are at a significant disadvantage when applying to particular residency types. IM, EM, FM, OB/GYN, Peds, Psych, Neuro, Path, Anesthesia, and PM&R tend to be more DO-friendly. Rads and Gen Surg are typically somewhere in the middle. Surgical subspecialties, Rad-Onc, and Derm tend to be DO-unfriendly. Also realize that many ACGME program types require USMLE. PM&R does NOT, but not having USMLE will hurt you while applying to most other specialties.

STEP 3. Educate yourself on the types of civilian residency programs
-The military match is very simple to understand. You match in December, and you show up the next Summer to start training. It’s not that simple for civilian programs. The reason is that there are multiple program types. Here is a brief overview on the residency types:
Transitional: PGY-1 only; starts the Summer after the match
Advanced: PGY-2 through completion of training; starts two summers after the match (assumes you will complete a transitional year prior year)
Categorical: PGY-1 through completion of training; starts summer after the match
Physician: PGY-2 through completion of training; starts summer after match (assumes you have completed PGY-1)

STEP 4. Determine the type of program you will apply
-I am going to assume that you have completed your internship, so that takes transitional programs off the table. That leaves advanced, categorical, and physician spots. There are advantages and disadvantages to each, but I personally believe that advanced programs have far less risk than other programs. Here’s the reason. You will later read that you have to get your resignation paperwork in about a year prior to separation. You match two years in advance for “advanced” programs, and therefore you will find out whether or not you have matched before you have to submit your resignation papers. You will not be able to do that with categorical and physician slots because you match only a few months prior to your resignation. So if you fail to match, oh well…you keep your military job and you don’t starve to death. You could try to reapply civilian the following your or apply military…life goes on. Not matching after you have submitted your resignation paperwork is a life altering event. It is NOT easy to pull back resignation paperwork. In my opinion, the only times you should apply categorical or physician is if your specialty doesn’t have advanced spots (unlikely), or if you get a military deferment or full-time out-service for the following year. Obviously, going physician only would be preferable to categorical because you won’t have to repeat an internship (assuming you have a qualifying PGY-1 under your belt), but the problem with physician spots is that there are FAR fewer of them available each year. Have I sold you on applying to advanced programs yet? Good. Now let’s move on.


28 MONTHS PRIOR TO SEPARATION

STEP 1. Communicate with your clinical education department
-You know those awesome LORs you received in medical school? In all likelihood, your clinical education department got rid of them over the years. The LORs that were uploaded into ERAS years ago have disappeared into cyberspace. You will need to notify your clinical education department about your intent to apply to civilian residency for a particular match season and for them to expect to see LORs sent their way. They will be responsible for giving you your ERAS token (when ERAS opens), submitting your LORs, and submitting your Dean’s Letter (which will likely still be on file).

STEP 2. Collect Letters of Recommendation
- Understandably, you may not be able to get a new specialty LOR for an obscure specialty during your fleet tour. You can use medical school recommendations, but at the very least I would get your letter writers to update the dates on their letters. A program may have a tough time taking a recommendation seriously if it is 4-5 years old. I would encourage you to get “grown-up LORs”. A strong LOR from your internship program director and your senior medical officer will likely have more importance than a random non-specialty med school LOR.

STEP 3. Set your application season budget
-Figure out the cost of applications, lodging, and travel for the number of interviews you anticipate attending.


24 MONTHS PRIOR SEPARATION

STEP 1. Write personal statement
-I would recommend not using your internship PS. You can try to amend your prior PS to include more updated information, but you really run the risk of it not being a flowing prose. After a strong introduction, I prefer a chronological personal statement. When you get to your fleet experience, be sure to tie in how your fleet experience has prepared you to enter the residency you desire. An example could also be helpful in putting it over the top. Most medical school resumes look very similar. The personal statement of a GMO has a very good opportunity to stand apart. Do NOT underestimate the power of a strong personal statement.

STEP 2. Discuss residency plan with your commanding officer
-You must have your CO’s support to go on leave and/or TDY for the number of interviews you will need to attend to match. If you CO is concerned about giving you that many days off, I would recommend printing out the NRMP Charting Outcomes for your speciality to show how many programs you need to have a 90% probability of matching. I would request No-cost TDY, but if they are unwilling at bare minimum you should be able to land cost-TDY so you don’t have to eat into your leave.

STEP 3. Discuss coverage plan with other providers
-Self-explanatory. You need to have a general coverage plan.


MONTH OF MAY, YEAR PRIOR TO YOUR SEPARATION

STEP 1. Gain access to ERAS
-You may need to create a new ERAS account if you have forgotten your log-in information. At minimum, you will need your AAMC number, ACGME number, AOA number (if DO), and ERAS token. This can be acquired from your medical school’s clinical education department, and if they don’t have it you will need to contact AAMC/ACGME/AOA.
-ERAS opens in late May. Having access to ERAS is very helpful because you can very quickly search program information. For instance, you can look up advanced FP programs and it will spit out the entire list of them at you. This will allow you to focus your search on where you want to apply and how many applications you want to put out. The number of applications depends largely on the specialty you are applying and the competitiveness of your application. I would recommend applying to as many programs as your budget allows. You do NOT want the reason you didn’t match to be because you didn’t apply broadly enough.


MONTH OF JULY-SEPTEMBER, YEAR PRIOR TO YOUR SEPARATION

STEP 1. Submit applications.
-I would have EVERYTHING ready to go with ERAS weeks before invitations are sent out. ERAS will slow considerably in the days before the opening day for invites.
-Submit your application on opening day. Interviews are often issued on a first come, first served basis. For AOA, applicants can start applying in July. For ACGME, applicants can start to apply in September.


MONTH OF JANUARY-FEBRUARY PRIOR TO YOUR SEPARATION

STEP 1. Certify rank list on NRMP.
-Ensure you have selected the appropriate program type (as in advanced) and correct program.
-Try to cope with the longest 2 or so months of your life.


CONGRATS, YOU HAVE MATCHED! WHAT’S NEXT? WHILE THE OTHER FOLKS WHO MATCHED TO YOUR ADVANCED CLASS GO THROUGH INTERNSHIP, YOU CONTINUE YOUR DAY JOB, WHILE GETTING A FEW THINGS ACCOMPLISHED.


14 MONTHS PRIOR TO SEPARATION

STEP 1. Determine your GI Bill status
-Were you given incorrect counseling regarding your Montgomery GI Bill benefits? If you will be attending residency in a location with a low BAH, now is the time to contest your Montgomery GI Bill benefits. The appeals process can take a year, so you want to get started. Read my post here to see more details on how to do that: http://forums.studentdoctor.net/threads/important-info-for-new-accessions-gi-bill.485739/page-4


12 MONTHS PRIOR TO SEPARATION

STEP 1. Submit your resignation paperwork
-You will need to submit the following three documents on command letter head through your admin department to the appropriate authority (Navy is SECNAV): unqualified resignation from active duty, first endorsement for unqualified resignation from active duty, reason for submission of request. Speak to your detailer or admin department for more details. Ask someone who has gone through this before for a template. I’m Navy and I don’t mind sending anyone a template.

STEP 2. Talk to your command counselor
-They will give you information on TAPS (or the other branches equivalent transitions course) along with filling out paperwork you will need.


6-12 MONTHS PRIOR TO SEPARATION

STEP 1. Attend TAPS
-They will provide you more information on your GI Bill benefits, get you signed up for E-benefits, and talk about disability. You could be exempt from a portion of TAPS with your residency program letter of assignment.


6 MONTHS PRIOR TO SEPARATION

STEP 1. Have Separation physical
-This can’t be done until 6 months prior to separation. I would do it promptly at the 6-month mark, especially if you have any service connected disability

STEP 2. Request GI Bill benefits on E-benefits
-It will take time for the VA to mail you a letter saying that you are all set. At that time you will get instruction to contact a certifying official at the program you will be attending. This is usually handed by the medical school and NOT the residency program. Eventually you will need to get your certifying official a copy of your DD-214 which you receive at the time of getting your resignation orders.

STEP 3. Speak with your local AMVET representation
-If you have service connect disability, you will want someone to walk you through the process. There are lots of forms to fill out and stay on top of. You can’t afford to make a mistake on the forms and delay yourself lots of time. Get a representative. If you are married, you will need a copy of your marriage certificate. If you have children, you will need copies of their social security cards.

STEP 4. Contact resignation authority
-For the Navy it is PERS-834F to ensure that your request for resignation has been approved. They will unlikely write you your resignation orders right away due to budget constraints, but the key at this point is that they have been received and approved.


3-4 MONTHS BEFORE SEPARATION

STEP 1. Ensure that your residency program has contacted you
-They at the very least should give you instruction on filling out paperwork for your state medical licensure
-Also, look into the perks of the company that will employ you…you’ll be surprised. There are sometimes hospital specific classifieds where you can find a place to live. You can also look into medical, dental, insurances, etc. Get that stuff squared away to get an idea of your post-military budget

STEP 2. Get your resignation orders and DD-214
-They are your ticket to completing your disability claim, getting household goods scheduled, along with having the ability to separate.
-Waiting for order sucks. Assuming that they have been approved, you will get them. If you DO NOT receive your orders (very rare), they can be produced within a week by contacting your service's resignation authority (PERS-834F in the Navy)...so don't sweat it.
-After you receive your orders (you will likely get them from your personnel authority or command), you will need to notify your command career counselor. He/she will then organize a meeting with PSD (or your personnel support detachment "pay people" equivalent) who will go over your separation itinerary including travel and your DD-214.
-Your DD-214 may be required to apply for your medical licensure for civilian residency, and will be required for you to submit for disability. It is not essential to process your MGIB/P911GIB but your residency program will request a copy in case they get audited.

STEP 3. Start talking to your detailer and commanding officer to see if your replacement is in line.
-Who wants to be grinding up until the time you get into residency? It's also a nice thing to do for your command.


AFTER THAT YOU SHOULD HAVE COMPLETED EVERYTHING YOU NEEDED TO GET ACCOMPLISHED BEFORE RESIDENCY. SIT BACK AND DO YOUR BEST TO RELAX.

FWIW - just sent @j4pac a $10 Amazon gift card for this extremely helpful post. :)
 
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Thanks for the awesome thread!

Quick question, do you know how difficult it is to get matched into the residency you want when compared to a 4th year med student/pgy-1 med student? I'm assuming the only advantage they have over someone who just finished 4 years GMO is that the programs might know the student better if they rotated in those departments.
 
Thanks for the awesome thread!

Quick question, do you know how difficult it is to get matched into the residency you want when compared to a 4th year med student/pgy-1 med student? I'm assuming the only advantage they have over someone who just finished 4 years GMO is that the programs might know the student better if they rotated in those departments.

Bingo. You don't have as good of an opportunity to audition. But the truth is that military service is still seen as a plus by the majority of residency programs. Residency programs want diversity to their classes. Not to mention that if you have made it through med school, internship, and have managed to do well on a fleet tour...chances are you will be able to make it through residency. You are probably a little lower risk, especially in regard to personality, than the mass majority of applicants applying out of med school.
 
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If you do HPSP, internship, 4 years gmo/fs and separate, can you then realistically pursue a civilian residency in any specialty you want provided the rest of your application is up to par?
 
If you do HPSP, internship, 4 years gmo/fs and separate, can you then realistically pursue a civilian residency in any specialty you want provided the rest of your application is up to par?

Yes, the author of this thread matched PM&R at the Mayo Clinic, my mentors both did this route and matched into EM at Wake Forest and UC Davis. Assuming of course the rest of your application is up to par...that and also you have to be self motivated to do the civilian match as no one in the military will hold your hand to help you through the process.
 
If you do HPSP, internship, 4 years gmo/fs and separate, can you then realistically pursue a civilian residency in any specialty you want provided the rest of your application is up to par?

Your military service could definitely help you if you play your cards right. But you have to play your cards right, and if you are the type of person who wants to passively be involved in the matching process...you will likely not achieve your goal. You have to be more motivated than the average person. You have to have a very well organized plan and strategy to do it. What I wrote above is a good starting point. You will have to deviate away from the plan every once in a while, but it's important to hit as many wickets as possible.

I would say that the best training that the military provided me was learning to be independent and persistent. Those are the qualities that will likely separate you from your piers come interview season. The key is getting invites and being able to attend enough interviews. If you can attend enough interviews...you will find at last one PD that falls in love with you. I have pretty average scores...average research experience...but I have very strong letters of recommendation and I want it. I begged for an interview at my top choice...and was still able to match there. Your military service will help separate you from the pack...but only if you put in the work.
 
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I have a couple ?'s, so thank you in advance if anyone can/wants to answer them. Greatly appreciated!

Under what circumstances would someone consider grinding out GMO before residency? Avoid later hassle? Family? Money? Sanity?

Is there a way to know if this path is better based on certain factors?

How long is too long before going to residency? No more than 4 years?

Thanks
 
I have a couple ?'s, so thank you in advance if anyone can/wants to answer them. Greatly appreciated!

Under what circumstances would someone consider grinding out GMO before residency? Avoid later hassle? Family? Money? Sanity?

Everything that I write (and anyone else writes) will be littered with bias. Someone's experience may be different based on branch of service, command, deployment cycle, family status, location of duty station, future residency, etc. Some people are absolutely spent after their internship year and need a break...SOMETIMES a GMO tour is a break opposed to residency. That would be the biggest sell. It is uncommon for someone to complain about a flight surgeon tour...though occasionally it does happen. I personally wanted to do a flight surgeon tour because I'm more about the journey than the destination. Ultimately I'm getting out of the military because the navy didn't have my choice specialty. But if you don't need a break from residency, more time to figure things out, or having a burning desire to do GMO/UMO/FS...you should try to get into and out of residency asap. That is probably what's in the best interest of your pocketbook, family, and sanity.

Is there a way to know if this path is better based on certain factors?

Again...very user dependent. See my note above.

How long is too long before going to residency? No more than 4 years?

More than two FS/UMO/GMO tours will start to be detrimental to your career. 1-2 usually isn't a big deal, and actually can be looked upon favorably. You will have knowledge/skill rot the longer you are away from inpatient medicine...no question. If you want to be a doc that predominately works inside of a hospital for a career...a GMO could hurt you. I've gotten very good at ENT, outpatient med, Sports Med, and Psych. But I do have some concerns about going back into the wards (albeit rehab wards) 2 months from now. I've been busting my ass trying to learn all of the info I've forgotten, and all of the new medical literature that I may have never learned. My inpatient procedural skills are going to suck. It will definitely be a learning curve to go back. I will have some advantages because of my experience but the monkey skills of inpatient med are not among those skills.
 
All,

I'm not nearly as organized as the OP, I seem to prefer to do things the hard way. However, I recently matched into an Emergency Medicine residency program after fulfilling my ARMY HPSP commitment and ETS'ing. I'm a D.O. who graduated in 2011, did a rotating intern year from 11-12, deployed almost immediately after internship. Spent the remaining time doing the usual GMO stuff, and most recently seen the last two years at Ft. Bragg with the 82nd.

I took only COMLEX (way back when). I applied to allopathic programs only because of the shorter duration of EM residency, three vs. four years. I have nothing against the Osteopathic community, I'm proud to be a D.O.; for a guy that graduated back in 2011, I was ready to get this show on the road and prioritized a shorter [3yr] program.

I consider myself very fortunate to have matched, very excited. I love the ARMY but it was time to move on. I'm happy to answer any specific questions about applying, interviewing, etc as a GMO with an impending ETS. The OP clearly has a great handle on the timeline, I just wanted to make myself available because its such a small demographic, a small group of us, that find ourselves in this scenario.

EDIT: I also just received the official word last week that my application for the GI Bill was approved. I received quite a bit of [incorrect] counsel from the civilians that led the ACAP process. Nothing against them, but they were incorrect as I suspected, fortunately for me.
 
I can offer advice as well. I did HPSP, did 4 years as a UMO in the Navy, interviewed for civilian residencies from Guam (which was expensive and kind of a pain), and separated from there. I did Emergency Medicine at UPenn, got the GI bill during residency, joined FAP during residency, and am now paying off my FAP commitment. I'd be happy to answer any questions about the whole process.

Just to make clear, my program director, and almost every other one I talked to, said that my prior military service was a BONUS, and put me on the top of his list despite me lacking solid letters of recommendation.

One other thing - residency directors will throw your application in the trash if they don't think there is a chance you'll go there. For instance, if you apply to a West Coast program, and have no history on your CV of being on the West Coast, they will figure you just applied there but don't really want to go there. If you really want to go to an area that you haven't really been before, explain the specific reason you want to go there to the residency director. And if they don't offer you an interview, you can always call or email them and say, "hey, you want me as a resident, and here's why", and ask them for an interview.
 
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I can offer advice as well. I did HPSP, did 4 years as a UMO in the Navy, interviewed for civilian residencies from Guam (which was expensive and kind of a pain), and separated from there. I did Emergency Medicine at UPenn, got the GI bill during residency, joined FAP during residency, and am now paying off my FAP commitment. I'd be happy to answer any questions about the whole process.

Just to make clear, my program director, and almost every other one I talked to, said that my prior military service was a BONUS, and put me on the top of his list despite me lacking solid letters of recommendation.

One other thing - residency directors will throw your application in the trash if they don't think there is a chance you'll go there. For instance, if you apply to a West Coast program, and have no history on your CV of being on the West Coast, they will figure you just applied there but don't really want to go there. If you really want to go to an area that you haven't really been before, explain the specific reason you want to go there to the residency director. And if they don't offer you an interview, you can always call or email them and say, "hey, you want me as a resident, and here's why", and ask them for an interview.

If I plotted my invitations and rejections on a map, it would be somewhat comical. I got interviews from practically every east coast and Midwest program I applied. I got rejected or never received an interview at practically all the west coast and southern programs that I applied. Tough to say if it was because I was a DO, or if it was because I was military. I'm from the south and I thought that I would do great in the red states. Other than Texas...I was wrong.
 
Great post. Thanks.

I have 9 months left. 4 years as flight surgeon overseas was good time but I'm ready to exit.

I am applying to civilian residency currently. Did not do the advanced option. I would like to hear the experience of those that applied to categorical PGY2 for the upcoming year (not advanced).

Are people really getting paid TDY to do interviews for a civilian job? How about permissive TDY for interviews?

For those that were overseas during interview season, how did you schedule interviews? Trying to lump them all into one 10-14day visit seems to be the most feasible.
 
Hello.

Thank you for this post!

I'm a Navy categorical OBGYN PGY-1 right now, and I'm hoping to go operational as a flight surgeon next year.
I'm very interested in the "advanced" and "physician" spots- I didn't know that there was a formalized way to apply for PGY-2 spots, and I'd LOVE to avoid repeating internship!

Can anyone provide more information about these routes? How many programs offer such spots? How do you find out which programs those are? And, I think I understand from the first post that you still use ERAS when applying in this way?

Thank you!!

V/R
 
What about rotations? It gets tricky when you request a rotation as a licensed physician, and some of the programs I spoke with could really only offer shadowing. For those who have matched, did you rotate at your program prior to the application? What was the nature of the rotation: shadowing or actually seeing patient's independently?
 
What about rotations? It gets tricky when you request a rotation as a licensed physician, and some of the programs I spoke with could really only offer shadowing. For those who have matched, did you rotate at your program prior to the application? What was the nature of the rotation: shadowing or actually seeing patient's independently?

It's going to be a challenge to get a formal rotation. There isn't a structure in place for non-medical student rotations. I tried to get an audition at a program and they essentially told me that they would love to have me but the most they could offer was a very limited shadowing experience. You can check more broadly, because different institutions may have different policies. Another barrier is getting the time off to audition. I was fortunate enough to get time off to attend 10 interviews.

But in all reality...if you have competitive scores and you have a good match strategy...your military experience will help you stand apart in spite of not auditioning. A significant aspect of the match from a PDs prospective is risk. A military applicant has already proven that they can pass all their boards...get through internship...get through a primary care tour. And even more than that, they have demonstrated that they don't have a personality disorder for a longer period of time.

I matched to my dream program...a program that got over 1000 applications. I have pretty average scores and yet...I was able to take a spot over probably over hundreds of applicants with better scores. The general consensus is that military applicants are coveted. Granted...you have to be somewhat competitive...but if you are in the ballpark, shoot for the stars.
 
It's going to be a challenge to get a formal rotation. There isn't a structure in place for non-medical student rotations. I tried to get an audition at a program and they essentially told me that they would love to have me but the most they could offer was a very limited shadowing experience. You can check more broadly, because different institutions may have different policies. Another barrier is getting the time off to audition. I was fortunate enough to get time off to attend 10 interviews.

But in all reality...if you have competitive scores and you have a good match strategy...your military experience will help you stand apart in spite of not auditioning. A significant aspect of the match from a PDs prospective is risk. A military applicant has already proven that they can pass all their boards...get through internship...get through a primary care tour. And even more than that, they have demonstrated that they don't have a personality disorder for a longer period of time.

I matched to my dream program...a program that got over 1000 applications. I have pretty average scores and yet...I was able to take a spot over probably over hundreds of applicants with better scores. The general consensus is that military applicants are coveted. Granted...you have to be somewhat competitive...but if you are in the ballpark, shoot for the stars.
In all honestly, the "rotation" experience I'm looking for is mostly for face time. And thus far the most traction I've been able to get has been shadowing (that includes military rotations as a GMO). I suppose different places will have different policy but my guess is that the majority will be more very limited shadowing experiences. I am hoping time won't be too much of an issue: my command is tracking my situation and they are supportive (very lucky as far as that goes).

I have tried to put myself in a prospective PDs shoes, and I can extrapolate two scenarios, and all points in between. The first is an ivory tower type place that sniffs at my delay in training and my time playing Army. The other is the PD who looks at my CV, sees what I have done in the mil, and knows that I will be a low risk for a liability. I don't think I will make it as high as you @j4pac but I'll be happy to match to a place that is happy to have me. Thanks for the input.
 
Hello.

Thank you for this post!

I'm a Navy categorical OBGYN PGY-1 right now, and I'm hoping to go operational as a flight surgeon next year.
I'm very interested in the "advanced" and "physician" spots- I didn't know that there was a formalized way to apply for PGY-2 spots, and I'd LOVE to avoid repeating internship!

Can anyone provide more information about these routes? How many programs offer such spots? How do you find out which programs those are? And, I think I understand from the first post that you still use ERAS when applying in this way?

Thank you!!

V/R

According to the NRMP stats, I don't believe that there are OB/GYN advanced programs. I don't see any "Physician" spots from last year. You would have to ask someone with an ERAS token to see if there are any this year.

Considering that there are usually only a handful of "Physician" spots for any given specialty each year, there looks like a pretty high likelihood that you will have to repeat an internship if you go civilian.
 
All,

I'm not nearly as organized as the OP, I seem to prefer to do things the hard way. However, I recently matched into an Emergency Medicine residency program after fulfilling my ARMY HPSP commitment and ETS'ing. I'm a D.O. who graduated in 2011, did a rotating intern year from 11-12, deployed almost immediately after internship. Spent the remaining time doing the usual GMO stuff, and most recently seen the last two years at Ft. Bragg with the 82nd.

I took only COMLEX (way back when). I applied to allopathic programs only because of the shorter duration of EM residency, three vs. four years. I have nothing against the Osteopathic community, I'm proud to be a D.O.; for a guy that graduated back in 2011, I was ready to get this show on the road and prioritized a shorter [3yr] program.

I consider myself very fortunate to have matched, very excited. I love the ARMY but it was time to move on. I'm happy to answer any specific questions about applying, interviewing, etc as a GMO with an impending ETS. The OP clearly has a great handle on the timeline, I just wanted to make myself available because its such a small demographic, a small group of us, that find ourselves in this scenario.

EDIT: I also just received the official word last week that my application for the GI Bill was approved. I received quite a bit of [incorrect] counsel from the civilians that led the ACAP process. Nothing against them, but they were incorrect as I suspected, fortunately for me.
I was under the impression that we could only use GI bill for fellowship after residency. Considering you do GMO GTFO CIV-RES.
 
For anyone who has gone civilian EM residency post GMO. Are there advanced standing programs that accept residents post-GMO, or did you repeat internship? And how did it work with your SLOE's? Were those still valid 5 years later, did you need to get new ones, or just used other LOR's inplace of them?
 
For anyone who has gone civilian EM residency post GMO. Are there advanced standing programs that accept residents post-GMO, or did you repeat internship? And how did it work with your SLOE's? Were those still valid 5 years later, did you need to get new ones, or just used other LOR's inplace of them?

The Board of EM has recently changed the rules, which I believe go into effect this summer. If you have spent 3 years (it may be worded as "more than 3 years") between internship and starting PGY2 you will be required to repeat internship.

If you are less than that then you Gould be able to find some programs that will give you at least some advanced standing (although if you didn't do an EM internship they could certainly decide not to).


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As far as I know...PMR programs still honor your PGY-1 years later.


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Prior Navy GMO here who matched into an advanced spot in anesthesiology. Happy to answer any questions. I did the complete 4 year tour as a GMO after categorical PGY-1 year as a general surgery intern.
 
Prior Navy GMO here who matched into an advanced spot in anesthesiology. Happy to answer any questions. I did the complete 4 year tour as a GMO after categorical PGY-1 year as a general surgery intern.

Were you planning to do general surgery before your GMO tour? Also, was the 4 year GMO tour length set from the start?
 
Were you planning to do general surgery before your GMO tour? Also, was the 4 year GMO tour length set from the start?
Yes, planned to do surgery when I started, but changed my mind. Could have gone back to residency after a 2 year tour, but elected to do 4 years to finish my obligation and complete residency as civilian.
 
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Yes, planned to do surgery when I started, but changed my mind. Could have gone back to residency after a 2 year tour, but elected to do 4 years to finish my obligation and complete residency as civilian.

How was matching into an advanced spot? Did you find that having done intern year + 4 years of service was looked upon favorably?
 
How was matching into an advanced spot? Did you find that having done intern year + 4 years of service was looked upon favorably?
You know, honestly, some programs appreciated it and some did not care at all. I can't say that it was an overwhelming positive response, but I did end up getting my first choice for residency, so maybe I am wrong.
 
You know, honestly, some programs appreciated it and some did not care at all. I can't say that it was an overwhelming positive response, but I did end up getting my first choice for residency, so maybe I am wrong.

I really appreciate your insight! After internship year and 4 years of GMO, did you feel ready to jump into an advanced spot? And do you feel that you gained skills/experience as a GMO?

Also, after 2 years of GMO, I guess you could have jumped into an advanced spot in the military and finished residency to serve 2 more years as a .mil anesthesiologist. Instead though, did you figure that you would rather get out as soon as possible and just train at a civilian program?
 
I really appreciate your insight! After internship year and 4 years of GMO, did you feel ready to jump into an advanced spot? And do you feel that you gained skills/experience as a GMO?

Also, after 2 years of GMO, I guess you could have jumped into an advanced spot in the military and finished residency to serve 2 more years as a .mil anesthesiologist. Instead though, did you figure that you would rather get out as soon as possible and just train at a civilian program?
Anesthesiology is a three year program so he would have had to do three years in the military as an anesthesiologist if he had gone that route.
 
Anesthesiology is a three year program so he would have had to do three years in the military as an anesthesiologist if he had gone that route.

Ah this part always gets me. I thought residency years essentially washed out even from serving/owing. But it sounds like it's the greater of residency training (minus internship year) and years still owed.
 
Doing residency in the Navy actually accrue time you owe to the military as a military residencies pay more than civilian residencies. I elected to do 4 years as GMO and leave the military because of personal/family reasons, but really enjoyed my time in the Navy and would have otherwise stayed in. If you are interested in a particular field of specialty, my recommendation is finding someone in that field and try to learn as much as you can while you are a GMO; otherwise jumping back into residency can be quite a dramatic change from a 8-5 tour as a GMO, or not too different schedule wise if you are used to working longer hours on deployment. Read and get hands on while you have time can benefit you and make the transition back to residency much easier.
 
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Prior Navy GMO here who matched into an advanced spot in anesthesiology. Happy to answer any questions. I did the complete 4 year tour as a GMO after categorical PGY-1 year as a general surgery intern.

Glad to see you post as it's been somewhat difficult to find others who went the track I'm expecting to pursue; I'm an MS3 Navy HPSP in the middle of aways and planning to match into Transitional Year PGY1 with the expectation of completing 4 years of GMO and matching into an Advanced Anesthesia spot after it's all said and done. Any advice about the planning process now? Is the advanced spot application submitted in the last year of GMO? Were you able to make some time for an audition rotation or didn't matter too much? Thanks again
 
Glad to see you post as it's been somewhat difficult to find others who went the track I'm expecting to pursue; I'm an MS3 Navy HPSP in the middle of aways and planning to match into Transitional Year PGY1 with the expectation of completing 4 years of GMO and matching into an Advanced Anesthesia spot after it's all said and done. Any advice about the planning process now? Is the advanced spot application submitted in the last year of GMO? Were you able to make some time for an audition rotation or didn't matter too much? Thanks again
Glad to help any way I can. You should submit your application in the next to last year of your service if you are expecting to match into an advanced spot, as they are usually gapped by a year (your last year of service). For example, I interviewed in the 2013 season for a July 2015 start. I did not do any audition rotations as active duty probably would not allow you to be gone for a month at a time, but you don't have to do any away rotations. The key is to work hard during your active duty tours, be a team player, read, shadow and find an anesthesiologist to be your mentor, get some good letters of recommendations, but also enjoy your Navy experience, volunteer for deployments and travel to see the world (if that is part of the reason you joined), take the first year to two to just immerse yourself in the GMO experience, too!
 
My wife is finishing up her surgical internship in the AF right now and will be doing a tour as a flight surgeon. I was just wondering how all those who have gone before us dealt with the transition from flight surgery to the lower pay as a resident. It appears as though you'd drop about 30k or so a year from flight surgeon to civilian resident, which could present problems to people who aren't prepared. Additionally, does anyone have experience staying in the military for residency after a FS tour? Does your pay also decrease as much in that scenario? As the spouse who takes care of our families finances, I want to be as informed as possible. Thanks for any who respond!
 
My wife is finishing up her surgical internship in the AF right now and will be doing a tour as a flight surgeon. I was just wondering how all those who have gone before us dealt with the transition from flight surgery to the lower pay as a resident. It appears as though you'd drop about 30k or so a year from flight surgeon to civilian resident, which could present problems to people who aren't prepared. Additionally, does anyone have experience staying in the military for residency after a FS tour? Does your pay also decrease as much in that scenario? As the spouse who takes care of our families finances, I want to be as informed as possible. Thanks for any who respond!
There will be a drop in pay going back to residency in the military but not as much as going back to civilian residency. With the new combined special pays the drop would be in the form of IP from 20000 to 8000. (As an intern she is getting only 1200 vsp annually right now) This is a little offset by the increase in basic pay with her having been in longer at that point but not 12 grand worth. If you aren't familiar with it the military pay tables are easily searchable and publicly available.

As for how people cope with the paycut going back to residency as a civilian I have no personal experience with that. (Though I am sure their are wiser posters on this forum than I that could give you some more personal advice) I would advise keeping expenses reasonable now and saving. Also look in to the threads about using the GI bill as that could offset some of the decreased pay. (Check out the stickied thread)
 
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My wife is finishing up her surgical internship in the AF right now and will be doing a tour as a flight surgeon. I was just wondering how all those who have gone before us dealt with the transition from flight surgery to the lower pay as a resident. It appears as though you'd drop about 30k or so a year from flight surgeon to civilian resident, which could present problems to people who aren't prepared. Additionally, does anyone have experience staying in the military for residency after a FS tour? Does your pay also decrease as much in that scenario? As the spouse who takes care of our families finances, I want to be as informed as possible. Thanks for any who respond!

If you're not prepared you could be in for a world of hurt. Budget wisely and live below your means while in the military if there's a chance to go to civilian residency.

I was making over $90k when I got out. Once starting civilian residency, I started making about $50k through the program. I also bought in late to MGIB, which pays out over $22000/year. I also have some serve associated VA disability which pays some. Living in a good COL area...I'm fine. Definitely educate yourself on GI Bill options, VA disability, and COL calculators.

As mentioned above...the drop from FS to military residency is even less of a hit.


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Thanks for the replies. I'm definitely hoping to keep our lifestyle the same as it is now. We'll be heading to Japan, so I'm hoping things won't be more expensive across the board. If so, then it sounds like an excellent opportunity to use the pay raise to invest/pay down student loans while we can.
 
Glad to help any way I can. You should submit your application in the next to last year of your service if you are expecting to match into an advanced spot, as they are usually gapped by a year (your last year of service). For example, I interviewed in the 2013 season for a July 2015 start. I did not do any audition rotations as active duty probably would not allow you to be gone for a month at a time, but you don't have to do any away rotations. The key is to work hard during your active duty tours, be a team player, read, shadow and find an anesthesiologist to be your mentor, get some good letters of recommendations, but also enjoy your Navy experience, volunteer for deployments and travel to see the world (if that is part of the reason you joined), take the first year to two to just immerse yourself in the GMO experience, too!

Thanks docblue! This helps a lot. Since we're obligated by contract to apply to ERAS also...did you just apply into Anesthesiology and TY programs through ERAS when you did it? I wasn't sure if there was some record where programs will see your application or record of withdrawal in ERAS if you apply after getting accepted to MODS. I just didn't want this to hurt me down the line when I apply through ERAS years later for Advanced spots and they have the old record of my application withdrawing.
 
This is a fantastic post! Wish this had been around when I was applying back in 2014! Hang in there, it can be done. I got into my top choice (which is a very noncompetitive program), but my program was very excited about my military experience. Don't forget to sell yourself and accentuate all the amazing "character-building" things you've done (had to do) in the military that a 4th year med student has never had the "opportunity" to do...leadership, self motivation, making-it-happen, learn-as-you-go...
 
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Thanks docblue! This helps a lot. Since we're obligated by contract to apply to ERAS also...did you just apply into Anesthesiology and TY programs through ERAS when you did it? I wasn't sure if there was some record where programs will see your application or record of withdrawal in ERAS if you apply after getting accepted to MODS. I just didn't want this to hurt me down the line when I apply through ERAS years later for Advanced spots and they have the old record of my application withdrawing.

I applied to all civilian programs as my spouse and I made the decision that I would be doing a civilian residency. You apply through ERAS. Record of withdrawing from ERAS should not hurt you as programs do not see that from year to year. I did not have to repeat my internship year so just matched into an advanced spot without having to repeat PGY1.
 
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