CME in AF?

[radspouse]

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Hubby just told me last night that he was recently (as in the last few days) informed by higher-ups that the Air Force will no longer pay for CME courses nor will they allow time off specifically for the purpose of attending CME.

Ummmmm.....

Is the rest of the military experiencing this sudden refusal to fund or allow time for CME? Could it just be his particular specialty? Could it just be his hospital?

And, as of today he still has not received the paperwork for his specialty pay (ISP?)....

😕

 

[former military]

The last 3 years of my specialty I was offered a total of 25$ for CME and travel. I would say CME money allocation and physician morale with CME are probably on the lowest part of the military medicine worry list.

 

[NavyFP]

Hubby just told me last night that he was recently (as in the last few days) informed by higher-ups that the Air Force will no longer pay for CME courses nor will they allow time off specifically for the purpose of attending CME.

Ummmmm.....

Is the rest of the military experiencing this sudden refusal to fund or allow time for CME? Could it just be his particular specialty? Could it just be his hospital?

And, as of today he still has not received the paperwork for his specialty pay (ISP?)....

😕

It depends on the command. Mine still pays for a conference per year. Others say you must do something local. I will confess there is a shortage of money for CME.

 

[MedicalCorpse]

Hubby just told me last night that he was recently (as in the last few days) informed by higher-ups that the Air Force will no longer pay for CME courses nor will they allow time off specifically for the purpose of attending CME.

When I left (June 2005), the key was applying for AFIT funding for CMEs.

Squadron funding is hit or miss (depending on how much your husband's work unit overspent on basic supplies since the beginning of the fiscal year).

Key points:

1) Apply for AFIT funding early
2) Aim for a CME early in the fiscal year, but NOT in October (often don't get funds "released" until November or so)
3) Ask for squadron funding if AFIT turns him down; the USAF should STILL be able to fund at least one CME per year per attending. If this has changed, boy howdy, the USAF Medical Corpse is truly rotting in its grave.

--
R
Ex-LtCol, USAF, MC
Ex-Medical Director of Anesthesia, Travis AFB, CA
etc.
http://www.medicalcorpse.com
Learn How to Use Ether! Join the USAF Anesthesiology Team!

 

[resxn]

MedicalCorpse's experience still holds in my med group. You are required to apply for AFIT funding first. Only if you apply and do not receive it can you then ask for squadron funding.

The issue is that for our squadron (consisting of about 45 docs) there were only 3 funded AFIT slots, so all 45 people had to apply and then they could apply through the squadron. The squadron says that they will fund 1 CME per year, but you have to have 1 year of retainability from the date of the CME. Basically, that rules me out and about 30% of the docs in the squadron.

Nice waste of paperwork and nice way to back out of a promise to do CME TDY every year.

 

[radspouse]

I will clarify with him tonight but what he told me was that he and his colleagues were informed that they could not - as in NEVER - request time off to do CME. The guy (boss) telling them this said they could take off vacation time for it. And, he and this one, long-time-in-former-flight-surgeon were told they could not get funding for doing CME anymore - period (and, they filled out all required AFIT forms previously). The other guy (former flt surgeon) said this was really abnormal and was more than a little hacked off - going so far as to show the boss (don't remember ranks 🙄 ) the recruiting website "promising" time and funding for CME. The higher up was emphatic that this wasn't his call or his decision but that it came from higher up. And, this is at least department wide - don't know if it is hospital wide at the moment.

So, I'll check with him tonight but from what he told me it was absolutely NO funding for CME (via AFIT or squadron - local) and you have to take your normal vacation time off for any CME courses. 😱

BTW: My husband has eight years after this one - so it's not an issue of retainability for him or the particular colleague I mentioned (who will be in for at least eleven years).

 

[resxn]

BULLCRAP.😡 😡

I wouldn't take the "you need to use vacation time" line because that is just garbage. At minimum, even if they don't fund it, they should let it be permissive TDY so it doesn't count toward vacation. Honestly, I'd go right over the head of his supervisor and go to the squadron level or higher (to his specialty's consultant) if necessary. I'd be so pissed if I was told that I think I honestly would earn an LOR on the spot for the number of times I would call my chain of command some sort of lying __________ (fill in your favorite series of epithets) pieces of ________ (fill in the rest with whatever necessary to satisfy personal needs).

The one thing I've learned in the military is that you never ask the guy who only answers "no," go ask the person who can answer both "yes" and "no." In other words, the "this comes from over my head" bullcrap line should be then followed by, "Well then who is above your head that can at least tell me why?" Never accept, "this comes from on high." I can guarantee you it is not above your husband's med group, because it has not affected ours and there is no reason why funding would stop to yours and not ours. If you do find out that it was a local decision, I'd make sure I talked to your consultant who should be your advocate for that kind of stuff and hopefully has the rank to help.

 

[USAFdoc]

BULLCRAP.😡 😡

I wouldn't take the "you need to use vacation time" line because that is just garbage. At minimum, even if they don't fund it, they should let it be permissive TDY so it doesn't count toward vacation. Honestly, I'd go right over the head of his supervisor and go to the squadron level or higher (to his specialty's consultant) if necessary. I'd be so pissed if I was told that I think I honestly would earn an LOR on the spot for the number of times I would call my chain of command some sort of lying __________ (fill in your favorite series of epithets) pieces of ________ (fill in the rest with whatever necessary to satisfy personal needs).

The one thing I've learned in the military is that you never ask the guy who only answers "no," go ask the person who can answer both "yes" and "no."

let me say that I did get CME time when I was in the USAF. It was like pulling teeth (no it was not dental CME), but I got it. Sometimes it required multiple submissions. I always applied early in the fiscal year.

Having said that; I know of many docs that just got refused time and time again. Now that was with the idea that the USAF footed the bill (which they should do). If you offered to pay it yourself, that should be a no brainer (as long as the training was legit).

I was told you got 1 week a year CME as a USAF FP; I believe there is a USAF instruction on that.

below is a link, no time to search it but this is probably it.

PDF] DEPARTMENT OF THE AIR FORCEFile Format: PDF/Adobe Acrobat - View as HTML
Air Force Instruction (AFI) 36-2629, Individual Mobilization ... health service officer to attend one continuing medical education (CME) activity each year ...
https://www.safaq.hq.af.mil/contracting/public/ima/adobe/reserve-guide.pdf -

 

[former military]

I got refused cme money even though I had papers written from that hospital to present at the meeting I wanted to go to. Our CME budget also included the trips for the doctors to take their board specialty exams and recerts... after that there was none left including the AFIT thing

 

[Ex-44E3A]

I found the "no money your last year" thing to be particularly odious. Despite the fact that you're still serving and still caring for the warfighters, once you make it clear that you're planning to get out, you are treated as even more of a red-headed stepchild than ever.

After 9/11 many reserve units were activated... but some were only activated for a year at a time. This handily prevented the activated docs from collecting MSP. Coincidence?

Also, the fact that the ISP big bonus (for most specialties) falls four months after the ASP means that either way, the AF is getting something for nothing. If you choose not to take it, then the AF pays four ASP and three ISP bonuses on a four-year committment. Alternatively, if you do take it, then the AF pays four ASP bonuses and four ISP bonuses... but it's on a four-year-and-four-month committment. Either way, they win, and you lose.

Also, never forget that your "bonuses" are exactly that. They are not part of your pay (despite the fact that they're sold that way). It's AF and commander discretion whether you get them, and they make a handy financial cudgel that commanders can use for payback. Normally somebody would have to go through legal channels to take money from you... but your bonuses make up a huge chunk of your income, and they can be withheld fairly arbitrarily.

 

[USAFdoc]

I found the "no money your last year" thing to be particularly odious. Despite the fact that you're still serving and still caring for the warfighters, once you make it clear that you're planning to get out, you are treated as even more of a red-headed stepchild than ever.

After 9/11 many reserve units were activated... but some were only activated for a year at a time. This handily prevented the activated docs from collecting MSP. Coincidence?

Also, the fact that the ISP big bonus (for most specialties) falls four months after the ASP means that either way, the AF is getting something for nothing. If you choose not to take it, then the AF pays four ASP and three ISP bonuses on a four-year committment. Alternatively, if you do take it, then the AF pays four ASP bonuses and four ISP bonuses... but it's on a four-year-and-four-month committment. Either way, they win, and you lose.

Also, never forget that your "bonuses" are exactly that. They are not part of your pay (despite the fact that they're sold that way). It's AF and commander discretion whether you get them, and they make a handy financial cudgel that commanders can use for payback. Normally somebody would have to go through legal channels to take money from you... but your bonuses make up a huge chunk of your income, and they can be withheld fairly arbitrarily.

The moral of the story is the USAF could care less about you. It is about money, metrics and promotion....................so if your concern goes against the "New USAF Core Values" then expect the worse. A physician asking for CME time goes against the "money, metrics" so it should surprise no one to get denied.👎

Expect similar treatment when you apply for leave, ask for equipment to do your job etc.👎

 

[MedicalCorpse]

It's AF and commander discretion whether you get them, and they make a handy financial cudgel that commanders can use for payback. Normally somebody would have to go through legal channels to take money from you... but your bonuses make up a huge chunk of your income, and they can be withheld fairly arbitrarily.

True story, related to me by an O-4 ophthalmologist, Dr. X., while I was still on AD:

Ca. 2002, the 89th Surgical Operations Squadron at Metropolitan Guatemalan Medical Center, Andrews AFB, MD, under the command of Col. "Rusty", decided to force ophthalmologists to operate on people without ophtho-trained O.R. technicians. The senior-ranking ophthalmologist, Dr. Y., complained to the Commander that this policy did not meet standard of care. He refused to take any patients to the operating room under these conditions, given the lack of skill he had witnessed from the occasional non-ophtho-trained techs who had "filled in" while the one specialty tech was on leave/quarters/etc.

According to Dr. X., Col. "Rusty" called Dr. Y. into his office. Col. "Rusty" then proceeded to threaten Dr. Y. with an LOR and/or Article 15 for failure to obey a legal order. He then explicitly stated that he, the Commander, would not sign Dr. Y.'s specialty bonus pay unless Dr. Y. shut up and went back to the O.R. under what Dr. Y. felt were substandard, dangerous conditions.

Strangely enough, Dr. Y. abruptly left the military shortly thereafter.

In Dec. 2003, a Sentinel Event occurred involving one of my sweet German-American patients, in which the wrong lens was implanted into her eyeball during cataract surgery. As always, there were many contributing factors (surgery proceeded during a 6 inch snowstorm, which had caused the patient before to cancel, which led to the wrong case cart being lined up outside the O.R.). However, dollars to doughnuts the Sentinel Event committee (of which I was not a part) found that "technician inexperience" was a contributing factor to this mishap. Dr. X felt very bad about this incident.

So, the moral of the story, dear HPSPers and USUites: in addition to LOCs, LOAs, LORs, and Article 15s, the military can use and has used the threat of withholding specialty bonus pay (ISP) as a rubber hose to coerce physicians to commit care which they consider, in their professional, medical judgment, to constitute malpractice.

Pleasant dreams...

http://www.dreamquencher.com

--
R

 

[USAFdoc]

True story, related to me by an O-4 ophthalmologist, Dr. X., while I was still on AD:

Ca. 2002, the 89th Surgical Operations Squadron at Metropolitan Guatemalan Medical Center, Andrews AFB, MD, under the command of Col. "Rusty", decided to force ophthalmologists to operate on people without ophtho-trained O.R. technicians. The senior-ranking ophthalmologist, Dr. Y., complained to the Commander that this policy did not meet standard of care. He refused to take any patients to the operating room under these conditions, given the lack of skill he had witnessed from the occasional non-ophtho-trained techs who had "filled in" while the one specialty tech was on leave/quarters/etc.

According to Dr. X., Col. "Rusty" called Dr. Y. into his office. Col. "Rusty" then proceeded to threaten Dr. Y. with an LOR and/or Article 15 for failure to obey a legal order. He then explicitly stated that he, the Commander, would not sign Dr. Y.'s specialty bonus pay unless Dr. Y. shut up and went back to the O.R. under what Dr. Y. felt were substandard, dangerous conditions.

Strangely enough, Dr. Y. abruptly left the military shortly thereafter.

In Dec. 2003, a Sentinel Event occurred involving one of my sweet German-American patients, in which the wrong lens was implanted into her eyeball during cataract surgery. As always, there were many contributing factors (surgery proceeded during a 6 inch snowstorm, which had caused the patient before to cancel, which led to the wrong case cart being lined up outside the O.R.). However, dollars to doughnuts the Sentinel Event committee (of which I was not a part) found that "technician inexperience" was a contributing factor to this mishap. Dr. X felt very bad about this incident.

So, the moral of the story, dear HPSPers and USUites: in addition to LOCs, LOAs, LORs, and Article 15s, the military can use and has used the threat of withholding specialty bonus pay (ISP) as a rubber hose to coerce physicians to commit care which they consider, in their professional, medical judgment, to constitute malpractice.

Pleasant dreams...

http://www.dreamquencher.com

--
R

A good question is often raised; what value is it to current/future HPSPers listening to all the problems that Military Medicine has.

Well, one very good reason/help is that when the type of things, such as that described above, happen to you, you can realize that its NOT JUST YOU. These things are happening all over. Sure they are Commander dependent, but it seems there are alot of commands that it happens at.

And again; the whole system is DESIGNED backwards. For example; the bonus pays should be AUTOMATIC, instead of every physician having to download forms, get sigs and hope that the commander will sign them.The work should have to be on the Commander if they want to stop and cancel a bonus pay, then they should be the ones having to submit paperwork and reasons etc up the chain of command.