Considering blowing off med school for a year just to go to USUHS

[Dr Buddy]

Hey all,

Got applied too late and ended up wait listed at USUHS. Still waiting to hear back from other schools but given my credentials (3.7GPA, 33MCAT) I should be okay to get it somewhere, especially since I applied to several D.O. programs.

Regardless of this, I am considering waiting on USUHS and reapplying next year if I don't get in. I am very committed to doing military medicine and see myself staying career, so the longer commitment vs HPSP doesn't bother me. Accordingly, I think the benefits of the military specific training and rotations I'll get at USUHS are worth waiting a year. I think I'll also be a better officer coming out of USUHS than HPSP which is also to me.

Any thoughts from someone further along than I am? Am I blowing the benefits of USUHS out of proportion? Is it worth another year of crappy jobs and boredom?

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[notdeadyet]

Are you prior service?

 

[DrMetal]

Hey all,

Got applied too late and ended up wait listed at USUHS. Still waiting to hear back from other schools but given my credentials (3.7GPA, 33MCAT) I should be okay to get it somewhere, especially since I applied to several D.O. programs.

Regardless of this, I am considering waiting on USUHS and reapplying next year if I don't get in. I am very committed to doing military medicine and see myself staying career, so the longer commitment vs HPSP doesn't bother me. Accordingly, I think the benefits of the military specific training and rotations I'll get at USUHS are worth waiting a year. I think I'll also be a better officer coming out of USUHS than HPSP which is also to me.

Any thoughts from someone further along than I am? Am I blowing the benefits of USUHS out of proportion? Is it worth another year of crappy jobs and boredom?

Well, you got great numbers, and you go on the waitlist fairly early. For which service? I'd bet that you'd get in.

Now, if you get into another allopathic school and not USUHS, I'd recommend going to that school via HPSP. Yeah it's not the same as USUHS, but I'm sure you could do some elective rotations at military hospitals. You don't want to give up that opportunity, bird in the hand . . .

 

[utahjazz]

You have a great chance of getting off of the waitlist... especially since you heard back from USU relatively quickly and have great stats. Your 1st choice branch and whether you would be willing to take a slot in another branch are also big factors. I wouldn't really think about this too much until you know what your options are. Good luck with the waitlist... don't get discouraged!

 

[Habeed]

What's the difference between USUHS and HPSP besides 3 more years of service committment, and a military lite medical school environment?

Oh, and they pay you during med school...but, you can get that same pay doing National Guard ASR...

Either way, you'd be an idiot to blow off a year. If you want to do USUHS for the money : waiting a year costs you a year of future income, putting you behind in the long run. If you want to do USUHS for military lite experiences during med school : go ASR and hang out with a national guard unit on weekends or something. If you just want to do military medicine in general : do HPSP, or better still, wait until you are an attending and then decide if you want to serve.

Also, all of the ways I mention drastically reduce your service time committment, so that if you suddenly hate military medicine, you are only stuck in it for a much shorter time span.

 

[DrMetal]

What's the difference between USUHS and HPSP besides 3 more years of service committment, and a military lite medical school environment?

There can be a world of difference between USUHS and HPSP. Some would say the extra 3 year committment is very significant, along with the fact that USUHS requires you to do a military residency.

If you know for sure that you want to do a career in the military, and if you have options, then you should definintely opt to go to USUHS. But if you're unsure of a career, then it makes more sense to do HPSP.

Either way, you'd be an idiot to blow off a year.

No, you wouldn't be an idiot for doing so. If you're really unsure and confused, taking time off to collect your thoughts, soul-search, and make a better decision is always a good idea. A year is nothing. Your MCAT will probably still be valid, the OP has a great application, I'm sure he/she would do well in the next application cycle as well.

you want to do USUHS for the money : waiting a year costs you a year of future income, putting you behind in the long run. If you want to do USUHS for military lite experiences during med school : go ASR and hang out with a national guard unit on weekends or something. If you just want to do military medicine in general : do HPSP, or better still, wait until you are an attending and then decide if you want to serve.

Agree that all of the above are interesting options, but you shouldn't do any of these paths if all you're concerned about is money. In fact, one might argue you shouldn't be going into medicine at all if that's your primary motivation.

You should evaluate your own interests, the life-styles of each path, the career options, and make your choice based on that.

What's your deal Habeed? You sound really abrasive? How exactly has the military wronged you? And if you're so hateful of it, why even do ANG?

 

[Dr Buddy]

Either way, you'd be an idiot to blow off a year.

Well that's what I'm trying to figure out. I'm not in a terrible situation right now (I teach MCAT for Kaplan and wait tables on the side) and don't have a lot of bills. Money difference HPSP and USUHS isn't really an issue - I make enough now. I'm a little bored with it and eager to get my medicine on, but sticking around a year won't break my heart.

What I'm thinking is that if I end up staying career milmed, the advantages of USUHS are much in my favor. Not only are the training and rotations military specific, but there is something to be said for the networking connections one would make there. On top of all that, from a purely academic standpoint, it is still a stronger medical school than many I applied to.

If the USUHS advantages is really as good as I see it, then it is definitely good to wait. However, since I am not a doctor and have never been in the military, I figured I would see if anyone would come out and say "USUHS vs. HPSP makes no difference in your career." There is a difference the way I see it, but I'm in no position to know any better.

 

[Habeed]

This is a very bad idea. Just trust me. The whole military mindset is just...well, you'll understand when you get there. That's why you should sign up for the minimum service commitment you possibly can.

As for 'connections and networking'...if you read these forums, you will realize that for the most part, those are not worth it. Medical officers are not on the fast track to making it into the upper echelons of the military command structure. For the most part, their authority is much more akin to that of a warrant officer : ie your job is to be a highly skilled technician, and you are not in charge of more than a handful of other soldiers. Hence, it doesn't do jack for you to know more people : you are still highly unlikely to make General officer, nor be in charge of anything that matters. If you want to be a military leader, you need to start in combat arms. Sign up for OCS if you want that.

And, for the vast majority of competitive residencies, as you will see elsewhere on these forums, military medicine sharply reduces your chances of matching them on the first try. It's akin to attending a D.O. school rather than allopathic in what it does to your chances. (in fact, D.O. students are on even ground with you in the military match)

But the killer dealbreaker that I think makes this an idiotic idea is that you have never been in the military. Consider this : the overwhelming majority of posters here who have been in the military, myself included, hate it with a passion. There's maybe one person here who is not a recruiter who is truly happy with the military and the overall experience. Message boards don't necessarily accumulate malcontents : check out the positive posts on other forums on SDN from attendings who are happy with their jobs.

Or, from another angle : the reason I hate the military is I feel the whole system is "efficient idiocy." The whole organization efficiently and with passion goes about doing some of the most boneheadedly stupid things you will see in your life. And, to people who are intelligent and can see past the hoorah bs and doublespeak, you will be perpetually irritated at the things that go on. The military treated me fairly for the most part, by military standards.

DrMedal : the reason I am considering doing ANG ASR is because I know that being a reserve doctor is not that bad, and so is not too big of a stick compared to the carrot of ~$225,000 even after taxes, during the time that I need it the most. I'm doing it for the money. That mountain of money is enough to make up for the hassles.

Bottom Line : If the OP doesn't care about money, and wants to serve, he should go to med school and get a civilian residency. He should get a light taste of the military through the ASR program first, or sign up for the bare minimum 2 years that military doctors can contract for.

Whether you do the longest contract offer (USUHS) or the shortest, you get about the same chance to serve. The only reason to take the longer offers is for the money they give you.

 

[DrMetal]

The only reason to take the longer offers is for the money they give you.

Ok, so it's not that you hate the military, you just don't like the prospect of being on full-time active duty. That's fine, I understand that, I'm a reservist myself.

 

[Habeed]

Poison is all about the dosage. And full-time active duty that you are forced to stay for is a rather large dose.

I think that an occasional short deployment as a doc or a weekend drill can be a nice change of pace. It's when you're stuck in the Dilbert of the military machine that you really and truly begin to hate it.

 

[mslall]

I wouldn't worry too much about getting in off the waitlist. I'm fairly certain applicants get positioned on the waitlist according to merit, not date. So even if you interviewed in December or January, you could get placed higher on the waitlist than someone who interviewed in November.

Sounds like your application is pretty damn strong, so I wouldn't worry too much. There's a whole lot of movement on the waitlist even up until school starts. You might have to miss "summer camp," but you could still end up there in the fall as late as August

 

[BigNavyPedsGuy]

Any thoughts from someone further along than I am? Am I blowing the benefits of USUHS out of proportion? Is it worth another year of crappy jobs and boredom?

If you get into another allopathic school, I'd go there. The USUHS cirriculum only made a difference for about a month after internship started - then the only difference was the payback. I wouldn't turn down and acceptance to an MD school because you hope to get into USUHS. Who's to say that you wouldn't get wait-listed again next year?

 

[notdeadyet]

However, since I am not a doctor and have never been in the military, I figured I would see if anyone would come out and say "USUHS vs. HPSP makes no difference in your career." There is a difference the way I see it, but I'm in no position to know any better.

I can't imagine signing up for a 14 year minimum commitment to the military that comes from USUHS without having any experience in the military. But maybe I'm just not bold.

USUHS is a good school, but there are a lot of good schools out there and your odds of getting in to one of them are excellent if you apply early and broadly. You can take HPSP to hedge your bets and get out if you find you don't like the military. With USUHS, it could be a painful, relatively long portion of your life if you find out that the military isn't for you.

Just my $0.02. Congrats on your acceptance.

 

[giuseppe]

If you end up at USUHS let me know. I'd love to sit down and talk about leadership and being an officer with you. There are some of us out there doing it for more than just the money or a perfect medical career. If you've read that oath and you really see your calling, you'll find others with a similar vision everywhere you go. Hopefully, we get a chance to meet in the fall...

 

[The White Coat Investor]

If you end up at USUHS let me know. I'd love to sit down and talk about leadership and being an officer with you. There are some of us out there doing it for more than just the money or a perfect medical career. If you've read that oath and you really see your calling, you'll find others with a similar vision everywhere you go. Hopefully, we get a chance to meet in the fall...

I was that idealistic once...then I went to medical school.

 

[Habeed]

If you end up at USUHS let me know. I'd love to sit down and talk about leadership and being an officer with you.

Attendings, what's this fellow talking about? While it is possible to become a leader starting as a medical officer, why would one want to? The whole idea of med school/residency is to spend about a decade perfecting the skill of fixing actual patients. It's kind of a waste of all that time to go sit behind a desk or stand in front of a formation telling people what to do.

 

[giuseppe]

Attendings, what's this fellow talking about? While it is possible to become a leader starting as a medical officer, why would one want to? The whole idea of med school/residency is to spend about a decade perfecting the skill of fixing actual patients. It's kind of a waste of all that time to go sit behind a desk or stand in front of a formation telling people what to do.

if that's what you think being a leader means then i hope you're never my doctor.

 

[Habeed]

if that's what you think being a leader means then i hope you're never my doctor.

Pray tell, then, what does it mean? Honestly, I'm confused myself. I've done ROTC, I've done enlisted basic and AIT, I've seen every form and flavor of 'leadership'. And I've also not seen how an expert physician really needs more than a pinch of it. Heck, one of my blood relatives made it to Colonel and director of an Air Force hospital...and his version of leadership is just not as 'strong' as even a platoon first sergeant.


Finally, if I were your doctor, why would you care about my 'leadership' abilities. Wouldn't you rather I get the diagnosis right, or that my procedure skills are near perfect if you need a procedure done?

 

[giuseppe]

Pray tell, then, what does it mean? Honestly, I'm confused myself. I've done ROTC, I've done enlisted basic and AIT, I've seen every form and flavor of 'leadership'. And I've also not seen how an expert physician really needs more than a pinch of it. Heck, one of my blood relatives made it to Colonel and director of an Air Force hospital...and his version of leadership is just not as 'strong' as even a platoon first sergeant.


Finally, if I were your doctor, why would you care about my 'leadership' abilities. Wouldn't you rather I get the diagnosis right, or that my procedure skills are near perfect if you need a procedure done?

As a member of the military for the past 6 years I can tell you a military physician is different than a civilian physician in the eyes of anyone else that wears the uniform. This isn't just medicine, it's a way of life. A culture with expectations based solely on the rank on your uniform. If you wear officer rank and you don't act like an officer, just a computer dishing out the right diagnosis or abusing your rank, then you are missing the big picture of what it means to serve and probabily inciting the cynicism you wish to avoid. If I was a civilian just looking for the best surgeon, you're right, I could see not caring about the leadership abilities of my surgeon as long as the job is done. But your patients will be men and women sacrificing much more than you and I, and they won't care about the extra $100K you could be making outside, or the year of GMO you did to get into your specialty... they will expect more of you than you can probably give. But if you give up on meeting their expectations, both as an officer and a physician, before you even finish med school, then you're already doing them a disservice. Please don't turn your back on a noble profession just because you feel your career as a doctor would suffer.

Leadership takes much longer than 4 years of med school or even 7 years of residency. I'm sorry your uncle seemed to discourage you from developing your leadership skills, but that mindset seems to be the source of much of the woes in milmed today.

 

[giuseppe]

Pray tell, then, what does it mean? Honestly, I'm confused myself. I've done ROTC, I've done enlisted basic and AIT, I've seen every form and flavor of 'leadership'. And I've also not seen how an expert physician really needs more than a pinch of it. Heck, one of my blood relatives made it to Colonel and director of an Air Force hospital...and his version of leadership is just not as 'strong' as even a platoon first sergeant.


Finally, if I were your doctor, why would you care about my 'leadership' abilities. Wouldn't you rather I get the diagnosis right, or that my procedure skills are near perfect if you need a procedure done?

As a member of the military for the past 6 years I can tell you a military physician is different than a civilian physician in the eyes of anyone else that wears the uniform. This isn't just medicine, it's a way of life. A culture with expectations based solely on the rank on your uniform. If you wear officer rank and you don't act like an officer, just a computer dishing out the right diagnosis or abusing your rank, then you are missing the big picture of what it means to serve and probabily inciting the cynicism you wish to avoid. If I was a civilian just looking for the best surgeon, you're right, I could see not caring about the leadership abilities of my surgeon as long as the job is done. But your patients will be men and women sacrificing much more than you and I, and they won't care about the extra $100K you could be making outside, or the year of GMO you did to get into your specialty... they will expect more of you than you can probably give. But if you give up on meeting their expectations, both as an officer and a physician, before you even finish med school, then you're already doing them a disservice. Please don't turn your back on a noble profession just because you feel your career as a doctor would suffer.

Leadership takes much longer than 4 years of med school or even 7 years of residency. I'm sorry your uncle seemed to discourage you from developing your leadership skills, but that mindset seems to be the source of much of the woes in milmed today.

 

[Habeed]

So you disagree with my assessment that doctors fit into the command structure in a position more akin to warrant officers? For a surgeon or primary care doctor to do his or her job well, he or she needs to run an O.R. and a small office. Direct reports include maybe 2-3 nurses and 2-3 techs. For setting up a forward surgical unit, there are other officers who have the job of actually leading all the troops needed to set one of those up and defend it.

And that's that. Yes, it is possible for a doctor to rise up in the command structure above this point and become a real leader. But, if you want to do that, becoming a doctor first is dumb. Med school and residency teach you an enormous number of things...none of which help you with this. It's just not possible to do both. You can be a good clinician in your specialty, or you can be a good leader...you do not have enough lifespan to be an expert in both.

As for 'showing respect to the rank', that doesn't mean jack. There are too many officers in the military for this to really mean anything, and for every stick up their ass USUHS grad, there are going to be 20 deployed reservists such as myself. No one is even going to notice.

I've also been a military of the military for the past 5 years. I infer that you are not active duty, nor am I. (if you were, then my time in service means nothing, I'll retract that part of my claim)

 

[DrMetal]

Pray tell, then, what does it mean? Honestly, I'm confused myself. I've done ROTC, I've done enlisted basic and AIT, I've seen every form and flavor of 'leadership'. And I've also not seen how an expert physician really needs more than a pinch of it. Heck, one of my blood relatives made it to Colonel and director of an Air Force hospital...and his version of leadership is just not as 'strong' as even a platoon first sergeant.


Finally, if I were your doctor, why would you care about my 'leadership' abilities. Wouldn't you rather I get the diagnosis right, or that my procedure skills are near perfect if you need a procedure done?

Your posts are rather confusing.

You critique the notion of 'leadership' in medicine, making the case that it's not a necessary virtue to be a good doctor. Ok, point taken.

But then you talk about joining the ANG, in which case you'd be a commissioned officer (albeit not full-time AD) and thus be serving in a leadership role, as a military physician.

Do you see the contradiction here?

You seem hopeful that you'll deploy as a member of the ANG, but, I should warn you that the ANG/SELRES can be just as unpredictable as the active component. You could be 'deployed' to a CONUS MTF, where asked to fill the hole of a hospital administrator that has been sent forward. Then, indeed, your must be a good leader to fight through the beuracracy of MilMed.

So if you really feel the way you do about 'leadership' and it's relevance (or lack thereof) in medicine, then you really shouldn't be joining the military (in any sense, ANG or whatever have you).

 

[mcclesm]

But the killer dealbreaker that I think makes this an idiotic idea is that you have never been in the military. Consider this : the overwhelming majority of posters here who have been in the military, myself included, hate it with a passion. There's maybe one person here who is not a recruiter who is truly happy with the military and the overall experience. Message boards don't necessarily accumulate malcontents : check out the positive posts on other forums on SDN from attendings who are happy with their jobs.

Clearly, your anger stems from some sense of entitlement that the military owes you something that you haven't gotten. I guess posting your hatred for the military on a message board that originated from someone who aspires to be a military doctor some day makes you feel better. Most people who read these boards never post, and I would contend that they are trying to read useful information about military medicine, myself included. I've been in the military (AF) 6 years, AD, captain, been to Iraq as part of an Army unit in 2007, and now am trying my darndest to get into USUHS for 2010. Very few people I've encountered hate the military "with a passion" or with anything else. True, many are unhappy about certain aspects of the bureaucracy. I didn't like my job as an engineer so now I'm changing it.

If you don't have anything useful for the OP, why post?

DrMedal : the reason I am considering doing ANG ASR is because I know that being a reserve doctor is not that bad, and so is not too big of a stick compared to the carrot of ~$225,000 even after taxes, during the time that I need it the most. I'm doing it for the money. That mountain of money is enough to make up for the hassles.

Please don't. If your bad attitude on these boards is any reflection of how you are as an officer, I feel bad for your unit.

 

[DrMetal]

Clearly, your anger stems from some sense of entitlement that the military .

Well said, good post. If you want some comedy, check out his previous posts. Habeed, you're all over the place, raising a lot of contraversy. I'd advise you change your SDN name. I've already pieced together what school you go to, and if you apply to ANG, it wouldn't be too hard to narrow it down. If you're CO gets on here sometime in the futre, you might be toast.

I don't know why I just told you that, I'm feeling generous.

 

[Habeed]

DrMedal : I know several physicians in the National Guard, and none of them do anything but basic stuff any doctor (or intern) could do. They don't tell anyone anything. While there's a shortage of officers, it is not so large that any doctor, myself included, would ever have to lead more than a handful of people.

This whole idea that you are a leader because your uniform says 'captain/major/LTC' on it isn't just drinking the koolaid - you're grabbing a box from the cabinet and making up a fresh batch. This is a perfect example of one of the things I hated most about the military. People, from the top of the chain of command to the bottom, would earnestly believe something that was very obviously not true simply because someone above them said it was.

mcclesm : My experiences were ANG, enlisted. Mostly enlisted training. No, it was not that I failed to get anything...it was that I hated the sheer tedium of it, and I hated watching people earnestly doing the dumbest things I have ever seen anywhere. It sounds like you had a better experience.

DrMedal : I intend to. As a matter of fact, there are certain misrepresentations of fact in some of my other posts, so that it is unlikely that anyone will ever figure out who I am.

 

[giuseppe]

Actually, 4 years active, 2 in the reserve in probably the most cynical unit in the Air Force. But I'm not going to lose any sleep over your cynicism. If anything, it just makes me work harder at becoming a leader and improving my officership (which is basically interpersonal skills, essential to a good physician), knowing that I will not add to the negative stereotype of military physicians you seem eager to promote.

The most inspiring officer I ever met was both an excellent military officer and a respected neurosurgeon. I don't think everyone who becomes a military physician is meant to be good at both, but when they are, they are definitely inspirational to everyone around them. That inspiration has positive effects not only for milmed, but the military as a whole. And you are joining the military, not just medicine. Think beyond yourself.

 

[notdeadyet]

Or, from another angle : the reason I hate the military ...

DrMedal : the reason I am considering doing ANG ASR is because I know that being a reserve doctor is not that bad, and so is not too big of a stick compared to the carrot of ~$225,000 even after taxes, during the time that I need it the most. I'm doing it for the money. That mountain of money is enough to make up for the hassles.

As someone who is also in the ASR pipeline for the National Guard, I think if someone hates the military, joining the military in any form, even the National Guard is a baaaaaaad idea.

Any money that comes with military service attached is not smart if you hate the military. The $225K carrot from ASR may look worth the "stick", unless you keep in mind that the "stick" could change. You can be deployed during residency. The 90 day boots-in-sand policy could be wiped with a pen and you could find yourself being activated for a year at a time.

I'm in agreement with you on USUHS probably being a bad idea for someone with zero military experience. But if your experience led you to hate the military, taking any money for the sake of furthering your association with it is bad juju, imho.

 

[notdeadyet]

Yes, it is possible for a doctor to rise up in the command structure above this point and become a real leader. But, if you want to do that, becoming a doctor first is dumb. Med school and residency teach you an enormous number of things...none of which help you with this. It's just not possible to do both.

Actually, Habeed, with all due respect, I disagree with this.

One of the things you'll find that med schools (or good med schools, anyway) try to instill in students is leadership abilities. I think you'll find that every step of the way in medical training, you are part of a team that has a pecking order. By the time you finish your residency, you should have leadership abilities both to manage your team and to help inspire and train physicians-to-be.

In med school admissions, one of the big things we look for is leadership potential. You probably noticed this on your applications. When I interview medical students, if I don't think the student has leadership potential, it's a big red mark.

You can be a good clinician in your specialty, or you can be a good leader...you do not have enough lifespan to be an expert in both.

I'd argue that you need to be a good leader in order to be a good clinician in your specialty. As for lifespan, no one lives long enough to stop learning and improving either as a clinician or leader, but that shouldn't stop you from trying.

 

[DrMetal]

Actually, .

Well said, regarding both of your posts.

 

[mslall]

owned

 

[Habeed]

We're arguing over the definition of leadership. I think the word you mean is "professionalism". Aka, always acting with proper demeanor, setting an example for others to follow, and mentoring those junior to you to develop their skills. Good doctors, military or civilian, all do that.

When I say leadership, I mean running a military unit of increasing size into training exercises and eventually combat. You manage a large group of people and equipment and try to employ them in a manner that accomplishes the mission. A doctor does do this : but almost always not with a large group, but with maybe a squad worth of people.

Scale does matter : there's a giant difference between a platoon or battalion commander and a squad leader in what leadership skills are required. I'm saying that while doctors are officers, to rise up to command a battalion and then brigade and then eventually reach the rank of General officer is a waste of your clinical skills. (note : I am aware that most officers never make it to the last step, but career military officers generally are trying to make it that far)

And msIall : whether or not these particular people disagree does not change who is correct. If I'm right, everyone here will figure it out eventually when they enter military medicine, and vice versa.

I think I'm right, and my original warning to the OP was that he will not gain any connections from USUHS that will significantly help him for the career of military doctor in almost all circumstances. Since almost all military doctors never command/lead any more than about 8-20 people at one time, there is no need to get the connections needed to reach the level of commanding a large operational unit. To become a better doctor, the OP would be vastly better served by getting a better residency, not going to USUHS. And the best residencies are all reached purely from the civilian side, without the military match.

 

[DrMetal]

We're arguing over the definition of leadership. I think the word you mean is "professionalism". Aka, always acting with proper demeanor, setting an example for others to follow, and mentoring those junior to you to develop their skills. Good doctors, military or civilian, all do that.

When I say leadership, I mean running a military unit of increasing size into training exercises and eventually combat. You manage a large group of people and equipment and try to employ them in a manner that accomplishes the mission. A doctor does do this : but almost always not with a large group, but with maybe a squad worth of people.

Well then you're definition of leadership is all screwed up. Leadership transcends the military realm, I think most would agree. What do you think mentoring is? That's a form of leadership! Don't make me bust out the dictionary, please.

 

[Mirror Form]

As a member of the military for the past 6 years I can tell you a military physician is different than a civilian physician in the eyes of anyone else that wears the uniform. This isn't just medicine, it's a way of life. A culture with expectations based solely on the rank on your uniform. If you wear officer rank and you don't act like an officer, just a computer dishing out the right diagnosis or abusing your rank, then you are missing the big picture of what it means to serve and probabily inciting the cynicism you wish to avoid. If I was a civilian just looking for the best surgeon, you're right, I could see not caring about the leadership abilities of my surgeon as long as the job is done. But your patients will be men and women sacrificing much more than you and I, and they won't care about the extra $100K you could be making outside, or the year of GMO you did to get into your specialty... they will expect more of you than you can probably give. But if you give up on meeting their expectations, both as an officer and a physician, before you even finish med school, then you're already doing them a disservice. Please don't turn your back on a noble profession just because you feel your career as a doctor would suffer.

Leadership takes much longer than 4 years of med school or even 7 years of residency. I'm sorry your uncle seemed to discourage you from developing your leadership skills, but that mindset seems to be the source of much of the woes in milmed today.

I don't know what world you're living in but it's very different from practicing patient care. If you (or a loved one) ever develops a serious health problem, you're going to want the best "doctor," not leader. Other factors such as leadership will be completely dwarfed by the traditional qualities that people look for in physicians.

 

[Habeed]

Sweet! reinforcements! You take the flank and help me roll up these n00bs!

 

[pgg]

I think the benefits of the military specific training and rotations I'll get at USUHS are worth waiting a year.

Can you list the military specific training and rotations USUHS offers?

(Go ahead - you may be surprised at how short that list is if you actually write it down.)

 

[mslall]

I'm not trying to argue with you, but i will agree with Giuseppe that military personnel and families expect more from a colonel than they would from a major, and they'd expect more from that major than they would from a warrant officer--even if the warrant officer could do his job better than the major who could do his job better than the colonel, the colonel would be expected to 'perform' better. Even though this is not always the case, especially in the medical field.

You're just being abrasive and seem to be promoting the idea that you cant be a good leader, professional, officer, and physician all at one time. I think that all of these go hand in hand. If you're a great doctor and not arrogant about it (ie, have some professionalism) you'll be a good officer and a good leader. Leadership is not rocket science (and i guess this really isn't directed toward you habeed). There's no hidden holy-grail that you can only achieve by attending a service academy, going to USUHS, or doing ROTC. You set an example that those under and around you will respect and want to emulate, and try to understand/empathize with those below you (are these not the same things a physician tries to do for their patient?).

I totally agree that the OP should not pass up an acceptance somewhere else if he doesn't get taken off the wait-list at USUHS. However I do think that if he wants to be a military physician there are advantages for him coming to USUHS. Even if the school itself is 'minimally military' he will be doing all of his rotations at MTFs and will have more experience dealing with patients that come to expect more from you pending on the rank on his shoulder. I also think he would gain more of an appreciation and understanding for enlisted personnel and families, as they are the ones that do the majority of the actual tasks in the military.

I just really dont understand why, if you dislike the machine/beuracracy that is the military so much, you would even do ANG. Lite cigarettes can still give you cancer and a mortar shell doesn't care if you're deployed as a guardsmen or straight out of the academy--I just cant reconcile those risks without at least having a hint of idealism somewhere 😉

 

[Habeed]

Because military service members are often younger people who deserve a chance to survive. They're just as much victims of the military machine as anyone. It's definitely worth making some sacrifices to help them, so long as said sacrifices don't include giving up the base education needed to become a good physician in the first place. (aka residency in a good institution in the specialty I am good at, not the one I'm forced to take due to the vagaries of the military match)

And for those days that I'm not feeling patriotic, or when the Guard has me doing something impossibly stupid for no good reason, the $175k-$225k would go a long way towards making me feel better.

USUHS and HPSP both interfere with that ideal : being an expert physician who does his or her job well. Both programs reduce that chance that you will get the residency, in a timely manner without wasted years, that trains you to actually be someone. And, the money they offer is not worth it in almost all circumstances.

And it's not just residency : if you are locked into a long contract, your skills may very well atrophy away if you get stuck at the wrong posting. And you won't be helping soldiers right off the battlefield, you'll be involved in providing less than first rate medical care to military dependents for most of your repayment period.

And, every year you waste trying to be a leader and run a military clinic or hospital just makes that skill atrophy worse.

 

[GMO2003]

if that's what you think being a leader means then i hope you're never my doctor.

ahh..the innocent and naive...he too will one day realize that everything is not all black and white...

 

[Galo]

Hey all,

Got applied too late and ended up wait listed at USUHS. Still waiting to hear back from other schools but given my credentials (3.7GPA, 33MCAT) I should be okay to get it somewhere, especially since I applied to several D.O. programs.

Regardless of this, I am considering waiting on USUHS and reapplying next year if I don't get in. I am very committed to doing military medicine and see myself staying career, so the longer commitment vs HPSP doesn't bother me. Accordingly, I think the benefits of the military specific training and rotations I'll get at USUHS are worth waiting a year. I think I'll also be a better officer coming out of USUHS than HPSP which is also to me.

Any thoughts from someone further along than I am? Am I blowing the benefits of USUHS out of proportion? Is it worth another year of crappy jobs and boredom?

I think you really ought to think hard and talk to alot more people before you commit yourself to a system you know little about. As a 6 yr AF active duty surgeon, I can tell you that military medicine is not a place where you can flourish as a physician, unless you are interested more in being a military officer.

You need to read this forum thoroughly, and contact as many AD physicians as you can. Learn all the potential problems you can encounter that will not be an issue in civilian training. Learn all the issues you can and will encounter as an active duty physician. You have this forum, and the ability to really learn what you are getting yourself into, unlike those of us who signed on based on faith that the right environment was there. It is not.

good luck, and feel free to pm if you want.

 

[a1qwerty55]

I think you really ought to think hard and talk to alot more people before you commit yourself to a system you know little about. As a 6 yr AF active duty surgeon, I can tell you that military medicine is not a place where you can flourish as a physician, unless you are interested more in being a military officer.

You need to read this forum thoroughly, and contact as many AD physicians as you can. Learn all the potential problems you can encounter that will not be an issue in civilian training. Learn all the issues you can and will encounter as an active duty physician. You have this forum, and the ability to really learn what you are getting yourself into, unlike those of us who signed on based on faith that the right environment was there. It is not.

good luck, and feel free to pm if you want.

Galo, not to minimize your experiences but it is fair to point out that you were a 6yr AD surgeon in he 1990's-early 2000's, in the USAF - stationed at Offut (Yuck), and Wright Pat. Neither surgical centers of excellence. This obviously colors you opinion.

There are plenty of us who are professionally stimulated and flourishing. There are many many instances where military healthcare is far better than the civilian equivalent. I get to live this almost weekly when I am undoing the crappy civilian treatment for patients who desperately wanted to get back INTO the military system, or when I'm rescuing my family members from profit driven yet not quality driven care that permeates much of civilian medicine.

It is essential to emphasize that there is no "ONE Military Medicine" - quality of care, volume and experience vary by job and location - e.g. GMO vs. Residency trained physician, or Community Hospital vs. Medical Center. I've already expounded on the fact that the entire ethos of military healthcare varies by service. The same is true with VA hospitals which range from abysmal to centers of excellence. Even University systems have massive variation in quality between their centers.

To the OP - If you get into a medical school and not USUHS - take it. I would not recommend waiting a year for USUHS. It is a good school but I agree with others that it isn't so unique that it is worth giving up a sure thing at another school.

If you get into USUHS and understand the legitimate issues of deployments, assignments, and residency uncertainty (overblown on this forum at least as it pertains to the Army), go ahead and take it. There are plenty of unique positives to military medicine which you won't hear about on this site.

There are plenty of us at least at my institution who are happy and do not regret joining. Even my residents who are faced with assignments to community hospitals and a unavoidable deployment are generally pleased and none complain at least to me about the quality of the residency.

 

[The White Coat Investor]

There are plenty of unique positives to military medicine which you won't hear about on this site. .

What are these secret positives that you can't learn about on this site? Seems to me that every positive military medicine offers has been discussed here at some time or other. If you're holding back on a few, why not start a thread?

Nobody is moderating this forum to delete any positive aspects of military medicine. The forum is made up of what people post.

 

[AF M4]

What are these secret positives that you can't learn about on this site? Seems to me that every positive military medicine offers has been discussed here at some time or other. If you're holding back on a few, why not start a thread?

Nobody is moderating this forum to delete any positive aspects of military medicine. The forum is made up of what people post.

I get to wear a flight suit to work most days. Just roll out of bed, zip up the one-piece and bam, out the door. Earns me like 15 extra minutes of sleep.

 

[Gastrapathy]

I'm not trying to argue with you, but i will agree with Giuseppe that military personnel and families expect more from a colonel than they would from a major,

This is such a funny idea. At least in procedural specialties, the senior guys who primarily perform administrative functions are exactly who I would avoid. There are rare patients (they are usually senior officers, so what does that tell you?) who think they are such amazing people that they should only be seen by the department head. We're always happy to send them onward because 1) it isn't worth the fight and 2) the irony of demanding to see a particular physician because of his/her collar device is exquisite. Savvy patients know better.

A number of the posts in this thread come from the perspective of military medicine solely as a line support function like supply, legal, etc. Where this misses the mark is that the majority of our patients are actually dependents and retirees. The healthy active duty patient can afford to care about "leadership" and rank because he/she doesn't have a medical problem that requires a doctor. Those other folks want doctors and could give a **** about my haircut.

For the OP, take any medical school acceptance. No one will care if you went to USUHS and, if so inclined, you can have just as long a military career from HPSP.

 

[a1qwerty55]

What are these secret positives that you can't learn about on this site? Seems to me that every positive military medicine offers has been discussed here at some time or other. If you're holding back on a few, why not start a thread?

Nobody is moderating this forum to delete any positive aspects of military medicine. The forum is made up of what people post.

Let me restate - anyone with positives will get shouted down by the cabal of bitter posters on this site. Happy people generally don't lurk on medical school forums waiting to respond to every post which deviates from the worldview.

 

[mslall]

This is such a funny idea. At least in procedural specialties, the senior guys who primarily perform administrative functions are exactly who I would avoid. There are rare patients (they are usually senior officers, so what does that tell you?) who think they are such amazing people that they should only be seen by the department head. We're always happy to send them onward because 1) it isn't worth the fight and 2) the irony of demanding to see a particular physician because of his/her collar device is exquisite. Savvy patients know better.

A number of the posts in this thread come from the perspective of military medicine solely as a line support function like supply, legal, etc. Where this misses the mark is that the majority of our patients are actually dependents and retirees. The healthy active duty patient can afford to care about "leadership" and rank because he/she doesn't have a medical problem that requires a doctor. Those other folks want doctors and could give a **** about my haircut.

For the OP, take any medical school acceptance. No one will care if you went to USUHS and, if so inclined, you can have just as long a military career from HPSP.

Sure a "savvy" patient might be able to put together that an O-4 who sees way more patients is a better physician, but I think these "savvy" patients are probably confined to 1)medical corp members or retirees and 2)family members who's spouses are medical corp members. I find it hard to believe that the average Joe Senior Chief's wife has any clue that the Captain who is seeing her son/daughter only occasionally sees patients while that Lt.Commander 3yrs out residency sees patients 5-6 days a week.

Sure a large amount of posts come from the perspective of the line, but the majority of dependents also come from families where there spouse is part of the line. Petty Officer Smith's wife will think that Captain Jones is a better doctor than Lieutenant Brown because she sees rank and assumes he's better. From growing up in a family who used (my parents and siblings still use) the military healthcare system and who has worked around families, both enlisted and officer, I can confidently say this is the case. Any NCO or family member would happily take a "lowly" O-3, but damnit that ensign or lt. jg's wife better see an OB thats an O-5 or higher.

I totally agree with you that 95% of the patient's coming to military hospitals could care less about their physician's rank. They just want a good doctor. However I'm saying that the majority of that 95% dont have any idea that Captain Smith mostly does admin work while Lt. Johnson is in the clinic 5 days a week for 10hrs a day. They see rank and assume that the higher rank is better at his 'job,' which to the average patient that comes through the hospital, is being a physician.

 

[Galo]

Galo, not to minimize your experiences but it is fair to point out that you were a 6yr AD surgeon in he 1990's-early 2000's, in the USAF - stationed at Offut (Yuck), and Wright Pat. Neither surgical centers of excellence. This obviously colors you opinion.

Agreed. However, when I left, WP was one of the major medical centers, and I would not consider it barely on par with a lowly community hospital. Also, I am not aware of ANY "centers of excellence" in the AF. Is there any in the army? and if so, where are they, and what are they "centers of excellence" in?

There are plenty of us who are professionally stimulated and flourishing. There are many many instances where military healthcare is far better than the civilian equivalent. I get to live this almost weekly when I am undoing the crappy civilian treatment for patients who desperately wanted to get back INTO the military system, or when I'm rescuing my family members from profit driven yet not quality driven care that permeates much of civilian medicine.

You keep saying this is your experience. It was not mine or that of many others. As you point out in your next paragraph it is highly variable. Would you tell the OP that he is certain to get to your clinic and be happy? I doubt it.

It is essential to emphasize that there is no "ONE Military Medicine" - quality of care, volume and experience vary by job and location - e.g. GMO vs. Residency trained physician, or Community Hospital vs. Medical Center. I've already expounded on the fact that the entire ethos of military healthcare varies by service. The same is true with VA hospitals which range from abysmal to centers of excellence. Even University systems have massive variation in quality between their centers.

Once again, I agree with all this. However, based on my experience, I think that the vast majority of the military system, (esp AF), is mediocre at best.

To the OP - If you get into a medical school and not USUHS - take it. I would not recommend waiting a year for USUHS. It is a good school but I agree with others that it isn't so unique that it is worth giving up a sure thing at another school.

That's sound advice.

If you get into USUHS and understand the legitimate issues of deployments, assignments, and residency uncertainty (overblown on this forum at least as it pertains to the Army), go ahead and take it. There are plenty of unique positives to military medicine which you won't hear about on this site.

There is a sticky about pros of military medicine, though I think it deteriorated near the end. No one should say there are no positives. I also had some positive experiences. However, the negatives far outweighed the positives in my case. Here's the link:

http://forums.studentdoctor.net/showthread.php?t=256225

 

[a1qwerty55]

Sure a "savvy" patient might be able to put together that an O-4 who sees way more patients is a better physician, but I think these "savvy" patients are probably confined to 1)medical corp members or retirees and 2)family members who's spouses are medical corp members. I find it hard to believe that the average Joe Senior Chief's wife has any clue that the Captain who is seeing her son/daughter only occasionally sees patients while that Lt.Commander 3yrs out residency sees patients 5-6 days a week.

Sure a large amount of posts come from the perspective of the line, but the majority of dependents also come from families where there spouse is part of the line. Petty Officer Smith's wife will think that Captain Jones is a better doctor than Lieutenant Brown because she sees rank and assumes he's better. From growing up in a family who used (my parents and siblings still use) the military healthcare system and who has worked around families, both enlisted and officer, I can confidently say this is the case. Any NCO or family member would happily take a "lowly" O-3, but damnit that ensign or lt. jg's wife better see an OB thats an O-5 or higher.

I totally agree with you that 95% of the patient's coming to military hospitals could care less about their physician's rank. They just want a good doctor. However I'm saying that the majority of that 95% dont have any idea that Captain Smith mostly does admin work while Lt. Johnson is in the clinic 5 days a week for 10hrs a day. They see rank and assume that the higher rank is better at his 'job,' which to the average patient that comes through the hospital, is being a physician.

You generally want a Major or LCDR since they are recently trained but not fresh out of residency. I remember a certain, hand surgeon, leading a key hospital.

After he would mangle a hand, his O-4 colleague would "close" for him and repair the carnage. I saw this as a medical student. I rememer the quote "Sir, I think you've done enough here, I'll close". There is almost an inverse relationship in both the military and civilian care between age/rank and clinical skill.

 

[mslall]

You generally want a Major or LCDR since they are recently trained but not fresh out of residency. I remember a certain flag officer, hand surgeon, leading a key hospital in a service which tends to work on ships..

After he would mangle a hand, his O-4 colleague would "close" for him and repair the carnage. I saw this as a medical student. I rememer the quote "Sir, I think you've done enough here, I'll close". There is almost an inverse relationship in both the military and civilian care between age/rank and clinical skill.

I totally agree with this. However I don't think the average enlisted family member knows this, or, for that matter, knows what a residency is. They know you went to medical school, but beyond that I would say they have limited knowledge of the medical education system. That goes for all patients, not just those that are members of the milmed system.

You and I understand that you want an O4 operating on you since he's been out of residency for a few years, but the average soldier, sailor, airman, or dependant sees rank and assumes the person got promoted because he was good at his job (even though he may just be a paperwork guru). I totally agree that a physician who is an O4, maybe O5, will probably be the best physician, especially in a surgical specialty.

So this has gotten a little off topic from the original post.

 

[Gastrapathy]

I totally agree with this. However I don't think the average enlisted family member knows this, or, for that matter, knows what a residency is. They know you went to medical school, but beyond that I would say they have limited knowledge of the medical education system. That goes for all patients, not just those that are members of the milmed system.

You and I understand that you want an O4 operating on you since he's been out of residency for a few years, but the average soldier, sailor, airman, or dependant sees rank and assumes the person got promoted because he was good at his job (even though he may just be a paperwork guru). I totally agree that a physician who is an O4, maybe O5, will probably be the best physician, especially in a surgical specialty.

So this has gotten a little off topic from the original post.

Right, the thread was started to discuss the "military specific training" that USUHS students receive that would make it worth passing up a med school acceptance.

 

[The White Coat Investor]

I get to wear a flight suit to work most days. Just roll out of bed, zip up the one-piece and bam, out the door. Earns me like 15 extra minutes of sleep.

I cannot believe you use that as a positive.

When I go to work at my military job, I have to put on my complete uniform to drive to work, then I walk in and change in to scrubs. When I finish my shift, I change from my scrubs back into my complete uniform to drive home. (by order of the group commander)

When I go to work at my civilian job, I roll out of bed, put on my scrubs (no zipper even), get in my car and drive to the hospital where I walk in and instantly start working. I am the king of 15 minutes extra of sleep, which I lose every day I have to wear the uniform to work.

Wearing the bag is only a benefit if compared to wearing blues/BDUs etc, not comparing it to civilian life. Also, what about the days you forget to grab your hat and have to go home to get it before you can finish driving to work?