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Corps Chief to SLs: we don't need you

Discussion in 'Military Medicine' started by Gastrapathy, Nov 19, 2017.

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  1. teacherman84

    teacherman84 Physician 7+ Year Member

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    See bolded answers
     
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  3. backrow

    backrow 60% of the time it works everytime Lifetime Donor Classifieds Approved 10+ Year Member

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    To the bottom point:

    You probably won’t ever see this unless DHA starts taking over the funding of the hospitals. You aren’t going to see the Navy releasing their person to cover at say an Air Force place (with a few exceptions) until the cost of running the hospital is shifted to DHA. Given the reduction in active duty staffing coming down the pike you are even less likely to see this. I don’t see the Services ever giving up this funding/control and will fight it tooth and nail.

    That is one of the current issues with DHA, they don’t have significant funding to actually effect the changes that they are being directed to do. It’s like the appropriators and authorizors in Congress. Authorizors (DHA) set the policy, but appropriators (the Services) actually make it happen. Until that changes you are going to have continued sibling fighting over their piece of the pie.


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  4. militaryPHYS

    militaryPHYS

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    1. Good question, but any answer on my end would be presumptuous. There has been no official guidance to provide a definitive answer (at least on the Navy side of the house). Per the Navy chart that I posted on there, the number of GMO's is not slated to change much
    2. The only way that GMO's affect competitiveness is when there develops a surplus of people who are out doing a GMO tour who want to come back and finish residency. They then have precedence over people without fleet time when it comes to filling a residency spot. Tour length doesn't really affect it much.
    3. Which MTFs and how "purple" they are is yet to be determined.
     
    Last edited: Dec 6, 2017 at 9:21 PM
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  5. Perrotfish

    Perrotfish Has an MD in Horribleness Physician 10+ Year Member

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    Also be aware that the points system that decides who has precedence only applies to residencies and fellowships, not internships. Who gets internships are decided entirely by the PDs. So if you want a residency that needs a qualifying internship (ortho, derm, whatever) then a GMO tour only helps you to whatever extent it makes the PD like you more.
     
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  6. backrow

    backrow 60% of the time it works everytime Lifetime Donor Classifieds Approved 10+ Year Member

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    For Navy at least the points system is still used it’s just not a tri-service panel that does the review. The applications are scored by the PDs and specialty leaders, but there is still standardization/objectiveness and not just “oh, I think this person is the best so they are my top choice.”


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  7. Perrotfish

    Perrotfish Has an MD in Horribleness Physician 10+ Year Member

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    Is this new in the last 2 years?
     
  8. Cooperd0g

    Cooperd0g Something witty goes here. 5+ Year Member

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    No, the point system has been their for interns. Just that there aren’t many points available for interns so the PD having up to 5 points to give has big sway.
     
  9. Perrotfish

    Perrotfish Has an MD in Horribleness Physician 10+ Year Member

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    I think this is incorrect. Otherwise anyone who did a GMO tour could snag a Derm Internship over every medical student. Anyone here involved in Navy GME who can clarify?
     
  10. Cooperd0g

    Cooperd0g Something witty goes here. 5+ Year Member

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    Your statement doesn’t make sense on a couple of fronts. First, there is no such thing in the Navy as a Derm internship. Second, medical students in the Navy are only applying for PGY-1 and are not competing with GMOs or current interns. Third, I wrote a white paper on the GME application system while an intern, which was shot down, so I’m quite familiar with the process.
     
  11. SeminoleFan3

    SeminoleFan3 Senior Member 10+ Year Member

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    In the Navy, it’s incredibly difficult to go from a GMO tour into a categorical residency that requires an intern year (like Peds). In that case, people straight from medical school have a better chance. Not the same though for something like Derm, Rads, etc that require a different intern year outside of their specialty.
     
  12. backrow

    backrow 60% of the time it works everytime Lifetime Donor Classifieds Approved 10+ Year Member

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    Edit: (Now that I reread your post we may be saying the same thing)

    I disagree with the “incredibly hard” part here. This happens on a regular basis. Let’s use Peds as an example:

    MS4 applies to Peds, is competitive but not selected for Peds internship. Ends up in TY, does some Peds time during internship, goes out as a GMO and did well as intern and GMO. They apply for Peds out of GMO....they are quite likely to be selected.

    Now, this is not necessarily the case if you aren’t competitive from the start or don’t do well I’m internship/GMO. Where it is becoming more restrictive by the year is trying to match as a PGY2 into a categorical residency (e.g. EM out of TY internship, ENT out of general surgery, etc.). In the past it was possible to be a “resitern” for a handful of months, but the Boards are getting more strict and requiring the full “correct” internship.

    Also, some programs are (or are trying to go) to a straight through model. For example, ENT.




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  13. SeminoleFan3

    SeminoleFan3 Senior Member 10+ Year Member

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    I don’t think this is likely at all. I’m Peds and have NEVER seen this happen. If they do a Peds intern year and go out and want to come back, that’s different (and they almost always get to come back). I have never seen someone do a GMO tour that wasn’t Peds beforehand get to do Peds starting from an intern year.
     
  14. backrow

    backrow 60% of the time it works everytime Lifetime Donor Classifieds Approved 10+ Year Member

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    I know someone personally that went straight from TY to Peds internship with no GMO. I am also aware of some that have gone from TY to GMO to Peds. (But many times the folks who end up as TY find something else they’d rather do then go reapply for Peds)


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  15. SeminoleFan3

    SeminoleFan3 Senior Member 10+ Year Member

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    They must end up at the other two because it hasn’t happened at my location in my entire service time.
     
  16. DrMetal

    DrMetal To shred or not shred? Physician PhD Lifetime Donor Classifieds Approved 7+ Year Member

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    The 'point system' is a just a suggestion when it comes to GME. And not all points are created equal. Your points from medical school/board exams etc count more than your points from prior service/GMO. We've seen plenty of applicants (who have no prior service/GMO/research points) go straight through to competitive specialties, because they were very academically strong. In the end, the programs are going to take whoever they want, and that's usually the academically stronger candidate.
     
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  17. dwb8p

    dwb8p 7+ Year Member

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    Agreed. I have observed this in both residency and fellowship level selection within Army. Crappy board scores and mediocre med school performance never goes away. Whenever you apply for the next level of training, program directors and/or specialty consultants will continue to see you as a big risk.
     

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