Does anyone actually like the HPSP program?

[Croooz]

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Now...now...
I've disagreed with Neuro in the past because much of his info is 2nd hand but I'll be damned if he isn't right more than he's wrong. Sure he's "jaded" but for good reason. Why can't we just accept that what you will get from here is more in line with reality? There are a few positive comments but mostly negative ones. If you guys/gals make your decisions based entirely on only what you read here or what your recruiter tells you then you deserve the experience whether good or bad.

HPSP is up to the individual but unfortunately everyone has the belief that "it'll work for me"..."I'm different"..."I'm not gullible"..."I've researched".....then they sign and are miserable and profess that they wouldn't have made the decision if "only I had known before".

I applaud Neuro for not just jumping on the bandwagon of a positive poster. It's great that we have someone to put a positive spin but we honestly have enough "positive" posts from those who have no experience. This is a welcome change, let's hope it last. Nice variety.

 

[haujun]

When you sign up for HPSP you are signing up to become an officer in the military. You make a solemn promise to support and defend the constitution of the U.S, (*I will give my life for U.S. or for my fellow soldier even if I have follow the order I don't support*); that I take this obligation freely without any mental reservation or purpose of evasion (*It is my will not my recruter's*); and that I will faithfully discharge the duties of office(*the military needs come before my otho residency in Hawaii*).
If you read the oath of office carefully like the time when you read the verbal passage in MCAT perhaps there shouldn't be so much surprises or unhappiness in the military. 😉

 

[HeartDoc14]

Not if a specialty is limited. USUHS students almost always get their choices over HPSP students. Also, with Navy GMOs, it has nothing to do with competitiveness. See the thread a few months ago about the ultra-competitive guy who wanted to do Ortho and instead got a GMO tour. Hopefully he'll get to come back to Ortho, unlike those who were GMOed when the peds programs were slashed and now have no residency.

Where are you getting this information??? What you're saying here is simply not true. At least in the AF, USUHS students receive no advantage over HPSP students. And until you've actually been involved in GME selection, you really should make statements like that.

There ARE specialties that the military does not train (cardiothoracic surgery, laparoscopy fellowships, electrophysiology, medical genetics, etc.) In these cases, since the military does in fact need these specialties (and trust me when I say that they do), they send their trainees out to civilian sponsored or deferred spots. And if a trainee is sponsored, they almost invariably get to train at the best facilities in the world (Duke, Hopkins, Brigham, MGH, Mayo, UCSF, etc) since they are funded. I know many, many people that have been able to train at these top medical centers who otherwise would not have had their application even looked at by these places because they graduated from a state medical school or didn't have enough publications. There are going to be pediatricians in the military, and if they aren't trained on military bases, they're going to be trained somewhere else.

 

[AubreyMaturin]

When you sign up for HPSP you are signing up to become an officer in the military. You make a solemn promise to support and defend the constitution of the U.S, (*I will give my life for U.S. or for my fellow soldier even if I have follow the order I don't support*); that I take this obligation freely without any mental reservation or purpose of evasion (*It is my will not my recruter's*); and that I will faithfully discharge the duties of office(*the military needs come before my otho residency in Hawaii*).
If you read the oath of office carefully like the time when you read the verbal passage in MCAT perhaps there shouldn't be so much surprises or unhappiness in the military. 😉

Yeah,
I don't see why getting the right residency or living in the best location are even points of contention. My understanding is that you join the military to become a military officer whose job it is to provide medical care according to the needs of the service. This should come as no surprise, and people should not be bitter because they did not become the type of doctor they wanted to be. You join to become a military doctor, your specialty is of secondary consideration. If you fell for the recruiter's BS, then I have a really good used car to sell you. Let the buyer be ware, I have no sympathy. Most college aged applicants that I know are clueless and sheltered, they have to learn the hard way sometime. The rest know what they are getting into, or at least put some time into researching it.

If you got screwed some other way in the service, well...life is a game, even military life. Learn the rules and play to the best of your ability, it is the same no matter where you are professionaly. I am sure I will BOHICA at some point as well, and it may have nothing to do with military service.
But I won't cry about it and try to warn others about how terrible it is because I got screwed for being ignorant.

Neuronix has theories about posters, well here is one:
People with positive experiences don't usuall post. They have no need to vent, they have no need to warn others, and they are probably too busy actually doing there jobs.

Having said all of that;
There should be more info availible about HPSP/USUHS. Some of the most valuabe info is found here, that should not be the case. The Govt should compile a comprehensive info and FAQ, whcih all recruiters should have. Instead they spend their money on high payed advertisements and cool looking folders (you would cringe if you saw how much of your taxes went to this crap)...all set out to capture you imagination and instill pride for your country.


To recap: shut the hell up and take it like a man, all of you.
BTW,
Did I mention that I have'nt actually started serving in the military yet.

 

[Neuronix]

Where are you getting this information???

Read this forum. Unless you believe that posters on here are making things up, you might find it enlightening. I'll find links for you this weekend when I get some more time.

PS: Aubrey, go read any other active residency forum, and you will find attendings around who like what they do and are handing out advice to the residents and med students. This is probably the sixth time I've said this in response to that "well the positive people don't post" criticism.

 

[chopper]

Yeah,
You join to become a military doctor, your specialty is of secondary consideration. If you fell for the recruiter's BS, then I have a really good used car to sell you. Let the buyer be ware, I have no sympathy.

Said like someone who has not been in the military.

This is the EXACT attitude in a 'recruit' that breeds bitterness and contempt of the military down the road. I'm not saying everything in the miltary is crappy - I had a good experience in the Navy. But I think you need a little more than your desiere than "RAAAAR GOD, COUNTRY, FIX THE BOYS RAAAAR"

When I was in the Nav, it was the patriotic hoo-yaas that ended up falling the hardest when they realized that they were being screwed yet again by the military. I think there is some subcouncious thing going on in your head that because you have 'the right reasons' for going in, that you are immune and can take the crap forever. It's hard to explain, but I've seen the transformation from youthful idealism and 'the military is like the movies - I am out here to save lives and make a difference' mindset to bitter hate too many times to not know it's there.

I am sure I will BOHICA at some point as well, and it may have nothing to do with military service. But I won't cry about it and try to warn others about how terrible it is because I got screwed for being ignorant.

Oh, you will cry about it. And you will warn others.

I think HPSP/USUHS CAN be a good choice, and there are ways to mitigate the eventual hate and bitterness that will take over your being. One thing I will disagree with most posters on why to go in. Don't go in JUST because you want to go in to serve. Of course, this has to be a major motivation. Do have some selfish reasons, like the money. If you think of this more as a contract (an not as some 'higher calling'), I think it cushions the fall. If in your head you replay WWII Navy propogandas movies every day, WATCH OUT. You will fall onto a rocky crag, only to emerge a scarred, jaded, bitter, man. 😀 😀

DISCLAIMER: My above thoughts are not based on actual HPSP/USUHS experience, but line officer experience. I believe that they are accurately reflective of trends across branches/designations. If I have somehow mis-represented the military MD perspective, my deepest apologies.

 

[AubreyMaturin]

PS: Aubrey, go read any other active residency forum, and you will find attendings around who like what they do and are handing out advice to the residents and med students. This is probably the sixth time I've said this in response to that "well the positive people don't post" criticism.

I have an arguement for that point (I can argue anything). There are about an order of magnitude more civilian residents/attendings that their are military ones, so there is more of a chance that they will post. Hence more posters. This could be a bad samping error.

 

[AubreyMaturin]

Said like someone who has not been in the military.

This is the EXACT attitude in a 'recruit' that breeds bitterness and contempt of the military down the road. I'm not saying everything in the miltary is crappy - I had a good experience in the Navy. But I think you need a little more than your desiere than "RAAAAR GOD, COUNTRY, FIX THE BOYS RAAAAR"

When I was in the Nav, it was the patriotic hoo-yaas that ended up falling the hardest when they realized that they were being screwed yet again by the military. I think there is some subcouncious thing going on in your head that because you have 'the right reasons' for going in, that you are immune and can take the crap forever. It's hard to explain, but I've seen the transformation from youthful idealism and 'the military is like the movies - I am out here to save lives and make a difference' mindset to bitter hate too many times to not know it's there.




Oh, you will cry about it. And you will warn others.

I think HPSP/USUHS CAN be a good choice, and there are ways to mitigate the eventual hate and bitterness that will take over your being. One thing I will disagree with most posters on why to go in. Don't go in JUST because you want to go in to serve. Of course, this has to be a major motivation. Do have some selfish reasons, like the money. If you think of this more as a contract (an not as some 'higher calling'), I think it cushions the fall. If in your head you replay WWII Navy propogandas movies every day, WATCH OUT. You will fall onto a rocky crag, only to emerge a scarred, jaded, bitter, man. 😀 😀

DISCLAIMER: My above thoughts are not based on actual HPSP/USUHS experience, but line officer experience. I believe that they are accurately reflective of trends across branches/designations. If I have somehow mis-represented the military MD perspective, my deepest apologies.

I am not as patriotic or ideal as you may think. I am also not as young (though not that old). I am surprised that my post was construed as gung-ho, but as I read it again, I can see that.

My main point in the previous post was that people put too much emphasis on residency placement in the military, and always complain when they don't get what they want. Also that my current "peers" have it coming to them in terms of real world experiences. I would be willing to bet that they are the ones who end up bitter.

Also I know extensive second hand experience that line the officer plight is considerably different than that of a staff officer, especialy medical staff. Being a line officer in the Navy is vert competitive (as you know) and I have seen many get the short end because of cutbacks and reconfiguring. Maybe it is more likely to get screwed as a line officer? You tell me. I am sure the bureacracy is the same

 

[Mirror Form]

Read this forum. Unless you believe that posters on here are making things up, you might find it enlightening. I'll find links for you this weekend when I get some more time.

I've been reading this forum for a long time and I've haven't heard too many people saying the USHUS students have a big advantage over HPSP students in the residency selection process. That is just plain wrong! USHUS students do have a slight advantage, but the majority of the military attendings are not USHUS and are not giving preference to USHUS students. The main advantage that USHUS students have is that they do many more rotations at military hospitals and hence get to know military attendings better then the HPSP students who just do a few ATD's.

 

[Croooz]

I've been reading this forum for a long time and I've haven't heard too many people saying the USHUS students have a big advantage over HPSP students in the residency selection process. That is just plain wrong! USHUS students do have a slight advantage, but the majority of the military attendings are not USHUS and are not giving preference to USHUS students. The main advantage that USHUS students have is that they do many more rotations at military hospitals and hence get to know military attendings better then the HPSP students who just do a few ATD's.

USUHS students get points which does give them an edge, which along with the increased rotations, and possible publications. It's not a big advantage but 2 applicants being equal the USUHS applicant will get the slot.

 

[Mirror Form]

USUHS students get points which does give them an edge, which along with the increased rotations, and possible publications. It's not a big advantage but 2 applicants being equal the USUHS applicant will get the slot.

I agree with you there, but I think that it only comes down to that relatively rarely. In most cases it's not USHUS that gets somebody into a residency. If two applicants are similar, then the person who the faculty gets along with better will get the slot. Also, if somebody is HPSP from a prestigious school (eg hopkins), then I'd bet they'd probably get preference over a USHUS applicant who is otherwise similar to them.

 

[militarymd]

I agree with you there, but I think that it only comes down to that relatively rarely. In most cases it's not USHUS that gets somebody into a residency. If two applicants are similar, then the person who the faculty gets along with better will get the slot. Also, if somebody is HPSP from a prestigious school (eg hopkins), then I'd bet they'd probably get preference over a USHUS applicant who is otherwise similar to them.

Back in 1993, I did beat out a USHUS guy for a residency spot, and I truely thought he was more qualified than me.......I think the residency director just liked me better....so it is hard to tell

 

[rotatores]

Croooz is correct. USUHS students do actually get an "extra point" when it comes to GME selection. I've actually spoken with members of the Navy GME selection on this. I'm not really sure if it really makes any different though...I will say that all my 4th year friends at USUHS got their first choice first location...and most were just average students.

rotatores
USUHS 2006

 

[bobbyseal]

Croooz is correct. USUHS students do actually get an "extra point" when it comes to GME selection. I've actually spoken with members of the Navy GME selection on this. I'm not really sure if it really makes any different though...I will say that all my 4th year friends at USUHS got their first choice first location...and most were just average students.

rotatores
USUHS 2006

Frankly they can have their "extra point" for all I care. It matches nicely with their extra 3 years of commitment.

 

[Mirror Form]

Croooz is correct. USUHS students do actually get an "extra point" when it comes to GME selection. I've actually spoken with members of the Navy GME selection on this. I'm not really sure if it really makes any different though...I will say that all my 4th year friends at USUHS got their first choice first location...and most were just average students.

rotatores
USUHS 2006

Keep in mind that the Army doesn't use that point system for FYGME though, which is when most people match in the army into the competitive specialties.

 

[bobbyseal]

Back in 1993, I did beat out a USHUS guy for a residency spot, and I truely thought he was more qualified than me.......I think the residency director just liked me better....so it is hard to tell

You're old.... 😉

 

[Croooz]

I agree with you there, but I think that it only comes down to that relatively rarely. In most cases it's not USHUS that gets somebody into a residency. If two applicants are similar, then the person who the faculty gets along with better will get the slot. Also, if somebody is HPSP from a prestigious school (eg hopkins), then I'd bet they'd probably get preference over a USHUS applicant who is otherwise similar to them.

All things being equal we are in the real world and residents are interviewed for their "fit" with the group. Prestigious school means bupkiss when you're attitude is "prestigious". I've seen average Joe Schmos from average HPSP school beat out USUHS and Tier 1 schools.

In the end it's more a matter of USMLE score and a rapport with the group. Sometimes you fit and other times you won't. Not much you can do.

Bringing this back to the original question:
I think everyone likes the HPSP program...just not the commitment.

 

[Rudy]

I am an active duty resident and USUHS grad. Other fellow USU graduates and I discuss nearly on a daily basis how much we regret having signed our lives away by entering into the near eternal USUHS contract. The military preys on the poverty-induced psychosis of poor undergrad students who literally know nothing about the field of medicine when they sign up. The idea that USUHS grads are "always" happy with their decision is total garbage.

And for all of you pre-med and medical/osteopath students out there that have never practiced military medicine, you need to realize that MilMD's views are a fair representation of the reality of military medicine today. People are getting out in droves. In my dept, we have lost 12 of 13 staff physicians in the last 2 years. The average age of our staff is extremely young because of lack of retainability, so mentorship from seasoned, experienced physicians is almost non-existant in many fields in mil med. Many of the other depts at my military med center are similar. For example, the most senior ER doc has only been out of residency since 2000, and most of the rest are less than two years out. Radiology is so short staffed that they have hired civilians who literally could not find work anywhere else in the civilian world and should not be at a teaching institution. Docs are so anxious to leave that they clean their offices out 6-8 months in advance; everyday the talk is "how much time have you got left?" When some poor USUHS grad indentured servant pipes up, "I am stuck until 2013", all the staff bust into laughter and make some comment like, "dude, I've got fewer months left than you have years". More laughter.

The problem with this forum is that most of the posters are extremely biased in their reasons for choosing military medicine. Many are prior service guys that are only joining military medicine because they were sick of their other job in the military and med school was a way to try something new. Other prior service guys join because they are only a few years from retirement and they will be making a ton of money because of all of their time in service. The most of the rest of the posters are pre-med students at expensive medical/DO schools that are so afraid of incurring debt that sign up for military medicine without much of an understanding of what they are really getting themselves into. Unfortunately very few staff physicians with actual experience in mil med post here. I wish more would post; you all would see that MilMD is not alone in his views, and that often times he actually represents the majority.

To all of you truly trying to make the right decision: the only way to know if military med is right for you is to go to a military medical center and talk to a bunch of military docs. Ask them the hard questions. You will get a real understanding of what things are like. If you signed up without doing this, you may have made a mistake. Do not waste you time talking to recruiters--they have never practiced military medicine. Go right to the source. Be careful putting too much stock in what line officers say either--they have never practiced military medicine.

The bottom line is that no amount of student loan debt is worth it just for the money. You will regret it if you are doing it just for the money or even 50% for the money. Loans are cheaper than they have ever been, so money should not be factor in your decision. Go the civilian route for med school, select your specialty of choice, then if you still want to be a military doc, you can always sign up later. Believe me, they will be hurting for warm bodies to fill billets for the forseeable future. Don't forget, there are other important ways to serve your country besides the military, go volunteer at an underserved medical clinic in the inner city or rural community--these American citizens need you just as much as our troops do.

 

[AubreyMaturin]

I am an active duty resident and USUHS grad. Other fellow USU graduates and I discuss nearly on a daily basis how much we regret having signed our lives away by entering into the near eternal USUHS contract. The military preys on the poverty-induced psychosis of poor undergrad students who literally know nothing about the field of medicine when they sign up. The idea that USUHS grads are "always" happy with their decision is total garbage.

And for all of you pre-med and medical/osteopath students out there that have never practiced military medicine, you need to realize that MilMD's views are a fair representation of the reality of military medicine today. People are getting out in droves. In my dept, we have lost 12 of 13 staff physicians in the last 2 years. The average age of our staff is extremely young because of lack of retainability, so mentorship from seasoned, experienced physicians is almost non-existant in many fields in mil med. Many of the other depts at my military med center are similar. For example, the most senior ER doc has only been out of residency since 2000, and most of the rest are less than two years out. Radiology is so short staffed that they have hired civilians who literally could not find work anywhere else in the civilian world and should not be at a teaching institution. Docs are so anxious to leave that they clean their offices out 6-8 months in advance; everyday the talk is "how much time have you got left?" When some poor USUHS grad indentured servant pipes up, "I am stuck until 2013", all the staff bust into laughter and make some comment like, "dude, I've got fewer months left than you have years". More laughter.

The problem with this forum is that most of the posters are extremely biased in their reasons for choosing military medicine. Many are prior service guys that are only joining military medicine because they were sick of their other job in the military and med school was a way to try something new. Other prior service guys join because they are only a few years from retirement and they will be making a ton of money because of all of their time in service. The most of the rest of the posters are pre-med students at expensive medical/DO schools that are so afraid of incurring debt that sign up for military medicine without much of an understanding of what they are really getting themselves into. Unfortunately very few staff physicians with actual experience in mil med post here. I wish more would post; you all would see that MilMD is not alone in his views, and that often times he actually represents the majority.

To all of you truly trying to make the right decision: the only way to know if military med is right for you is to go to a military medical center and talk to a bunch of military docs. Ask them the hard questions. You will get a real understanding of what things are like. If you signed up without doing this, you may have made a mistake. Do not waste you time talking to recruiters--they have never practiced military medicine. Go right to the source. Be careful putting too much stock in what line officers say either--they have never practiced military medicine.

The bottom line is that no amount of student loan debt is worth it just for the money. You will regret it if you are doing it just for the money or even 50% for the money. Loans are cheaper than they have ever been, so money should not be factor in your decision. Go the civilian route for med school, select your specialty of choice, then if you still want to be a military doc, you can always sign up later. Believe me, they will be hurting for warm bodies to fill billets for the forseeable future. Don't forget, there are other important ways to serve your country besides the military, go volunteer at an underserved medical clinic in the inner city or rural community--these American citizens need you just as much as our troops do.

You put alot of words into saying that military med sucks, but you did not say why you hate it. In any field thier are people that hate thier job. Hell, I know proffesional musicains that are unhappy with thier job. Please explain to me, and all other future and potential mil docs why it is so bad. Why does it suck? I value your opinion.

 

[rotatores]

Rudy,

I'm curious...what year are you in your payback and what specialty are you in.....you say a lot of your USUHS friends are unhappy....but I'm willing to bet there are an equal amount of grads that are truely happy in their decision. I do agree with you that there appears to be a lot of bias on this site but I'd say the bias tends to favor the unhappy...which makes sense...if one's truely enjoying life and a military career their not spending their free time posting on a web site. Of course...i may be in your shoes in the near future if i'm stuck doing a residency that I didn't choose.

rotatores

 

[DCM]

I am stationed at the pentagon and like many of you agonizing over USUHS vs HPSP vs civilian.

I have talked to 6 attendings at Bethesda. 1 cards, 1 rads, 2 peds, 1 OB and 1 CT surgeon. Everyone gave me a balanced view of pros and cons and everyone was very much in favor of mil med. Of course they are biased. Positives include: good cause, like taking care of mil families, no debt is nice, secure, better lifestyle in general, don't have to worry about business side, broadening. Negatives: lower pay, moving, deploying(although in Navy this seems to apply to GMOs mostly), typical HMO-type frustrations. All of them are good docs w/good training: Yale(2), Tulane, Rochester, Loyola, Tufts.

The heart surgeon I have been shadowing for a year. He is president of the most successful private practice in Northern Viginia, an ex-Navy doc, and still covers bethesda as a civilian doc in a rotation with his group. he is up there about 1/week. He operates and trains fellows/residents. He is emphatically recommending USUHS fo me. He is impressed with their clinical skills and the institution. He thinks that the training is good, and that the time he had in the Navy not worrying about business was good for hime clinically. Financially he also thinks that it is better in the long run. He did comment that if my goal was to be chief of surgery at MGH than maybe I should try for a bigger name.

My mother is a private practice radiologist. Two of her partners are ex-mil, one USUHS, one HPSP. They are both very much recommending military citing personal growth and finances.

The perspective that I am getting off of this board from impressive civ and mil docs is totally positive and just want to offer that for thought.

 

[militarymd]

I am stationed at the pentagon and like many of you agonizing over USUHS vs HPSP vs civilian.

I have talked to 6 attendings at Bethesda. 1 cards, 1 rads, 2 peds, 1 OB and 1 CT surgeon. Everyone gave me a balanced view of pros and cons and everyone was very much in favor of mil med. Of course they are biased. Positives include: good cause, like taking care of mil families, no debt is nice, secure, better lifestyle in general, don't have to worry about business side, broadening. Negatives: lower pay, moving, deploying(although in Navy this seems to apply to GMOs mostly), typical HMO-type frustrations. All of them are good docs w/good training: Yale(2), Tulane, Rochester, Loyola, Tufts.

The heart surgeon I have been shadowing for a year. He is president of the most successful private practice in Northern Viginia, an ex-Navy doc, and still covers bethesda as a civilian doc in a rotation with his group. he is up there about 1/week. He operates and trains fellows/residents. He is emphatically recommending USUHS fo me. He is impressed with their clinical skills and the institution. He thinks that the training is good, and that the time he had in the Navy not worrying about business was good for hime clinically. Financially he also thinks that it is better in the long run. He did comment that if my goal was to be chief of surgery at MGH than maybe I should try for a bigger name.

My mother is a private practice radiologist. Two of her partners are ex-mil, one USUHS, one HPSP. They are both very much recommending military citing personal growth and finances.

The perspective that I am getting off of this board from impressive civ and mil docs is totally positive and just want to offer that for thought.

Ed Zech? They made him president of that group??? I'm a little surprised. Anyways, Capital area military medicine is not really same as the rest of military medicine.

A lot of the physicians there hold unique billets.....not having moved in a long time.....Bethesda is a rotten apple in military medicine.....lot of doctors, very little work....everyone stays there for mutiple tours....Also, the people you are talking to practiced in a different era than now.

Keep that in mind when you hear things from the DC area.

 

[Teufelhunden]

I see all these negative threads (which I respect, there's pros/cons to everything). What I'm not seeing is posts from these guys...

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18

Okay, so there's 18 people who obviously do not hate Navy medicine. Personally...as I read some of their bio's I'm thinking, wow these are some pretty cool careers. For someone like myself who's interested in the administrative side of medicine, it's nice to see so many leadership opportunities. Many of these people also were able to pursue other degrees while in the Navy - these bio's are riddled with JDs, MBAs, MHAs, MPHs, etc.

It would be nice if some of these type of people would post, to give this forum some balance. You all have to admit, we have a skewed sampling on this forum.

 

[militarymd]

I see all these negative threads (which I respect, there's pros/cons to everything). What I'm not seeing is posts from these guys...

Okay, so there's 18 people who obviously do not hate Navy medicine. Personally...as I read some of their bio's I'm thinking, wow these are some pretty cool careers. For someone like myself who's interested in the administrative side of medicine, it's nice to see so many leadership opportunities. Many of these people also were able to pursue other degrees while in the Navy - these bio's are riddled with JDs, MBAs, MHAs, MPHs, etc.

It would be nice if some of these type of people would post, to give this forum some balance. You all have to admit, we have a skewed sampling on this forum.

These bios really show you if you would like military medicine. If you want to be a doctor who is good at taking care of patients and take care of patients, then military medicine is not for you.

If you want to be a doctor who never really get good at their jobs, and who spends their time telling other doctors how to do their jobs, then military medicine is perfect for you.

This is not a negative post...just a accurate description of how military medicine is....If one is really interested in just finishing training and not really interested in practicing medicine...but being a beaurecrat who makes up policy then military medicine is perfect for you.

I served under 3 or 4 of the above named individuals, and I know about their clinical histories......essentially, never good clinicians....really trained so that they can have "bullets" on their CVs...so that they can become beaurecrats.

Unfortunately, most folks who sign up for the scholarship want to be clinicians who spend their time perfecting their clinical skills and taking care of patients.

 

[Teufelhunden]

So you're suggesting what? These are all, supposedly, poor clinicians? I can't argue with your experiences. If you say the 3-4 of those people were "never good clinicians" then I'll have to take your word for it. You still seem to be trying to make a generalized statement with your n=4 anecdotal experiences.

Most people here know my 'deal'...former jarhead, married to a Corpsman....my wife and I loved the military. Ever since leaving in 1995, I have been itching to get back in. Most of what I miss about the military can be described as intangible, so I won't write an essay entitled "Why I Loved Being a Marine." Some of you would understand. Some of you never will.

I did go back into the military to be an Officer first and a Physician second. I know that irks a lot of you, but that is how I feel. Now, I certainly don't believe that equates to "I wan't to be a crappy doctor." Nothing could be further from the truth. I hope to become an excellent psychiatrist, and look forward to serving in that capacity. However, I have goals and aspirations in other realms as well. I believe I could develop into a solid leader in the Navy, and at some point would like to steer my career towards administrative/leadership billets. Hopefully, though, I would like to always see patients...even it was for one afternoon a week. (And hopefully, mmd, I can break the mold and still be a good clinician).

Again, I respect all your opinions. We're all very different. We all went into the military with different sets of expectations. For me, the Navy represents a way of life...as corny as it sounds, I believe in all that stuff: Honor. Courage. Committment. Discipline. Respect for Authority. Teamwork.

I would have gone back into the military after med school for free. HPSP was just icing on the cake for me.

 

[DCM]

I'm not familiar w/Ed Zech. These guys primarily operate at Inova Fairfax and as a group cover CT at NNMC.

Our military will keep on running whether we join or not, it would be nice to think that good doctors will keep coming in and troops will get the best possible care. Our OB and Pediatician were excellent by any standard and had busy clinical schedules.

 

[militarymd]

I'm not familiar w/Ed Zech. These guys primarily operate at Inova Fairfax and as a group cover CT at NNMC.

Our military will keep on running whether we join or not, it would be nice to think that good doctors will keep coming in and troops will get the best possible care. Our OB and Pediatician were excellent by any standard and had busy clinical schedules.

Then Steve Philips? Phillips is a great guy, but he said a lot of bad things about the Navy when he was in...when I knew him.....The Fairfax group has been covering NNMC since the early 90's....I assume we are talking about the same group.

 

[militarymd]

So you're suggesting what? These are all, supposedly, poor clinicians?

Not suggesting it......something that a couple of them admitted freely...leading to their careers.

I'm simply pointing out how things are....versus what a lot of medical students envision themselves doing after training.

 

[R-Me-Doc]

BTW,
Did I mention that I have'nt actually started serving in the military yet.

Yeah, well, that pretty much says it all. Those of us who are actually in the military (and specifically the medical corps) do know what's going on. Please don't blow off all of us negative posters as a minority of disgruntled complainers who would never be happy no matter what. I've run into precious few "happy" military docs -- the great majority are voting with their feet and getting out ASAP. Many of those who aren't getting out after their 1st tour is up are just staying in because they are too close to 20 years to toss away a pension. There are very few docs in the military with between 8 and 16 years experience. It's sort of a reverse bell curve: lots of newcomers and a bunch of oldtimers. Those in the "prime" of their careers are gone. This is due to a lot of things: dislike of the system itself, money, not wanting to get deployed, etc. Also, I think a lot of military docs (myself included) see the writing on the wall and realize that military medicine is going to change a whole lot in the next 10 years, and see that we won't fit in the future military.

Military medicine, like the rest of the military, is headed for "transformation." That's going to mean that military docs are going to be highly deployable and, excluding surgeons, who will be operating on traumas, will for the most part function in the old GMO mode (even as that term is being officially phased out, the job of being a primary provider for deployed troops will continue, as obviously it must.) This is going to mean that fewer and fewer specialists are needed. Think about this seriously for a minute: does the Army (or Navy or AF) really need endocrinologists, cardiologists, rheumatologists, radiation oncologists, neruologists, etc to support a combat force? Of course not. Anyone with a medical condition that requires ongoing care from any of these specialites probably has a condition that renders them nondeployable, and therefore of no use to the new military. They get a medical discharge. As for the argument that we need specialists to take care of dependents and retirees, that's out the window too. At many military medical centers, dependent and civilian specialty care (and even a lot of active duty specialty care) is all being handled by civilian contractors. Think about it: why should the army spend a zillion bucks training a military cardiologist when they can rent one with no benefits etc as a part time contractor?

Bottom line: In the future, military medicine will be a) surgeons to take care of trauma and b) family practice/internal medicine docs to take care of all other general medical needs, i.e. GMOs. Oh yeah, they need shrinks too, for the combat stress stuff. That's about it. And you know what? I have no problem with that. The job of the military is to fight wars, not to take care of retirees and babies. So, since I've come to view my specialty as more or less superfluous in today's military, I simply plan to step out of the way as soon as I can so I don't get snagged into being a GMO somewhere.

I'm not sure exactly how all this is going to get reflected in the military GME picture, but I suspect over the next decade there will be a big drawdown of military specialty residencies and fellowships, closings of smaller military hospitals, and a big shakeup in the specialty mix of military docs.

RMD 1-2-14

 

[Teufelhunden]

Not suggesting it......something that a couple of them admitted freely...leading to their careers.

"...admitted freely"

Ha ha! You gotta appreciate honesty. God, I couldn't imagine going through all this, only to one day say, "Yeah, I'm a terrible clinician." Makes me think I should maybe be studying rather than surfing through SDN.

Hey, thanks for all your insight, mmd...I'm not disagreeing with any of you here. I just think that there's a silent minority that's not being spoken for. I have to believe that there are some good Navy docs who go 20-30 years. If not, then it'll be my mission to be the first one!

 

[militarymd]

I have to believe that there are some good Navy docs who go 20-30 years. If not, then it'll be my mission to be the first one!

There are, and I have said so else where....and I admire them for it. 👍

 

[AubreyMaturin]

Military medicine, like the rest of the military, is headed for "transformation." That's going to mean that military docs are going to be highly deployable and, excluding surgeons, who will be operating on traumas, will for the most part function in the old GMO mode (even as that term is being officially phased out, the job of being a primary provider for deployed troops will continue, as obviously it must.) This is going to mean that fewer and fewer specialists are needed. Think about this seriously for a minute: does the Army (or Navy or AF) really need endocrinologists, cardiologists, rheumatologists, radiation oncologists, neruologists, etc to support a combat force? Of course not. Anyone with a medical condition that requires ongoing care from any of these specialites probably has a condition that renders them nondeployable, and therefore of no use to the new military. They get a medical discharge. As for the argument that we need specialists to take care of dependents and retirees, that's out the window too. At many military medical centers, dependent and civilian specialty care (and even a lot of active duty specialty care) is all being handled by civilian contractors. Think about it: why should the army spend a zillion bucks training a military cardiologist when they can rent one with no benefits etc as a part time contractor?

Bottom line: In the future, military medicine will be a) surgeons to take care of trauma and b) family practice/internal medicine docs to take care of all other general medical needs, i.e. GMOs. Oh yeah, they need shrinks too, for the combat stress stuff. That's about it. And you know what? I have no problem with that. The job of the military is to fight wars, not to take care of retirees and babies. So, since I've come to view my specialty as more or less superfluous in today's military, I simply plan to step out of the way as soon as I can so I don't get snagged into being a GMO somewhere.
RMD 1-2-14

This type of info is something that I am really interested in hearing more about. Why do you think this? What signs have you seen? I tried to start a new thread for a discussion about the future of military medicine , but there were not many posters.

I like the idea that mil med is becoming more operational, this is one of the primary reasons for my choosing USUHS. I want to be deployed. If I wanted to be a neurologist or cardiologist I would accept my offer to stay in Boston and go to Tufs or BU, but that is not what I am interested in. I may still find a specialty, but I hope that it is one that is deployable. Once I am too old or tired, I will get out and practice privately.

Thanks for the info, please tell me more!