Drawdown in Afghanistan

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narcusprince

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To all, as a new attending coming on board in July. I wondered how the 2013 drawdown is going to effect deployment's. My specialty is Anesthesia what other locations can we deploy during peacetime? What kind of trends can we expect in a drawdown? I probably will not be deployable until the 2013 timeframe (time I finish the oral boards).
Thanks
NP
 
To all, as a new attending coming on board in July. I wondered how the 2013 drawdown is going to effect deployment's. My specialty is Anesthesia what other locations can we deploy during peacetime? What kind of trends can we expect in a drawdown? I probably will not be deployable until the 2013 timeframe (time I finish the oral boards).
Thanks
NP

As you probably know, Navy anesthesia generally won't deploy people until they've taken their oral boards, though there are exceptions. So you can reasonably expect to be safe until you've done your orals. (Incidentally, if you draw the fall oral board date, the ABA has been known to move people up to the spring date if they tell them they're scheduled to deploy and want to be board cert before deploying).

As for the draw down ... don't hold your breath. 🙂 Afghanistan is probably going to be it for the next couple years. As the story goes, certain segments of the line have been less enthusiastic about solo CRNAs of late, so the demand for anesthesiologist deployments hasn't dropped the way you might have expected since leaving Iraq.

The "fun" deployments like humanitarian cruises seem to go more toward peds fellowship trained guys, which makes some sense, given the cases and patients they have.

There really aren't any other Navy anesthesiologist deployments to speak of. We generally don't wind up on ships, at least not for long.
 
As you probably know, Navy anesthesia generally won't deploy people until they've taken their oral boards, though there are exceptions. So you can reasonably expect to be safe until you've done your orals. (Incidentally, if you draw the fall oral board date, the ABA has been known to move people up to the spring date if they tell them they're scheduled to deploy and want to be board cert before deploying).

As for the draw down ... don't hold your breath. 🙂 Afghanistan is probably going to be it for the next couple years. As the story goes, certain segments of the line have been less enthusiastic about solo CRNAs of late, so the demand for anesthesiologist deployments hasn't dropped the way you might have expected since leaving Iraq.

The "fun" deployments like humanitarian cruises seem to go more toward peds fellowship trained guys, which makes some sense, given the cases and patients they have.

There really aren't any other Navy anesthesiologist deployments to speak of. We generally don't wind up on ships, at least not for long.
Do I sense a change in doctrine in the .mil? Is this the fuel we need to get back to the ACT model? So what was .mil anesthesia like before the solo CRNA practice took effect?
 
Do I sense a change in doctrine in the .mil? Is this the fuel we need to get back to the ACT model? So what was .mil anesthesia like before the solo CRNA practice took effect?

Probably no change. There aren't enough of us to cover every deployment, plus ships.

A cynic might say it's just the line making noise, because they can. Truthfully, the last thing we need is a bunch of Marines dictating who staffs how many medical billets where. Also, supposedly some of the Brit-run spots got CRNAs and didn't know what to do with them, and wouldn't let them work solo, leading to much hate and discontent on all sides.


But you've got it backwards; the civilian world got the solo CRNA idea from the military, 40+ years ago, not the other way around. Yes, it's all our fault. 🙂
 
What about FST teams? DO they ever employ anesthesiologists or do they mostly stick with CRNAs?

When deployed as a GMO in the 04-06 time frame, I only saw anesthesiologists at the FRSS level, but I know both CRNAs and anesthesiologists who've deployed to that kind of echelon 2 setting.

I don't know what the criteria are for deciding who goes where.
 
I think a couple things could influence our op tempo after the drawdown.
1. Other sites ie Horn of Africa
2. Low CRNA numbers could lead to us playing a bigger role with fst and carriers.
3. The Army. These conflicts have probably created new model in that operational deployments are no longer branch specific. I have no idea what the Army does for their peacetime deployments but but the Navy may become fair game to fill the needs.
 
As for the draw down ... don't hold your breath. 🙂 Afghanistan is probably going to be it for the next couple years.

Have you been following the news? The president wants us out of Afghanistan before the next election is over. This means it will probably happen. Sure we'll still have some sort of presence there. But everyone (including docs) will be a lot less likely to deploy there.

Of course the president could change his mind. But with the upcoming election, I doubt it. He'll want to campaign on having killed OBL and ending both OIF and OEF. It's a pretty good campaign strategy!
 
Have you been following the news? The president wants us out of Afghanistan before the next election is over. This means it will probably happen.

Same guy who wanted us out of Gitmo right after the last election was over ... and vacating Gitmo would've been quite a bit easier on every level than vacating Afghanistan.

I'm scheduled to deploy this fall, and would be happy to stay home. But I'm not holding my breath. 🙂
 
Same guy who wanted us out of Gitmo right after the last election was over ... and vacating Gitmo would've been quite a bit easier on every level than vacating Afghanistan.

I'm scheduled to deploy this fall, and would be happy to stay home. But I'm not holding my breath. 🙂

Yeah but there were politicians in DC who opposed moving gitmo and since they control the budget they didn't approve the funds to relocate the prisoners.
 
Yeah but there were politicians in DC who opposed moving gitmo and since they control the budget they didn't approve the funds to relocate the prisoners.

I think it's pretty far-fetched to claim that the reason Obama didn't close Gitmo was because Congress closed the purse strings. Regardless, his party owned the Senate and the House the first two years of his term.

Even today, with a hostile House, that place could be closed by next Thursday if there was executive will to do so.
 
Same guy who wanted us out of Gitmo right after the last election was over ... and vacating Gitmo would've been quite a bit easier on every level than vacating Afghanistan.

I'm scheduled to deploy this fall, and would be happy to stay home. But I'm not holding my breath. 🙂

I wouldn't be surprised if you're right. But right now the plan is to get pretty much out of Afghanistan in a year and a half. The president wasn't that committed to gitmo obviously. But he is committed to getting reelected.

Now if he was saying, "I'll withdraw troops from Afghanistan AFTER the election," then I'd be a lot more skeptical.
 
Probably no change. There aren't enough of us to cover every deployment, plus ships.

A cynic might say it's just the line making noise, because they can. Truthfully, the last thing we need is a bunch of Marines dictating who staffs how many medical billets where. Also, supposedly some of the Brit-run spots got CRNAs and didn't know what to do with them, and wouldn't let them work solo, leading to much hate and discontent on all sides.


But you've got it backwards; the civilian world got the solo CRNA idea from the military, 40+ years ago, not the other way around. Yes, it's all our fault. 🙂

The line isn't really making the decisions there. It's medical officers working for the line deciding how they want to staff the FRSS's, which are doctrinally staffed by medical officers and not nurse corps. Some units have decided to waive the requirement and allow CRNAs to function as one of the 3 physicians in a FRSS. But make no mistake, when a CRNA is placed in that role, they are filling a ULN (unit line number) reserved for an "Anesthesiologist." The people making the FRSS decisions are generally surgeons and anesthesiologists, and they have to decide whether they are comfortable using CRNAs instead of Anesthesiologists. That's for the Marine side anyway.

I know the brits don't use CRNAs, but I've also heard that Kandahar won't use CRNAs, which is just silly, since it's basically an American trauma center.

I don't attest to know all of the idiosyncrasies of running a combat medical unit, but I'm sure some of the decisions can be tough. Even if it means more Anesthesiologists deploying and maybe a couple sitting around in a role 2 facility doing nothing for a couple of months, it may sometimes be the better part of valor to put your best foot forward when it comes to saving wounded Marines and Sailors. When I think of the possibility of my son coming into a role 2 with 2 limbs amputated, losing blood, and half of his jaw missing, I would want the best combination of medical personnel to be available. Just my thoughts.

There probably are actually enough of us to cover all of the deployments if the deployment tempo increases to greater than one every 5 years. There are quite a few hiding out there with no deployments or a humanitarian boondoggle every 5 years.
 
To all, as a new attending coming on board in July. I wondered how the 2013 drawdown is going to effect deployment's. My specialty is Anesthesia what other locations can we deploy during peacetime? What kind of trends can we expect in a drawdown? I probably will not be deployable until the 2013 timeframe (time I finish the oral boards).
Thanks
NP

Um, just to let you know, they had no issues deploying me without the opportunity to take boards. MyBDE surgeon BTW (ER trained) had the chance to take his written, but had to defer orals until after deployment. Just a heads up.
 
Um, just to let you know, they had no issues deploying me without the opportunity to take boards. MyBDE surgeon BTW (ER trained) had the chance to take his written, but had to defer orals until after deployment. Just a heads up.

Yes. 2 out of the 3 new anesthesiologists at my command are deployed before given the opportunity to take boards. We SHOULD both be back in time to take the October exam, but only by a couple of weeks.
 
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