Failure of APFT during PGY1 = Kicked out of Army

[DD214_DOC]

So here is an interesting bit of information I discovered today and wanted some other people's thoughts on the matter.

A bunch of us did not pass the October APFT for various reasons. Initially we were told during orientation that the requirement for advancement was to pass an APFT by April/May of PGY1 and that failure would prevent advancement as well as various other bad things such as referred OERs and what not.

So, the company commander is telling the people who failed that the CG of the MTF has a new "policy" that anyone who failed has 90 days to pass the APFT or that, "paperwork to get you out of the Army would be started and sent to CG who will then decide what to do". I find this a bit difficult to believe.

I discussed the matter with the PD here and he says that this is how things work with enlisted personnel who fail but not officers and that there shouldn't be anything to worry about, at least with being discharged. Would the CG here at the MTF even have this type of authority? I know most of you will say, "If that's true then fail it and get out", but I'm wondering wtf is up with this.

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[AF M4]

So here is an interesting bit of information I discovered today and wanted some other people's thoughts on the matter.

A bunch of us did not pass the October APFT for various reasons. Initially we were told during orientation that the requirement for advancement was to pass an APFT by April/May of PGY1 and that failure would prevent advancement as well as various other bad things such as referred OERs and what not.

So, the company commander is telling the people who failed that the CG of the MTF has a new "policy" that anyone who failed has 90 days to pass the APFT or that, "paperwork to get you out of the Army would be started and sent to CG who will then decide what to do". I find this a bit difficult to believe.

I discussed the matter with the PD here and he says that this is how things work with enlisted personnel who fail but not officers and that there shouldn't be anything to worry about, at least with being discharged. Would the CG here at the MTF even have this type of authority? I know most of you will say, "If that's true then fail it and get out", but I'm wondering wtf is up with this.

(Said through mouthful of Twinkies)

Speaking from the AF side...yeah, technically. But we have all sorts of Fitness Review Panels and a ton of other administrivia to sort through first. Plus there's the argument that residency does not allow a lot of time to PT, etc. etc....there's a lotta hurdles to jump first.

Not to mention the carnage that would impact the commanders after they nuked the highly lucrative, very valuable and critically needed services of multiple health professionals who would have been indentured to military service for several years.

I'll wager on "bluff", thanks. Might want to replace a few burgers with salads for your overall health though.

 

[DD214_DOC]

As interesting as your recommendation to substitute salads for burgers is, I actually have no problems making weight. I'm fine on pushups and situps but epically fail on the run.

In the mean time, I looked up the regs regarding officer eliminations in AR 600-8-24 and it appears that AMEDD officers paying back an ADSO are excluded from the section that states elimination proceedings may begin after two consecutive APFT failures.

 

[AF M4]

As interesting as your recommendation to substitute salads for burgers is, I actually have no problems making weight. I'm fine on pushups and situps but epically fail on the run.

In the mean time, I looked up the regs regarding officer eliminations in AR 600-8-24 and it appears that AMEDD officers paying back an ADSO are excluded from the section that states elimination proceedings may begin after two consecutive APFT failures.

Right. In that case, I suggest trying this new fad called uh, jogging. I believe it's jogging or yogging. It might be a soft j. I'm not sure but apparently you just run for an extended period of time. It's supposed to be wild.

Also, I'm totally taking credit for providing you with the motivation to look up the reg. Where the threats of commanders fail, the threat of the salad always succeeds.

 

[DeadCactus]

Where the threats of commanders fail, the threat of the salad always succeeds.

 

[NavyFP]

If you owe time (and you do) it is unlikely they will kick you out of the Army. Will they allow you to continue on into PGY-2? Not sure. They could send you off into GMO land to pay back your time. If you pass future PFTs, you could be allowed back into the GME system.

 

[DogFaceMedic]

In the Army if you are under an HPSP contract obligation, they do not discharge. You just don't get promoted or good assignments. More troublesome, however, is repeated failures at end on intern year can lead to becoming a GMO and being pulled out of residency.

People have tried to get fat and slow to get out and were disappointed with remaining a CPT for 7+ years, and denied the extra $1K/month as a major at 6.

 

[burs0028]

to be blunt, a psych residency isn't exactly considered one that is known to break hours in most institutions; not enough time to work out is not a valid excuse.

 

[DD214_DOC]

to be blunt, a psych residency isn't exactly considered one that is known to break hours in most institutions; not enough time to work out is not a valid excuse.

Half of the year isn't psych. We do at least 3 months of inpatient medicine in addition to other non-psych stuff.

 

[IgD]

I wonder if the RRC has a position on this issue. If the military is requiring people to maintain fitness as a medical training standard, do they have to provide specified workout time during the normal work day. I think it is a fair question to ask. Surely the RRC must have reviewed this issue before.

 

[narcusprince]

What is upsetting is how GMO = Punishment. Did not score well on your USMLE GMO tour, want a competitive specialty Gmo tour, did not pass your PT test GMO tour. I would argue that serving our troops and sailors should never be equated to punishment. I know plenty of AD that have done GMO tours and have never equated it to punishment. How pervasive is this stance within military GME?

 

[notdeadyet]

In the mean time, I looked up the regs regarding officer eliminations in AR 600-8-24 and it appears that AMEDD officers paying back an ADSO are excluded from the section that states elimination proceedings may begin after two consecutive APFT failures.

Though they won't kick you out for failing the APFT twice, they can make your life very uncomfortable. Folks in my program that failed the APFT were given a diagnostic in one month's time and if they failed that, they were to be put on mandatory three mornings/week work outs with an NCO who wasn't happy to be woken up at that hour. You're better off working out at your convenience than someone else's.

The Army takes passing that thing pretty seriously. With no more than a few hours working out each week and watching what you eat, passing the APFT should not be a problem. It's required of all soldiers, doctors are no exception. If you have the drive to complete medical school, you definitely have the drive to pass the APFT if you make it a priority.

 

[notdeadyet]

I would argue that serving our troops and sailors should never be equated to punishment.

Serving our troops isn't punishment, it's a privilege. They deserve the best care they can get. They will get better care from someone who has completed what is considered the standard for medical training (i.e.: residency).

Having basic medical training interrupted and put into the field is a negative thing for most people. It's bad for most physicians involved and can be bad for the troops your serving.

 

[pgg]

What is upsetting is how GMO = Punishment. Did not score well on your USMLE GMO tour, want a competitive specialty Gmo tour, did not pass your PT test GMO tour. I would argue that serving our troops and sailors should never be equated to punishment. I know plenty of AD that have done GMO tours and have never equated it to punishment. How pervasive is this stance within military GME?

While my GMO tour wasn't "punishment" it did delay my training 3 years and cost me $115,500 in lost ISP & BCP. I'm a grand-champion level Master of looking on the bright side, and there were many things about my GMO tour that were personally and professionally rewarding. But if one is to look at things objectively from a distance and weigh the pros & cons, a six-figure fine assessed by the US Navy is one hell of a con (punishment?) ... to say nothing of the usual list of cons that come up in GMO-bashing threads.

I absolutely agree that serving our troops isn't punishment. However, the people who were allowed to go straight through to residency got to serve the troops too. These days, I'm also certain that I'm better able to serve them as a board certified anesthesiologist than I ever did as a GMO s/p transitional internship.

90% of military physicians get out when their obligation is up. If you look at a USUHS grad with a 7 year payback, does it make the most medical and economic sense for the Navy to get 7 years of attending-level service, or 3 years of flight surgeon sick call + 4 years of attending-level service?

 

[OBDude]

I'm a grand-champion level Master of looking on the bright side...

 

[AF M4]

90% of military physicians get out when their obligation is up. If you look at a USUHS grad with a 7 year payback, does it make the most medical and economic sense for the Navy to get 7 years of attending-level service, or 3 years of flight surgeon sick call + 4 years of attending-level service?

How dare you! How dare you question the fiscal aptitude of a branch of our federal government?! You think you're smarter than them? And don't even try to support your heresy by mentioning our 12 trillion dollar national debt - everyone knows that we can just print more money to pay that off. Back, back unbeliever, back I say!

 

[colbgw02]

I wonder if the RRC has a position on this issue. If the military is requiring people to maintain fitness as a medical training standard, do they have to provide specified workout time during the normal work day. I think it is a fair question to ask. Surely the RRC must have reviewed this issue before.

I believe an Army general surgery program jumped through these hoops a few years ago, and the ACGME decided that mandatory fat-boy PT for those that don't pass their APFT does not count toward the 80-hour work week. It stands to reason that if they can obligate you to workout without affecting duty hours, then they can expect you to pass without providing protected PT time.

 

[Apollyon]

...if they failed that, they were to be put on mandatory three mornings/week work outs with an NCO who wasn't happy to be woken up at that hour.

Haha! When I was at VMI (play soldier) the "Chub Club commander" was not only happy, but - always - gleeful at the torture he could inflict. (I say "he" because I was there before coeducation.)

 

[Zulu451]

I believe an Army general surgery program jumped through these hoops a few years ago, and the ACGME decided that mandatory fat-boy PT for those that don't pass their APFT does not count toward the 80-hour work week. It stands to reason that if they can obligate you to workout without affecting duty hours, then they can expect you to pass without providing protected PT time.

My general surgery PD made it real simple, don't pass the PT test... You get to do PT in the morning after rounds instead of operating.

 

[OBDude]

My general surgery PD made it real simple, don't pass the PT test... You get to do PT in the morning after rounds instead of operating.

Awesome. Motivation that aims for the soul.

 

[EMH]

Right. In that case, I suggest trying this new fad called uh, jogging. I believe it’s jogging or yogging. It might be a soft j. I’m not sure but apparently you just run for an extended period of time. It’s supposed to be wild.

Seriously speaking. You just have to start running. I was seriously worried about this when I joined. I'm a short guy with a broad frame and short legs and have never been a runner. When I first started I couldn't run a mile without having to stop and walk. There are plenty of training schedules on the web that can help you come up with a plan to increase your endurance, search for them. I did an alternating run/walk program for a couple of months gradually increasing the distance running. I then just started running two miles at a speed that I could maintain without having to walk. After a couple of months of this I got my speed up. Managed to pass my first record a couple of months ago. Just have to take this seriously.

 

[pgg]

My general surgery PD made it real simple, don't pass the PT test... You get to do PT in the morning after rounds instead of operating.

I don't know if I can get behind that. Yeah, the military stuff is important, everyone should pass the PFA.

Deliberately compromising a resident's training for any reason related to the military doesn't sit well with me though. There are a dozen ways to punish or motivate bad officers that don't involve making them bad doctors too.

For the record, I've never failed or medically waived a PFA.

 

[EMDoc0411]

Personal question:

I'm AD. I pass the PRT. I've had a calf strain for the last 6 months. It hurts everytime I run or bike. I haven't said anything about it. I've essentially just sucked it up. However, I'm getting to the point where it is persisting and not getting better. Would this be something that would get a medical waiver?

 

[notdeadyet]

I don't know if I can get behind that. Yeah, the military stuff is important, everyone should pass the PFA.

Deliberately compromising a resident's training for any reason related to the military doesn't sit well with me though. There are a dozen ways to punish or motivate bad officers that don't involve making them bad doctors too.

Meh, we signed a contract agreeing to pass the APFT as a condition of our employment. Not doing so won't just impair our training, it's grounds for kicking us out. Of all of the indignities and inconvenience's of the military, the requirement of passing a pretty basic APFT doesn't seem to be very high on the list.

 

[a1qwerty55]

Personal question:

I'm AD. I pass the PRT. I've had a calf strain for the last 6 months. It hurts everytime I run or bike. I haven't said anything about it. I've essentially just sucked it up. However, I'm getting to the point where it is persisting and not getting better. Would this be something that would get a medical waiver?

Go to sick call or your PCM and get your injury documented, examined and treated. You probably will warrant a profile or "limited duty board", term depends on your service (Army versus Navy), I don't know the USAF term, but basically if you have a legitimate injury and running will aggravate it or the injury will keep you from fairly passing, then you would be exempted while it is being treated.

 

[DD214_DOC]

Just an update for the naysayers. Despite my concern for a possible pulmonary issue limiting my ability to meet physical expectations, I have continued to train with very interesting results. I improved my run time by over 5 minutes in the course of three days. After the improvement, I ran again with results similar to my APFT (> 20 minutes on the 2 mile run with resultant dyspnea, palpitations, chest tightness, and presyncope). I ran again at home, finishing just short of 3 miles in approximately 27 minutes. My performance is completely random.

At any rate, my PCM believes that I may have a legitimate pulmonary issue. My baseline PFT was "borderline normal" whatever that means and I am scheduled for a methacholine challenge test in a week. While all of this is going on, I'm continuing to run at least 3x/week and declined a temporary profile.

So no, I'm not a fatty fatty and some people DO have legitimate issues that are concerning. I'm sure it's hard to see them int he crowd of whiners who just don't want to put forth any effort.

Now, what happens if I'm diagnosed with something like EIB or EIA is another topic ...

 

[pgg]

Meh, we signed a contract agreeing to pass the APFT as a condition of our employment. Not doing so won't just impair our training, it's grounds for kicking us out. Of all of the indignities and inconvenience's of the military, the requirement of passing a pretty basic APFT doesn't seem to be very high on the list.

I'm not saying that flunking the basic fitness test is acceptable. Just that the "solution" of not allowing a surgery resident to operate is, to use an overused cliche, cutting off one's nose to spite one's face.

You have a person who is a bad officer (perhaps) and the solution is to make him a bad doctor, too?

If a resident repeatedly flunks the PFA, you give him a crappy first staff assignment, or you hold up his O4 promotion. You don't refuse to train him! Unless you're a military program director with a seriously whacked set of priorities.

 

[a1qwerty55]

I'm not saying that flunking the basic fitness test is acceptable. Just that the "solution" of not allowing a surgery resident to operate is, to use an overused cliche, cutting off one's nose to spite one's face.

You have a person who is a bad officer (perhaps) and the solution is to make him a bad doctor, too?

If a resident repeatedly flunks the PFA, you give him a crappy first staff assignment, or you hold up his O4 promotion. You don't refuse to train him! Unless you're a military program director with a seriously whacked set of priorities.

Agree completely. While not passing the APFT may have negative consequences they should not be consequences which degrade training or place future patients at risk. Poor judgment on the part of the program director if you ask me.

 

[notdeadyet]

I'm not saying that flunking the basic fitness test is acceptable. Just that the "solution" of not allowing a surgery resident to operate is, to use an overused cliche, cutting off one's nose to spite one's face.

You have a person who is a bad officer (perhaps) and the solution is to make him a bad doctor, too?

If a resident repeatedly flunks the PFA, you give him a crappy first staff assignment, or you hold up his O4 promotion. You don't refuse to train him! Unless you're a military program director with a seriously whacked set of priorities.

The problem with solutions like threatening a bad first staff assignment or withholding an O-4 promotion is that both of those are long term consequences. Threats whose affect aren't felt for years isn't a great motivator, particularly when the problem (failing the APFT) is likely due to laziness. Threaten someone with something important to them immediately and you're more likely to get compliance.

I agree that immediately keeping someone off surgeries isn't a good thing, but threatening to have forced physical fitness training in lieu of surgeries in 3 months time if they don't get their act together sounds logical. It is a scary motivator that allows adequate time for correction. And it's an identifier: if you have someone who isn't willing to put in the time to pass an APFT for the sake of their surgical training, what kind of physician are they likely to be?

Disclosure: I'm no jock throwing stones. Ex-smoker and not in great shape when I started med school. Had to lose 15 lbs for my initial weigh in at MEPS. When my first APFT came around, I failed push-ups and sit-ups. Within 30 days of really working on passing the thing, I did, and most folks could have. Given adequate motivation. For me, that was the prospect of having to wake up 2 hours before my third year rotations started to work-out with an NCO who was likely not happy about having to do push-ups with medical students at 0400.

 

[toooldforthis]

Truth's since i was in and out (1992-1998):
Most things are waiverable.

Rattle the chains of leadership you have access to, ask questions. You will get the answers you need.

 

[Apollyon]

For me, that was the prospect of having to wake up 2 hours before my third year rotations started to work-out with an NCO who was likely not happy about having to do push-ups with medical students at 0400.

Again, I ask, "likely" not happy? Who does the working out of the failures? Somebody in buff shape who is motivated. Some hua, grungy MFer with a mean streak/sadistic, or with the 1000 yard stare - someone who gets off on this sort of stuff. Special forces guys roll out at 0-dark-30 daily to enjoy a grueling, crushing workout - why would the CO assign someone who was demotivated to motivate the failures?

 

[AF M4]

Motivation is finding out what's important to someone and either offering it to them if they don't have it or threatening to take it away if they already do. It's all in an effort to prevent this from happening, and quite frankly I can't believe we've gone this long without an appearance.