Flight surgery fantasy (USN)

[mdmph2024]

Hi everyone,

Current med student starting 3rd year rotations later this month. A couple years ago I tried to apply for Navy HPSP but was late to the game, and by the time I got everything done the 4-year slots were all gone so I moved on. But this has been eating away at me ever since. I know the ship has sailed regarding HPSP and doing the military match but the door to military med isn’t closed—I am planning on going into IM and hopefully doing the FAP program. But is flight surgery a dream I need to let go of? I have my private pilots license and my original HPSP dream was to do intern year then go for FS training to be a flight surgeon for a few years and see how that goes. I have found some posts on here about folks doing a residency in IM, EM, etc. then somehow managing to get into flight surgery after, but I’m not sure if that’s a real thing or something viable. Thanks in advance.

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[pawprint]

Current Navy Flight Surgeon here.

Yes, absolutely you can still become a navy flight surgeon. The current model is in the process of switching from taking interns and sending them to flight school, to taking board certified docs and doing it. There’s a huge flight surgeon shortage starting this summer (will be short about 40 billets…which is nuts). So if you want to become a flight surgeon after finishing your residency training, it’s going to be all yours.

The most useful specialities for being a flight surgeon with a board specialty are going to be either IM or FM. Having these under your belt can help with some of the waiver requirements for some conditions (lots of conditions have to be signed off by an IM/FM doc prior to waiver submission, so if you have the board certification then you can just do it yourself). EM not so much, you aren’t really doing too much en route care so you won’t get to use those skills at all.

 

[Konigstiger]

Current Navy Flight Surgeon here.

Yes, absolutely you can still become a navy flight surgeon. The current model is in the process of switching from taking interns and sending them to flight school, to taking board certified docs and doing it. There’s a huge flight surgeon shortage starting this summer (will be short about 40 billets…which is nuts). So if you want to become a flight surgeon after finishing your residency training, it’s going to be all yours.

The most useful specialities for being a flight surgeon with a board specialty are going to be either IM or FM. Having these under your belt can help with some of the waiver requirements for some conditions (lots of conditions have to be signed off by an IM/FM doc prior to waiver submission, so if you have the board certification then you can just do it yourself). EM not so much, you aren’t really doing too much en route care so you won’t get to use those skills at all.

So for those of us in HPSP, would you recommend applying for a straight-through IM residency instead of flight surgery right out of medical school, then? I've heard from numerous people in the Navy that they are trying to shift heavily towards straight-through residency positions and trying to get rid of GMOs, but I didn't realize you could still apply for flight surgery after completing a residency.

Flight surgery was one of the big reasons why I did the HPSP, so I'm glad to hear it has not been completely eliminated yet. Only thing is, I feel like I'll be pretty old after completing residency...

 

[pgg]

Odds are, if you complete a residency first, they'll make you to a staff utilization tour in that specialty before allowing you to go to Flight Surgery land.

And honestly that's probably for the best. You're going to work hard in residency to acquire knowledge and skills that will need/deserve a busy practice immediately after to grow. The absolute worst thing a new residency grad can do is slide into a do-nothing (medically speaking) GMO tour.

 

[mdmph2024]

Current Navy Flight Surgeon here.

Yes, absolutely you can still become a navy flight surgeon. The current model is in the process of switching from taking interns and sending them to flight school, to taking board certified docs and doing it. There’s a huge flight surgeon shortage starting this summer (will be short about 40 billets…which is nuts). So if you want to become a flight surgeon after finishing your residency training, it’s going to be all yours.

The most useful specialities for being a flight surgeon with a board specialty are going to be either IM or FM. Having these under your belt can help with some of the waiver requirements for some conditions (lots of conditions have to be signed off by an IM/FM doc prior to waiver submission, so if you have the board certification then you can just do it yourself). EM not so much, you aren’t really doing too much en route care so you won’t get to use those skills at all.

Thank you for your insightful and encouraging reply. I know that in milmed one should always expect some degree of uncertainty in terms of career trajectory, assignments, etc. but it is nice to know that IM-->FS is potentially viable. And if the timing doesn't work out for me in FS 5 years down the road, I will still be a physician! But for now I will keep working to finish up medical school and match (probably into IM as I was already leaning towards it), aim for FS as a potential long-term goal, and see how things pan out.

 

[DeadCactus]

It's not clear what your goals are. Some people want to be a flight surgeon to spend a few years of their youth doing more operational work before diving into their true professional goals. Some people want to a career focused on flight medicine. Some people have other professional goals but find flight medicine interesting and like to take care of pilots as part of their patient population.

Depending on where your goals fall, there are two other options worth considering. The Guard and Reserve have plenty of flight surgeon spots and would allow you to do some flight medicine without the skill atrophy of working exclusively as a flight surgeon after residency (Caveat: I can't speak to the specific situation of the USN Reserve, this may require considering the Army or the Air Force). If you really want to focus your career completely around flight medicine, UTMB has a combined 4 year IM/Aerospace Medicine residency.

 

[pawprint]

If someone wants to do flight surgery straight out of IM residency, they are going to get it. The Navy currently has way more gapped flight surgeon billets than IM billets, and the navy can always defer any IM care out to the civilian network. Can’t do that with operational medicine…if people want to become operational flight surgeons, the Navy isn’t going to give any pushback to that. We have an IM doc and an OB/GYN in my clinic who were both voluntold to be GMO’s (or OMO’s as they are now being called) straight out of residency due to the huge gap in operational billets.

Regardless of board specialty, operational needs will always come first. And right now there is a huge gap in operational medicine.

Also, in regards to aerospace residency…that board specialty is basically useless. That only sets you up to be an administrative doctor, you don’t really gain anything from that except to say you are ‘board certified’ in something. You get the same background training in the year-long Navy flight surgeon school, the only addition the aerospace medicine residency adds is an MPH and some focused clinical rotations with high-up navy leadership. Highly recommend going into FM or IM even if the goal is to work with pilots your whole career.

 

[dr zaius]

Odds are, if you complete a residency first, they'll make you to a staff utilization tour in that specialty before allowing you to go to Flight Surgery land.

And honestly that's probably for the best. You're going to work hard in residency to acquire knowledge and skills that will need/deserve a busy practice immediately after to grow. The absolute worst thing a new residency grad can do is slide into a do-nothing (medically speaking) GMO tour.

One of my friends trained straight through in psych. They got their first assignment and it was...to flight surgery training followed by a FS billet. They were not pleased.

 

[SirGecko]

One of my friends trained straight through in psych. They got their first assignment and it was...to flight surgery training followed by a FS billet. They were not pleased.

The air force has actually been designating some of their trainees for this when they match residency. Like someone matches peds but they already know that their first billet will be as a flight surgeon not a pediatrician.

 

[pawprint]

Yeah my clinic has the IM doc and the OB/GYN who were forced to be GMO’s instead of doing a utilization tour.

I forgot we also have a psychiatrist and a neurologist who were told they had to do something operational as their first tour, so they “chose” flight surgery.

1st post-residency tour being a utilization tour is no longer a sure-thing. Someone has to do the gmo/flight surgeon jobs, and if they aren’t forcing interns down that pathway anymore, the only people they have leverage over are people trying to push towards retirement and those who still have their Hpsp comittments post-residency.

 

[j4pac]

If you want to do FS…then do it. You only live once. People have been talking about eliminating GMO for decades now. It’s still around…and with war upon us…it’s not going anywhere.

 

[mdmph2024]

Current Navy Flight Surgeon here.

Yes, absolutely you can still become a navy flight surgeon. The current model is in the process of switching from taking interns and sending them to flight school, to taking board certified docs and doing it. There’s a huge flight surgeon shortage starting this summer (will be short about 40 billets…which is nuts). So if you want to become a flight surgeon after finishing your residency training, it’s going to be all yours.

The most useful specialities for being a flight surgeon with a board specialty are going to be either IM or FM. Having these under your belt can help with some of the waiver requirements for some conditions (lots of conditions have to be signed off by an IM/FM doc prior to waiver submission, so if you have the board certification then you can just do it yourself). EM not so much, you aren’t really doing too much en route care so you won’t get to use those skills at all.

Any sense of whether IM or FM is better for military medicine/FS? I think I'd be happy with either in the long run including post-military career. I kinda like the acuity seen in internal medicine (and don't think I'd be interested in doing a fellowship later in life), but I also am intrigued by some of the breadth seen in FM. Again, this is all stuff I'll have to hash out soon, so hopefully my upcoming rotations provide insight.

 

[pawprint]

Any sense of whether IM or FM is better for military medicine/FS? I think I'd be happy with either in the long run including post-military career. I kinda like the acuity seen in internal medicine (and don't think I'd be interested in doing a fellowship later in life), but I also am intrigued by some of the breadth seen in FM. Again, this is all stuff I'll have to hash out soon, so hopefully my upcoming rotations provide insight.

You’re essentially doing a family medicine practice as a flight surgeon, although all your OB cases are sent to the local MTF and you don’t have any pediatric patients. I think FM is more geared towards what you’d be doing as a flight surgeon, especially since you won’t be doing any inpatient time and really IM is geared towards inpatient. Either will be fine…but I think you’d find a lot more similarity in your typical FM practice and a flight surgeon clinic than you would with IM and flight surgery.

 

[lmesina]

Hello all, I have a somewhat tangential but related question regarding FAP on here (through the USAF). Though it's been discussed in the past, I can't seem to find any recent discussions on it.

I am a US-IMG applying this match cycle (IM and Pathology), and I have always intended to start off my career with the Air Force. My question is - for the process of applying to FAP, would I start my application package upon getting matched into program, upon start of program or sometime during? Or would I start the process (officially starting paperwork etc with a med recruiter) during the NRMP match process (i.e. during interviews)

Thanks in advance for the insight - I see a lot of experienced members in here always willing to help

 

[DrMetal]

Sorry, I saw 'Flight Surgeon Fantasy' and happily clicked expecting something very different. Never mind, carry on.

 

[DeadCactus]

Hello all, I have a somewhat tangential but related question regarding FAP on here (through the USAF). Though it's been discussed in the past, I can't seem to find any recent discussions on it.

I am a US-IMG applying this match cycle (IM and Pathology), and I have always intended to start off my career with the Air Force. My question is - for the process of applying to FAP, would I start my application package upon getting matched into program, upon start of program or sometime during? Or would I start the process (officially starting paperwork etc with a med recruiter) during the NRMP match process (i.e. during interviews)

Thanks in advance for the insight - I see a lot of experienced members in here always willing to help

Reach out when you're starting to apply. They'll tee up what they can. The federal government moves slow, you want to give them a solid lead time.