Flight surgery vs go straight through?

[jjh7]

I am in the fortunate position of having the option of either doing flight (Navy)or going straight through. Don't have a family so don't need to worry about that. The residency I was selected for is fairly painful and a break sounds delightful, however, I am pretty sure I would like to do this residency eventually.

Any advice?

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[pgg]

I am in the fortunate position of having the option of either doing flight (Navy)or going straight through. Don't have a family so don't need to worry about that. The residency I was selected for is fairly painful and a break sounds delightful, however, I am pretty sure I would like to do this residency eventually.

Any advice?

I applied for residency while an intern, and would have accepted a spot had one been offered to me. I ended up doing a 2-year GMO tour with the Marines, and chose to extend it for a 3rd year rather than return to GME after two years.

The two factors that led me to choose another GMO year over residency

• I was enjoying my time with the Marines (still am)
• Wife & three school age children are happier with less frequent moves

Not many people are ambivilent about their GMO years - they either love them, as I do, or hate them. Flight surgery requires you to commit 3 years of your life to doing medically uninteresting and administratively painful tasks, but it offers some great experiences that you'll never be offered again.

At the time when I could choose between residency and GMO, I had family reasons to stay put as a GMO, and I was already in a great GMO environment with a unit and command that I liked.

In your position, I'd take the residency slot, for a few reasons.

• that residency might be a lot more competitive in 3 years, and you might not get it. Eg, compare Navy anesthesia three years ago (3 interns taken straight through) to this year's match (no interns taken, and 33 alternates on the list that include a number of returning GMOs).
• you might get stuck with a lousy environment as a GMO, and not enjoy it as much as you think you will
• you'll get dumber every day you spend as a GMO dealing with ankle sprains, URIs, and cluster B personality disorders
• long term, you'll make less money (even by military standards) by going the GMO route

That said, I've done lots of unique and interesting things as a GMO ... and you'll just have to weigh how much fun you think an operational tour might be against the sure thing of an open residency slot now.

 

[ishii123]

I am in the fortunate position of having the option of either doing flight (Navy)or going straight through. Don't have a family so don't need to worry about that. The residency I was selected for is fairly painful and a break sounds delightful, however, I am pretty sure I would like to do this residency eventually.

Any advice?

That's a tough decision.

Here's my take. I am currently a flight surgeon and I will be finishing up my required tour in July 2006 (to start a great military residency). Here's what my flight surgeon experience was like:

• Flight School at NAS Pensacola was AWESOME! It was definitely a GREAT 6 month experience!

• First year as a designated flight surgeon (aka "glorified GMO") was slightly above average.

• The 2nd year (and final year) has absolutely SUCKED!

I think part of the reason for my final year SUCKING SO BAD was because I learned to despise practicing military primary care medicine, fixing patients' so called "emergencies" (most were actually created by their lack of planning and not letting me know until last minute), doing lame admin duties (civilians hire secretaries for these jobs!), and deploying away from my family for prolonged periods. But that's just me. Some people actually like military primary care medicine, admin, and travelling a lot. If I was single, it might have been more enjoyable (maybe). But as a family guy, I started to dread my flight surgeon duties. However, in the long run though, I think being a flight surgeon has allowed me to mature as a physician and leader and given me a sense of what the military is really all about. These learned and developed skills will definitely will help me when I become a resident again.

Under current policy, flight surgery tour lengths are 0.5 year of flight school and at least 2 years as a designated flight surgeon. Thus, AT LEAST 2.5 YEARS TOTAL. But if I could be Admiral for one day, I would change flight surgery tour lengths to 0.5 year of flight school and AT LEAST 1.5 years as a flight surgeon. This would make FS tour lengths AT LEAST 2.0 YEARS TOTAL (yes, I think 6 months do make a difference!). Then I think that FS would be a good and worthwhile experience overall

 

[usnavdoc]

The other thing to consider is that the navy is a very small community. If you turn down the residency spot you may be closing the door on that specialty within the navy. You can always get out and apply as a civilian but reapplying in the navy may not get you accepted again.

I would talk to the specialty advisor to get their opinion.

 

[Heeed!]

I am in the fortunate position of having the option of either doing flight (Navy)or going straight through. Don't have a family so don't need to worry about that. The residency I was selected for is fairly painful and a break sounds delightful, however, I am pretty sure I would like to do this residency eventually.

Any advice?

Easy answer from my perspective...Don't pass up the guaranteed good deal (residency of your choice) to get a "good" deal (the possibility of getting your residency of choice in the future, a good GMO tour, etc). "A bird in the hand is worth 2 in the bush" (sts). Many cliches could apply, but I wouldn't pass up the guaranteed entrance into your career field of choice and take a detour, no matter how attractive. You might not make it back in. "Futures" is a very risky game in the military.

 

[orbitsurgMD]

The other thing to consider is that the navy is a very small community. If you turn down the residency spot you may be closing the door on that specialty within the navy. You can always get out and apply as a civilian but reapplying in the navy may not get you accepted again.

I would talk to the specialty advisor to get their opinion.

Take the residency and don't look back. The decision to do a FS tour should done if no acceptable residency opportunity is available.

Turning down the residency opportunity in the military is basically telling the program you don't want them. If you ask later, chances are they won't want you. That is just how it is.

I did my HPSP payback in full and got out. Had a Navy ophthalmology slot been available to me, I would have taken it in a heartbeat. At the time I was eligible, there were 40+ qualified applicants for 3 Navy positions, and the odds were not good.

Flight surgery is fun if you can work for a good command (I did) and the clinic you are affiliated with is at least benign (mixed experience for me). Even under the best circumstances, it it professionally idle time. You are growing professionally only inasmuch as you learn to deal with the deficiencies of the military medical system and avoid hurting anyone while working as an under-trained physician. Any education you get will likely be on your own dime and on your time. And few physicians with any professional qualifications have much respect for GMO flight surgeons (or for the RAMs, but that is another matter).

The argument that you will have family time during a FS/GMO tour is specious. Deployment and predeployment workups will subtract from your time at home.

My $0.02. Good luck.

 

[USAFGMODOC]

I was HPSP and applied for a military radiology slot; I was deferred and due to my prior service I strongly desired a military slot.. so, I took the FS tour and 2 years later got my slot in a military residency... But, I could never imagine turning down a residency slot (you) desired to go perform a FS tour...

I had a great time in my FS tour, but listen to the others-- your skills do erode even if you read like a mad-man; you are never guaranteed you'll get pick up after your FS tour and the slots for GME continiously change and your specialty may be one that gets cut dramatically the year or two you are applying and you get the shaft....

 

[Nylesor]

I was HPSP and applied for a military radiology slot; I was deferred and due to my prior service I strongly desired a military slot.. so, I took the FS tour and 2 years later got my slot in a military residency... But, I could never imagine turning down a residency slot (you) desired to go perform a FS tour...

I had a great time in my FS tour, but listen to the others-- your skills do erode even if you read like a mad-man; you are never guaranteed you'll get pick up after your FS tour and the slots for GME continiously change and your specialty may be one that gets cut dramatically the year or two you are applying and you get the shaft....

Two questions: Can you still be a flight surgeon and have a specialty at the same time or is FS something you do while waiting for a residency slot to open up? I was kind of looking forward to doing FS as maybe a military career. Second, what is the process of becoming a RAM? Is it just a flight surgeon with a Master's in Public Health? What does a RAM do that's different from a FS? Sorry for all the questions. I shadowed both a Air Force FS and RAM so I have a very basic idea, but the more I know before I commit myself, the better. Thanks!

 

[USAFGMODOC]

Two questions: Can you still be a flight surgeon and have a specialty at the same time or is FS something you do while waiting for a residency slot to open up? I was kind of looking forward to doing FS as maybe a military career. Second, what is the process of becoming a RAM? Is it just a flight surgeon with a Master's in Public Health? What does a RAM do that's different from a FS? Sorry for all the questions. I shadowed both a Air Force FS and RAM so I have a very basic idea, but the more I know before I commit myself, the better. Thanks!

You can be a residency trained FS, but whatever residency you go into you must perform in that specialty for 2 years minimum before applying to FS (typically done by FP, but others may apply). If you join with a residency done (FP) you can get right into FS w/o that time in your primary residency.

A RAM is a person who at the minimum does an intern year, then have completed a 3 yr program (MPH/prev med/Occ med) in aerospace medicine. They get an MPH and can be boarded in Prev Med and Occ Med both... But, most RAM's usually have finished some type of residency prior to completing this program, but I have seen several w/o that.

RAM's typically don't see many patients and if you are considering a career, it's probably OK because making rank is good, but not for keeping up your clinical skills! The RAM's at the bases are the ones in charge of flight medicine at that base (in almost all cases). Most bases now have a RAM too. If you're a med student, the USAF does now have slots in GME for FS/Family practice - which is far better than straight family practice in my opinion... Hope this helps

 

[pescaDr]

I am in the fortunate position of having the option of either doing flight (Navy)or going straight through. Don't have a family so don't need to worry about that. The residency I was selected for is fairly painful and a break sounds delightful, however, I am pretty sure I would like to do this residency eventually.

Any advice?

As I have read what others have advised, If I were in your position, I'd take the residency as has been discussed...

I am a Navy FS with the Marines. I have never deployed, but have had the wonderful opportunity to travel all over the US and Europe on short detachments...this nearly 3 years total has been a marvelous experience...flying the C-130, sitting in the back seat of harrier triainer, doing aerobatics in a T-34, etc. is something I would of never been able to do elsewhere...but alll fun must come to an end...I think 2 years (vice 3) would of been the perfect balance. The break has been nice, but now the overwhelming sense of wanting to reach that professional milestone of completing residency is burning. And not to downplay the whole GMO medicine routine that we all have to painfully live with...you are expected to do medicine beyond your training most of the time...it sucks, but it the model that has been developed...you have to live with it...

So, as has been said, take the residency jj

 

[helo doc]

A vast majority of folks above have advised going straight into residency. Several of them folks have got the 'been there, done that and got the t-shirt' experience of GMO/FS living. For all you epidemiology diggits, the n of your brief research project is growing and it gives you a nice p value on which to make a data driven decision. Now pretty please, take the frickin' residency. Navy medicine is a changing. Get your foot in the residency door now before it closes. You can always go play later (while getting paid a helluva lot more).

BTW, props to my fellow USUHS alum pgg for snagging gas at P-town (see you in this summer for resident orientation, i'll be down in the bat cave reading out where you placed the ETT) and props to my NMCP tern and FS class alum pescaDr for his gas select in DC (we'll miss you in P-town).

Low and slow in the mighty TH-57 warbird,

Helo doc

 

[Anna K]

I am really glad you asked that question. I am also considering a similar choice but my husband is doing flight surgery and my residency is internal medicine which is not very competitive. I would like to be with my husband and my question to all out there is do you think I would have a better chance of being with him if I did flight too or if I went through? We will both be in for a career, most likely....

Thanks everyone-I am really learning a lot from these replies!

 

[orbitsurgMD]

I am really glad you asked that question. I am also considering a similar choice but my husband is doing flight surgery and my residency is internal medicine which is not very competitive. I would like to be with my husband and my question to all out there is do you think I would have a better chance of being with him if I did flight too or if I went through? We will both be in for a career, most likely....

Thanks everyone-I am really learning a lot from these replies!

If I were you, I would finish my residency first, regardless of your future plans. If you are not presently in the military, your opportunities for work will not be diminished by staying civilian (and you will be paid better); if you later enter the military, you will be able to go into flight surgery anyway (physically qualifying) and be paid better for having completed your training. (And of course, you will have the undeniable advantage of having been trained, something I hope you see as important).

If you left your training, there would always be the chance that you would not be co-located with your spouse--needs of the service will dictate where you go.

Thinking of a career in military medicine is fine. Just realize that many people who have thought that have also later changed their minds. You might too.

In short, I would never recommend forgoing your postgraduate training in favor of a flight surgery tour, unless you were certain you didn't want the training you were taking and you had no other acceptable alternative program to start and you really wanted to do flight surgery more than anything else.

 

[jjh7]

Thank you all for your advice!!

 

[pescaDr]

and props to my NMCP tern and FS class alum pescaDr for his gas select in DC (we'll miss you in P-town).

Low and slow in the mighty TH-57 warbird,

Helo doc

helo doc...good to receive your words of congrats...and the same to you. All the p-town residents will be grateful for the upcoming years of stand-up comedy from the bat cave...hope all is well in L.A., tell the fam hola from the homeland...