future military doc in need of help choosing service

[xmsr3]

Ok, so I will hopefully be getting an invite for an interview at USUHS in the next couple of weeks and while there will have to make the important decision of ranking my choice of services. I could use the advice of those who have experience with mil med.

Specifically, assuming someone had their heart set on military medicine, which branch would you recommend? From my research and discussions on this site I have the following pros and cons of each service.

Army:

pros: the largest of the services with the greatest diversity and quantity of specialties. So if during clinicals you decide that pathology is your passion your best shot of matching into that residency would be with the army.

Cons: the longest deployments and the worst base locations, also deployments will likely be to Iraq and Afghanistan for the forseeable future so the odds of being killed are the highest of any service.

Conclusion: in the army you have the best chance of choosing your favorite specialty and doing what you love, though you may be doing it in places you hate and deployed to dangerous areas for long periods of time.

Air Force:

Pros: Has many nice base locations such as Hawaii, California and Florida and the bases themselves are supposedly very comfortable. Also has the shortest deployments.

Cons: The smallest service with the the least number of specialties so matching into which ever specialty you love most in clinicals could be very difficult.

Conclusion: a great pick for primary care, such as FP or IM, who will probably match easily and spend their careers in the poshest bases in some really nice locations. For those who fall in love with non primary care specialties however, they may spend their careers in posh, nicely located bases wishing they could be in a different specialty.

Navy:

Pros: The best locations by far, almost all coastally located and as the second largest service it does offer a good number of specialties such as rad and anesthesiology. Also, shorter deployments than Army, deployments aboard a ship can be a great adventure/life experience for those who have the right mindset/enjoy that short of thing.

Cons: GMO tour is done by 2/3 of folks who can't immediately match into their preferred residency.

Conclusion: For those who are planning a career in mil med and don't mind the 2 year residency postponement, post GMO navy docs are much more likely to get into the residency program of their choice. Thus, with a greater variety of specialty programs than AF and much nicer locations than Army and shorter deployments to safer areas, the Navy seems like a good compromise between the Army and AF that combines the strengths of both and minimizes the cons of both as well.

At least that is the sense I get from reading these forums for several months now.

I would appreciate the advice of people here who have experienced mil med first hand. Specifically my concern is with this fact:

Almost all med students start school planning on one specialty but change their minds after doing their clinicals. So that being the case and taking into account the positives and negatives of each service I would appreciate hearing everyone's opionion about which service offers the best chance to find a happy balance between, doing what you love everyday,(specialty) and doing it in a location you love,(base location) and doing it in nice facilities, (modernity/comfort of bases).

Any thoughts, advice or comments would be greatly appreciated.

Oh and if you don't feel like commenting please take part in the poll.

Thanks everyone for all your help and patience. I know I have gone a bit nuts at times but your wise words will hopefully allow me to launch a career that serves both my country, humanity and myself.

Please have a great weekend, a terrific summer and may you and yours know only health, joy and prosperity in the days to come.

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[Charlie0318]

I think it really depends on your situation. You do a great job in your conclusions for each branch pointing out those who would be most suited for each branch. Evaluate your own personal goals and see what you want out of your career and you will find you already know your answer

 

[NavyFP]

Ok, so I will hopefully be getting an invite for an interview at USUHS in the next couple of weeks and while there will have to make the important decision of ranking my choice of services. I could use the advice of those who have experience with mil med.

Specifically, assuming someone had their heart set on military medicine, which branch would you recommend? From my research and discussions on this site I have the following pros and cons of each service.

Army:

pros: the largest of the services with the greatest diversity and quantity of specialties. So if during clinicals you decide that pathology is your passion your best shot of matching into that residency would be with the army.

Cons: the longest deployments and the worst base locations, also deployments will likely be to Iraq and Afghanistan for the forseeable future so the odds of being killed are the highest of any service.

Conclusion: in the army you have the best chance of choosing your favorite specialty and doing what you love, though you may be doing it in places you hate and deployed to dangerous areas for long periods of time.

Air Force:

Pros: Has many nice base locations such as Hawaii, California and Florida and the bases themselves are supposedly very comfortable. Also has the shortest deployments.

Cons: The smallest service with the the least number of specialties so matching into which ever specialty you love most in clinicals could be very difficult.

Conclusion: a great pick for primary care, such as FP or IM, who will probably match easily and spend their careers in the poshest bases in some really nice locations. For those who fall in love with non primary care specialties however, they may spend their careers in posh, nicely located bases wishing they could be in a different specialty.

Navy:

Pros: The best locations by far, almost all coastally located and as the second largest service it does offer a good number of specialties such as rad and anesthesiology. Also, shorter deployments than Army, deployments aboard a ship can be a great adventure/life experience for those who have the right mindset/enjoy that short of thing.

Cons: GMO tour is done by 2/3 of folks who can't immediately match into their preferred residency.

Conclusion: For those who are planning a career in mil med and don't mind the 2 year residency postponement, post GMO navy docs are much more likely to get into the residency program of their choice. Thus, with a greater variety of specialty programs than AF and much nicer locations than Army and shorter deployments to safer areas, the Navy seems like a good compromise between the Army and AF that combines the strengths of both and minimizes the cons of both as well.

At least that is the sense I get from reading these forums for several months now.

I would appreciate the advice of people here who have experienced mil med first hand. Specifically my concern is with this fact:

Almost all med students start school planning on one specialty but change their minds after doing their clinicals. So that being the case and taking into account the positives and negatives of each service I would appreciate hearing everyone's opionion about which service offers the best chance to find a happy balance between, doing what you love everyday,(specialty) and doing it in a location you love,(base location) and doing it in nice facilities, (modernity/comfort of bases).

Any thoughts, advice or comments would be greatly appreciated.

Oh and if you don't feel like commenting please take part in the poll.

Thanks everyone for all your help and patience. I know I have gone a bit nuts at times but your wise words will hopefully allow me to launch a career that serves both my country, humanity and myself.

Please have a great weekend, a terrific summer and may you and yours know only health, joy and prosperity in the days to come.

I am not sure I agree with the two bolded statements. There are plenty of unhappy AF primary care docs in the upper mid west.

You don't have to want to be a career guy/gal to be Navy, but the willingness to postpone is key.

 

[TheGoose]

French Foreign Legion: +1

On a serious note, you put together a fairly well thought out piece that would be useful for the new people asking the same questions over and over again.

I might disagree with "Army...deployments will likely be to Iraq and Afghanistan for the forseeable future so the odds of being killed are the highest of any service." The Marines use Navy docs and they are in the ****. And if we are still in Iraq and Afghanistan...all of the services will be there for the forseeable future, not just army.

 

[DrMetal]

Ok, so I will hopefully be getting an invite for an interview at USUHS in the next couple of weeks and while there will have to make the important decision of ranking my choice of services. I could use the advice of those who have experience with mil med.

It also pays to think a little about the mission of each service, their warfighting posture, and what you'd like to ultimatley support. For instance, if you'd like to do SOF medicine, you'd probably rank Army first, then Navy then AF (based on the size of their specops communities). On the other hand, if you'd like to go out to sea and support the surface fleet, gotta go Navy . . .

agree with Goose . . .don't discount a service (like the Army) b/c they deploy too much. It's true that they do at the moment, b/c the Army is bearing the brunt of these two wars. But if the USMC gets more involved (as we're seeing in AF), then Navy docs will surely deploy more. And if we go to war with N. Korea sometime in the next 20 years, that's sure to be a nice naval battle, and we'll see Navy docs deployed all over the place, GMOs galore!

You can only really predict the optempo of a service within a 2-3 yr window. Who knows what the worlds gonna be like in 10.

Anyway, its better to be of the mentality that you will deploy, in any branch.

 

[Ziehl-Neelsen]

I am not sure I agree with the two bolded statements. There are plenty of unhappy AF primary care docs in the upper mid west.

You don't have to want to be a career guy/gal to be Navy, but the willingness to postpone is key.

You have the basics right, but I agree with NavyFP's caveat.

In my opinion, the Air Force has the crappiest duty stations of any of the 3 branches. Clovis NM, Mountain Home ID, Wichita Falls TX, Abilene TX, Minot ND... Air Force bases tend to be in desolate areas, so that when a plane crashes it does less damage. Furthermore, I've always felt that AF docs got jobbed with regards to the setting of their residency programs. I love San Antonio, but Dayton Ohio and Biloxi Mississippi aren't generally considered to be the equal of Hawaii, Seattle, or San Diego.

 

[xmsr3]

I would like to sincerely thank everyone here who has contributed to this thread and helped me to see some very important facts.

First, deployment is not really a big deal for me after all, in terms of choosing a service. As you say whichever you choose you get deployed and that is essentially part of why we chose to go into military medicine, to see new places we normally wouldn't.

Second, it seems a good idea to do a lot of research into specialties, because if you have some idea about which ones you are most likely to enjoy then you can look into which branch of the service offers you the likeliest chance of doing what you love.

So I would like to thank the gentleman who recommended I read, The Ultimate Guide to Chooseing a Medical Specialty, I have ordered it on Amazon and will read it carefully and, once armed with the real facts about each specialty's lifestyle, training and best suited personality type, will make a list of my top three.

I will then research the match data for each branch to see who has the highest likelyhood that I would end up in that specialty. Of course I won't know how I truely feel about a specialty until 3 and 4th year in med school but for chooseing which branch to go into, it will certainly help to have a good idea.

One question though. I hear that many of the AF bases are in desolate areas but is the same not true about Army bases? Are they not similarly located in places like Texas, Idaho and North Dakota? Is the difference that they are closer to towns and so less isolated?

 

[Ziehl-Neelsen]

Before I go slinging mud at rural/non-metropolitain, let it be known that I prefer rural areas. My idea of the perfect duty station is pretty close to Mountain Home ID. But the fact remains that most physicians prefer to be close to major, cosmopolitain population centers.

To be sure the Army has some isolated/rural posts but none that I would call desolate. Watertown NY is about as desolate as the army gets, and even there one is 2 hours from Syracuse and 4/5 from Toronto. Minot is 3 hours north of Bismarck. Clovis is equidistant from Albequerque and Lubbock. I've passed through both places and can honestly say I'd rather be in Lawton OK or Columbus GA any day. Look at a list of bases if location is that big of a deal to you. Keep in mind that the longest you will be in one place is probably residency. I can honestly say that of all the military MEDCENS, the absolute last one I would want to be stationed at is Wright Pat.

Do the research and know what you are getting into. Then have a great time doing it.

 

[a1qwerty55]

You have the basics right, but I agree with NavyFP's caveat.

In my opinion, the Air Force has the crappiest duty stations of any of the 3 branches. Clovis NM, Mountain Home ID, Wichita Falls TX, Abilene TX, Minot ND... Air Force bases tend to be in desolate areas, so that when a plane crashes it does less damage. Furthermore, I've always felt that AF docs got jobbed with regards to the setting of their residency programs. I love San Antonio, but Dayton Ohio and Biloxi Mississippi aren't generally considered to be the equal of Hawaii, Seattle, or San Diego.

Agree -

The Army's primary medical centers are in San Antonio, Washington DC, Tacoma, Honolulu, El Paso, Augusta Georgia and Germany, none remote from civilization or terrible places to live.

The Army also has in my opinion more interest in retaining physicians and the military specific baloney is less of an issues - I mean the USAF gets super hung up on rank and you will be lead by a non-clinician with UCMG authority. As far as primary care or any care - good luck finding a happy USAF FP, or surgeon. USAF facilities are grossly understaffed, outdated, and lack sufficient patients because of the very short sighted decision to disengage medicare age patients. Should I go on.... because there is plenty more.

Navy - far better clinical facilities than the USAF, more commitment to GME, and attempting to reduce the number of GMO's. Locations are pretty good, but you occasionally run into CAPT Blye who thinks you can staff a hospital with one doc and operate with bailing wire.

Deployments - USAF 4-6 months generally. Army 6-12 months, 6 if you go to a Combat Support Hospital. By the way there are Navy and USAF docs at the Combat Support Hospitals also getting mortared, and the point about USN docs going with fleet marine force is a good one.

Lastly, the Army is a bit more understanding about homesteading (staying one place for several tours). This is very much frowned upon in the USAF. It is a big deal if you have a working wife or you want to build a practice.

My summary is quite different.

Diversity of training opportunities: - Army > Navy >>> USAF
Practice of medicine - access to patients, equipment and colleagues: - Army > Navy >>> USAF
Assignment locations: Army = Navy > USAF
Deployments: USAF > Army = Navy
Military Headaches and crazy leadership: Army > Navy >>> USAF.

 

[xmsr3]

The more research I do into the better the Army appears to be for those whose primary concern is making sure they can choose a specialty they love.

http://www.med-ed.virginia.edu/specialties/

Useing this test, which matches your specialty based on your personality, it appears my 3 top specialties are:

1. Pathology
2. Neurology
3, Radiology

From preliminary research done on Wikipedia, I must say that I agree with the Virgia university matches. Of course, I will have to confirm that when The Ultimate Guide to Choosing A Medical Specialty, arrives this saturday.

Assuming that those are the 3 specialties I would most enjoy then based on this website: http://www.militarygme.org/4.html I conclude this:

AF residency spots, (for Path, Neuro and Rads) 17,, (13 of which are rads so essentially in the AF I would only have a shot at 1 of my top 3 specialties, and until 3rd,4th year of med school I wouldn't know which one I liked the most)
Navy residency spots: 22
Army residency spots: 26

So AF can be completely eliminated and, for me at least, its down between Navy and Army. Looking at the specialties themselves, Navy has 5 Paths to Army 6 and same number of Rads, 15. Army has 5 Neuro while Navy has 2.

So it appears that with the Navy I would have a realistic shot at 2/3 of my likely top 3 specialties.

http://forums.studentdoctor.net/showthread.php?t=608636

Looking at the 2007 Navy Match stats one thing pops out, the match ratios.

Rads, 2:1 appliants/spot, Path 2.25:1 and Neuro 5:1

Of course things change year to year, as in 2007 Navy had 1 Neuro residency but in 2009 they have 5. But this is the best data I could find and there is one other important thing to consider.

Army match stats: from the military GME website, they have a link to the ratio of applicants/spot for 2003-2008. Here's what I conclude.

Though Path used to be very competative in 2003 and 2004, in the last 3 years it has been a near 1:1 ratio of applicants/spot.

The same holds true for radiology and Neuro has almost always been beneath 1:1.

In other words, not only does the Army have more residency spots open for the specialties that I am likely to enjoy the most, but the competativeness of these specialties in recent years has been such that, if the ratios hold into the future, I would be nearly guranteed to match into my preferred specialty.

I'm afraid that the difference between the match statistics is simply to much for me to ignore. If I am granted the honor of an interview at USU I will have no choice but to rank Army #1 and Navy #2.

BUT, its not only the specialty match stats that are making the Army seem better than the Navy. Today I did research into Army OBLC and, though it is 2 weeks longer than ODS, I have to say that people seem to have only nice things to say about Fort Sam. So I looked a bit into the difference between life on post vs life on base and it seems that the sense of commraderie is greater on an army post. The big bases such as fort Sam are their own cities, complete with their own housing, schools, resteraunts, ect.

From what I can determine online, navy bases are not such self contained cities, but rather smaller, with less people and more off base housing. Can anyone verify whether or not I am correct in my assesment?

And then there is the opinion of a1qwerty55, who brought up some very imporant intangibles, such as a slight difference in cultures of the Army and Navy.

Add it all up and it seems that for someone like me, who is joining the military because of the social aspect of the institution, it seems like Army life would be a better fit.

 

[scooter02]

The more research I do into the better the Army appears to be for those whose primary concern is making sure they can choose a specialty they love.

http://www.med-ed.virginia.edu/specialties/

Useing this test, which matches your specialty based on your personality, it appears my 3 top specialties are:

1. Pathology
2. Neurology
3, Radiology

Fun quiz!! That and SDN are a good way to use up my last half hour at work!

It told me I would be best suited for OB/GYN and aerospace medicine... kind of a wierd top two.

I really have too many ideas of I want to do, and I know a lot of people change their mind in school, so who knows?!?!?

 

[xmsr3]

Fun quiz!! That and SDN are a good way to use up my last half hour at work!

It told me I would be best suited for OB/GYN and aerospace medicine... kind of a wierd top two.

I really have too many ideas of I want to do, and I know a lot of people change their mind in school, so who knows?!?!?

Which is why so many people here voted for Army, because they have the most oppertunities to match into whatever specialty you most enjoy.

This is an amazing stat, from 2003-2007 the average ratio of applicants to residency spots was 1.1625, meaning that almost everyone in those years got to match into the residency of their choice.

This offers one flexibility, something that is important as you will change your mind often in med school.

 

[DrBloodmoney]

I'll give you the Path perspective (since I've been at this a bit):

Army: straight in from med school (no transistional year of second knuckling old gomers and dealing with ****ty nurses) = major win. Also you will likely match into a military spot if you want (since Army has the most residency slots for Path), or you could defer out to a civilian spot. [Typically 7-8 spots per year, only 6 in 2009 for some bizarre reason]

Air Force: straight in to your program (likely not Air Force, since they have 2-3 spots in San Antonio, but they dole out the deferred spots). So count on doing a civilian residency unless you are lucky enough to match in. [2-3 spots per year]

Navy: You will not go straight in. You WILL be doing a transistional year. If you get extremely lucky you may be able to get a slot after your prelim year, but I would plan on doing a tour as a GMO (3 years). For a couple of years, the GME gods were kind to folks in this position an took a lot of PGY2 folks for path spots, but the past 2 cycles have all gone to GMOs (at least 3/4 this year possibly all 4). As far as I know, the Navy does not defer anyone to civilian residencies for path. This is probably because the Navy also seems to be hell-bent on forcing all their pathologists out. [currently 4 spots but GME tried to drop them to 2 so they had to petition hard to get an additional 2]

So bottom line, if you know you want to do pathology before you sit in your first medical school lecture on day one (like I did), the Navy is the absolute worst option. Or the best option if you would like to waste 4 years of your life doing things of marginal value to your future training/career as a pathologist.

Additionally, you will likely not have to deploy unless you would like to. OEF has never had a pathologist doing pathology, OIF was one pathologist on a 6 month rotation. All the pathologists who went were volunteers. That just got shut down and pulled out. So currently no pathology deployments in the short term 1-2 years. But I think we'll probably be in OEF in 3-4 years, probably one/ 6months.

 

[xmsr3]

I'll give you the Path perspective (since I've been at this a bit):

Army: straight in from med school (no transistional year of second knuckling old gomers and dealing with ****ty nurses) = major win. Also you will likely match into a military spot if you want (since Army has the most residency slots for Path), or you could defer out to a civilian spot. [Typically 7-8 spots per year, only 6 in 2009 for some bizarre reason]

Air Force: straight in to your program (likely not Air Force, since they have 2-3 spots in San Antonio, but they dole out the deferred spots). So count on doing a civilian residency unless you are lucky enough to match in. [2-3 spots per year]

Navy: You will not go straight in. You WILL be doing a transistional year. If you get extremely lucky you may be able to get a slot after your prelim year, but I would plan on doing a tour as a GMO (3 years). For a couple of years, the GME gods were kind to folks in this position an took a lot of PGY2 folks for path spots, but the past 2 cycles have all gone to GMOs (at least 3/4 this year possibly all 4). As far as I know, the Navy does not defer anyone to civilian residencies for path. This is probably because the Navy also seems to be hell-bent on forcing all their pathologists out. [currently 4 spots but GME tried to drop them to 2 so they had to petition hard to get an additional 2]

So bottom line, if you know you want to do pathology before you sit in your first medical school lecture on day one (like I did), the Navy is the absolute worst option. Or the best option if you would like to waste 4 years of your life doing things of marginal value to your future training/career as a pathologist.

Additionally, you will likely not have to deploy unless you would like to. OEF has never had a pathologist doing pathology, OIF was one pathologist on a 6 month rotation. All the pathologists who went were volunteers. That just got shut down and pulled out. So currently no pathology deployments in the short term 1-2 years. But I think we'll probably be in OEF in 3-4 years, probably one/ 6months.

Thanks for the input, could you please explain what OEF and OIF are?

 

[xmsr3]

Which is why so many people here voted for Army, because they have the most oppertunities to match into whatever specialty you most enjoy.

This is an amazing stat, from 2003-2007 the average ratio of applicants to residency spots was 1.1625, meaning that almost everyone in those years got to match into the residency of their choice.

This offers one flexibility, something that is important as you will change your mind often in med school.

This is absolutley amazing!http://www.nrmp.org/data/resultsanddata2008.pdf


In 2008, in the NRMP, the national residency match program, had
49,945 total applicants who applied for 25,066 positions.

So the civilian residency applicant/spot ratio is: 1.99, pretty damned competative.

Now, check the army ratio, from 2003-2007 it is 1.16, or about half as competative.

Now lets look at some specific specialties.

Pathology:

PGY-1 spots available: 508
applicants: 793
Ratio of applicants/spot= 1.56

2003-2007 Avg Army ratio: 1.43

Neurology:

PGY-1 spots available: 177
PGY-2 spots available: 398
Total: 575
PGY-1 applicants: 620
PGY-2 applicants: 730
Total: 1350
Ratio of applicants/spot: 2.35

2003-2007 Avg Army ratio: 0.68

Radiology:

PGY-1 spots available: 157
PGY-2 spots available: 928
Total: 1085
PGY-1 applicants: 757
PGY-2 applicants: 1364
Total:2121
applicant/spot ratio: 1.95

2003-2007 avg Army ratio: 1.24

Wow! So it seems for most most specialties (the same holds true for Anesthesiology and Orthopedic surgery, two of the most sought after specialties), and for sure my top 3, the Army offers a better shot at matching than does the civilian world.

 

[notdeadyet]

This is absolutley amazing!http://www.nrmp.org/data/resultsanddata2008.pdf
...
Wow! So it seems for most most specialties, and for sure my top 3, the Army offers a better shot at matching than does the civilian world.

I don't think you're reading the data correctly.

Take your NRMP data for Path:

PGY-1 spots available: 508
applicants: 793
Ratio of applicants/spot= 1.56

The 793 applicants include international and foreign medical graduates. You should be more interested in the number of U.S. seniors applying; in the military match, you will be up against only other U.S. grads. There were 326 U.S. seniors applying for path in the civilian match, not 793. So the ration of US senior applicants/spot is 0.64.

I've heard that for some of the uber-competitive specialties, you're better off in the military match, but by my read, there are relatively few slots so I would take a guess that the competitiveness of these specialties will vary widely from year-to-year.

 

[xmsr3]

Are you sure we shouldn't include foreign students? The point of that excercise was to compare the ratio of applicants to the number of spots, because I wanted to compare the difficulty of matching in a specialty in the civilian world vs army.

For example, yes, in the army I would only be up against US seniors, BUT if I wasn't in the army, then I would not be. I would be up against non seniors and foreign students as well which would decrease my chances of matching into a specialty of my choice.

I think you wanted to make sure I was comparing apples to apples, but I was trying to compare a special kind of army orange, (that is available only to HPSP and USU students) to the apple of the civilian world because after graduating med school we have to pick a fruit to eat for the rest of our lives. If the army orange is better than the civilian apple, then it dosn't matter that the civilian apple may be the best apple in the world.

After all, if I was civilian and didn't get in because a non US senior or foreign student beat me out for a spot, I wouldn't much care that the civilian applicant/spot ratio )just counting US seniors) may have been lower than the armies.

I may still be mistaken, and I appreciate people correcting me when I am.

In case that is so the Rads civilian ratio is 1.43 when calculated with only US seniors.

For Neuro its 1.12, so in both of those cases Army still offered a greater chance to match your prefered choice.

Of course, as you say things change over time and by the time a new med student gets around to matching things could be a lot different. For example, Path, the one residency I looked at that NotDeadYet's formula found to be more competative than in the civilian world, that was only the case because in 2003 and 2004 Path was super competative in the Army.

This has been a solid trend over 5 years, for example the applicant/spot ratio for army path, beginning in 2003 and going through 2007 was,

2.81.7111.160.5

Of course stats such as that may influence future seniors in the army which means the path ratio could rise to 3 again by the time I need to match.

Its good to have the army data saved, so that when future data comes out, not only can I have a better idea of the current trend but I can verify my hypothesis that the applicant/spot ratio moves in waves.

This could help one make a decision about which specialty to apply for.

Of course what all this number crunching and analysing means in the context of this thread, is that Army is the obvious best choice for those concerned about ending up in the the specialty they most enjoy.

 

[xmsr3]

Someone in the premed forum was awsome enough to provide me this:

http://www.nrmp.org/data/chartingoutcomes2007.pdf

They already calculate the applicant/spot ratio and the results are interesting.

Comparing just army vs civilian 2007 here is what one finds.

My favorite 3:

Path:
Army: .5
Civilian: 1.3

Neuro:
Army: .6
Civilian: 1.2

Rads:
Army: 1
Civilian: 1.3

Now some other popular specialties

EM
Army:1.23
Civilian: 1.21

Orthopaedic Surgery
Army: 1.95
Civilian: 1.4

Anesthesiology
Army: 1.42
Civilian: 1.2

Internal Medicine
Army: 1.06
Civilian: 1.3

Along with Rads, EM, Ortho, Anesthesiology and IM are the top 5 specialties in the poll I created on the pre-med thread.

As you can see civilian has an edge in 3/5, though for EM it really is a tie.

So specialty can make the difference, however I should note that, in 2007 the only specialties where the civilian world was easier to match was in EM, Ortho, Anesthesiology and Otolaryngoloy, (which for some reason spiked from a ratio of 1 in 2006 to 4 in 2007).

For things like Dermatology, General Surgery or pretty much anything else, army is better.

In fact, in the civilian world there is no specialty that had a ratio of less than 1. In the army there were 6, (FP, peds, Path, Preventative med, neurology and aerospace med). What's more in the civilian world there were no specialties with a ratio of 1. In the army there were 3, (neurosurgery, urology and rads).

 

[notdeadyet]

Are you sure we shouldn't include foreign students?

I would focus on comparing relevant applicants. Most residency programs will take U.S. allopathic graduates before they will foreign medical students. If you look more into match data, you'll see that the acceptance rates for foreign medical students is much, much lower, even applying to many more progams. Comparing all applicants is misleading.

Much more accurate is to focus on the percentage of U.S. allopathic graduates who apply for a particular specialty who match. Compare this between civilian and specialty. What percentage of folks applying for, say Pathology make it. Compare US Allopathic seniors civilian vs. military. This is much more indicative.

I think you wanted to make sure I was comparing apples to apples, but I was trying to compare a special kind of army orange, (that is available only to HPSP and USU students) to the apple of the civilian world because after graduating med school we have to pick a fruit to eat for the rest of our lives. If the army orange is better than the civilian apple, then it dosn't matter that the civilian apple may be the best apple in the world.

Your analogy lost me, but don't worry about it. Look at relevant data. What % of US Allopathic grads who apply for radiology get it as civilians vs. what % of Army match applicants?

 

[26miles385yards]

Interesting quiz from UVA. My top 3 were:

1. Emergency Med
2. Nuclear Med (what is this?)
3. Radiology

I was thinking Emergency or Gen Surgery would be up near the top. GS was down 1/2 way though.

 

[a1qwerty55]

Interesting quiz from UVA. My top 3 were:

1. Emergency Med
2. Nuclear Med (what is this?)
3. Radiology

I was thinking Emergency or Gen Surgery would be up near the top. GS was down 1/2 way though.

Funny my specialty was at the bottom 1/3 of the list and I'm pretty happy and with my choice so I'm not sure how valid a tool this is, but it is fun nonetheless.

 

[The White Coat Investor]

Diversity of training opportunities: - Army > Navy >>> USAF
Practice of medicine - access to patients, equipment and colleagues: - Army > Navy >>> USAF
Assignment locations: Army = Navy > USAF
Deployments: USAF > Army = Navy
Military Headaches and crazy leadership: Army > Navy >>> USAF.

Holy Army Apologist Batman. I'm not a big fan of the Air Force, but this is so skewed I had to say something. Here's my opinion:

Diversity of INSERVICE training opportunities: Army > Navy > AF
Diversity of CIVILIAN training opportunities: AF >> Army=Navy
Practice of Medicine: Army=Navy>AF
Assignment Locations: AF=Navy>> Army
Deployments: AF>>>Navy>Army
Crazy Leadership: Army=Navy > AF
Likelihood of having to do a GMO tour: Navy>>>AF>Army

I think that's a little more balanced perspective.

To the OP: You must keep in mind that all of this is not only year specific, but also SPECIALTY specific. Sure, the AF may have a few really crappy bases on its list, but you know what, if you're not doing Primary Care you'll never be sent to those. Here's the list of AF bases in my specialty: San Antonio, Ohio, Tidewater (Virginia Beach area) Virginia, Coastal Florida X 2, Las Vegas, Northern California, Germany, England, Washington D.C., Alaska. Not exactly Alabama, North Dakota, and Kansas.

 

[rogershru2]

Holy Army Apologist Batman. I'm not a big fan of the Air Force, but this is so skewed I had to say something. Here's my opinion:

Diversity of INSERVICE training opportunities: Army > Navy > AF
Diversity of CIVILIAN training opportunities: AF >> Army=Navy
Practice of Medicine: Army=Navy>AF
Assignment Locations: AF=Navy>> Army
Deployments: AF>>>Navy>Army
Crazy Leadership: Army=Navy > AF
Likelihood of having to do a GMO tour: Navy>>>AF>Army

I think that's a little more balanced perspective.

To the OP: You must keep in mind that all of this is not only year specific, but also SPECIALTY specific. Sure, the AF may have a few really crappy bases on its list, but you know what, if you're not doing Primary Care you'll never be sent to those. Here's the list of AF bases in my specialty: San Antonio, Ohio, Tidewater (Virginia Beach area) Virginia, Coastal Florida X 2, Las Vegas, Northern California, Germany, England, Washington D.C., Alaska. Not exactly Alabama, North Dakota, and Kansas.

As a Navy GMO I agree with this assessment. Also, you should realize that when we talk about "Navy", we're really talking about Navy + USMC. I did not know this before I signed up. If you like me have a Y chromosome, you're likely to be a USMC GMO.

Deployments: AF>>>>Navy>>>USMC=Army. Army has (not always, some units deploy 1 year or longer) longer deployments but MUCH longer dwell time in between deployments. USMC you deploy for 7 months and have 7-10 months in between total. The tempo is much crazier.

 

[DrMetal]

Also, you should realize that when we talk about "Navy", we're really talking about Navy + USMC. I did not know this before I signed up.

LOL! what planet are your from?

 

[a1qwerty55]

Holy Army Apologist Batman. I'm not a big fan of the Air Force, but this is so skewed I had to say something. Here's my opinion:

Diversity of INSERVICE training opportunities: Army > Navy > AF
Diversity of CIVILIAN training opportunities: AF >> Army=Navy
Practice of Medicine: Army=Navy>AF
Assignment Locations: AF=Navy>> Army
Deployments: AF>>>Navy>Army
Crazy Leadership: Army=Navy > AF
Likelihood of having to do a GMO tour: Navy>>>AF>Army

I think that's a little more balanced perspective.
.

Sure -
Well Robin, fairly minimal changes with the only appreciable ones I can see being your addition of civilian training opportunities - which I agree with.

Equating Army and Navy leadership as equivalently crazy and similar levels of military specific bs. - not sure I agree there - I've seen the Captain Blye leadership style in the Navy more than a few times - Don't tell me I can't have something - just make it happen - Aye Aye Skipper - Army is definitely less hung up on rank, and appearance -

Practice of Medicine - very subjective - I'd rather practice in the Army but again a subjective call. Army in general has more capable facilities, better staffing - so this has to be considered. The USAF is without a doubt inferior here.

Assignments - Every service has some junk postings - be it Camp Lejune, Offutt AFB, or Ft Polk. AF has pretty good locations no doubt - too bad you can't actually practice medicine or surgery in any of them.

Deployments - Navy is not better than Army - sorry here but Army policies are for 6 month rotations for all medical personnel who are deployed in treatment facilities - not GMO's unfortunately. Navy assigned to Marine units go as long if not longer and more frequently.

 

[rogershru2]

Sure -
Well Robin, fairly minimal changes with the only appreciable ones I can see being your addition of civilian training opportunities - which I agree with.

Equating Army and Navy leadership as equivalently crazy and similar levels of military specific bs. - not sure I agree there - I've seen the Captain Blye leadership style in the Navy more than a few times - Don't tell me I can't have something - just make it happen - Aye Aye Skipper - Army is definitely less hung up on rank, and appearance -

Practice of Medicine - very subjective - I'd rather practice in the Army but again a subjective call. Army in general has more capable facilities, better staffing - so this has to be considered. The USAF is without a doubt inferior here.

Assignments - Every service has some junk postings - be it Camp Lejune, Offutt AFB, or Ft Polk. AF has pretty good locations no doubt - too bad you can't actually practice medicine or surgery in any of them.

Deployments - Navy is not better than Army - sorry here but Army policies are for 6 month rotations for all medical personnel who are deployed in treatment facilities - not GMO's unfortunately. Navy assigned to Marine units go as long if not longer and more frequently.

Blue side Navy has better deployments generally, but if you're going with USMC then it can easily be as bad or possibly worse than Army. There are tons of Army GMO's and other roles for Army doctors and they may be gone the full year, depending on their specialty - if you have a surgical skill that you have to keep current usually your deployment will be shorter so you do not lose practice.

 

[rogershru2]

LOL! what planet are your from?

Non-military one - My recruiter told me I would be deployed on a carrier or on the Mercy/Comfort if I ended up being deployed. The worst part is that I believed him.

 

[TopSecret]

Non-military one - My recruiter told me I would be deployed on a carrier or on the Mercy/Comfort if I ended up being deployed. The worst part is that I believed him.

Are female GMO's ever deployed with the Marines? I think that they would have a higher chance of serving onboard ships because the environment is less austere for them.

 

[NavyFP]

Are female GMO's ever deployed with the Marines? I think that they would have a higher chance of serving onboard ships because the environment is less austere for them.

Women serve in the Support Group and Airwing. They do not typically serve with Division.

 

[kcmedic]

This is a great thread. Thanks for posting these questions xmrs3, I had the same exact ones.

 

[xmsr3]

bump

 

[dwb8p]

Why did you bump this thread?

 

[MSS07]

Women serve in the Support Group and Airwing. They do not typically serve with Division.

sorry, excuse my ignorance but what is the "support group" and airwing. So women usually don't do the fleet marine force GMO?

 

[rogershru2]

sorry, excuse my ignorance but what is the "support group" and airwing. So women usually don't do the fleet marine force GMO?

Women don't do Division (infantry battalions). They often go with logistics groups, and they sometimes deploy as well, but usually to larger/nicer bases than the male GMO's tend to go to. Air can have either male or female flight surgeons, and they will deploy to larger/nicer bases as well. If you're with the Marines in any capacity you're part of the fleet marine force, and you can get your FMF qualification if you so desire (why you would want to go through that I have no idea).

 

[MSS07]

Oh, I was just asking because I was curious. If I have to do a GMO then it will definitely be flight surgery for me.

 

[mmcnamara]

The more research I do into the better the Army appears to be for those whose primary concern is making sure they can choose a specialty they love.

http://www.med-ed.virginia.edu/specialties/

Useing this test, which matches your specialty based on your personality, it appears my 3 top specialties are:

1. Pathology
2. Neurology
3, Radiology

From preliminary research done on Wikipedia, I must say that I agree with the Virgia university matches. Of course, I will have to confirm that when The Ultimate Guide to Choosing A Medical Specialty, arrives this saturday.

Assuming that those are the 3 specialties I would most enjoy then based on this website: http://www.militarygme.org/4.html I conclude this:

AF residency spots, (for Path, Neuro and Rads) 17,, (13 of which are rads so essentially in the AF I would only have a shot at 1 of my top 3 specialties, and until 3rd,4th year of med school I wouldn't know which one I liked the most)
Navy residency spots: 22
Army residency spots: 26

So AF can be completely eliminated and, for me at least, its down between Navy and Army. Looking at the specialties themselves, Navy has 5 Paths to Army 6 and same number of Rads, 15. Army has 5 Neuro while Navy has 2.

So it appears that with the Navy I would have a realistic shot at 2/3 of my likely top 3 specialties.

http://forums.studentdoctor.net/showthread.php?t=608636

Looking at the 2007 Navy Match stats one thing pops out, the match ratios.

Rads, 2:1 appliants/spot, Path 2.25:1 and Neuro 5:1

Of course things change year to year, as in 2007 Navy had 1 Neuro residency but in 2009 they have 5. But this is the best data I could find and there is one other important thing to consider.

Army match stats: from the military GME website, they have a link to the ratio of applicants/spot for 2003-2008. Here's what I conclude.

Though Path used to be very competative in 2003 and 2004, in the last 3 years it has been a near 1:1 ratio of applicants/spot.

The same holds true for radiology and Neuro has almost always been beneath 1:1.

In other words, not only does the Army have more residency spots open for the specialties that I am likely to enjoy the most, but the competativeness of these specialties in recent years has been such that, if the ratios hold into the future, I would be nearly guranteed to match into my preferred specialty.

I'm afraid that the difference between the match statistics is simply to much for me to ignore. If I am granted the honor of an interview at USU I will have no choice but to rank Army #1 and Navy #2.

BUT, its not only the specialty match stats that are making the Army seem better than the Navy. Today I did research into Army OBLC and, though it is 2 weeks longer than ODS, I have to say that people seem to have only nice things to say about Fort Sam. So I looked a bit into the difference between life on post vs life on base and it seems that the sense of commraderie is greater on an army post. The big bases such as fort Sam are their own cities, complete with their own housing, schools, resteraunts, ect.

From what I can determine online, navy bases are not such self contained cities, but rather smaller, with less people and more off base housing. Can anyone verify whether or not I am correct in my assesment?

And then there is the opinion of a1qwerty55, who brought up some very imporant intangibles, such as a slight difference in cultures of the Army and Navy.

Add it all up and it seems that for someone like me, who is joining the military because of the social aspect of the institution, it seems like Army life would be a better fit.

I worked with someone from the pathology residency at Madigan Army Med Ctr in Washington who pretty much confirmed your conclusions. I worked with him last month (Aug 09), so this is very recent. Although, he did say that it was expected that the ratio for path might actually increase slightly, as it was getting more competitive based on applications so far this year. One caveat was that he said that fellowships can be difficult to get across the board. I am not sure about how it is with the other branches. I am currently in a civilian path residency and have been accepted for a fellowship. The civilian view on fellowship for pathology is that it is pretty much a requirement for civilian employment. I think that it may be difficult to remain competitive after you get out of the military if you get out with only a few years of experience and no fellowship. We receive memos and emails all the time about jobs that are available in the civilian sector, and the great majority of them want a pathologist who is certified in cytopath, or heme, or derm, etc. The expectation is that they will do service work in the subspecialty area as well as perform routine surg path and run the lab. Despite all of this, I still think that the Army has the best opportunities overall. I am also prior active duty Army, so I am a little predjudiced.

 

[mmcnamara]

NEVER BELIEVE A RECRUITER!!! I am prior active duty Army, and, while I was not a recruiter myself, I had several friends who were (it is actually considered an assignment for only the best NCOs along with being a drill sergeant). I was lied to when I enlisted, and my friends all confirmed that they would lie as much as possible to get a good evaluation, which was based in large part on how many idiots they recruit.

 

[Lui Kang]

Ok, so I will hopefully be getting an invite for an interview at USUHS in the next couple of weeks and while there will have to make the important decision of ranking my choice of services. I could use the advice of those who have experience with mil med.

Specifically, assuming someone had their heart set on military medicine, which branch would you recommend? From my research and discussions on this site I have the following pros and cons of each service.

Army:

pros: the largest of the services with the greatest diversity and quantity of specialties. So if during clinicals you decide that pathology is your passion your best shot of matching into that residency would be with the army.

Cons: the longest deployments and the worst base locations, also deployments will likely be to Iraq and Afghanistan for the forseeable future so the odds of being killed are the highest of any service.

Conclusion: in the army you have the best chance of choosing your favorite specialty and doing what you love, though you may be doing it in places you hate and deployed to dangerous areas for long periods of time.

Air Force:

Pros: Has many nice base locations such as Hawaii, California and Florida and the bases themselves are supposedly very comfortable. Also has the shortest deployments.

Cons: The smallest service with the the least number of specialties so matching into which ever specialty you love most in clinicals could be very difficult.

Conclusion: a great pick for primary care, such as FP or IM, who will probably match easily and spend their careers in the poshest bases in some really nice locations. For those who fall in love with non primary care specialties however, they may spend their careers in posh, nicely located bases wishing they could be in a different specialty.

Navy:

Pros: The best locations by far, almost all coastally located and as the second largest service it does offer a good number of specialties such as rad and anesthesiology. Also, shorter deployments than Army, deployments aboard a ship can be a great adventure/life experience for those who have the right mindset/enjoy that short of thing.

Cons: GMO tour is done by 2/3 of folks who can't immediately match into their preferred residency.

Conclusion: For those who are planning a career in mil med and don't mind the 2 year residency postponement, post GMO navy docs are much more likely to get into the residency program of their choice. Thus, with a greater variety of specialty programs than AF and much nicer locations than Army and shorter deployments to safer areas, the Navy seems like a good compromise between the Army and AF that combines the strengths of both and minimizes the cons of both as well.

At least that is the sense I get from reading these forums for several months now.

I would appreciate the advice of people here who have experienced mil med first hand. Specifically my concern is with this fact:

Almost all med students start school planning on one specialty but change their minds after doing their clinicals. So that being the case and taking into account the positives and negatives of each service I would appreciate hearing everyone's opionion about which service offers the best chance to find a happy balance between, doing what you love everyday,(specialty) and doing it in a location you love,(base location) and doing it in nice facilities, (modernity/comfort of bases).

Any thoughts, advice or comments would be greatly appreciated.

Oh and if you don't feel like commenting please take part in the poll.

Thanks everyone for all your help and patience. I know I have gone a bit nuts at times but your wise words will hopefully allow me to launch a career that serves both my country, humanity and myself.

Please have a great weekend, a terrific summer and may you and yours know only health, joy and prosperity in the days to come.

Bump

Does this trend still hold true for the 3 branches? This is a really good thread for people trying to decide which branch.

 

[Lui Kang]

bump

 

[Navy Flight Doc]

I'm wondering if the OP wants to chime in. Based on the profile, looks like he's at USUHS in the Army. Was it all it was cracked up to be? (Maybe waiting for match day to really know...)