Future of Navy Pediatrics

[MCCareer.org]

---

Members don't see this ad.

And this year?

We don't start planning for academic year 2022 until March. When I said last year, I meant academic year 2021, the board conducted in DEC 2020.

 

[Gastrapathy]

What did way more deferments look like?

 

[orbitsurgMD]

What did way more deferments look like?

The illusion and tyranny of small numbers: "we increased the numbers of deferments by 100%: we authorized two."

 

[Matthew9Thirtyfive]

The illusion and tyranny of small numbers: "we increased the numbers of deferments by 100%: we authorized two."

Or you could let the person who actually knows answer.

 

[orbitsurgMD]

Or you could let the person who actually knows answer.

Please forgive the attempt at humor. I am all ears.

 

[Matthew9Thirtyfive]

Please forgive the attempt at humor. I am all ears.

Sorry, I’m so used to the complete anti mil med sentiment on this forum that I missed the humor.

 

[MCCareer.org]

And this year?

Planning for 2021's GMESB doesn't start until late next month.

 

[MCCareer.org]

What did way more deferments look like?

I'm not going to count them all up, but when I was the Emergency Medicine Specialty Leader I usually got 3-5 NADDS deferments and this year we gave EM 14. We also used RAD-to-NADDS deferements for people already on Active Duty for Gen Surg and Anesthesia.

 

[deleted314957]

Lord how this has changed! I graduated scholarship navy in 1977. At my request, i did surg internship at san diego. at my request i did 6 months submarine and diving and spent two operational years in charleston. ( my first choice), i got my first choice of residency and an immediately following fellowship. Served my last two years and got out as O-5 with a great CV.
The Navy vas veddy, veddy gut to me.

 

[Gastrapathy]

Trying to give the benefit of the doubt but EM certainly feels cherry-picked. I guess we’ve learned in this thread that the future of Navy peds is improved opportunities to train in EM.

Im surprised that the total number of GMOs sent to the fleet last year versus prior years isn’t readily available information.

 

[orbitsurgMD]

Lord how this has changed! I graduated scholarship navy in 1977. At my request, i did surg internship at san diego. at my request i did 6 months submarine and diving and spent two operational years in charleston. ( my first choice), i got my first choice of residency and an immediately following fellowship. Served my last two years and got out as O-5 with a great CV.
The Navy vas veddy, veddy gut to me.

Sounds like you got the kind of deal people should normally expect, the kind you could normally expect before CHAMPUS and Tricare, when the Navy and Army operated large and comprehensive hospitals and treated enough patients to have large classes for PGY2 residents returning from operational tours, when fellowship opportunities were plentiful and generously-funded. The world where there was an Oak Knoll and a Letterman, pre-DOPMA, when medical school under HPSP counted as time-in-grade and toward retirement, which meant a career-long higher payscale. HPSP was once competitive and regularly drew from top medical schools. Good for you. Enjoy the retirement. But you are right, if you went back today, you wouldn't recognize it at all.

 

[DrMetal]

Sounds like you got the kind of deal people should normally expect, the kind you could normally expect before CHAMPUS and Tricare, when the Navy and Army operated large and comprehensive hospitals and treated enough patients to have large classes for PGY2 residents returning from operational tours, when fellowship opportunities were plentiful and generously-funded. The world where there was an Oak Knoll and a Letterman, pre-DOPMA, when medical school under HPSP counted as time-in-grade and toward retirement, which meant a career-long higher payscale. HPSP was once competitive and regularly drew from top medical schools. Good for you. Enjoy the retirement. But you are right, if you went back today, you wouldn't recognize it at all.

It's really quite the opposite today. We're so bored! I saw 4 patients in clinic yesterday (2 telehealth), that was considered a busy day. I was bored during residency too. I started moonlighting right after residency, it was like the floodgates had opened and I finally saw the pathology I was supposed to be seeing. Moonlighting has definitely been a 'second residency' for me, very educational.

 

[orbitsurgMD]

Trying to give the benefit of the doubt but EM certainly feels cherry-picked. I guess we’ve learned in this thread that the future of Navy peds is improved opportunities to train in EM.

Im surprised that the total number of GMOs sent to the fleet last year versus prior years isn’t readily available information.

That figure is probably available but not shared, for obvious reasons.

 

[layman_3]

Former Navy Peds intern here, currently out doing flight surgery tour. I was navy pediatric intern of the year and still got booted out to the fleet with all the other Peds interns to allow returning GMO’s to come back (and because of reduction in available pgy-2 spots).

Navy pediatrics is awesome, my intern year was the best year of my life. However, the programs are shrinking to shockingly low levels of patient management with nearly everything being outsourced to civilian medicine. ACGME will likely step into the situation in the next couple of years and remove program accreditation if things maintain the status quo. Not because of poor doctors, but because the patient volume is just so low now at the MTF’s as all care has now shifted away.

I recommend still doing the intern year as it was such a good experience, and then do your time and get out. And do Peds in the civilian world. If you like working with military families, just get hired as a civilian contractor at the military hospital.

Thanks for the advice. I'm told I will need to apply to two specialties for the military match, especially since Peds spots are so limited and from the sounds of it, civilian deferment is incredibly unlikely. What would you recommend as a backup specialty? I'm thinking FM since it also (usually) contains a pediatric component which would be helpful if I GMO/GTFO and reapply to civilian Peds

 

[orbitsurgMD]

Thanks for the advice. I'm told I will need to apply to two specialties for the military match, especially since Peds spots are so limited and from the sounds of it, civilian deferment is incredibly unlikely. What would you recommend as a backup specialty? I'm thinking FM since it also (usually) contains a pediatric component which would be helpful if I GMO/GTFO and reapply to civilian Peds

You might consider a TY over FM. All of the internship programs rotate on peds, even surgery. A TY internship will be at a center where there is a peds residency program where a FM program may not be (The FM programs were at Pendleton, Lejeune, Jax, Pensacola and Whidbey, although IIRC a couple have closed; none hosted a peds residency. ) You might not care, but if you really want a shot at peds, you should prioritize peds at any/all acceptable centers followed by TY at the same centers in the same order.

 

[Matthew9Thirtyfive]

It's really quite the opposite today. We're so bored! I saw 4 patients in clinic yesterday (2 telehealth), that was considered a busy day. I was bored during residency too. I started moonlighting right after residency, it was like the floodgates had opened and I finally saw the pathology I was supposed to be seeing. Moonlighting has definitely been a 'second residency' for me, very educational.

It varies here. We had a pretty slow day today. Only about 7 patients or so. We had like 20+ on Tuesday.

 

[layman_3]

You might consider a TY over FM. All of the internship programs rotate on peds, even surgery. A TY internship will be at a center where there is a peds residency program where a FM program may not be (The FM programs were at Pendleton, Lejeune, Jax, Pensacola and Whidbey, although IIRC a couple have closed; none hosted a peds residency. ) You might not care, but if you really want a shot at peds, you should prioritize peds at any/all acceptable centers followed by TY at the same centers in the same order.

Thanks for that. Do you know how competitive TY slots are? They aren't that common in the civilian world, so I don't hear much about it. It sounds like a backup spot for most people, but I would hate to get shunted into something else because TYs were taken. Obviously this depends on many factors, but I'm trying to go forward with a general idea of how things have panned out in previous years.

 

[pgg]

Thanks for that. Do you know how competitive TY slots are? They aren't that common in the civilian world, so I don't hear much about it. It sounds like a backup spot for most people, but I would hate to get shunted into something else because TYs were taken. Obviously this depends on many factors, but I'm trying to go forward with a general idea of how things have panned out in previous years.

Historically TY internships have been relatively competitive ... mainly because they have been the preferred PGY1 year of a lot of competitive specialties that didn't and don't have categorical internships of their own. Think derm, rads, rad onc, etc.

Relatively fewer spots with a bunch of board score superstars who got ill at the thought of doing a prelim surgery or IM year = competitive.

I did a TY prior to an anesthesiology residency, and knew a few IM interns who were also bound for anesthesia ... and every week the ENTIRE YEAR when they trudged off, heads hung low, to spend a half day slogging through some BS "continuity clinic" I felt a mix of sad pity for them and personal relief that I was a TY. For this and other reasons TY years were desirable.

 

[backrow]

Historically TY internships have been relatively competitive ... mainly because they have been the preferred PGY1 year of a lot of competitive specialties that didn't and don't have categorical internships of their own. Think derm, rads, rad onc, etc..

Competitiveness of TY, at least in the Navy, has drastically reduced since you and I were there. Now it is very frequently open for the “scramble” and takes people who failed to match in other specialties.

The biggest change that caused this was EM developing its own internship, but TY keeping the same number of positions. Yes, you still have those people gunning for the ROAD specialties, but that only accounts for maybe half to 2/3rds of the spots now.

 

[pgg]

Competitiveness of TY, at least in the Navy, has drastically reduced since you and I were there. Now it is very frequently open for the “scramble” and takes people who failed to match in other specialties.

The biggest change that caused this was EM developing its own internship, but TY keeping the same number of positions. Yes, you still have those people gunning for the ROAD specialties, but that only accounts for maybe half to 2/3rds of the spots now.

Interesting, how times have changed.

 

[sedgeshaveedges]

Thanks for that. Do you know how competitive TY slots are? They aren't that common in the civilian world, so I don't hear much about it. It sounds like a backup spot for most people, but I would hate to get shunted into something else because TYs were taken. Obviously this depends on many factors, but I'm trying to go forward with a general idea of how things have panned out in previous years.

The competitiveness of TY really varies from year to year -- keep in mind that in addition to the applicants that list TY as a first choice because their specialty of choice doesn't offer a categorical intern year, it is also the second choice/back-up speciality for the majority of applicants. That said, everyone I personally know who applied TY as their back-up this past year got a spot, although not necessarily at their first choice of location.

I'm an incoming Navy peds intern who applied TY as my second choice for the reasons mentioned above -- specifically that the TY locations were at the same hospitals as Peds residency programs (San Diego, Portsmouth, Walter Reed) whereas FM is offered in different locations (Pendleton, LeJeune, Jacksonville, and Ft Belvoir). That said, I think FM is a valid choice, too, especially if you don't think you'd reapply to Peds if you didn't get a spot your first time around.

I don't claim to have any special knowledge of the future of Navy peds, but happy to answer questions based on my application experience.