Regarding the first quote, I know it's the military, but seriously, how many docs find themselves in places where they are being shot at? Do doctors actually find themselves working is these conditions or is that up to the corpsmen/medics?
Second quote, what does it mean exactly to stay in the field? and is this seen as micromanagement on the part of the docs? Meaning, do the corpsmen/medics resent this and does command frown on it thinking a doctor is too valuable to get dirty? Can a doctor actually determine if he's "in the field" or in a hospital?
Finally, do all docs have to opportunity to get this training, or is this a "needs of the military" situation?
Thanks for all the info. Regardless of all the negatives I am still very interested in military medicine, so any thoughts are more than welcome.
First off... I only speak from the perspective of a GMO with infantry Marines.
Dive Medicine and Flight Surgery are formal training schools. They are somewhat competetive and have physical standards you have to meet before you go to them. They also have limited slots. The training I was referring to was the Tropical Med etc... Money (and often time) is out there to do some of this more non-traditional medical training while you are a GMO. Personally, I have been to multiple conferences and 2 Navy schools with no friction from the Command. These schools often go unfilled and the money is used to buy new desks for the folks at the training command. It's probably more due to lack of knowledge of the GMOs that these programs are out there and bad timing. I can't speak for residency trained docs. Their time is obviously more precious, so they probably don't get as many opportunities.
Yes, docs end up in places where they are shot at. A lot of the GMOs with the Marines have Combat Action Ribbons (this means you performed your duty while receiving fire). We don't clear buildings or run out into the street to save wounded Marines (usually), or any of that stuff. But sometimes you have to load people into helos, travel by helo, travel by convoy, etc... I've heard of doctors doing some really heroic stuff in Iraq and Afghanistan. I always question whether they were really doing their job..., but I wasn't there, so I can't really say.
By being "in the field", I was referring more to training evolutions. For instance, a battalion may have 2 GMOs and set up a field expedient BAS (Battalion Aid Station). Often the Corpsmen can run this, but the doctor is almost always a welcome addition to the crew. A GMO is never too valuable to get dirty. The Marines and Sailors generally appreciate it if you take an interest and participate in what they do. I always let my guys run it, but I like to be there if possible. If your battalion is getting substandard medical care anywhere it is YOUR fault as far as the CO is concerned. The other doctor can stay at base camp and run sick call, etc... Or you two can rotate. There are other example of opportunities to get out in the field, but basically, if you don't get out there, you'll never feel comfortable with the Marines (my opinion). What you won't be doing is patrolling around in the woods with a platoon of Marines.
Of course there can be impediments to this scenario. A substandard Chief, a bad CO, only one doc for the battalion, etc... There are a lot of bad things about the GMO billets (you have to postpone residency, you're given more responsibility than you warrant), but if you want to experience the military in a medical capacity, but outside the hospital/clinic, it's not a bad deal. Hope this answers some of the questions. I'll leave it to the board certified guys to give you the woes of Big Military Medicine.
