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Guard? Reserves? Need information

Discussion in 'Military Medicine' started by Skeedalisk, Aug 6, 2018.

  1. Skeedalisk

    2+ Year Member

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    Note: I am going to be matriculating next fall. I've narrowed down (and am confident of) the specialties I see myself doing to psych, rads, IM, and path. I'd like to start next year.

    Last week, I spoke to my state AMEDD recruiter about the Guard, and he said they were looking for flight surgeons and field surgeons only. He said 3 of the 4 specialties I am interested in are not able to perform those jobs. If I were to go into one of those specialties, psych/rads/path I have questions about my options. The recruiter said I should look into the reserves, but I also heard the reserves don't always drill in the state they live in. How is the drilling location for reserves determined? Another big question was about HPLRP. If I am not a flight/field surgeon, how do the benefits work? I have seen people referring to a critical shortage list, where does this tie in? Do those specialties even get benefits in the reserves?
    Also something that looks like a possibility-starting with the guard, training in flight school, and then switching to the reserves. Has anybody switched over that could elaborate? The AMEDD officer said flight school length was a year full time but I am not sure he understood me; is it really a year long?
     
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  3. Lee

    Lee Sleestack
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    I’m not sure what your recruiter is telling you.

    Are you interested in NG, Reserves, or active component? That’s a good place to start this discussion.

    Basically, do you want to do 1 weekend a month and 2 weeks a year, or do you want to serve full time? Are you trying to get a few thousand dollars (NG, Reserves) or get school 100% paid for by Uncle Sam (active)?
     
    #2 Lee, Aug 6, 2018
    Last edited: Aug 6, 2018
  4. Skeedalisk

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    1 weekend month/2 weeks per year. NG, or Reserves. Initially Guard but recruiter mentioned Reserves instead
     
  5. Lee

    Lee Sleestack
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    If you want to be part of your state guard, they will most likely have you serve as a physician in a brigade combat team, aviation unit, or other line unit. You’re not going to go to flight school or anything. At most you’ll attend a 6-week ‘flight surgeon’ course that will train you to do physical exams for flight crews.

    A ‘field surgeon’ is an antiquated term for a doctor that is part of a line unit. They don’t have special training (I’ve worked with general surgeons, FM, IM, ER, peds, OB/GYNs, etc. that were ‘field surgeons’).

    If you want to be part of the Reserves, you will most likely join a field hospital (combat support hospital) and practice in your specialty. Reserves have no combat forces.

    Advantage for the Reserves is no state activation. Downside is you may not regularly drill with your unit if your unit is in another state. That’s not great if you have no prior service experience.

    Your NG may offer better financial incentives to sign up than the Reserves. But if you have a Reserve medical unit in your state, that may be a better choice than NG if you’re concerned about state activations for disasters, etc.
     
  6. dingdong28

    dingdong28 Don't answer that, a rhetorical question

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    I'm not a physician but enlisted medical in the Reserves (USAF). We have some flight surgeons at our unit. They mostly perform (flight) physicals and other administrative duties. They all practice in their specialty (I know we have a dermatologist, anesthesiologist, and a few IM) when not at drill. I know that more critical care specialties (CCM, emergency medicine, general surgeon, anesthesiologist) can be part of CCATT (after training) which I believe my reserve unit is qualified for but not as active as they used to be. Google CCATT if you want more information but I see you're not into those specialties at the moment. I'm not sure how deployments work for when it comes to practicing in their specialty (I may ask them out of my own curiosity) or what Lee said about not regularly drilling with your unit if your unit is in another state, but I was told by my enlisted recruiter that whatever base you enlisted/commissioned at is where you're going to drill every month, regardless of where you live (unless you transfer to another base). This may be different for physicians since they're a helluva lot more precious than myself and need to retain them. I will say that the physicians at my unit look extremely bored when they are at drill or on annual tour. At times, they may be in-house or on-call if they receive critical values or other pertinent information that needs to be given to the physician.

    Sorry if I couldn't provide some insight. I'm sure others will add to the little I contributed or may stump my accusations. Good luck with your decision.
     
  7. notdeadyet

    notdeadyet Still in California
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    You are not confident of these specialties, as you have not rotated in them. This isn't a knock. Most folks end up in a specialty that they did not anticipate when they started medical school. I actually got an award IN medical school because I was to be a "future leader" in the field of Emergency Medicine and I ended up in something that wasn't on my list.
    He is correct. Almost every specialty can be slotted as a field surgeon (or flight surgeon after the Army's 6 week course) EXCEPT for the one's you listed (with the addition of nuclear medicine and anesthesia as well). Basically, any field that has minimal physical contact is excluded.
    This happens all the time. Medical students join the Guard and then graduate and get into residency and one of two things happens: they match out of state or they match in-state into a specialty they don't need (and the Guard pretty much needs only Field Surgeons, Flight Surgeons, and Psychiatrists [typically one per state of the latter]). New residents then transfer to another state Guard or switch to the Reserve. It happens all the time.

    In the Reserve, google APMC (AMEDD Professional Medical Command). You basically can work as an Army of one if you are too far away from a medical unit to drill.
    There is a document that shows the Critical Warfare Shortage List by specialty by branch (including distinguishing between the Army Reserve and ARNG and active). Ask your recruiter for this. He should have it.
    To be a military pilot is a completely separate career path. It is over a year and you are obligated for several years of service before they will let you switch over and become a doctor. Wipe that off your list.
     
  8. Skeedalisk

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    Thanks everyone for the replies!

    I want to consider all possibilities before commissioning...I know there's a lot left to be decided, but if my top choice going into school is psych and rads, joining the reserves initially does seem more harmonious going forward. However switching from the reserves to guard if I decide on a different specialty doesn't seem possible as said before on this board. I guess what I am trying to say is that I was leaning towards the guard at first but then after talking to the recruiter my plans have been in disarray.

    Basically their differences are what I am interested to know more about- because you say the guard has better financial incentives-so far I have not found anything that would make them different, at least for my state.

    I googled APMC and I found a site within 15 miles of my school to be (which is nice if that means I would drill there).

    My question about flight school was in regards to the course needed to become a flight surgeon, I'm sorry for the confusion! Could one of those non-patient contact specialties, or psych (if additional psychiatrist are not needed in my state) be slotted as a flight surgeon if they take the course or does the exception still hold true? I have no preclusion cross training if doing so is a way to obtain financial incentives such as HRPLP or STRAP. Again I just want to consider the possibilities up front in event that I do end up in one of those fields. Thx
     
  9. DeadCactus

    DeadCactus SDN Lifetime Donor
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    I think it would be helpful if you backed up for a second and just explained what it is you're hoping to get out of the military.
     
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  10. Skeedalisk

    2+ Year Member

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    A sense of purpose, fulfillment, and also debt relief
     
  11. FortunateSon

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    Skeedalisk, thanks for your interest in serving - Reserves and NG are both great places to find fulfillment as well as debt relief. A couple points that you may find helpful:

    - When thinking about what you want to get out of the military, keep in mind that (as a generality, not a rule), the Reserves and the Guard have somewhat different purposes and are composed of different types of units: The Reserves tend to be support type units, whereas the National Guard has the majority of combat power in the reserve components. As such, physicians in the reserves will mostly find themselves practicing within their specialty while attached to combat support hospitals or as an IMA - individual mobilization augmentee. This is why your recruiter told you that you should consider the Reserves if you are planning to go into pathology or radiology. Docs in the National Guard are unlikely to function as a specialist, but rather as a generalized "field surgeon" (which can mean a lot of things). The types of positions available depend on what types of units exist in a given state, but may include primarily doing routine annual physicals as part of the state medical detachment or command, serving as a primary care/emergency resuscitation physician as part of an Area or Brigade Support Medical Company, or serving as a battalion or brigade medical staff officer responsible for the oversight of unit medical readiness and coordinating operational medical support for the unit. Essentially, if you are interested in strictly practicing medicine within your specialty, the Reserves is the place for you; however, if you're looking for more of an "Army" experience, you will probably have better luck with the Guard.

    - Flight surgeons are not pilots, but they are on flight status and are required to log a certain amount of flight hours per month. They are the docs who are specifically trained in the nuances of aviation medicine. They ensure flight crews are fit to fly and may be involved with the oversight of medical air evacuation. The training is 6 weeks, not 1 year.

    - The National Guard does use psychiatrists, but they usually function as behavioral health officers, not as field or flight surgeons.

    - It is possible (although often cumbersome) to switch between Reserves and Guard. I.e., if you join the Guard as a student, then decide to specialize in radiology, you can transfer to the Reserves.

    Hope that helps - best of luck!
     
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  12. erupe

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    Really enjoy all the thoughts on this thread.

    In the last year of residency in radiology. Recently contacted by reserves recruiter. I would probably do 3 years. A few questions:

    Anyone know what a radiologist getting deployed looks like?

    Which branch is best?

    Anyone with experience would be helpful.
     
  13. dwb8p

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    I am an active duty Army radiologist. All of the Army reserve radiologists I have met were activated to backfill a spot at a stateside MTF for approximately 3 months while a radiologist normally assigned to that MTF is deployed to a combat theater. I have seen this happen to 4 reservists. I also heard about a potential Kuwait deployment for a reservist. If you were to get deployed to a combat theater, generally it is as radiologist (rather than as a GMO/Brigade Surgeon) at a Role 3 facility (ie. combat support hospital). However, there are plenty of active duty radiologists who have never deployed; so I would predict your chances of a combat deployment to be low.
     
  14. PCC108050

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    I assume the promotion rates to O-5 are about the same between the reserve and guard. How about to O-6? Anyone with experience on the Air Force side? Thanks.
     
  15. sb247

    sb247 Doer of things
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    Commissioning requires 6 iirc
     
  16. sb247

    sb247 Doer of things
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    Assuming there is a slot available, should be....making o4 is pretty much just breathing, but a lot of slots aren’t rated o5 so you need to be in one
     
  17. Skeedalisk

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    Ok. I would be able to switch from the guard into the reserves, and the scope of practice differs between each other :thumbup:
    Having said that, what would the difference be for the next 4 years (while actually in school) between the two? What questions do you recommend I should I be asking these recruiters to help decide one vs. the other?
     
  18. armytrainingsir

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    What exactly do you mean my the above? APMC doesn't have 'sites'. APMC is a command located in Atlanta. Physicians don't drill there.

    For drill, err, Battle Assemblies, you have the following options after you join the Army Reserves.

    1. Drill with the unit to which you are assigned. This is what is 'normal'. Some reservists drive hours and hours to make drill.
    But the unit must have a slot for you. Just because you find a convenient unit for you and want them doesn't mean they need or want you.

    But what if there is no medical unit nearby that has a slot for your specialty.

    So, that's where APMC comes in.
    If there is no unit with a slot for your within 50 miles or 1.5 hours (IIRC), you can be put in APMC. APMC then puts you in a unit somewhere in the US but you don't drill with that unit. Your admin stuff is split between your unit and APMC. Your unit does your yearly evals for example, but APMC processes your pay. Being APMC opens up your drill opportunities.

    Once with APMC...

    You can drill with a local unit. You call them up and ask if you can hang out with them. I do this. But since they really don't have a slot for you, you just hang out and get your paperwork signed off on Sunday afternoon so you get paid. It is good because you are hanging out with soldiers, but you are kinda a third wheel. How enjoyable this is depends on you and the unit. If you are a go getter, you can do some good, but the initiative is all on you.

    If there is no local unit, you can work at a local VA or MTF. Again, you are most likely a third wheel and they may or may not use you. And they tend to be closed when you want to drill and open when you are at work.

    Finally, you can get a Clinical Training Site agreement. You work at a local civilian hospital for free for two 8 hour shifts and the Army pays you for that as drill. Generally, this involves being on call, in house for them for free. This is the option of last resort, and APMC will only do it when you have no other option.

    You also mentioned you wanted to be a flight surgeon. That means you have to drill with an aviation unit. No one is gonna pay to send you to the flight surgeon course for 6 weeks and not use you as a FS. And it means the unit needs a FS. Pretty sure any specialty can go to the FS course at Rucker.

    And finally, what the NG recruited told you is pretty much true. My very limited experience with the NG and a couple of NG docs, is the NG doesn't want or need specialists. The want primary care docs as field surgeons. Just because you want to be in the NG doesn't mean they need or want you. Trying to convince your state NG they really really need a pathologist is just gonna end in frustration (yours). And while you might be able to join during your internship, live near a aviation unit that needs a FS, get the unit or state to pay for FS course, pass the physical, go to Rucker for the FS course, and be a FS for you state guard, well, I would venture to say the odds are pretty stacked against you.
     
  19. armytrainingsir

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    The commitment when you commission is 8 years. No way to 'do 3 years' IME.

    Which branch is best?
    Army. Biggest, so the most opportunities. Helicopters. And no kid grows up playing navy or air force.
    Navy. Snazzy dress uniforms, aircraft carriers, and hospitals are almost always near the beach.
    Air Force. F15s and F16s. They don't deploy without air conditioning and a golf course.
     
    #18 armytrainingsir, Aug 20, 2018
    Last edited: Aug 22, 2018
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  20. teacherman84

    Physician 10+ Year Member

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    Disagree...i hear my boys regularly playing "soldiers" and one of then always wants to be the AC-130 pilot providing CAS (and saving the Armys butt).
     
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  21. Skeedalisk

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    I've uploaded a document the reserves recruiter left me with. Two things...the way it sounded was that any specialty could receive HPLRP per the way the incentive is currently written (regardless of being critical wartime shortage; see attached), also that it is not possible to commission into the reserves as a med student without taking MDSSP (anyone have more info on this?)
     

    Attached Files:

  22. erupe

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    A bunch of people mentioned needing to do more years. All three of the emails I received mentioned a 3 year option.

    quotes from emails

    "receive a $***** signing bonus for 3 years of service, and/or a $****** student loan repayment option for 6 years of service while still maintaining civilian employment in your local area. "

    "With a minimal commitment of 1 weekend a month and 2 weeks a year, our applicants can receive a $****** signing bonus for 3 years of service, or a $****** student loan repayment option for 6 years of service while still maintaining civilian employment in your local area. "
     
  23. sb247

    sb247 Doer of things
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    That’s likely enlisted. An officer commission means 8
     
  24. USCguy

    USCguy Earnest Internist
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    You have to look at this as a difference between minimum obligation (8 total years when you join) vs the obligation or payback for different incentives. You’re going to be on the hook for 8 years (at least 6 years drill status); whether you take a bonus or incentive is a different animal
     

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