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Hello all (general issue, not Navy specific)

Discussion in 'Military Medicine' started by Rorschach117, Aug 6, 2011.

  1. Rorschach117

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    Hey all, I've been reading these forums (and other information regarding military medicine and graduate medical education) over the past year, meaning that I've sorted through the pages of pros and pages and cons, so don't worry, I'm not a total noob and you don't need to talk and explain "GMO" to me slowly :)

    Anyway, I'll try to keep it sort and provide details as needed. I'm a rising senior in high school, and as a 17 year old I had a great opportunity to be an intern at a hospital where multiple ex-Navy docs work (San Diego, CA here, for what it's worth). I've gotten an earful of pros and cons from them too, and they're a diverse group on their own (some did HPSP, one did USUHS). Ultimately, it's the "us-us'er" that convinced me (or rather, inspired me) to fully pursue the University for my medical education (in his field of radiology, no less).

    I guess what I mean to ask is, is this a reasonable course for my life? I know it is hard to plan out decades ahead into one's life, and be expected to have the willpower to maintain it, but I do very well in high school now, and so hopefully I can put that towards my credit. My plan is as follows:


    • 1 more year of high school
    • 4 years of the US Naval Service Academy (or another 4 year university if I could get sweet financial aid there)
    • If service academy, then hopefully defer the 5 years active duty until later in my career
    • USUHS time (7 years)
    • my intern year, plus, if they don't phase GMO tours out by then, I'd like to be a DMO (being in San Diego, I've met friends with SEALs in their family, so I've known the Coronado Gator Beach pretty well by now :))
    • radiology residency (4 years active in residency, then another 4 years for the commitment)
    • and finally, a civilian (since there are no military ones, I believe) fellowship for neuroradiology (2 years) with the tag a long 2 year commitment.
    I believe that, assuming service academy, then I'll be leaving the Navy at the ripe old age of 51, and if not a service academy, then I'll be 49. Am I correct in that analysis? And also, is there anything that can be said about my path choice? As I mentioned, I'm attempting to not rehash an old topic, instead trying to use research of my own, but if anyone can offer me specifically tailored advice, I would highly appreciate it.
     
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  3. pgg

    pgg Laugh at me, will they?
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    I don't think your service obligation math is quite right
    18 @ finish high school
    22 @ finish Naval Academy (owe 5)
    26 @ finish USUHS (owe 12)
    31 @ finish intern/residency (owe 12 still - residency payback concurrent with USUHS)
    43 @ end of obligation


    Going to the Naval Academy might not be best if your aim is medicine. I think only a certain (small) number of grads are permitted to go on to medical school right away.

    It's waaaaaaaay to early to think about committing yourself to military medicine and an inservice residency. Military residencies (GME) are a different beast now than they were 10 years ago, and you're looking at residency a minimum of 10+ years from today.

    Planning ahead is great, but your life, your circumstances, the military, and the world all have a way of changing and a military obligation limits your choices.

    Almost everyone changes their mind about what specialty they choose during medical school at least once. The truth is you haven't really been exposed to enough specialties in a meaningful enough way to pick something as specific as neuroradiology. Goals and dreams are OK, but good plans need flexibility.

    I'd only go to the Naval Academy if you want to be an officer first. Otherwise, pick a good university, go there, do well, and revisit the military medicine question in a few years.


    Also, be wary of the fond memories old ex-military doctores have. Military medicine was enormously different in the Cold War days, and even 10-15 years ago pre-War-on-Terror it was different than it is now. The milmed they remember may not be the milmed of today, and it absolutely won't be the milmed of 2030 when you're in payback mode with the above schedule.
     
  4. Apollyon

    Apollyon Screw the GST
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    Unless things have changed, USNA gives up to 1% to go to med school, and you have to be a chemistry or oceanography major.

    USMA was 2%, but I don't know if it still is. Way back in 1992, when I interviewed at USUHS, there was a guy there who had gone to West Point, and I recall him saying "they own me for pretty much the rest of my life". I now see that he was exaggerating.
     
  5. Rorschach117

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    Thank you both for your replies and advice.
    You are right as far as the math goes, sorry. A detail I forgot to mention was that I intended (via my crystal ball, of course :)) to stay for the full 20 years to receive the 4 year bonus add-on from USUHS.

    Regarding the USNA choice and the lack of clarity of the future, I'll be sure to tread carefully and take what the Blue and Gold officer has to say regarding deferring the time with a grain of salt. The benefit to wanting to serve out 20 years is that I have some leeway, I think, instead of needing everything lined up "right this second" so that I could exit the Navy at the quickest possible time.

    The fellowship at neurorad might have been a stretch but my heart definitely lies in the field. During the multi-month internship at the hospital (it's actually part of a large association), I've met a lot of doctors in a lot of disciplines, and done everything from watching the surgeries to doing the rounds, and nothing enraptures me more than radiology. Interventional is good too, but neuro covers it all.

    And that's true on what you say about context and bias. My USUHS source has a lot in common with Captain America, and he only recently retired from the Navy, but looking at his example it's hard to not want to follow his footsteps. Him and I see eye to eye on a lot, although I definitely do take and welcome your advice, pgg, thank you.


    1% per graduating class...is that an assumed rule, or is there really a cap on the deferments that are possible? Also, 12 years still is a lot, plus reserve, I think...
     
  6. pgg

    pgg Laugh at me, will they?
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    My MS1 anatomy lab partner was a USNA grad, oceanography major. Apparently not a lot of majors available that would get the med school prerequisites done. He said there were only a handful of people in his class who were OK'd to go to medical school ... 1% of the class is around 10 people I think.

    Smart guy, think he ended up doing neurosurgery. With that long residency and long payback, he's looking at being retirement eligible about the time his payback is up. Obviously still young enough to work a long time afterwards though.
     
  7. NavyFP

    NavyFP Senior Member
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    Each year there are 15 Middies who are selected to be allowed to go to medical school. Upwards of half go on to USUHS the others tend to go to high end medical schools. Occasionally there is a dentist or two thrown into the lot and they count against the 15 cap. More often than not there are other highly qualified candidates who could certainly get into a decent school who do not make the cut and must go off to the fleet for 3-5 years before they can try again.

    When we are young and have never been turned down for anything for which we have applied, we always assume we will continue to be amongst the chosen. It does not always work out that way. Not trying to discourage the OP, just throw a little reality on the fire.
     
  8. DeadCactus

    DeadCactus SDN Lifetime Donor
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    I couldn't recommend anyone going to the Naval Academy with any intention other than being a Navy or Marine Officer for a few years after undergrad.

    Going to a military academy and serving as an officer for a few years is a great path for getting a solid education, scratch the itch to serve, mature a little bit, and build a solid foundation for a resume and medical school application.

    Going to a military academy with the intent to continue immediately into HPSP or USUHS is a great way to set yourself up for disappointment, frustration, and needless financial and personal sacrifice.

    Your goal right now is figuring out what your top goals for 1, 2, and 5 years from now are and figuring out the way to secure those things. Planning out a 12 year education and 20 year career in advance is futile. If your main goal is to be an academy grad and serve as an officer, go for it. If your main goal is to be a physician, then it's difficult to justify a route that puts needless hurdles in the way of going to medical school.

    Every year you put off a goal is another year you may have permanently missed the boat. There are almost certainly 34 year old surgeons who realize they've probably missed their chance to be a fighter pilot and 24 year old Officers who wake up in a hospital bed to realize an IED in Iraq or a car accident in Colorado crushed their chances of being a surgeon...

    I'm not trying to be so melodramatic. The point is that there's nothing wrong with taking the scenic route through life, but put the more important target at 25 meters and hope you get a chance to worry about the one at 50 meters.
     
  9. Apollyon

    Apollyon Screw the GST
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    1202 matriculated for the class of 2011, and they state about 80% complete, so that would be about 960 grads (to compare, the class of 1958 graduated 899, of which John S. McCain III was #894). So it looks like about 1 1/2%. And 1% is indeed 10, rounded up.
     
  10. Mirror Form

    Mirror Form Thyroid Storm
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    Yep, so at the age of 18, you're planning on signing away your freedom until the age of 51? You have absolutely no f'ing idea what you're doing! If you think that's remotely rational, then you have no concept of how your life will change in the future.

    A far better "path choice" would be to keep your options open. Remember that military and medicine are both changing rapidly. Your experience in military medicine would completely different than the radiologists'.

    First, you have to decide if medicine is your goal. If it is, then avoid any association with the military during college like the plague. Once you get into med school, the military will be throwing HPSP scholarships at you.
     
  11. The White Coat Investor

    The White Coat Investor AKA ActiveDutyMD
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    17? Planning your fellowship? Get a life. Seriously. There is so much fun stuff to be doing right now, go do that and don't worry about this for at least 3 or 4 more years. Get good grades and don't get a criminal record. You can figure the rest out later.
     
  12. AF M4

    AF M4 Junior Member
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    OP, I am going to draw up a new Master Plan for you, right now. You are starting your senior year in high school, yes? Your assignment for the rest of the year is the following:

    - Get good grades, do well on the SAT, get a scholarship, yadayadayada.
    - Become really good with the ladies. Laugh if you like, but figure it out. This will serve you well in the rest of your life as well as the next phase of the Master Plan.
    - Use your good grades and scholarship, etc., to convince your parents to let you go to Europe for the summer between high school and college. Feel free to mow lawns or something to help fund this. But do it. Go to London.
    - Once in London, your one and only objective is to somehow make contact with Pippa Middleton. You know, the attractive (and single) sister of the new princess. This is where the ladies' man skills will come in handy. You will be a charming young foreigner and will have a better shot than you think. If all goes well, you could have a landed estate in York by age 23.

    Report back in August 2012. If you do happen to succeed in your endeavor, remember me when you come into your kingdom. Godspeed.
     
  13. ravager135

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    Best advice yet. I couldn't stand the kids in medical school who would go out and do things I did four years earlier in college. You're 17 years old, act like it. Do well and good things will come with options at each junction. Try and plan out your fellowship at 17 and you'll be the tool in medical school who thinks the best time ever in his life is the night after his gross anatomy exam.
     
  14. BOHICA-FIGMO

    BOHICA-FIGMO Belt-fed Physician
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    Similar situation happened to me out of the Air Force Academy. Only 20 or so people were allowed to go to medical school, PT school, and dental school combined. I ended up doing 11.5 yrs before going to med school.

    So, unless you want to do something in the line (e.g., USMC, NSW, aviation, subs, or {god forbid} SWO) I would NOT go to the Naval Academy. If your main goal is to become a physician as quickly as possible, I would recommend: (1) civilian state school for undergrad --cheaper and easier to get good grades (2) medical school anywhere. If you still want to do the whole military thing, then do either HPSP, HSCP, or FAP. Just my $0.02.
     
  15. pgg

    pgg Laugh at me, will they?
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    Quoted for truth, emphasis mine. No one has ever asked me where I got my undergrad degree. Undergrad prestige is overrated.
     
  16. Mirror Form

    Mirror Form Thyroid Storm
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    True to some degree. But each step builds off the previous one. So if you want to get into a top tier medical school, you'll have much better chances if you go to a top tier school for undergrad.
     
  17. Trajan

    Trajan Senior Member
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    While I am glad that I did HPSP and would do it all over again if I could, my advice to you is to be very careful. When I joined before medical school, my plan was to be career. Fast forward a few years and I got out after 4 years of GMO.

    I am a very different person now than I was when I started medical school, and a drastically different person than I was before college. I think completely differently now than I did as a 22 year old, let alone a 17 year old. The thought of being forced to live the life and career that I imagined as a 17 year old frankly scares me to death.

    That is one of the greatest negatives of HPSP/USUHS, especially if done right after USNA or ROTC. Unlike virtually every other military program that I can think of, the medical programs are the only ones that require you to sign and commit years before you actually start to serve. The problem is that the time in between is (or has the potential to be) a life transforming educational experience. And furthermore, for most of us this period also occurs during a decade in life when one's values and/or world view change dramatically.

    Again, I'm a civilian now but am very glad that I did HPSP, and am actually grateful for the opportunities and experiences that the military gave me. That said, I was happy to move on with my life at the earliest opportunity.

    You would be amazed at how much payback time some military physicians build up, especially if they started accruing it as midshipmen, went directly to USUHS, and became flight surgeons before long residencies and fellowships. Remember, training just postpones payback even longer. I've seen residents who owe enough time that they will be retirement eligible and pushing 50 when their obligations are up. Imagine being in that position. You're 15 years (or more) removed from high school when you signed the ROTC or USNA contract and are only now starting to begin the payback. Then imagine that you aren't that psyched about being in the military or even being in medicine! You then look at your old ROTC classmates who are either decorated veterans now established in successful civilian careers or are experienced line officers with multiple combat deployments under their belts. I've seen that happen. Does it scare you? It should.

    Be careful.
     
    #16 Trajan, Aug 9, 2011
    Last edited: Aug 9, 2011
  18. Rorschach117

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    Hey all, it's me again. I've been reading the replies but I stayed away from replying before I happened to talk to a couple of the doctors and advisers again.
    Well, I'll look at the published profiles of the students I guess and estimate where I could see myself graduating. I see your points though, as far as how being an officer in an unrelated field could slow me down from being a doctor, with that path being full of unnecessary hurdles and all.... I'm definitely not going to put all of my eggs in one basket when I apply to the USNA (I still will apply there, but put it towards the back of my priorities).
    You're right about the difference in experiences....even I know a lot has changes since the 80's. Off the top of my head, I know that we don't have Reagan saying that we need to rapidly expand the Navy's tonnage anymore. But, I think that when the budget gets shorter, it's hard to say which will take more cuts, USUHS or HPSP.
    While fellowship may be extreme, I don't think that it's fair that you're implying that I sit around with a ruler and some draft paper while plotting out my life, waiting for the tea leaves to dry instead of participate in many, many other activities.
    If you get angry that I'm at least trying to have some guidelines for the future, then don't read the paper and get angry at "those dang kids that don't have any common sense" and just complain about my generation. Some of us do make an effort, but we can't all live life like Stand By Me.
    i laughed
    :thumbup:
    I don't go around bragging it to people as if I already made the match. I just asked for some insight from people that already have hindsight behind them. And indeed, you do have a great advice to pass on, so thank you, even if it's just tips on how to be around other students.
    I think by now, it really sunk into me that just practically speaking, I have to use the USNA as a backup, rather than my primary choice. But, my main goal isn't to be a physician as quickly as possible, so I think that USUHS is still (forbidding anything else happens) on the table for me to consider.
    Yeah, unfortunately nowadays it's a lot of a rat race, as least for higher tier schools :( but it's not a big deal to me, only a scholarship would be nice.
    I hear a lot of stuff from admissions officers that sometimes they even prefer grad students that didn't take undergrad at their university....might just be one of the University of California's pet peeves, but who knows if the sentiment goes elsewhere also.
    I see what you're saying about how, for better or for worse, it's "backwards" in its process, but I can see why the military has to do that for something that requires so much training such as becoming a physician. So that's the name of the game, and I think that I have to take a risk just like anybody else and hope that I come out fine, even if I'll be taking a step into the unknown.


    Like I said, thanks for all of the responses guys, even ones that notice that I'm a bit naive ;)
     
  19. AF M4

    AF M4 Junior Member
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    You are a thoughtful and well-prepared individual. It is good that you are listening carefully to the posters on this forum.

    Also, I meant every word that I wrote in my previous post.
     

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