How bad is AF GME

[LauraDO]

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Ok, the consensus seems to be that Army GME is tops and AF is terrible, but just how bad is it, lets say I don't get deferred and I don't get shafted into Flight surgery but get put into a AF residency-- What is the results, will I be unprepared as a doctor? I would like to hear from people who have done an AF residency and what their experiences have been

Also, in the AF I could get a civilian deferral but could I get a military deferral to a different branch like say the army?

 

[Galo]

Ok, the consensus seems to be that Army GME is tops and AF is terrible, but just how bad is it, lets say I don't get deferred and I don't get shafted into Flight surgery but get put into a AF residency-- What is the results, will I be unprepared as a doctor? I would like to hear from people who have done an AF residency and what their experiences have been

Also, in the AF I could get a civilian deferral but could I get a military deferral to a different branch like say the army?

It really depends on what you end up in. First off, in the last two cycles you would have had a 30% chance of ending up a gmo/flight surgeon.

I can only speak to what I know, but for surgery, Keesler I am not sure is even certified by the RRC, all the other surgical programs are combined with some civiilan program (which is good), but overall, I think the decline in medicine (lack of support, leadership, money, deployment, staff) will make for a less than optimal training experience no matter in what. My opinion.

 

[sethco]

Another thing to keep in mind is that AF GME is rapidly changing over the next couple of years. Wilford Hall, the "AF Flagship Hospital" in San Antonio will be closing inpatient services and turning into a "superclinic" (ala Malcolm Grow/Andrews AFB). All of the residents will be moved over to Brooke Army Med Center. Not really sure about the impact this will have, but I guess we will see. Howver, the higher ups are definitely drinking the kool aid regarding the AF GME. They plan on (Over the next couple of years) opening residency programs at Nellis, Langley, and other bases consisting of FP, Surgery, and OB/GYN.

As a flight surgeon, I can only comment on my 2 months as a med student rotating through the Anesthesiology department. Sorry if I offend anyone, but I was not impressed at all will the program. It seemed they were "farming" residents out to other hospitals way too often (Corpus Christi, Dallas, Houston, etc.). Their main bragging point was they have a 100% boards pass rate. So what? They are out of thier too early and there were very few complicated cases going on. Hopefully things are different when they go over to Brooke Army, but can't speak for this. In fact, I thought so little of the program I didn't even rank it come match time. Maybe this is why I did not match, but regardless, I am happier as a GMO/FS because I am doing my 4 years and then leaving for a great civilian residency, free of the military. Just my opinion, take it for what it's worth.

 

[LauraDO]

Another thing to keep in mind is that AF GME is rapidly changing over the next couple of years. Wilford Hall, the "AF Flagship Hospital" in San Antonio will be closing inpatient services and turning into a "superclinic" (ala Malcolm Grow/Andrews AFB). All of the residents will be moved over to Brooke Army Med Center. Not really sure about the impact this will have, but I guess we will see. Howver, the higher ups are definitely drinking the kool aid regarding the AF GME. They plan on (Over the next couple of years) opening residency programs at Nellis, Langley, and other bases consisting of FP, Surgery, and OB/GYN.

As a flight surgeon, I can only comment on my 2 months as a med student rotating through the Anesthesiology department. Sorry if I offend anyone, but I was not impressed at all will the program. It seemed they were "farming" residents out to other hospitals way too often (Corpus Christi, Dallas, Houston, etc.). Their main bragging point was they have a 100% boards pass rate. So what? They are out of thier too early and there were very few complicated cases going on. Hopefully things are different when they go over to Brooke Army, but can't speak for this. In fact, I thought so little of the program I didn't even rank it come match time. Maybe this is why I did not match, but regardless, I am happier as a GMO/FS because I am doing my 4 years and then leaving for a great civilian residency, free of the military. Just my opinion, take it for what it's worth.

That is interesting, and very helpful. Thank you.

Is there no one on this board that has actually done an AF residency?

 

[elderjack21]

Ok, the consensus seems to be that Army GME is tops and AF is terrible, but just how bad is it

It is so bad that you likely can't even trust the opinions of those who went through the programs. 😉

 

[mitchconnie]

I’m not sure that there is a consensus that the Army GME is “tops.” Having trained and worked in both AF and Army GME, I see exactly the same problems with both. The Army does, however, have the largest GME program and the best chance of going through without interruption for GMO time.

It’s hard to generalize about AF GME, but overall, highly specialized, procedure-heavy programs have the biggest problems. Once Wilford Hall closes, the AF will have no medical centers that are the equivalent of a large community or university teaching hospital—hard to generate a high volume of complex cases at a small hospital. But the situation is also complicated by the fact that some AF programs have essentially closed and been folded into nearby civilian programs, so quality is essentially dependent on the civilian institution, for better or worse (usually better).

No residency program is “bad” since they are all (with the possible exception of Keesler) ACGME approved. You will likely end up as a competent physician if you train in the AF. But a better question to ask might be this: How would an average student rank the Air Force programs if they were in the same match with civilian programs? For many specialties, AF programs are relatively low volume, not big name, with transient faculty, poor ancillary support, multiple off-site rotations, and unattractive locales. I think it’s a safe bet that these programs would rank near the bottom of everyone’s list. So it’s not that they are bad programs per se, but they would be much less attractive to most top-notch American grads. If forced to compete with civilian institutions, they would attract only bottom-tier American grads and FMG’s.

That’s why there are many students coming to this forum with the question, “How do I get a deferment?”. It’s because for a top-notch student, there are civilian programs in virtually every specialty with a lot more to offer.

 

[elderjack21]

I'm not sure that there is a consensus that the Army GME is "tops." Having trained and worked in both AF and Army GME, I see exactly the same problems with both. The Army does, however, have the largest GME program and the best chance of going through without interruption for GMO time.

It's hard to generalize about AF GME, but overall, highly specialized, procedure-heavy programs have the biggest problems. Once Wilford Hall closes, the AF will have no medical centers that are the equivalent of a large community or university teaching hospital—hard to generate a high volume of complex cases at a small hospital. But the situation is also complicated by the fact that some AF programs have essentially closed and been folded into nearby civilian programs, so quality is essentially dependent on the civilian institution, for better or worse (usually better).

No residency program is "bad" since they are all (with the possible exception of Keesler) ACGME approved. You will likely end up as a competent physician if you train in the AF. But a better question to ask might be this: How would an average student rank the Air Force programs if they were in the same match with civilian programs? For many specialties, AF programs are relatively low volume, not big name, with transient faculty, poor ancillary support, multiple off-site rotations, and unattractive locales. I think it's a safe bet that these programs would rank near the bottom of everyone's list. So it's not that they are bad programs per se, but they would be much less attractive to most top-notch American grads. If forced to compete with civilian institutions, they would attract only bottom-tier American grads and FMG's.

That's why there are many students coming to this forum with the question, "How do I get a deferment?". It's because for a top-notch student, there are civilian programs in virtually every specialty with a lot more to offer.

Let us just be honest here. If you were a top-notch student you are generally not going to join the military to pay for school. So there you have it.

The types of people that sign up for the scholarships are probably your average medical student...not saying average medical student doesn't = great doctor, because there are too many other factors to consider.

But I think you get the point.

 

[LauraDO]

Let us just be honest here. If you were a top-notch student you are generally not going to join the military to pay for school. So there you have it.

The types of people that sign up for the scholarships are probably your average medical student...not saying average medical student doesn't = great doctor, because there are too many other factors to consider.

But I think you get the point.

I think that is a biased and unfair generalization👎

 

[MaximusD]

Pre-clinical A's (alone) do not a top-notch physician make.

 

[BigNavyPedsGuy]

Let us just be honest here. If you were a top-notch student you are generally not going to join the military to pay for school. So there you have it.

The types of people that sign up for the scholarships are probably your average medical student...not saying average medical student doesn't = great doctor, because there are too many other factors to consider.

But I think you get the point.

That's one of the dumbest things I've ever heard. How can that be a correlation? If you're a top notch student you're just as likely to need help paying for school as the "average" guy.

Seriously, that's just really stupid. And coming out of college I was a "top student". I decided to join, and it had nothing to do with my success to that point.

 

[BOHICA-FIGMO]

Let us just be honest here. If you were a top-notch student you are generally not going to join the military to pay for school. So there you have it.

The types of people that sign up for the scholarships are probably your average medical student...not saying average medical student doesn't = great doctor, because there are too many other factors to consider.

But I think you get the point.

This is just the absolute dumbest thing I ever heard. Most of us signed up just before medical school and before we had any idea of what kind of medical student we would be.

 

[elderjack21]

Are your feelings hurt? Sorry.

Tell me students at/from top-notch schools are lining up at the local HPSP recruiters office to sign up in greater proportion than those attending extremely expensive average private MD and DO schools.

According to the numbers Harvard, Duke, Mayo, Stanford et al. Have some of the lowest amounts of student indebtedness (aside from state schools). Why? They have more scholarships to give to their "top-notch" college students that get into these programs. I could be wrong, maybe all of these kids are taking HPSP and have hardly any debt because of that.

And don't think I fall into the undefined category of "top-notch sudent". Although clearly everyone else on SDN is...I am an average accepted applicant, from a below average financial back-ground and like most everyone else who signs up for HPSP....would like a better way to pay for school than taking 250k in loans out to pay for my private school.

Also, as I clearly stated a couple times in my statement, these are generalizations. As I also stated, a top-notch student doesn't make a top-notch doctor. It may be quite the opposite...who knows, I won't lose any sleep on either way.

 

[elderjack21]

Most of us signed up just before medical school and before we had any idea of what kind of medical student we would be.

FYI - Past performance is usually the best indicator of future success...true even in academics. This is the basis for the decisions made by admissions committees on who gets into school and who doesn't.

 

[Rudy]

The following link is to an article by a former Navy Surgeon General who is now a member of the Society of Medical Consultants to the Armed Services (basically a group of retired senior leadership in mil med). This article is fascinating because it contains some actual data regarding trends in the applicant pool to military med. As stated in the article, the senior leadership is concerned about the downward trend in applicant quality. Interesting to note the disproportionate number of DO students in mil med. The reasons seem obvious: 1) DOs schools are generally private and expensive and 2) most DOs that I have met prefer to do "MD" residencies, and military residencies are relatively easy to match into in some specialties, especially if you earn brownie points by doing a GMO/flight surgery tour.

So, according to the article, Elderjack is correct: few students from "top notch" MD schools are applying to HPSP these days, which apparently is a change from recent years.

http://www.usmedicine.com/column.cfm?columnID=147&issueID=56