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How not to match

Discussion in 'Military Medicine' started by mrsmd2be, Mar 16, 2004.

  1. mrsmd2be

    mrsmd2be New Member

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    My husband has a military ROTC obligation from undergrad. We know he must apply to five military residency programs, yet he prefers for various reasons a civilian residency. Any advice on how NOT to match in the military match.
     
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  3. Homunculus

    Homunculus SDN Caveman Administrator
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    there's really two ways to do it, the nice way and the not so nice way.

    first, what branch is he in? the navy and air force are smaller and more likely to give out deferments, though the navy is equally likely to make him a GMO after his internship.

    depending on what your husband is interested in, some program directors *may* be open to letting him get a civilian deferment, and if he's open about it they'll jsut not select him. this option is very very iffy. it would probably work for pathology and a few other specialties without many slots.

    the not so nice way is to to simply not rotate at programs in the field he wants, then on his pref sheet put down the most competitive specialties. this way has a greater chance of working, but they really really hate it when people try to "beat the system". you have to put what your "career goal" is when you pref, and if you put "orthopedics" then they (i think) will only approve a civilian deferment for that. chances are they'll stick him in a transitional spot somewhere.

    either way, they don't make it easy to beat. and it would suck if he actually matched into one of his fake selections. COL Raines told us about a couple of women who wanted civilian peds and tried to beat the system by putting down general surgery. they both matched, lol. luckily they were able to get some stuff rearranged and ended up doing peds like they wanted. but i'm sure they aren't the most well liked people in GME, lol.

    why is he so against military residencies? if he's interested in primary care, he shouldn't be afraid of the military.
     
  4. mrsmd2be

    mrsmd2be New Member

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    He is army.
    I guess that is the "good' part is that his true interests ( although he hasn't yet 100% decided are competitive; General Surgery, OrthoPedic surgery or Emergency Medicine
    The army although competitive actually has six ortho programs.

    He is not against military residencies, however, he has been leaning toward EM because he claims he would like to see myself and our two children occassionally.The Army is quite limited in EM programs (3) and perhap competitive enough that it won't matter. He isn't drawn to any of the three and would rather do civilian than a transition Army year.
    We are still just tying to research and gather information though an area in which our Army contact has been soooo helpful:laugh:
    This forum has been good in that reguard.
     
  5. Homunculus

    Homunculus SDN Caveman Administrator
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    the Army's EM programs are actually pretty good, and yes, they are all *very* competitive. Does he know the military EM programs are all fast-tracked (PGY1-3) now?
     
  6. Mirror Form

    Mirror Form Thyroid Storm
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    As long as your husband is applying to a competitive specialty, not matching should be pretty easy. All he has to do is not rotate at any of the sites and not schedule any interviews. If the specialties are competitive, they'll take someone else. I've been told that it's the army's "policy" to hand out deferments to those who don't match in the army. However, I still haven't seen that in writing. So if your husband doesn't match in the army, there's always that small but scary chance that he might not be given a deferment and get stuck doing some transitional year somewhere.
     
  7. Homunculus

    Homunculus SDN Caveman Administrator
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    this reminds me . . .

    when COL Raines was at our school, she told us that in cases where the military has less than 5 programs (such as EM) if you don't match into one of the three that they will automatically give you a deferment. especially in EM this would make sense, since you wouldn't be able to get into a PGY-1 slot as a PGY-2 after doing an intership since all the programs are fast-tracked.

    sledge is right on though. there are enough people that *want* military residencies (say what you want, but military residency pay is *great* compared to civilian) that if he really doesn't want one and doesn't rotate there they probably won't take him sight unseen.
     
  8. NJEMT1

    NJEMT1 Member
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    When you say "military" are you referring to only the Army? I thought it was only Army *policy* to give out deferrals... Is the air force much less likely to give a deferral?
     
  9. Homunculus

    Homunculus SDN Caveman Administrator
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    yeah, military = army above. COL Raines is in charge of Army GME. sorry about the confusion. i don't know much about the air force system other than it's small. :)
     
  10. s42brown

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    COl Raines was just at our school tonight. She told us the same story using EM as an example. If your husband ranks the three EM programs and then puts down two transitional years for his last two choices, but then at the bottom of the rank list he lists that EM is his specialty desired then if he does not match he will be given a defferal. sorry for the run on. The army is no longer producing GMOs so the transitional years are not going to be given to him. See if one does not match into a PGY-1 position that is designated for a particular specialty then they will probably have no place to train for their pgy-2 year, in which they would become a GMO. However, like I said the army is no longer interested in producing GMOs therefore they are very reluctant to put someone in a transitional year that is not earmarked for a particular specialty. COL Raines was very persistant on this point and it made me feel great about matching military in about two and a half years.
     
  11. Andrew_Doan

    Andrew_Doan Doc, Author, Entrepreneur
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    Side note, perhaps the ARMY should produce more GMOs considering that specialists are being called up to be GMOs in Iraq.
     
  12. edmadison

    edmadison 1K Member
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    Actually, no branch should be producing GMOs at all considering Congress ordered the military to stop doing it. The Army and the Air Force have largely complied and, at least in the Army, GMO tours are largely voluntary. The Navy needs to attract more FP and IM people to use for its GMO billets and stop putting unqualified physicians into those roles.

    Ed
     
  13. Homunculus

    Homunculus SDN Caveman Administrator
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    peds, FP, EM and IM are the primary sources for "GMO" type work for the army. even if they are subspecialized, they can still be brought in for primary care. case in point, NICU docs getting deployed to Iraq for primary care. these are docs that haven't dealt with a patient over the age of a month in 3 years or more, lol.

    that being said, i'm glad the Army phased out GMO's. i know at one time it wasn't uncommon to have internship trained only docs (i've even rotated with a few FP's that did it this way) but there really isn't a need for them now. it's more of a detriment than benefit for GME.

    *edit* oh, and what ed said :)
     
  14. Andrew_Doan

    Andrew_Doan Doc, Author, Entrepreneur
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    Ed,

    Interesting. I didn't realize Congress ordered the stop of GMO tours. Thanks for the info.

    In regards to the ARMY, they need more FP or IM physicians too, because my colleague informed me that two ARMY ophthalmologists are being ordered to IRAQ as GMOs to relieve the physicians there.
     
  15. Homunculus

    Homunculus SDN Caveman Administrator
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    do they still get all their optho pay for doing GMO work?

    "hey doc, i've been having this back pain" . .

    "ummm.... here, try some Timoptic"

    "hey doc, i've got this burning when i pee"

    "ummm... here, try some proparacaine"

    "hey doc, i''ve got this thing in my eye"

    "holy crap!! a real case!!" <passes out>

    :)
     
  16. Andrew_Doan

    Andrew_Doan Doc, Author, Entrepreneur
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    They do. Expensive GMO! ;)
     
  17. r90t

    r90t Senior Member
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    I just came back from the Persian Gulf and my deployment wasn't too bad. I didn't feel way of my league, esp. with telemedicine/email and a big ship called an aircraft carrier within helo range. They have a fleet surgical team embarked in the "war zone." Anything really bad was medevac'ed to shore facilities, ideally, then to the carrier. Would 2 more years of training helped? Sure. Did I hurt or kill anyone. No. Work your butt of in clinical rotations and internship and you will be ready.

    BTW I felt the GMO should have been replaced by FPs prior to this tour. Our pt population in the navy, on my ship, is 18-51. Not too much stuff going on.
     
  18. iwakuni_doc

    iwakuni_doc Emergency-a-Go-Go
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    I agree with r90t regarding the FP's moving to fill GMO's, and I think that maybe what comes to pass with the planned privatization of many CONUS primary care billets.
     
  19. GMO_52

    GMO_52 Senior Member
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    At least in the Navy, the only way that GMO tours could be replaced by FPs is if the FPs deployed all the time. The great thing about the GMO system is that everybody takes a turn at filling the operational billets. The alternative is that the primary care docs never stop deploying. Also, Congress didn't outlaw GMO tours, they outlawed unlicensed physicians. I think the Navy is going to end up keeping people at the MTFs until they get their license (which can happen about 3 weeks after internship in some states).
     
  20. militarymd

    militarymd SDN Angel
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    I think you guys have it wrong. Rather than replacing a GMO with someone with even more training, the GMO should be replaced with a non-physician practitioner.

    Put physicians where they belong....at places where you practice medicine...not where you hand out ibuprofen and do administrative work...No offense to you all GMO's, but let's face it...one year of training does not prepare you to do anything other than to get your license...which in the grand scheme of medical training, is the first step in many to becoming a full fledged physician.

    Before everyone chimes in with..."I saw a case of fill in the blank or I did whatever"....that's what all that telemedicine gizmo is for...to help someone who doesn't know what he is doing...whether it is a GMO or a paramedic.
     
  21. r90t

    r90t Senior Member
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    Would you rather have a PA (1 year clinical experience) with a couple years of training, or an independent duty corpsman with 1 year of training (6 months clinical experience) out there, rather than someone with 3 years of clinical experience. GMO's get placed on medium sized platforms, whereas board certified physicians are on large platforms with GMOs working for them. The Senior Medical Officer on NIMITZ when I deployed with her was peds. One would say he was the wrong candidate for the job, but he did just fine. IDCs go to smaller platforms. Corpsmen run with the platoons when on the green side. The idea is that with a smaller crew, the less likely you are to run into problems. Also, we are the only one's out there certified in ACLS/ATLS. The non-physicians are not allowed to take the course.

    Also, a LT or LCDR interfaces better with the CO of the ship, than a petty officer when it comes to recommending a course change to medevac someone.

    I agree that an FP would likely do the job better than what I could do, however, I think I am doing a better job than a PA/IDC. Also, if you lose a GMO, you are losing your least trained physician asset....

    Oh, BTW, I have no intention of doing primary care for a career. I'll leave that for the FPs and IMs.
     

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