Ditto what Deuist said.
Military medicine is a complete disaster - STAY AWAY!
Take out loans or do some other type of rural medicine/primary care/Native American/VA payback program if you don't want to take out loans but do not join the military. The reasons are expalined in detail on this forum (i.e. see 40+ reasons and counting).
1. 40+ reasons not to be a military physician (please feel free to reply to my post to add more):
1-6. When you deploy for 6+ months (sometimes as long as 12 months with the Army in Afghanistan), you'll enjoy a daily schedule that will look something like...
1) No sex while your civilian counterparts enjoy a normal sex life.
2) Crappy food (though sometimes decent in large bases) while your civilian counterparts enjoy choice restaurants. For me, an MRE is
awful. Shipboard food is blah. "Tray-rats" are awful.
3) No broadband internet while your civilian counterparts enjoy whatever they want.
4) Stay in a work environment 24/7 while your civilian counterparts enjoy weekends and holidays off. Then when you go on leave
during deployment, they have the nerve to charge you despite the fact that you hadn't taken a single weekend off for months at a
time.
5) Sleep in a crappy rack/cot (it doesn't deserve the term 'bed')/crap in port-o-pottys while your civilian counterparts enjoy queen/king
sized beds and flushing toilets. The worst is sleeping on a 'isomat' on dirt - I never thought I could strain my clavicles until I slept
like that.
6) Repeat over and over, daily, for approximately 180+ days, meanwhile, the rest of society is enjoying high def television, plumbing,
broadband internet, the freedom to go out and shop/dine/romantic evenings/etc, raising a family and spending thousands of more
hours with their spouse and/or children.
But of course, if you prefer living in a tent, trying to pass time playing cards with your coworkers, then you should sign up !
7. Serve your country and expose yourself to enemy fire while celebrities and bank bonus recipients get paid millions for a lot less danger.
8. YOU LOSE BIG IF YOU TAKE AN HPSP SCHOLARSHIP: you're a sucker to take the HPSP scholarship - I like to call it a "MAFIA loan" (small short term rewards via a little more money during med school/residency, but ultra heavy payback). On the front end, you can get paid a little more as a resident (say 30K more each yr) and a little scholarship.
Clearly if you specialize, you're giving yourself a pay-rape by staying in the military.
The people whose foresight is overshadowed by their fear of carrying debt seem to enjoy getting pay-raped by the military.
9. GOODBYE AUTONOMY: kiss your right to feeling privileged as a physician good-bye. You will do what they tell you, go where they tell you, no questions asked (you can ask all you want, but it will fall on deaf ears). You may get lucky and get to live in a nice area, but you might also end up living in less cultural/popular areas like 29 Palms CA, Okinawa, Guam, Norfolk VA, Meridian MS, Ingleside TX, Camp Le Jeune NC, Guantanamo Cuba, among others. Remember you're a doctor - why subjugate yourself to a chain of command? - be all you can be - your own boss.
10. TIME IN MED SCHOOL DOES NOT COUNT TOWARDS RETIREMENT: the military doesn't respect the time you spent during medical school. You might find it interesting that it used to count:
http://comptroller.defense.gov/fmr/07a/07a_01.pdf At the top of page 1-10, prior to the year 1981, time during HPSP/USUHS counted towards your pay. This matters as the pay is quite different between an O-3 with less than 2 yrs vs an O-3 with 4 years.
IT'S A SHAME THAT TIME DURING MED SCHOOL DOES NOT COUNT TOWARDS ACTIVE DUTY TIME. MSCs (medical planners) CAN GET THEIR MASTERS DEGREE IN HEALTH ADMIN AS A CIVILIAN, GET PAID AS AN E4 AS WELL AS TUITION, AND THAT TIME COUNTS TOWARDS RETIREMENT. THEY EVEN ACCRUE LEAVE. SO MEDICAL PLANNERS CAN RETIRE AT 42, BUT YOU WITH A MEDICAL DEGREE CAN RETIRE AT 46.
11. ADMINISTRATIVE JOBS: makes me laugh how one of the advertisements in military is "don't have to worry about setting up your practice". well they more than make up for it by giving you plenty of administrative duties on top of seeing patients - lol. Jump into the pyramid, climb and reach for the stars with titles like Department Head, Senior Medical Officer, and Director! If these titles turn you on, then by all means sign up !!
12. NO CHOICE IN YOUR EQUIPMENT: you can't change things like you can with your own practice. You get to enjoy folks working under you who rotate as often as you do (and therefore need constant training). don't like the old computer you're working on? well in your own practice, you can change that. In the military, you won't, unless you have that admin job.
13. YOUR EVALUATIONS: Fitness reports - this is the most comical part the military that takes away any feeling of autonomy and privilege. To make a higher rank after you've been in for awhile, your fitness reports need to be filled with bullets (stuff you've done in addition to seeing patients) - so have fun racking up the admin duties to show how good of a manager you are. Failure to do so will result in you being very frustrated at not making captain/colonel (O-6). And don't forget that lots of **** kissing can often beef up fitness reports to make you more competitive than your colleagues. Do yourself a favor - don't enter an arena you don't need to be in, and remember that NOT joining the military means you don't have to deal with the BS associated with 'competing with your peers'.
14. NO CHOICE IN FRUSTRATIONS OF INFORMATION TECHNOLOGY: Don't like your electronic records? In the military, you better get therapy to enjoy AHLTA, because it's not going to change - only you can change.
15. FIGHT FOR FREEDOM, BUT DON'T EXPECT ANY FOR YOURSELF: In the military, you're under the Uniform Code of Justice. Odds are, this won't affect you. But god help you if you've put in 10+ yrs, trying to make it a career, then you get pulled over for DUI. In the civilian world, nobody will penalize your career as swiftly as the military.
16. TRAINING: Training, training, training. First you get a taste of it at ODS - several wks of boot camp style living (early to bed, early to rise). You get to learn things that will be vital to your future success as a physician - the first thing that comes to mind is marching in formation. Your civilian friends in the meantime can stay home, enjoy their time, but suffer the consequences of not knowing how to march in formation. To get a taste of your valuable training at ODS, go to their website, look at their FAQ at
http://www1.netc.navy.mil/nstc/otc/ods_faq.asp
You'll also love C4 training too - that's 10 days or so of living spartan, showering in communal showers (when you're not camping), completing your bowel movements in port-o-pottys, crappy food, the usual - kind of like conditions in a deployment.
17. REQUIRED COMPUTER TRAINING: navy knowledge online (and similar other training) - every so often, you'll get to update your computer training as you sit in front of a screen for many hrs, clicking thru outrageously slow 'learning modules'. Every year the list of required training gets longer and longer.
18. NOT ALWAYS 30 DAYS VACATION: they say you get 30 days of paid vacation per year. This isn't always the case. Also remember that leave days count even if it's the weekend. Once you report to a command, you will often have difficulty taking all 30 days of leave per year. over time this will build up, and if you carry more than 60 days of leave on the books, you can end up losing it.
19. LOST SPOUSE INCOME: those with spouses who want careers too:
The military is the absolute worst place to be, given that you have no idea where you will be in 2 yrs and the frequent moving (don't forget moving overseas). So if you join the military, if your spouse loses out on a good job making decent $$$/benefits, then you just intentionally killed thousands of $$$ of potential earnings. If your spouse does not work or works for very little, then the military won't hurt.
20. CONTRACTED PHYSICIANS. The best physician jobs are being taken by contracted physician jobs. This means those who are left in the military get stuck on deployment, or are in the worst jobs. If you want a nice job in a military hospital, work under contractual agreement. As a civilian specialist, you'll get paid way more, never deploy, and you have your pick of location. Every time i see a civilian getting a contracted position, I'm more convinced that the way to go is civilian. In the worst places, like Guantanamo Bay Cuba, they can't find any civilians willing to work on a contractual basis: but they can find you if you're in the military
21. HIGH TURNOVER: the military finds that it is cheaper to have high turnover (don't give many incentives to keep people in, but make up for it in recruiting those who are naive). This is very true for specialists. For primary care, you may have a tough time in the civilian world, but an even tougher time in the military. What's the retention rate for deploying specialists (ortho, ER, surgery, anesthesia) - almost zero unless they're close to that 20 yr retirement. If specialists are leaving by the droves, is this the career for you?
22. NOT SO GREAT RETIREMENT: your retirement pay is the same as any officer who didn't go to medical school (less if you count the fact that officers entering the service straight out of undergrad will end up retiring 4 yrs sooner than you). Remember that retirement pay is based on 'base pay'. So all those bonuses you made as a doctor don't get factored into retirement pay. Hence you end up with retirement pay equal to a nurse.
23. EDUCATION FOR YOUR CHILDREN. If you're stationed overseas with children, your children will be taught by teachers contracted abroad (and no, these teachers are not typically Philips Exeter material). I have heard good things about overseas schools however. But if for some reason you don't like the school system in Okinawa or wherever, what private school choice do you have? - nothing. Want your kids to enjoy the advantages of having private lessons in music or sports? - good luck finding them abroad or in desolate areas such as LeMoore, CA, 29 Palms, or El Centro, CA.
24. FINANCIAL LOSS WHEN MOVING: DLA (dislocation allowance) - approx $2K for officers to help off-set the cost of your move every 2-3 yrs. This is laughable considering that civilian mid-level managers/consultants are paid 70K or more to move, to include guarantees that the company pick up the tab if their house loses value.
25. LOST HOME INVESTMENT. The #1 investment in America is your home. However with moving every few years, don't expect your home to be your investment. Most people in the military rent, very few go thru the trouble of keeping their home long-term.
26. SLAVE LABOR. remember that when you sign a contract, there is no limit to the hours you can work. Not always abused to the extreme, or else everyone would leave. However it is abused from time to time, like when you deploy. Imagine what the military would have to pay a family physician to go 6+ months in a war zone, in a wonderful place like Afghanistan - upwards of 500K I'm guessing? The Pentagon gets one hell of a deal if you sign up
27. GREAT FOR PRIVATE PRACTICE. For every year spent in the military, that is a year lost in building up your practice.
28. MOVING (an experience you'll learn to love). I guarantee that with every single move, the movers will f*ck up your furniture. They routinely mark that it is scuffed, scratched on every side of the furniture, even if the furniture is brand new. So only with the most obsessive photo-history will you get compensated.
28. FAIR RETIREMENT. Stay in for 20 yrs so you can earn a retirement that is equivalent to what a nurse would earn for the same amount of time. Oh actually your retirement is less - remember, a nurse can retire at age 42 whereas you start at age 46.
29. MORE INTERVIEWS. Your civilian buddies get to interview typically once to get into residency. Join the military and you'll get to
interview 3, 4, maybe even 5 times! You'll interview once to get into internship. Then interview again for pgy-2 while you're an intern. Then when you don't get into pgy-2 cause you have to play GMO (as is the case for 2/3 of navy interns), then while you're a GMO, you get to interview for PGY-2 yet again. And if that PGY-2 spot is tough to get (ie dermatology), expect to interview yet again after GMO tour #2.
30: PERSONAL DEVELOPMENT: personal reasons to join the military as a physician (in addition to what the recruiter tells you):
a) you enjoy spending time away from your family.
b) the thought of being away while your child is born is appealing (for males) - this happens often, given deployment schedules.
c) if you're single, you like to stay single (kind of hard to develop a relationship if you're in middle of nowhere or on deployment or stationed in Okinawa, Diego Garcia, or Guam).
31. Sometimes you have the opportunity to be a guinea pig. Just ask the folks who previously tried refusing the anthrax vaccine. I think it's unfortunate that the British military is smart enough to not require their folks to get shot for anthrax and smallpox, but we in the US military are too dumb to follow suit.
32. Non-physicians in higher administrative positions: I roll with laughter when a non-physician congratulates one of the physician staff for having the highest RVUs (a point measurement system that measures productivity from IDC codes). A certification of "congratulations" - lol - what a friggin joke - physicians becoming the new 'employee of the month'.
33. When you're getting close to finishing your time with your commitment, don't expect to be around stateside to interview for residency. What's convenient for you has ABSOLUTELY no bearing on whether you get deployed to the sandbox. And to top it all off, by the time you finish your commitment, your civilian classmates will be ATTENDINGS while you're back to playing resident-slave.
34. Odds are (since 2/3 do GMO), you'll do your 4 yrs of GMO, and get out to do residency while your CIVILIAN CLASSMATES are now ATTENDINGS, getting their life and practices together. Perhaps you're not envious now as a medical student, but you may very well be just a whee bit put off when your civilian friends are happy they're done with training. Oh and don't forget, some specialty programs might require you to re-do your internship, and wouldn't that be lovely as well? Also this situation can make a little wrinkle in your life: you do your 4 years commitment (HPSP), and if you want a residency that is competitive (ie more than foreign MDs want it), you may be told to re-do your internship since "it's been awhile." However since you already did an internship, your program might not get funding for you to re-do your internship (so guess what, they might not pick you!). And remember - when you're applying for PGY2 - who do you think has more clout - the medical student who has been there doing a rotation, or you the applicant who looks good on paper? If you find yourself overseas (oh and btw don't forget to apply ONE YEAR EARLIER for PGY2 - some folks get burned by forgetting that little tidbit), good luck trying to finish your residency in any place other than ones that are vacant or are filled with foreign MDs.
35. I think one of the biggest reasons why people don't stay beyond their commitment is the fact that they don't factor in the stress on their family with regards to deploying or moving. They think, "i can handle a deployment to iraq, a ship, afghanistan, move overseas, etc". But when they complete all of these events, they find that things take a greater toll than they had expected with regards to their family. Thoughts include, "hmmm...my son or daughter missed a lot of time with me...don't need to do that to them again". Then off to the civilian world they go
36. If you're a pet lover, you'll want to keep your pets down to 2 cats or dogs (or 1 of each). If you go overseas, you will have restrictions. Go to Japan, and enjoy following a whole list of stuff to bring them over (you may have to keep them quarantined for 6 months). All in all, a big headache.
37. If you're single, you're going to have a very rough time trying to fix your love life with the click of a mouse button. Your
match.com pursuits will be very challenging when you write back saying you can't go on a date for the duration of your deployment
38. You think you can enjoy seeing the world in the military? Most married people, when traveling abroad, don't seem to enjoy their travels as much when their spouse isn't around. To further complicate things, you will enjoy all sorts of restrictions when you're out on 'liberty'. These include having a 'liberty buddy' (they don't want you exploring by yourself) as well as Cinderella curfews. If you stay overnight in a hotel (at your own expense), you'll enjoy calling at 6am to 'check in'.
39. GMO PENALTY. Increasingly, many of us after internship are completing 4 yrs of GMO so we can get out as fast as possible. It is also unfair to those who complete 4 yrs of GMO who then stay in the military to complete a residency. Here's how: if you're part of the 33% who go straight thru to complete residency, you'll spend (let's say a 4 yr residency) 8 yrs in the military (4 yrs residency, then 4 yrs concurrent payback). If you do 4 yrs of GMO and therefore delay residency, you spend 11 yrs in the military (1 yr internship plus 4 yrs GMO plus 3 yrs residency plus 3 yrs residency payback). And because you end up owing more yrs (11 instead of 8), if you choose to stay in beyond, you're delaying by 3 yrs all the incentive specialty pay retention bonuses, which range from roughly 30K/yr for primary care on up. In other words, a 4 yr GMO person misses out on 90K+ of specialty pay if they stay beyond their commitment when compared to their colleague who didn't do GMO.
40. Docs are deployed to war zones. Pity the person who receives a disabling injury, for I hear it's tough to perform procedures if you've lost a limb.
41. For people already in the military: transitioning to the field of medicine from another military job is insulting given the loss in rank. If you change jobs as an officer from Surface Warfare to Intel (or nukes or pilot or NFO, etc), you don't lose rank or time in rank. Only in the HPSP programs does an officer lose rank and/or time in rank !!! There's no reason why someone should make O-4 later than their ROTC/OCS/Academy classmates, just because they went from one officer job to becoming a military physician.
42. Not all physicians get promoted to O-5. If you're not board certified when you're up for promotion to O-5, you're probably not going to make it. Now it's reasonable to think one should be board certified prior to making rank as a Senior Officer. But think about this: nurses don't need to be board certified to make O-5.
43. Email and social networking sites will not work when you're at work. So no gmail, yahoo mail, hotmail, myspace, facebook, etc, etc. You'll find the military does a wonderful job preventing you from going to plenty of 'time-wasting' sites. But of course as a civilian, you can CHOOSE to check your email. Not so in the military. Your only escape is if you own an I-phone or equivalent.
44. A new bonus for physician assistants puts their pay higher than a GMO.
45. Canadian physicians make a lot more.
http://cdn.forces.ca/_PDF2010/PhysicianOpportunities_en.pdf
Canadian physicians are paid 50% of their entire pay for retirement (not 50% of a subset of their pay, ie "base pay" like US physician suckers)
After 25 yrs of service (the 4 yrs in medical school count towards the 25 yrs), Canadian physicians receive 50% of their entire pay (roughly 50% of 220K). So their retirement pay in today's dollars is 110K.
That's approximately double of what their nurses get in retirement.
Work 20 yrs in the US Military so that you can receive the SAME pension as a nurse !!!!
