IM / CC in Army vs. Navy?

[coolrunnings22]

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Hi all

I have done a lot of research and have read hundreds of old threads, but a lot of the information is outdated (and contradictory), so please forgive me if I am mistaken.

I am a non-trad 30yo post-bacc student applying for med schools in 2 years. I have spent a decent amount of time shadowing and working with various types of physicians, and am leaning strongly towards critical care medicine, and also HPSP (or USUHS).

How would the different paths likely look in the Army and Navy? Is the below realistic?

Army:
- Medical school
- 3 year IM residency
- Utilization tour (ie GMO) for 2-3 years
- CC fellowship (either at one of the two Army programs or a civilian program)

Navy (GMO):
- Medical school
- 1 year internship
- 1-3 year GMO tour
- 2 (?) year IM residency
- ?
- CC fellowship (likely civilian)

Here are my questions:

1. Is the above correct?
2. Which service offers a higher chance of a "better" IM residency?
3. Which service offers a higher chance of a civilian CC fellowship, and how does this work?
4. What would the remaining ASDOs be in each of the above scenarios?
5. Post fellowship, it seems like in the Navy, given you have likely already done a GMO tour, you are relatively (vs. Army) protected from further GMO type work? I would be OK to deploy at this stage, but not as a GMO.
6. Post fellowship, are there hospitals in each branch that an intensivist would most likely find him / herself?

Thank you all

 

[AvrgPreMedKid]

I would say that the Army offers a better chance than any branch of getting the specialty you want, simply because they have the largest medical corps. This is the reason I am in the process of commissioning for Army HPSP. But remember, if you do HPSP, you are doing a minimum of 4 years active duty after residency. You can end up with a longer commitment if you get a longer residency training like general surgery or something.

I think an IM residency in the Navy or Army would provide you solid training; however, the chances of landing an IM residency would probably be better in the Army. You would more likely do a GMO tour with the Navy as you pointed out. Your timeline for the Navy seems about right, but I'm not sure you understand the time commitment.

As for fellowships... If you are very competitive, you might be able to go straight from IM to CC fellowship, but consider that your service payback requirement may be lengthened. You may also be able to work as a GMO after IM residency or just work as an IM doc for some time in the Army and then apply for fellowship. I believe the military values seniority when it comes to applying for residency/fellowship positions. But, once again, consider the lengthened payback requirement.

I'm not sure about your questions regarding civilian fellowships. I do believe you are correct in regards to being protected from GMO tours in the Navy once you have done one and gone to residency. The Army is notorious for sending residency-trained docs on GMO tours, so I hear.

I'm a little scatterbrained right now because I'm under the weather. Hope I provided some helpful info. Thanks for your willingness to serve.

 

[WernickeDO]

1: Mostly, as noted already you are more likely to go straight through in the Army, but there are no promises for fellowship. You may need to do some time in some assignment, which is not necessarily the dreaded brigade "surgeon" tour, but you could end up in a very low volume/acuity place, like Ft Polk or Leavenworth.
2: Not in a position to comment, but remember that the Army has the most residency slots.
3: Not sure if either service makes a difference in the civilian world, both are respected.
4: So if you do HPSP you owe 4 years active duty, providing you do not take on additional training. Intern year neither pays back nor accrues. So 3 years IM + 3 years Pulm/CC - 1 year internship = 5 years of training, so you will owe 5 years AD time. If you get out after that then you will be at 11 years. If you go to USUHS, your ADSO will be longer. Bear in mind also that if you end up in a GMO for 3 years and then go IM, you will accrue more ADSO. This is one of the nasty surprises they don't tell you about when you sign up.
5: Can't comment on the Navy, but I know that the Army has no problem taking sub-specialists out of the clinic and killing their careers with brigade surgeon tours.
6: I think you're asking if you will be sent to the larger teaching hospitals as opposed to the smaller facilities. The answer is that no one knows, and there is no way to predict where you and your family will end up. If you think that they will not waste an intensivist on a clinic with healthy 20 year olds or an ICU with 3 beds, think again. The military loves to send the new guy to the middle of nowhere, or chain you to a desk to attend endless briefings staffed by O5s that love to talk.

If you have any goals within medicine, then you should avoid the military at all costs. Please read this forum extensively and hear the stories of people whose careers were put out to pasture to serve the greater good of the military. If you truly want to serve, consider FAP or joining after you are board certified and fellowship trained. HPSP surrenders too much of your freedom and ability to pursue a medical career. Take heed.

 

[Gastrapathy]

Navy trains almost no solo CC, it's all Pulm/CC. It has not been competitive for a while and most people go straight from residency if desired. IM residency is about 75% straight through as well.

That being said, you are making a plan based on fellowship before starting med school which is like choosing your NASCAR team before getting a drivers license.

 

[Shikima]

That being said, you are making a plan based on fellowship before starting med school which is like choosing your NASCAR team before getting a drivers license.

What if you lost your drivers license from multiple DUIs?

 

[HighPriest]

What if you lost your drivers license from multiple DUIs?

If you think stoplights are what's missing from Nascar, you're instant command material.

 

[Shikima]

If you think stoplights are what's missing from Nascar, you're instant command material.

1 star baby!

 

[coolrunnings22]

Navy trains almost no solo CC, it's all Pulm/CC. It has not been competitive for a while and most people go straight from residency if desired. IM residency is about 75% straight through as well.

That being said, you are making a plan based on fellowship before starting med school which is like choosing your NASCAR team before getting a drivers license.

Thank you. Does the Navy offer CC/Pulm fellowships , or would you receive a deferred or sponsored civilian fellowship?

My question above regarding fellowships may have been confusing. I meant to ask "which service would be more likely to offer a deferred or sponsored civilian fellowship" rather than asking which would be more attractive to civilian fellowships after separation.

Thanks again

 

[Gastrapathy]

Navy fellowships were having trouble filling when last I was around so outservice fellowship was not an option (they fill their own fellowships first). TBH, you'd be better off with an inservice fellowship. The training is fine and it doesn't stop the clock.

Now, what happens when you discover you always wanted to be a pediatric subspecialist? Thats another story.

 

[psychbender]

Right now, neither service will defer training for intensivists. The Army trains all the intensivists that they think they need in-house through either Pull/CCM or medicine CCM (open to EM, as well). They only seem to train one anesthesiology-intensivist internally every three or four years. I think they allow trauma surgeons to train externally, but that's it.

Sent from my SM-T700 using SDN mobile

 

[coolrunnings22]

Thanks again.

It seems in the Army you could do an IM residency in a number of locations, but they only have CC at Walter Reed.

In the Navy you could do the IM residency at any of the three main locations, and then a CC fellowship at either Walter Reed or San Diego.

That leaves me with the following questions:

1. How do these three fellowships compare to the best civilian fellowships (Pitt, UW, etc.)?

2. How would Walter Reed compare to San Diego?

3. Which Army and/or Navy location would provide the best IM training?

Thanks all