JSGMESB Question

[Bordeaux]

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Here is my situation. I am applying for a competitive field within the military match. I have worked hard in medical school, and stand a good chance of matching into a military position...which is my biggest fear (since military programs can fold overnight, and the quality of training is questionable as docs tend to be only a few years older then the residents they are training, and there is a high turnover of staff attendings). Civilian defferment positions (my preference) this year are slim to none.

The results from my civilian interviews thus far have been very encouraging as I have interviewed at half the top ten programs in my field. This leads me to my dillema. Do I go ahead and accept a military position (assuming one is granted to me) and use my four year commitment as experience before moving on to fellowship.....or do I simply decline my military position, pay my 4 years back as a GMO/flight surgeon , and then go on to receive training at a top tier program? Money is not an issue in my decision...only quality of training.

I would like to hear from people who have gone ahead and done their four year commitments as GMOs and then gone back and entered residency training as a PGY2. Was it very difficult to go from a relatively low volume, non- academic environment such as flight surgery to the university residency setting? Any input would be much appreciated.

 

[backrow]

(since military programs can fold overnight, and the quality of training is questionable

Have you ever rotated at a military hospital? I think I'd take my chance on the military program over a civilian program when it comes to "fold[ing] overnight."

The only program that folded was at Keesler and that was because the hospital was destroyed in a hurricane. All the residents from all the programs were placed in programs in other military hospitals, none really had to scramble. Now ask what happened to those residents in New Orleans? I doubt they had it as easy as those in the military programs.

I also take exception to your statement that the "quality of training is questionable". Again did you ever rotate at any of the programs? From this statement I would doubt it. The training may not be on par with some of the absolute top tier programs in the country, but I would say it is better than "questionable."

Sorry I can't be of help to your actual question, but your statements made seem to be from someone with little actual exposure to a military program other than what the hear from others.

 

[The White Coat Investor]

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[rad-doc]

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[rad-doc]

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[FliteSurgn]

Have you ever rotated at a military hospital? I think I'd take my chance on the military program over a civilian program when it comes to "fold[ing] overnight."

I also take exception to your statement that the "quality of training is questionable". Again did you ever rotate at any of the programs? From this statement I would doubt it. The training may not be on par with some of the absolute top tier programs in the country, but I would say it is better than "questionable."

Sorry I can't be of help to your actual question, but your statements made seem to be from someone with little actual exposure to a military program other than what the hear from others.

I would say that the residency training I observed in the military was definately sub-par to MOST civilian training programs in surgery. In fact, I had planned on doing a military general surgery residency until I rotated through as a med student during my HPSP AD tours. At that point, I was absolutely horrified that I might end up in one of their training programs.

 

[Bordeaux]

Just to clarify a few points:

I have rotated at 2 military hospitals, and I believe that the training specific to my field (sorrry for being 'sneaky' its just my preference) is not optimal. That being said I cannot speak for other fields.

Advantages of military residency include financial/ healthcare benefits, and maybe some extra free timw to study for boards. Major disadvantages accross many fields include a select patient population which does not include many if any HIV and transplant patients to name a few.
Also...these programs can close overnight. It's not just Keesler: For eg. if you could let me know what happened to Travis AFB in California and its IM and ObGYN programs I would love to know.

As for top ten programs, you are right. This is my subjective opinion on what I beleive to be the strongest and most desirable academic civilian programs, and my preference would be to train at one of these programs....big question is: Is it worth it to do a four year GMO tour and then start residency as a PGY2?

Your comments have been helpful ( especially rad-doc ????). If anyone has actually done a four year GMO tour and then enetered civilian residency please share in your experience as it would be very much appreciated.

 

[orbitsurgMD]

Just to clarify a few points:

I have rotated at 2 military hospitals, and I believe that the training specific to my field (sorrry for being 'sneaky' its just my preference) is not optimal. That being said I cannot speak for other fields.

Advantages of military residency include financial/ healthcare benefits, and maybe some extra free timw to study for boards. Major disadvantages accross many fields include a select patient population which does not include many if any HIV and transplant patients to name a few.
Also...these programs can close overnight. It's not just Keesler: For eg. if you could let me know what happened to Travis AFB in California and its IM and ObGYN programs I would love to know.

As for top ten programs, you are right. This is my subjective opinion on what I beleive to be the strongest and most desirable academic civilian programs, and my preference would be to train at one of these programs....big question is: Is it worth it to do a four year GMO tour and then start residency as a PGY2?

Your comments have been helpful ( especially rad-doc ????). If anyone has actually done a four year GMO tour and then enetered civilian residency please share in your experience as it would be very much appreciated.

I did that and a fellowship to follow. If you are already obligated and you think the military residency programs are inferior, or know that you really want the best possible opportunity to do a fellowship right away, then it is about the only way to go. The four year delay stinks, especially since your med school classmates are by then finishing their longer residencies, but that is how it is with HPSP. It is a big negative, maybe the biggest negative about the HPSP deal (not that GMO is anything wonderful.)

With the military, you aren't assured even the chance to do a fellowship, especially if there is pressure to fill unattractive billets with "utilization tour" graduates (as if your GMO time wasn't "utilization" enough.)

I don't think it helped me or hurt me, but I wouldn't say that would necessarily be the case in every specialty. For some, ex-mil is a definite plus, for others it makes you different and in some ways hard to compare with other applicants, even perhaps a little intimidating.

 

[colbgw02]

to the OP, when i was in your position, i decided to just go for the military residency. the idea of delaying my education for an additional 4 years in the middle of an already decade-long process was too much for me to bear. also, being a GMO is about as far away from my chosen field as one can get.

then again, i didn't really appreciate a considerable drop-off in the quality of training between my military program and the civilian ones i was considering. sure, the military program doesn't have the name recognition that civilian ones do, but unless you're going into academic medicine that typically doesn't matter too much.

 

[BomberDoc]

I'm 2.5 years into my 4 year GMO tour and applying for civilian residency. So far, programs are being very cool and accomodating for my situation as I'm deployed and won't return to CONUS until after interview season. Some are allowing late interviews and others are doing telephone interviews and just want to meet me in person whenever I get back.

There is something to be said for serving in the military. It matters. People appreciate it. It also sets you apart from 99% of the other applicants. This is an advantage. You will have experience vastly greater than the med students with whom you are competing for residency.

Mil med is badly broken and I wouldn't join again or recommend anybody else join, but I already made that mistake and now I'm using those lemons to make lemonade.