military and EM?

[stud247]

Would it be a good idea to do hpsp if you are certain that you want to go into EM? Let's pick 2 cases: if I go to a DO school, it is expensive and it will be harder for me to specialize. So it will be only natural to do Navy. But if I get into a state school?

I am interested in the navy because i would like to do something that you don't normally do as a civilian. I.e. riding a submarine and visiting Iraq. But in the navy I would do 1yr of intnernship and 4yrs of this work. And what bothers me is that once I do a civilian residency, I would still be inexperienced? So it might take another 5 years before I gained the reputation to get one of the better jobs and settle down and take long vacations to travel and do mountain climbing? So is there any way not to waste the 5yrs but still do the military? Or should i just forget it?

I also know that in the army there is a good chance to go into residency straight through. And I suppose that when you work as an attending in the army you gain the experience that would set you up for a nice civilian job. But in the army I would not get to dive or ride on a ship or a submarine..

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[BeatArmy]

Lots of info in the military med forum.

My personal advice to someone who is coming to med school without prior service is to NOT do hpsp, even if you know for certain that you want to be a military doc.
Take the debt for now. You can get the money from the military later and be in a lot better position to negotiate. Or at least to know what you are going to be doing before you sign. The military gives you opportunities to take the money at every step of the way.
For example, if you are concerned about continuity of training, you can wait until you have secured a civilian residency, then take the money and your service starts once you finish residency.
Or, if as 4th year approaches, you decide you would like to do some GMO stuff for a few years before residency, you can take the money then and do it.

In your case, if the number of years until you are able "to get one of the better jobs and settle down and take long vacations to travel and do mountain climbing" is your major concern, then give serious thought before signing. The military, by any route, will likely delay this goal. However, there are many other rewards to service.

Good luck.

 

[DogFaceMedic]

The Army has straight through contracts for EM. You would go GMO if you did not match in EM. But, as always, talk to guys who did/ are in military medicine. If you have a big tuition bill and would consider a stint in the military outside of medicine anyway, then bonuses and income without the debt and accrued interest is worth it. I am prior-service, so my pay scale is higher than new MDs, and I knew what I was getting into and have no excuse.

And, by the way, with all due respect to my above colleague: Beat Navy.

 

[Doctor Bob]

Would it be a good idea to do hpsp if you are certain that you want to go into EM? Let's pick 2 cases: if I go to a DO school, it is expensive and it will be harder for me to specialize. So it will be only natural to do Navy. But if I get into a state school?

Harder to specialize as a DO? Umm... well I won't address that because it's a little off topic. What is relevant is that when it comes time to do the residency application through the military (which you will be required to do as an HPSP person), they won't care if you're MD or DO. One does not carry any more weight than the other in the eyes of the military.

So before it ever becomes an issue with applying to civilian programs (the DO vs MD), you'll have to secure a "civilian deferred" spot with the military. If you don't get one, then you're stuck doing an internship and potentially a GMO tour (depending on the branch). If you do get a civilian deferred spot, well then you're a really good applicant and are nearly guaranteed to be able to match in the civilian matches (because the hurdle to get into ER through the military is a bit higher than in the civilian world).

That being said, if you have to do an internship straight out of school, and then go back into the military match the next year (if you're army or air force), you've got a much better chance of getting a spot, either military or civilian deferred, and then a much better chance of getting a civilian spot in the ACGME/AOA matches.

I wasn't succesful in getting a civilian deferral spot right out of medical school and did a year of surgical internship with the Air Force. Halfway through internship year, the match came around again and this time I was succesful in getting a civilian deferral, and succesful in getting the civilian residency.

 

[docbooboo]

You should also know that even if you are able to get deferred for a civilian residency and complete your residency training, you are not guaranteed to an ER position when you become active duty. You might end up as a GMO, as the military still needs to fill these spots with someone.

 

[Arcan57]

Civilian EM pays well enough that the debt incurred from training is formidable but not overwhelming. If you want to do military service, then obviously joining up makes sense. If you are just looking at it as a means to an end (ie. financial stability/freedom), the trade-offs in terms of personal freedom and (potential) limitation of career choice are substantial.

 

[Static Line]

But in the army I would not get to dive or ride on a ship or a submarine..

Ok - I don't see what you are missing but if that's what floats your boat... In the Army you will get to jump outta planes, helicopters, and anything else that goes airborne. You can jump from real low altitudes (hundreds of feet) or real high altitiudes (thousands of feet). I am a diver and a former paratrooper. I never got sick of jumping. On the other hand, sport diving in the Bahamas isn't the same as Military diving. If the high speed stuff is what you are after, Army special ops is a much bigger world than what the Navy can offer you.

Regardless, your choice to go into the military should be out of a desire to serve your country, not what the hpsp can do for you. Financially, as an EM doc you will do considerably better in the civilian world. However, I am glad I did it through Uncle Sam. I got to see things, do things and be a part of some really cool missions. None of which a civilian will ever get to do

 

[medivac]

MDs don't ride submarines. Sorry. They have IDC's (independent duty corpsmen). Too much of a resource to assign one doc to a small crew. You can fly. PM me, and I can give you my experiences. In my EM residency right now there is me, an MD, and a classmate, a DO, who were both flight surgeons for the full pay back time prior to going civilian.

 

[southerndoc]

MDs don't ride submarines. Sorry. They have IDC's (independent duty corpsmen). Too much of a resource to assign one doc to a small crew. You can fly. PM me, and I can give you my experiences. In my EM residency right now there is me, an MD, and a classmate, a DO, who were both flight surgeons for the full pay back time prior to going civilian.

That's odd. A recruiter told me they did, particularly those studying underwater and hyperbaric medicine.

Then again, a recruiter will tell you anything to try to get you to sign on the dotted line.

 

[stud247]

Thank you all for the replies. I searched the military forums extensively. I read the posts from NavyDiveDoc from 2004. He made navy 4yr dmo tour sound as the best career option. Actually he said that he spent a number of days aboard submarines.. Of course you do not get as much "operational" experience as a submarine officer or a diving officer, but certainly you get enough to translate it into some nice hobbies for after you get out.

My only problem with the military is that GMO's get paid $80k/yr while civilian EM get paid $300k/yr and work fewer hours per week. So those 5 years that I'll be "having fun" I will not be able to do things like raise a family. You mentioned that sport diving is not the same as military diving. That's right-unless you make $300k/yr the most sport diving you'll ever get is 1wk per year in the bahamas. And you will probably get the minimal diving certificate because you just do not have the time to waste on several months of courses to become a real diver. Sure you can get all the fancy certificates, if you are obsessed. But I think it would be fun to have a job which even if it's 90% regular primary care medicine, still involves something cool like diving. But I would not want it to hurt my career. How terrible would it be if I "wasted" 5yrs in the military and then couldn't even match into my intended specialty?

Flight Surgery would be another job that I would be interested in. But I have a lack of depth perception and terrible nearsightedness in 1 eye (I do not wear glasses and intend to get a civilian ppl when I have the time/money). I read that depth perception is not waiverable for FS. I haven't read anything about the army that would make it sound cool. You only have like 1 or 2 doctors per year who are allowed to go to the Navy's diving medical officer school. It seems that I would be more likely to spend my time in the army somewhere in louisiana.

I wonder if I do well enough on step1 and then become a GMO or whatever, may I just spend the 5yrs in the navy not worrying about anything? Would I basically get to spend all my 4wk vacations going to bahamas or europe and enjoying myself? Would I be set for the civilian residency, or would I have to do something to compensate for the fact that I don't get to do clerkships at the sites where I am applying for residencies?