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haujun

haujun

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According to a medical director (O-6) of the Army teaching hospital over 80% military docs leave after completing the required years of service (*before the war*). Not suprisingly, the docs are leaving left and right during this post war and deployments.

Are most you planning staying until your retirement? Why or why not?

More importantly, do you think military facilities will suffer in the areas of teaching the residents , care for troops etc as result of this departure...
 
Will this increase the number of full deferments???
 
Originally posted by haujun
According to a medical director (O-6) of the Army teaching hospital over 80% military docs leave after completing the required years of service (*before the war*). Not suprisingly, the docs are leaving left and right during this post war and deployments.

Are most you planning staying until your retirement? Why or why not?

More importantly, do you think military facilities will suffer in the areas of teaching the residents , care for troops etc as result of this departure...
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I haven't yet decided if I'll leave as soon as my requirement is fulfilled. I think it'll depend on how much I like my military position. But then again, if I'm working for 120k, and I got an offer from the private sector for 250k while my kids are getting old enough to start worrying about college, it may be pretty of hard to refuse.
 
I think it really depends on a persons specialty as to whether they stay or go. For example, a military family doctor or internist makes roughly not much less than their civilian counterparts with majors pay. However, if you're a radiologist or a surgical specialist, the civilian world is paying 2-3 times what the army will pay you and you would not have to relocate multiple times, why not go under those circumstances?
 
Have to agree with bustbones....specialty is the big decider. I don't intend to stay in right now, but that is a long way off. You loose the "Loan payback" advantage after your initial commitment is up. At my tuition and what I am getting in a stiped, it is as if I will get another 66K a year during payback (evne though I am recieving it now). After that...well we will see.
 
Originally posted by haujun
According to a medical director (O-6) of the Army teaching hospital over 80% military docs leave after completing the required years of service (*before the war*). Not suprisingly, the docs are leaving left and right during this post war and deployments.

Are most you planning staying until your retirement? Why or why not?

More importantly, do you think military facilities will suffer in the areas of teaching the residents , care for troops etc as result of this departure...
Click to expand...

I think everybody knows what I'm doing, and yes, training programs suffer immensely because of difficulty in retaining physicians.....well, at least the subspecialties....FP, peds, and IM seems to always do ok.

Other than the truely committed and dedicated, the physicians who are good at what they do, get out and make a lot more money and practice medicine. At least that's my experience in the 7 years that I have been an attending.
 
Originally posted by bustbones26
I think it really depends on a persons specialty as to whether they stay or go. For example, a military family doctor or internist makes roughly not much less than their civilian counterparts with majors pay. However, if you're a radiologist or a surgical specialist, the civilian world is paying 2-3 times what the army will pay you and you would not have to relocate multiple times, why not go under those circumstances?
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i agree. i think simply raising pays to be competitive with the civilian world would do wonders for retaining physicians, and in the long run would actually save them money since they won't have to be paying for the education and training of replacements.
 
Military does not want to give out a civilian deferment because those who perform the post graduate training at civilian institutions typically do not make a smooth transistion into military life after the training. And they amost aways get out after the required years of service.
Those who are make good transition into military life will stay in the military for non-monetary reasons.
 
Those who are make good transition into military life will stay in the military for non-monetary reasons.
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I think you are definitely right about this...I also think most USUHS grads stay in after their commitment b/c after seven years (and GMO's for Navy) it just makes sense to retire military. Heck...for me..I can retire at 46 (and this will equal 24 years for my retirement pay).
 
Originally posted by Homunculus
i agree. i think simply raising pays to be competitive with the civilian world would do wonders for retaining physicians, and in the long run would actually save them money since they won't have to be paying for the education and training of replacements.
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There's talk of congress raising the multi-year special pay to help with retention. Who knows when or if they'll approve such a thing.

As of right now, I plan on staying in after my 4 year payback.
 
Originally posted by Andrew_Doan
There's talk of congress raising the multi-year special pay to help with retention.
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They are so full of it. There has been talk of changing title X for the longest time. They can't even accomplish the simplest thing - make the lousy HPSP stipend tax-exempt.🙄

It's not all about the money, either. At this point, I don't see myself staying beyond my committment of 4/5 years. I don't want to have to deal with deployments longer than I have to. A promotion system based on military aptitude doesn't help with retention, either

I'm also not too fond of having to do a military residency - but that's a different story.
 
Originally posted by Andrew_Doan
There's talk of congress raising the multi-year special pay to help with retention. Who knows when or if they'll approve such a thing.

As of right now, I plan on staying in after my 4 year payback.
Click to expand...

The military is constantly looking at how to improve retention. We get surveys asking us what makes us dissatified, how to make things better, etc...., and guess what comes out as the number 1 reason why physicians are getting out.

It is lack of leadership. Pay comes out at the bottom of the list. I know everyone is going to ask for a reference, but unfortunately I don't have a web-link...I'll look and see if I can find it.
 
Originally posted by idq1i
They are so full of it. There has been talk of changing title X for the longest time. They can't even accomplish the simplest thing - make the lousy HPSP stipend tax-exempt.🙄

It's not all about the money, either. At this point, I don't see myself staying beyond my committment of 4/5 years. I don't want to have to deal with deployments longer than I have to.
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quite true, they couldn't even pay this year's ISP on time. I think late November was when people finally got paid....oh and back dated to October1 for when it was supposed to be paid.
 
There are few more factors to consider.

One is deployment. It doesn't matter what your specialty is, you may get deployed to be a GMO somewhere. There was one pediatric oncologist from BAMC that got deployed to be a doc-in-the-box in Iraq -- it wiped out there Chemo and BMT program. Can you imagine how much it cost to outsource that? No logic to it. Most people don't want to spend 3 months - 1 year away from their family.

Second is all the BS. The bureacracy, the civilian government (no work) employees. Having to make weight and PT for promotion. Add to this the chance of getting sent to FT. Sill.

Ed
 
Originally posted by edmadison
There are few more factors to consider.

One is deployment. It doesn't matter what your specialty is, you may get deployed to be a GMO somewhere.
Click to expand...

This is true. With the reduction of Army GMOs, there's not enough to draw from for deployment. My friend in the Army was given word that Army ophthalmologists are being called up to be GMOs and are being sent to Iraq.

I'm in the Navy where GMOs are still in good numbers, but I feel it'll be only a matter of time before Navy GMOs will be called up too.

I don't mind being deployed and feel this is my duty; however, for those who weren't prepared for deployment, this is a huge drawback.
 
Originally posted by Andrew_Doan

I don't mind being deployed and feel this is my duty; however, for those who weren't prepared for deployment, this is a huge drawback.
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I will anxiously await for the time when you actually join the ranks of active duty physicians, and start performing the duties that you have only heard about, then we'll see about your enthusiasim.

I plan on looking at these posts for the next 5 years. I'm actually going to save your posts, and I will wait to see if you change your mind.

I suspect that when you are doing rectal exams on 20 year olds complaining about back pain so they don't have to stand watch, you'll think differently.:laugh:
 
An optho exam that includes a rectal - now THERE'S a conscientious doc! :laugh:
 
Originally posted by militarymd
I will anxiously await for the time when you actually join the ranks of active duty physicians, and start performing the duties that you have only heard about, then we'll see about your enthusiasim.

I plan on looking at these posts for the next 5 years. I'm actually going to save your posts, and I will wait to see if you change your mind.

I suspect that when you are doing rectal exams on 20 year olds complaining about back pain so they don't have to stand watch, you'll think differently.:laugh:
Click to expand...

Save my posts. I can assure you that I don't mind doing my duty. At the most, I'll be a GMO for 6 months, if needed. However, being in the Navy with plenty of GMOs, I don't think the NAVY is going to actually make me a GMO.

They do send ophthalmologists to war zones, and I without a doubt, will not have any problems supporting our troops.

Also, being paid a six figure salary to do rectal exams on 20 year olds complaining of back pain is fine with me. In addition, I won't owe taxes while in a war zone, so my salary will be generous. If that's what the NAVY needs, then I'm there! 🙂
 
Originally posted by JKDMed
Judging from your signature, you didn't do the "required" Navy GMO tour. How did you manage that?
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I waited until I matched in ophthalmology and then was commissioned under the FAP (Financial Assistance Program: http://www.navy.com/jsp/career/career_details.jsp?cid=3&pid=1). This option allows you to determine your specialty and allows you to complete a civilian residency training program. Both are of great concern for students currently in the HPSP.

The FAP is a nice way to become a specialist for the military. It'll give you an extra $40K/year with about $30K/year after taxes. For those with ~$150K student loan debt, you can easily pay off those loans during a 5 year residency program. With a 4 year ophthalmology program, I'll have $120K at my disposal.

The payback is 1 year plus each year of support. If you leave after your payback, your salary is then generous because you've received a substantial portion of it up front. I think the FAP is a good option for those interested in a military career but also want to make sure they receive training in a particular specialty.
 
Thanks for the insight. I'm still debating between no military, HPSP, and now FAP. Of course, getting into medical school at all would be a nice first step.

My greatest concern was how the life of a military doc would affect family, because I will be married going through medical school and residency. It is something I would like to do, but I don't want it to hurt my family life more than med school and residency already would have.

Thanks for the FAP info, I will definitely keep that in mind. Also, I have to ask, why Navy?
 
Originally posted by JKDMed
Thanks for the insight. I'm still debating between no military, HPSP, and now FAP. Of course, getting into medical school at all would be a nice first step.

My greatest concern was how the life of a military doc would affect family, because I will be married going through medical school and residency. It is something I would like to do, but I don't want it to hurt my family life more than med school and residency already would have.

Thanks for the FAP info, I will definitely keep that in mind. Also, I have to ask, why Navy?
Click to expand...

I'm married with kids, and I have a wife who enjoys traveling and living in different cities. We've moved around so much for medical school and residency that it's part of our way of life.

We picked the Navy because it has a large medical corps and the bases are located in nice costal cities. Look at what I get to pick from in regards to assignment:

http://www.persnet.navy.mil/pers4415/Medical_corps_ophthalmology_page.htm
 
I've been off active duty for a couple of years now going to med school but as I recall only a portion of your basic pay is tax exempt in a war zone and for officers (I was an O-4 when I got out) it turns out not to be that much. Your hazardous duty pay is another story, but that's not going to make you rich either.

That said, I too would be willing to do rectals for $120K/year, in fact I'm interested in urology so that may turn out to be the case!

I'm curious to know what facts haujun's statement about residents doing FTOS having trouble adjusting to the military or whatever is based on. If someone did HPSP and then a full deferment, maybe, but I'm not so sure about FTOS. For a surgical specialty a Navy HPSP'er who does 1 year transitional and then FTOS of say five years, has 11 years active duty at the end of their committment plus the HPSP years toward calculation of retirement pay after 20 years active duty. I don't think that's much different than someone from USUHS. I had 13 years active as a Naval Aviator and turned down a USUHS acceptance to go to a civilian school on HPSP, and I don't think my motivation to stay after FTOS would be any different than an in-service residency. The military does not "give out" deferments, they allocate them in a given specialty based on projected demand, attrition and people in the pipeline. Granted it's not much more than a shot in the dark, but they do reason it out and I don't see how doctors' attitudes at the end of their committment can be figured in to that!!!


My .02, more than you asked for,


Spang
 
General Surgery has quite a few one-year onboard billets. 😱 Psych. has some nice locations though. Anyways, back to trying to GET IN to medical school. 😀
 
I don't know why transition to military life would be that difficult for docs coming out of civilian vs military residency. There isn't any really overt "military bearing" in a military teaching hospital (at least on the Navy side of the house). The atmosphere is essentially the same as its civilian counterpart in my experience. The only difference is in little things like white coats covering scrubs when out of the OR or khakis on clinic days.
 
Hi all, I am new to the forums but this thread caused me to go ahead and join so I could post.

My husband is an Air Force (HPSP) major who has a year and a half left of a four year committment. He was selected for an active duty residency. There is definitely a steep learning curve for physicians who come into the military after civilian residencies....all of the acronyms alone take awhile to learn, as well as the whole military sub-culture, leave, chain-of-command, etc.

As far as docs getting out.....our experience is OF COURSE they do. Military medicine at small bases is a very different animal than military medicine at the large medical centers, as my husband found out. He is very satisfied with his residency training, but a few of the doctors he has worked with since he has been staff have had skills that were suspect, at best. Deployment is a constant threat, and speaking from my perspective, as a mom with school age children who has already moved twice, both times far from family, that alone is enough to make us get out, even if the salary differential (~100K for DH's specialty) did not exist. Add in assignments officers who don't give a rat's ass about preferences or what would best serve a particular base, not being able to take leave because of staffing issues, no control over the support staff you have, or how many you have, and OH YES, the tens or thousands of dollars in bonus payments that were a month late in 2003........DH has no intention of staying in, and neither does anyone else we know who owes only four years.

We have had some good experiences with the military, but all things being equal, we would not go this route again. Uncle Sam gets his back, and then some, from people who take the scholarship. DH has been proud to serve his country, but oftentimes not proud of the type of medicine he has been forced to practice due to military constraints.

Sally
 
Thanks for the response Sally. I find that interesting indeed. Of course I already accepted so it doesn't much matter, but I do doubt I will stay in longer that my 3 years....unless I do family practice, then geting retirement at 46 and still being able to go out and join a practice could be intriguing....but probably not.
 
Andrew_Doan said:
There's talk of congress raising the multi-year special pay to help with retention. Who knows when or if they'll approve such a thing.

As of right now, I plan on staying in after my 4 year payback.
Click to expand...

So Andrew, what are you doing these days?

Are you active yet? and do you still plan on staying past your 4 years>?
 
elderjack21 said:
Love these old threads. Nothing ever really changes.
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It truly is like deja vu. Everything I've been saying has been said before. Arguments from snot nosed med students and residents and "patriots" abound. Its amazing how history repeats itself. I see a number of names that do not post again, mostly who argued for milmed. I wonder what happened to them when they got a shot of reality? A few here claim they will report back, but I think when people realize they've been bamboozelled, they are too embarrased to come back and tell people their worst fears are now coming true.
 
Galo said:
It truly is like deja vu. Everything I've been saying has been said before. Arguments from snot nosed med students and residents and "patriots" abound. Its amazing how history repeats itself. I see a number of names that do not post again, mostly who argued for milmed. I wonder what happened to them when they got a shot of reality? A few here claim they will report back, but I think when people realize they've been bamboozelled, they are too embarrased to come back and tell people their worst fears are now coming true.
Click to expand...

this is the first thread i just started reading about the military route... there's so much to read, and I don't even know where to start....and you just scared the crap out of me...:hardy:
 
phospho said:
this is the first thread i just started reading about the military route... there's so much to read, and I don't even know where to start....and you just scared the crap out of me...:hardy:
Click to expand...


What's amazing is that these posts are dating back to 2004, and things have only gotten worse.

Read the stickies, avoid military medicine, decline of military medicine, etc. You will see that there is lots of info speckled with emotional fights on both sides. Feel free to PM me or others, but most important make sure you do your diligence and find out as much as you can about military medicine before you just sign your career and part of your life away. As always, you must call up as many active duty physicians and get it straight from their mouths, instead of a bunch of anonymous internet posters. If you want to talk to me, send me your # and I will call you back and tell you what my experience was.
 
Galo said:
What's amazing is that these posts are dating back to 2004, and things have only gotten worse.

Read the stickies, avoid military medicine, decline of military medicine, etc. You will see that there is lots of info speckled with emotional fights on both sides. Feel free to PM me or others, but most important make sure you do your diligence and find out as much as you can about military medicine before you just sign your career and part of your life away. As always, you must call up as many active duty physicians and get it straight from their mouths, instead of a bunch of anonymous internet posters. If you want to talk to me, send me your # and I will call you back and tell you what my experience was.
Click to expand...

you are awesome...thank you...i've noticed that you and militarymed and neuronix are very active and have been very opinionated about this. You guys also back up your statements with proof/facts, which I have found very reassuring. Also frightening, since it's a huge wake up call for me. I'm taking my MCAT in a month, so I definitely have plenty of time to research this. I promise I will go through every single thread before I make any decisions, and will definitely bug active duty physicans as much as I can. Thank you very much for helping out the lost people like myself...😍:luck:
 
The latest leadership conference revealed the fact that physician retention in the Air Force is now a whopping 6%. I don't know if that is retention at the first available point to get out or if it is global retention including the higher-ups who have stayed past their initial commitment. Regardless, it is frighteningly low.
 
BomberDoc said:
The latest leadership conference revealed the fact that physician retention in the Air Force is now a whopping 6%. I don't know if that is retention at the first available point to get out or if it is global retention including the higher-ups who have stayed past their initial commitment. Regardless, it is frighteningly low.
Click to expand...

Good thing AF HPSP is still meeting 100% of their available scholarships, otherwise I might have to worry about a stop-loss. Keep the GMO/FS pool comin' (At least until 2010) 😉
 
Galo said:
lots of info speckled with emotional fights
Click to expand...


some threads are also lots of emotion speckled with info. some forego the info completely :laugh: s'ok though-- the outlet is good for people, as long as it doesn't get *too* bad. a few threads i've teetered on intervening, but for the most part this forum tends to do ok.

and BomberDoc-- 6%? jeebus! that's bad. i know army peds was 3.5% (1/28) but for an entire service (especially the airforce where deployments aren't as bad) that's. . . bad.

good news is that those of us with longer commitments will get promoted just by having a pulse 🙂

--your friendly neighborhood pulse-exhibiting caveman
 
Homunculus said:
and BomberDoc-- 6%? jeebus! that's bad. i know army peds was 3.5% (1/28) but for an entire service (especially the airforce where deployments aren't as bad) that's. . . bad.
Click to expand...

Seriously. I'll probably avoid the stop-loss, but five bucks says the AF stops filling its pipeline in the next year or two. Sethco, you might have something to worry about. Word is getting around, folks. The AF medical service is mortally wounded.

We have long been seen as the cush service. Hell, that is why I joined the chair force instead of the Army or Navy. Our PAs and IDMTs (IDC equivalent) are doing 12-15 month deployments. We are filling an ever increasing number of In-Lieu-Of taskings for the Army. The talk AF wide is increasing standard deployments from 4 to 6 months. Yes, still not Army 12 month style, but things are a-changin'. Naturally, physicians are voting with our feet since there is no way we can get leadership to understand that things are bad.
 
Military is immune to 6% retention numbers for docs. They'll just give those slots to PAs and NPs and call them "physicians" to make their metrics look good.
 
MacGyver said:
Military is immune to 6% retention numbers for docs. They'll just give those slots to PAs and NPs and call them "physicians" to make their metrics look good.
Click to expand...

The PAs are getting out in droves, too. They are already feeling the pain of year long deployments with the AF. NPs are nurses and as such, don't have to see patients or deploy. They only command those who do.
 
Homunculus said:
some threads are also lots of emotion speckled with info. some forego the info completely :laugh: s'ok though-- the outlet is good for people, as long as it doesn't get *too* bad. a few threads i've teetered on intervening, but for the most part this forum tends to do ok.

and BomberDoc-- 6%? jeebus! that's bad. i know army peds was 3.5% (1/28) but for an entire service (especially the airforce where deployments aren't as bad) that's. . . bad.

good news is that those of us with longer commitments will get promoted just by having a pulse 🙂

--your friendly neighborhood pulse-exhibiting caveman
Click to expand...

Not necessaryily true.......unlikely, but not necessarily true.
 
BomberDoc said:
Seriously. I'll probably avoid the stop-loss, but five bucks says the AF stops filling its pipeline in the next year or two. Sethco, you might have something to worry about. Word is getting around, folks. The AF medical service is mortally wounded.
Click to expand...



I buy into the theory that when they finally stop meeting 100% of the available HPSP participants, the effects won't be felt until 4 years later, when everybody is getting out of med school (Maybe even 5 years if you are counting internship). I think, what is more likely to happen will be more people put into GMO/FS billets right out of internship. Kind of the like the current Navy model (before it is supposedly being reformed). So, hopefully, I am safe. However, the people that are just starting med school will probably not be safe if they start not filling all the scholarship positions.



BomberDoc said:
We have long been seen as the cush service. Hell, that is why I joined the chair force instead of the Army or Navy. Our PAs and IDMTs (IDC equivalent) are doing 12-15 month deployments. We are filling an ever increasing number of In-Lieu-Of taskings for the Army. The talk AF wide is increasing standard deployments from 4 to 6 months. Yes, still not Army 12 month style, but things are a-changin'. Naturally, physicians are voting with our feet since there is no way we can get leadership to understand that things are bad.
Click to expand...

I just am not buying into this prospect. My supervisor told us this may be coming and she wanted me to get everybody up-to-date on their annual physicals assuming we were going to be on a 6 month deployment. My squadron commander quickly shot that down. When I mention this to friends in the squadron, they say there is no way that is happening. There has been no newsletters, AFIs, or anything that would suggest otherwise. Just pure rumors. This may happen in the future, though. For now, for at least the next couple of years, flying squadrons will continue to be on 2-4 month deployments.
 
militarymd said:
So Andrew, what are you doing these days?

Are you active yet? and do you still plan on staying past your 4 years>?
Click to expand...

I completed a fellowship in ocular pathology, and I am part of the faculty in San Diego. I've been active duty for two years now. At this time, I plan on staying beyond my 5 years of obligation.
 
phospho said:
this is the first thread i just started reading about the military route... there's so much to read, and I don't even know where to start....and you just scared the crap out of me...:hardy:
Click to expand...

Hopefully you are wise enough to understand the biased sample that you have here. Too small of numbers to represent the way things really are. Not saying they aren't as bad as is posted here (at least for the Air Force), but you couldn't publish a study based on such a small percentage of unhappy physicians.

Make sure you read more than SDN and get in touch with other physicians in the military if you are even thinking about. (PS any physician a recruiter links you up with will be biased in the other direction as well...PSS if you think civilian health care is without problems...think again as well...the grass is always greener)
 
edmadison said:
Where do I get one of these 12 month deployments you are talking about. That would be sweet!

Seven down, eight to go!

Ed
Click to expand...

Sorry, Ed. So after such shoddy treatment, are you planning on staying in past your commitment?

Does anybody have a fairly accurate number of Army or Navy physician retention? I bet they are declining just like the AF... perhaps even worse. When does the first year of less than 100% pipeline finally come out of internship for Army and Navy? Who is going to fill those empty positions? Are they just going to do the bulls#it "civilianize" the position and hope that somebody on the outside wants to work harder for less money? Will the AF just get more In-Lieu-Of taskings and thus the AF pipeline gets diverted to backfill the drying up Army/Navy pipeline?

Sethco, I agree that you are likely safe for the next two years, but I seriously worry for the new HPSP students still early in med school. There are more and more cracks in the dam and it just keeps raining.
 
What are everyone's opinions on civilian doctors who contract with the military? I get the impression from posts that many military doctors would consider those civilians "poor" or "inadequate" where they look to the military as a last resort. Is this accurate?
 
Mirror Form said:
I haven't yet decided if I'll leave as soon as my requirement is fulfilled. I think it'll depend on how much I like my military position. But then again, if I'm working for 120k, and I got an offer from the private sector for 250k while my kids are getting old enough to start worrying about college, it may be pretty of hard to refuse.
Click to expand...
These old threads are great. It has been kind of nice to see some of these guys' feelings about military medicine change a little. Something tells me Mirror Form doesn't feel like this anymore.

I think I even read an old post (not this thread) where MilitaryMD pulled the "You are just a year out of med school and don't know anything about milmed yet" card on Homunculus. I didn't realize how repetative these conversations can be. I wonder if in a couple of years it will be me telling the med students to shut the h#ll up. :laugh:
 
SF49ers Fan said:
I wonder if in a couple of years it will be me telling the med students to shut the h#ll up. :laugh:
Click to expand...

Hopefully.

Progress is a wonderful thing. Too bad military medicine hasn't made any in the last few decades.
 
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