Military FP vs IM

[DD214_DOC]

I still can't really decide between FM and IM, so I was wondering what the experience is like in the military. Isn't the military salary for FM and IM pretty similar to their civilian counterparts?

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[Gastrapathy]

I still can't really decide between FM and IM, so I was wondering what the experience is like in the military. Isn't the military salary for FM and IM pretty similar to their civilian counterparts?

OK NavyFP, I challenge you to a 10 round bout of why my specialty is better.

Seriously, FP, as its practiced in the military, is probably pretty fun. I'm glad I chose IM because there are the subspecialties and I was able to flee primary care once I realized it wasn't for me.

IM docs and FP docs are paid well in the military compared to the civilian world.

 

[HackFuJones]

Id go IM, the more options you have the better. You can always fall back and do FP like clinic work as an IM doc, but you also have the opportunity to do Fellows, become a hospitalist(whos pay and popularity are rising quickly at the moment), etc... As for pay, they along with peds are the most competitive the military gets with comparable civilian salaries. They are still lower but not that bad especially if you stayed in for 20 and got your pension and factored in the worth of your HPSP scholarship.

 

[DD214_DOC]

My step I Wasn't great. Can I still match?

 

[Gastrapathy]

My step I Wasn't great. Can I still match?

Yup. We're pretty much noncompetitive.

 

[DD214_DOC]

Yup. We're pretty much noncompetitive.

A big thing keeping me from "declaring" IM and going for it is the security of knowing I would match if I went for FM.

 

[ieatpizza]

A big thing keeping me from "declaring" IM and going for it is the security of knowing I would match if I went for FM.

I would say go for Army IM if you like IM over FP. If for some reason you don't match IM (I think the likelihood of not matching is pretty low given recent stats), I'm sure there will be many open spots in FP that will be happy to take you in the "scramble."

 

[DD214_DOC]

I would say go for Army IM if you like IM over FP. If for some reason you don't match IM (I think the likelihood of not matching is pretty low given recent stats), I'm sure there will be many open spots in FP that will be happy to take you in the "scramble."

How does the military, "scramble" work? Since we have to rank TY programs, we WILL match one way or the other. I don't know much about the scramble. Could someone explain it? Are we guaranteed a slot in something like FM if there's space? (which there would be)

 

[deegs]

How does the military, "scramble" work? Since we have to rank TY programs, we WILL match one way or the other. I don't know much about the scramble. Could someone explain it? Are we guaranteed a slot in something like FM if there's space? (which there would be)

The "scramble" is actually a case-by-case thing that happens after the official military match day, officially called the "rebuttal" process. If you are an unhappy TY-matched person , you can find an open slot (IM, FP, Psych, and some other specialties went unfilled this year), contact the specialty leader, and presto-chango: you're a categorical-matched happy person.

 

[DD214_DOC]

The "scramble" is actually a case-by-case thing that happens after the official military match day, officially called the "rebuttal" process. If you are an unhappy TY-matched person , you can find an open slot (IM, FP, Psych, and some other specialties went unfilled this year), contact the specialty leader, and presto-chango: you're a categorical-matched happy person.

Do you usually always get what you're going for during the rebuttal?

 

[psychbender]

Do you usually always get what you're going for during the rebuttal?

For the rebuttal, they will tell you what specialties did not fill--this year, it was FM, IM, Peds, and Psych--and you will indicate on your rebuttal your desire to seek training in one of those fields. Then, you rank ALL of the programs for whichever specialty you chose (they won't tell you which programs didn't fill). Since you already know that that specialty has open spots, you'll probably get it, just maybe not at your number 1 location (which might have filled). I suppose that if some specialty only had a bare handful of empty slots, and was something highly desired, then those spots may be harder to get in the rebuttal.

 

[DD214_DOC]

Thanks guys. I guess I'm going to shoot for IM and hope 2005 doesn't happen again, where the applicants:spot was 1.15 or whatever it was.

While I'm thinking about it, how do the fellowships work in the Army? I kinda like Cards but I know it's pretty tough to get in the civilian world.

 

[Perrotfish]

Wow, I had no idea this rebuttal thing existed.

 

[DD214_DOC]

me neither. Makes me want to shoot for IM/psych now.

 

[psychbender]

Yeah, I don't know why they don't explain things like the rebuttal board ahead of time. I did not find out about it until this year, when they sent out an email containing the instructions for rebuttal board, right before the match results came out. Unfortunately, I have since emptied my inbox, and cannot find the file containing the details and instructions.

 

[NavyFP]

OK NavyFP, I challenge you to a 10 round bout of why my specialty is better.

Seriously, FP, as its practiced in the military, is probably pretty fun. I'm glad I chose IM because there are the subspecialties and I was able to flee primary care once I realized it wasn't for me.

IM docs and FP docs are paid well in the military compared to the civilian world.

I will agree that subspecialty training is a significant body blow to my specialty. Followed by the right cross of the increases in pay for those specialties (on the outside at least).

As someone who loves primary care, FP is a perfect fit for me, but IM can give you more outs.

 

[NavyFP]

A big thing keeping me from "declaring" IM and going for it is the security of knowing I would match if I went for FM.

This year Army IM had more unfilled positions than Army FM and both were VERY underfilled.

 

[a1qwerty55]

Thanks guys. I guess I'm going to shoot for IM and hope 2005 doesn't happen again, where the applicants:spot was 1.15 or whatever it was.

While I'm thinking about it, how do the fellowships work in the Army? I kinda like Cards but I know it's pretty tough to get in the civilian world.

I don't want to offend you or anyone else but.......you aren't exactly selling yourself as a bright bulb. As an IM guy I have concerns about you based on your posts. If you have concerns about matching in a speciality which at its high point had a whopping 1.15 applicants/slot, you either have tremendously low self esteem, or extremely good insight into the poor quality of your application.

If you are that weak a test taker the odds are fairly high you might not do so well in IM - (In other words won't graduate or pass boards) not that FP's aren't as smart, but their residency is way more outpatient in nature (often more practical) and it is a little easier to fly under the radar in a clinic that on a ward team or ICU team.

My experience is that really bad boards scores can translate into really bad clinical skills as well. Medicine is highly cogntive and the margin for error in inpatient care is far less than in the outpatient setting.

 

[DD214_DOC]

I don't want to offend you or anyone else but.......you aren't exactly selling yourself as a bright bulb. As an IM guy I have concerns about you based on your posts. If you have concerns about matching in a speciality which at its high point had a whopping 1.15 applicants/slot, you either have tremendously low self esteem, or extremely good insight into the poor quality of your application.

If you are that weak a test taker the odds are fairly high you might not do so well in IM - (In other words won't graduate or pass boards) not that FP's aren't as smart, but their residency is way more outpatient in nature (often more practical) and it is a little easier to fly under the radar in a clinic that on a ward team or ICU team.

My experience is that really bad boards scores can translate into really bad clinical skills as well. Medicine is highly cogntive and the margin for error in inpatient care is far less than in the outpatient setting.

I think you're reading into my posts a little too much. My application isn't pristine, but it also is not tainted with things such as repeating a year, multiple failures, multiple board takes, failed rotations, etc. It just could be better.

When you have GAD, even an applicant to spot ratio of 1.15 worries you. I have also spent time around M4s who "should have matched" into their specialty given their numbers/application and, for whatever reason, still did not.

 

[a1qwerty55]

All I'm saying is don't look at IM as some kind of cush, fall back residency. I'm sure you will get what you want so don't stress so much.
It would be hard to imagine you not matching in FP or IM.

 

[DD214_DOC]

All I'm saying is don't look at IM as some kind of cush, fall back residency. I'm sure you will get what you want so don't stress so much.
It would be hard to imagine you not matching in FP or IM.

Na, I don't see it that way. I haven't completely decided yet but I've found I need a certain level of complexity and a challenge to stay interested; not sure I would get that with fm (other than that of staying profitable)

 

[glamqueen]

Does the AF have a rebuttal board also? Or is this just an Army thing?

 

[jabreal00]

My step I Wasn't great. Can I still match?

As long as you pass both Step I and II you should match in an Army IM program easily. If your scores are marginal, you likely won't match at the major medcen (Walter Reed or BAMC). Like others have said, positions go unfilled every year so it won't be a problem.

That being said, IM is not an easy residency. It's primarily inpatient based and can be intensive. While in residency, one has to take inservice exams (board preparations) every year. Then there's the IM board.

For subspecialties like cardiology or GI competition for a slot can be 2-3 applicants per slot. Hardly anyone gets Cards, GI, Pulm straight out of residency anymore due to the competition, including stellar applicants.

I would say, if you can pass your standardize exams (USMLE) and graduate from medical school without any failing grades you'll do fine. IM is much more versatile than FP, in the sense that you can do primary care, hospitalist, or subspecialize.

However, if you like working with kids and pregnant women family practice is a good option.

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