I hear this a lot, but I think it's mostly bull****. I spent 3 years as a Marine infantry GMO, deployed twice to places we were busy killing people and breaking things, and I honestly can't think of even a single instance in which my officerly duties got in the way of my medical duties and doing the right thing for a patient. The closest might've been when I recommended a few Marines be left behind for a predeployment training trip to 29 Palms so they could get their physical therapy, and the CO took them anyway and put them on radio duty. But that was on him not me.
I'm just curious to hear examples of how your duty as an officer "frequently" resulted in suboptimal care.
I think the whole GMO system is fundamentally flawed and we shouldn't be sending out glorified interns to do anything even resembling independent practice. You won't see me defend that.
I think the little bit of objectivity and hint of transparency the GMESB point system offers is a good thing, and I disagree that GMO time shouldn't be eligible for some points. And I wrote "eligible" meaning I think it should be fuzzy and discretionary so that real accomplishments and interim face time can be accounted for ... and a turn in the GMO barrel does deserve some kind of compensation.
Two years seeing feet at sick call shouldn't make up for a 175 Step 1 score, but that time is worth something. We can quibble over the details of how many points for what if you like, but your stance of GMO time ain't worth nothin' is extreme and seems to reflect more bitterness and bias than sense.
I've posted multiple times about how my duty as a military officer resulted in suboptimal care or the potential for suboptimal care. I think there are quite a few posts about that sort of thing, from a variety of posters. Cancelling cases due to mandatory UA, cancelling previously scheduled clinical appointments due to last minute command meetings, to attent last minute mandatory resiliency training. Being asked to cover call 24/7 for indefinite periods of time while being disallowed to refer treatment off post even in cases of extreme fatigue. Mandatory unit PT at 05:30 after a call night, and then still having to see a full patient load. These are small issues that regularly show up where you are expected to choose your duty as an officer over the best interests of your patients.
Another example might be your duty as an officer to take on a brigade surgeon spot, and then return to practice after 2 years of not actually providing care in your field. It hasn't happened to me, but it is happening. If that's not a contradiction to appropriate medical care, nothing is.
I am not saying, nor have I ever said, that I've been ordered to shoot a child or burn a village. But there are definitely recurring situations in which I am expected to do something that compromises patient care becaues it is my duty as a military officer. It may not seem like a big deal, but I assure you it was a big deal for the child who had their surgery cancelled, and for their mother who moved her work schedule around and now has to reschedule surgery. It was a big deal for me doing microsurgery with an amplified tremor due to lack of sleep. It isn't that these situations can't or don't occur outside of the military, but the fact is that the Army in these cases was the direct cause of the issue - all in the name of duty. You can draw your own line on what is acceptable in terms of balancing high-quality patient care with military duty. I have drawn my own, and I am asked to cross it not infrequently.
I'm glad you've had the career you've had in the military. In just a short period of time, I have obviously had a much worse time than you have. Considering the attritian rate in the military, I'm obviously not alone in that. Contrarily, I feel that the overall standard of care in the military is quite good (I stand against the common opinion on that one), but that is despite of the military, not because of it.
If you read my other posts, you'll note that I didn't say GMO time wasn't worth anything. But as you say, it ought to be a very measured point system, and it certainly doesn't qualify as more significant than medical school performance. At most, it is another CV bullet that should put a candidate ahead of his peers all other things more-or-less equal. But keep in mind, that is based upon my experience in the Army, where GMO tours are not frequent and are often (not always) a result of poor candidacy during the initial match process. I realize that is not the case in the Navy.
And you are right about one thing: I am very bitter when it comes to the military, that is true and it is entirely a product of my experience since joining. I had strongly considered a career in the military until the last year or so of my residency. All of my DoD-angst has come since that time, not before. But as are we all, I am a product of my environment, and this environment is not a good one in which to practice medicine.
