1. Did you ever think of going through with the 20 yr for retirement? What made you not end up wanting to do it?
2. Did you say you were part of the Army or Navy? I’m a bit worried about the GMO tour. I’m not quite sure how exactly that works. Would I be pulled from a let’s say 4 yr residency after my first year there? That doesn’t make any sense to me. I don’t mind doing one after my residency...
3. I’ve been hearing a lot of specialty atrophy during active duty times. (Maybe this was for on GMO tours) Did you feel like that was your case? Did you like where they placed you overseas?
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1. I thought about it a bit. One of the main reasons I elected to separate when my ADSO ended is that moving was getting harder and harder on my kids. In my case, the Army assigned me to an intern year spot at a different location than the rest of my residency. That meant we moved after med school, then moved again a year later, then moved
again three years after that when I finished residency. My son was 8 when I separated from the Army and our current (permanent) residence is his fifth home! It's not that way for everybody, though: one of my residency classmates did internship and residency at the same place, then stayed on there afterward. And some people handle multiple childhood moves very well. My kids don't, and that's one of the main reasons I got out.
2. I was in the Army. First, let me clarify what a GMO is. GMO stands for General Medical Officer, and they're general practitioners who have completed internship (and possibly more). They're not physicians who've completed residency and become attendings. The different service branches have different GMO requirements.
@Matthew9Thirtyfive can tell you more about how the Navy handles GMOs, but the last time I looked into it they had a mandatory GMO year after internship for all physicians-in-training. The Army has no such requirement -- if you match into a categorical residency program (i.e., a residency program that goes from internship through graduation), you go straight through with no interruption in your training, then do your payback as an attending physician rather than a GMO.
People who don't match into categorical programs, on the other hand, are slotted into transitional internship spots. During intern year, those people can apply for advanced positions (i.e., residency spots that go from PGY-2 onward) or reapply for categorical positions (which means they would do a second intern year, then progress on through residency training). If they get such a spot, they'll also progress through their training without serving as GMOs. If they
don't get picked up, though, they finish intern year with no contract for further medical training, and they're made GMOs to begin paying back their scholarship while serving as general practitioners for the Army. During GMO time, they can continue to reapply for the Army match each year, and their GMO time will end either when they match or when they've been a GMO long enough to pay back their scholarship.
Some people also elect to become GMOs of their own volition. Those folks apply for positions that are for intern year only, then go out as GMOs. They generally do so for the experience -- they're making a sacrifice to provide a much-needed service for the military.
People who complete residency don't serve as GMOs. Rather, they work for the military as attending physicians in their chosen specialty.
3. I experienced a very small amount of skill atrophy during my three years as a military attending. I was stationed at a medical center with generally lower-acuity patients, so I got out of practice just a little bit in terms of managing the trainwreck disaster patients. But it wasn't a big problem -- within a couple months of starting at my civilian job, I was right back up on the horse. Tonight, I'm working as the sole attending anesthesiologist in an 800+-bed level 1 trauma center. So skill atrophy hasn't really been a problem.
I never served overseas. Most Army attendings are stationed at stateside military medical centers or clinics, then deploy periodically when the Army requires them to do so. After deployment, they return to garrison (i.e., their stateside assignment). There are some Army anesthesiology attendings stationed in Germany and Korea, and those spots are
highly coveted for being some of the best assignments in the Army. In my case, I was stationed somewhere in the South, which resulted in my wife and I falling in love with the South and deciding to make it our permanent home after I separated. I was deployable as an attending but the Army never actually called me up to deploy.
