Military Medical School

[bobby_chamo]

Hey guys

A recruited talked to our pre-med society at my college, but I missed out because I had a big genetics assignment due that I was working on.

I heard some of these details from friends, but I am interested in fleshing out what I believe that I heard.

First, can the military can help you get into medical school? Or does the military have it's own medical school? I have good stats, so I'm not really in fear of not getting into a normal medical school, but I want to be totally aware of all my options.

One thing about medicine that does not turn me on is the traditional way of practicing. I am interested in what practicing medicine in the military is like.

e.g., I hear there is no malpractice, free travel, and you can pick where you want to work? And I hear it is a bit easier to get the residency that you want. I would love to be able to work and do medicine without the fear of frivilous lawsuits.

During war time, such as now, do doctors go to the lines? Do they volunteer or are they ordered?

Depending on the amount of input the military gives you on medical school (meaning, if they help you get in, or if you go with them for a residency after a normal civilian medical school), how long do you have to serve?

I have so many questions. I would love any answers you guys can give me, and if you would recommend me talking to a recruiter. Would my local recruiter know the answers to these questions?

Thank you
Bobby Chamo

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[Mirror Form]

hey, glad to hear you're intersted in the military. Army is the way to go btw (I'm slightly biased), here's a little info:

Originally posted by bobby_chamo
First, can the military can help you get into medical school? Or does the military have it's own medical school?

No. You have to get into medical school first, and then the military will fund your way through (HPSP). There is also a military med school, but it's no easier to get into then your state med school.

Originally posted by bobby_chamo
e.g., I hear there is no malpractice, free travel, and you can pick where you want to work? And I hear it is a bit easier to get the residency that you want.

The malpractice issue is a big advantage to being a military doctor. The travel is "free," but it's not always your first choice of where and when you want to go. Basically the military can order you anywhere at anytime. Usually they treat their doctors pretty well, but it can be stressful b/c there's few garauntees.

Depending on what branch you pick, it can sometimes be easier to get your residency choice in the military. For example, last year the Army only had 19 applicants for 19 slots in ortho, which in the civilian sector is very hard to get into, you usually have to be near the top of your class! However, the competitivness of fields fluctuates greatly, next year an Army ortho slot could be just as competitive as the civilian sector. Also, the army had 2 applicants for every 1 pathology slot last year, while in the civilian sector path's one of the easiest residencies to get and is often filled by mainly foriegn grads.

Originally posted by bobby_chamo

During war time, such as now, do doctors go to the lines? Do they volunteer or are they ordered?

You'll never be on the "front lines" so to speak, but depending on your field, you probably will get deployed. Ortho, gen surg, urology, etc will get deployed to military hospitals and field hospitals. Many military doctors in the reserves were called up and shipped to iraq this past year. While it is an honor to do life saving surgery on our troops, few doc really volunteers for it b/c few people really want to leave their comfortable home in DC to go to Iraq. Whereas, some fields (like ophthalmology) are non-deployable and never get deployed.

Originally posted by bobby_chamo

Depending on the amount of input the military gives you on medical school (meaning, if they help you get in, or if you go with them for a residency after a normal civilian medical school), how long do you have to serve?

This is actually a pretty complicated question, basically, it's one year as a licenced physician (not a resident or intern) for each year they pay, but the navy may try and screw you through these nasty GMO rules. Also, depending on your speciality, it may be one year longer (so five instead of four).

Originally posted by bobby_chamo
I have so many questions. I would love any answers you guys can give me, and if you would recommend me talking to a recruiter. Would my local recruiter know the answers to these questions?

Yes, but you can't trust them all the way b/c their job is to recruit you, so some have been known to bend the truth in the past. You have to be skeptical about some of the things they tell that sound too good to be true.

 

[Andrew_Doan]

Originally posted by Sledge2005
Whereas, some fields (like ophthalmology) are non-deployable and never get deployed.

Just a small correction. The NAVY sent about 3 ophthalmologists and the ARMY sent 4-5. The ARMY still has ophthalmologists in IRAQ, but I think the NAVY sent their's home recently. Some were volunteers. My friend volunteered, but the ARMY had enough volunteers and sent my friend to fellowship training instead.

?We?re capable in providing several different disciplines in surgery,? said FH-3 Director of Surgical Services, Capt. Charles Reese of Milton, Fla. ?We have specialists in Neurosurgery, Ophthalmology, Orthopedics, a vascular surgeon, and I?m an ENT (Ear, Nose and Throat) specialist. Plus, we also have some outstanding general surgeons.?

http://psaweb.med.navy.mil/fleethospital/FH3_Best_Care_in_Iraq.htm

 

[haujun]

When I went to OBC this past summer the current army policies are changing to increase the soldiers' care in the frontline which means that more doctors will be present where the action is...And more care in the frontline will motivate the soldiers to fight harder.

 

[militarymd]

That's right.....more doctors on the front lines where you put valuable resources (fully trained physicians) at risk without tangible improvements in outcome...ie improved survival or decreased disability based on what your Injury Severity Score is.

So the soldiers don't really have better care, but they think they do so they are more willing to risk their lives while valuable resources aren't utilized where they can be used....ie back at a real hospital......really smart.

 

[Homunculus]

Originally posted by militarymd
more doctors on the front lines where you put valuable resources (fully trained physicians) at risk without tangible improvements in outcome...ie improved survival or decreased disability based on what your Injury Severity Score is.

that's interesting. is there a study on the proximity of medical care in reducing morbidity and mortality in hostile situations? you would think that the closer the docs are the better the results would be-- if it's not the case i wonder what the reasons would be for not improving outcomes. any thoughts?

 

[militarymd]

There is without a doubt a positive correlation between improved survival and decreasing time to definitive care. Now that's the catch.

It has been demonstrated in trauma literature that the faster you get someone from the scene of injury to a trauma center, the better the chances of the person surviving rather than staying on scene to provide care...ie scoop and run.

Obviously, in combat, a trauma center is really not available nearby. Some of what the military has done is have units like the Devil Docs which is a unit with some surgical capabilities near the frontlines.....They actually do save lives. No arguments there.

So that is a good thing, so the military now decides that if some surgical capabilities up near the front is good, then sending highly trained physicians all to way up front must be better. During this last war, there were cardiologists, pulmonologists, Emergency Room physicians, Critical Care Medicine specialists, Internists, GMOs, moving with the marines. The only medical interventions available to them were: morphine, some ivf, bandages, anti-biotics, and some chest tubes.

Physicians can only work their magic if there are support facilities available. Without the support facilities, the injured patients are better off with EMTs who will move them to a level of higher care. An intensivist does you no good, if there isn't an ICU for him to work. A cardiologist does you no good, if there isn't a cath lab. Military medicine doesn't understand that.

A lot of the senior leadership in military medicine are doctors who never trained in advanced specialties( a lot of occ/health prev/health types). They spend a lot of time doing Executive Medicine..whatever that means, and they are the planners.

So a lot highly trained assets are put in harm's way, with no improvment in outcome.

 

[cdreed]

So if what you are saying is true, then I must assume that a physician's life is more valuable than that of a lowly soldier on the front lines?

The main reason that the military employs docs is to support its troops. Medical personnel are there to treat and return injured troops to battle and to keep healthy troops combat- ready... this is the catch to military medicine. Operational personnel are the priority. With that being said, I don't believe that it is wrong to send docs to the front line. After all, we are soldiers first. By vowing to lead in our oaths of office, we also agree to lead and serve when and where we are told to do so. Anyone that joins the military without understanding and accepting that is bound to be disappointed. Generally, the needs of the individual are second to the needs of the majority/command decisions.

 

[GMO_52]

No improvement in outcome? Not sure I agree with that. From the initial AARs, it looks to me like it worked. Maybe not as important as the new body armor, but I think the numbers bear out the success. Also, they did move some resources forward. The Comfort had a fluoro suite, where they did vascular repairs and a cardiac cath. The risk/reward may not have been to your liking but it sounds like thats because the risk was yours.

On another topic, its good to have your voice on the forum, however it would be more helpful if you would better define your experience. IM subspecialist?

 

[Ruby27]

well said cdreed!!!

the duty of military docs is indeed to serve the soldiers whether they are in the combat or at home. but the most honorable docs are those who sacrifice to support the bravest.

 

[militarymd]

A military physician has many duties. They include keeping the fighting forces healthy and fit, so that they are ready to fight. That is probably the easiest, seeing how you have to be healthy and fit to serve. This is probably the reason that GMOs can be used in the military.

The other part of keeping our forces ready to fight is to provide care for their dependents. I don't know where all the readers of this post are in terms of the stages of their lives, but many soldiers have young wives (many of them pregnant) and small children at home. When we deploy (at least the fully trained physicians), we stop taking care of these dependents. We bring reservists in to fill the gap, but it is not quite the same. If we aren't improving outcome at the very front, and I'm convinced we're not (I'm a surgical subspecialist), then all we're doing is taking away care from the dependents.

We also take care of retirees, and they are definitely the first to suffer when we all deploy unnecessarily. Remember, I have family who are retired after 30 years, and it is deplorable how they are treated. Do you think the guys who are putting their lives on the line right now expect to be treated poorly when they retire?

NOBODY's lives are more valuable than anothers. I REPEAT, NOBODY'S lives are more valuable than anothers, but you have to look at what's getting done. If outcomes aren't improved, and care is decreased somewhere else, something is not right. If we had the resources to staff all these places, then I would say that is probably ok, but the truth is there just aren't enough people.


It's funny someone brings up the COMFORT. I know exactly what took place there. All patients who were brought onboard have been stabilized somewhere else already. Many surgeries were performed, but none of them "life saving". "Life saving" surgeries is what putting personnel forward is for. I already admitted that units like the Devil docs were exceptional. I'm talking about the units with highly trained personnel but no other medical assets.

 

[militarymd]

By the way guys, I really resent the implication that I am trying to get out of serving, or that my life is more valuable than the "lowly soldiers".

There is no such thing as a "lowly soldier"....they are what makes our military great!! I would prefer that our ground troups not be referred to as "lowly soldiers"

Remember, I've been there, done that.

I'm wanting to prevent people from coming in without knowing what they are signing on for.

 

[tman]

militarymd,
I hate to jump on the band wagon but clearly you are disgruntled over the way you've been treated in the military. It seems clear based upon your posts that your intentions on here are to disuade people from joining the military because you felt you were done wrong somehow. Having served 12 years in operational units that were continuously deployed to some pretty crappy parts of the world >190 days/year prior to coming to medical school I must say that I've heard this all before. The funny thing is it usually comes from people in units who rarely deploy and have pretty cush jobs, those of us who were at the "tip of the spear" were always too busy training or carrying out real world missions and loving life in a masochistic sort of way to be bitching and moaning (too much). I think all of us who have spent any time in the military have been told one thing and then have something else handed to us, it's not uncommon. Hell I was in the desert one year for the entire fall and was told that I'd be back home with my family for christmas, 2 days before I was supposed to leave guess what? someone had a family emergency and I got to stay another 2 months. Sometimes life in the military sucks like that but it boils down to the mission first, service before self etc...Those words are not just rhetoric, sometimes you've just got to suck it up and get over it...or you can stew over it and be pissed off for an indefinite period of time making those around you and the rest of your unit miserable. Or I guess you could come on the internet and tell all about how you've been done wrong since you didn't get the assignment you were told you were going to get. You taking time to share this is a good thing because it does bring up some great points, namely the military isn't for everyone, if you are not flexible (sometimes extremely) and willing to do things that you'd rather not do sometimes, the military can be a terrible place to be caught in. People should not take it lightly and think that by taking an HPSP scholarship they are just going to get what they want without giving something back in return. For me serving has been a pleasure and even though there have been times when I was mad enough to just say "screw it i'm done with this mess" I have always somehow mananged to get over it in fairly short order. I must say that the military has been a great experience for me and I look forward to serving another 15 years at least. Without a doubt you'll have some crappy times intermingled with the good times but that's life in general I guess. There will be times when someone does you wrong, but again I believe that is not unique to the military way of life. One key to happiness in the military is being able to suck it up and press on after being dealt a crappy hand, sometimes a bitching and moaning session is just the thing to get you over the hump. Hopefully militarymd you can find your way over the hump and press on, if not it's time to move on to a different line of work, no use in being stuck someplace where you are hating life, it tends to be infectious to those around you. At any rate good luck and I hope the remainder of your military career proves to be a more fulfilling experience.

 

[rotatores]

tman,

You couldn't have said it better.

 

[haujun]

Rotatores, and (other military heroes) some of us appreciate and need to understand some of the negative experiences of military since we only get biased views from our recruiters. Not everyone wants to be or put himself/herself in a position (USUHS) to be a lifer. Do you even have any military experience? I guess it doesn't matter; you already made your decision.-- Rotatores, yep, you are a lifer.

 

[militarymd]

Tman,

You're not getting my point. I am disgruntled not because of how I was treated. I am disgruntled because of how I was lied to by senior officers and how medicine is practiced. I expected hardships in the military....I have posted that I have family in the line community...real soldiers....serving now and retired with 30 years.

I'm not trying to dissuade people from signing on. I want people to sign on knowing what they are signing onto. I think there is a big difference.

Now if you think logging onto the internet and telling people about past experiences is a way of dissuading peole from signing on, then I think that speaks volumes as to what military medicine is all about.

Being a soldier and serving in the line is one thing. Being a doctor is not the same. I guess you won't know until you finish with your training. Officer first, doctor second, is something that I have never been able to accept.

I think that is part of the problem with military medicine. It doesn't allow doctors to be doctors. The military respect rank, not individualized skills and knowledge in medicine. You don't get rank without doing collaterals that takes you away from clinical practice. Just look at the senior leadership, very impressive looking CVs, with lots of jobs held for a couple of years. Civilian doctors do the same job for 20 years, and still work on getting it right. Anywas, so decisions are made based on the people with rank but little practice experience.

 

[cdreed]

Militarymd,

I was using the phrase "lowly soldier" in a satirical manner. I was a lowly soldier before I decided to pursue a career in military medicine. I apologize if that offends you, but if I can take the satire, surely you can.

And I understand that you may not be able to accept officer first, physician second. My question is then... why did you join the military? These standards were in place before you signed on. And as a soldier, I rely on the fact that this principle will continue. Morale among the enlisted troops depends on it. How can they be expected to carry on and follow orders without complaint if their senior officers are not setting that example?

I do agree that not so fair things occur in the military. That is why I advise those interested in the military to talk to as many active duty and research as much as they can before they decide to join. Ultimately, that decision will render them with little control over their destinies. But believe it or not, some of us are proud to take on that responsibility. It is not always an easy task to assume, but the pain is worth the effort. I have been privileged to be an American citizen. I am grateful to those that have served before me... I want to return the favor that I have been given.

Thank you for your insights. But please don't assume that all of us are unhappy with the decisions that we've made. For those that are contemplating a career in the military, really consider whether you can subjugate your personal goals to the needs of the greater good. Do not take the decision lightly.

 

[GMO_52]

Originally posted by militarymd
Tman,

You're not getting my point. I am disgruntled not because of how I was treated. I am disgruntled because of how I was lied to by senior officers and how medicine is practiced.

This really doesn't do your position justice. It seems that you believe that how you were treated = lied to = disgruntled. I don't really understand why you make a distinction between how you were treated and what you were told. I think the shrill tone of the last few posts really obscures what is important in this thread. Namely, that people should know what they are getting into. I would point out that many of us do know (and we know that things won't always be rosy) and yet remain comfortable with our choices. Most of the people on this forum are already committed to military medicine by now. I would respectfully recommend that a better use of your experience would be to make suggestions about how best to negotiate the GME system to get what people want.

Hanjun,
Have to say I'm getting tired of your posts. No one here thinks he/she's the door gunner on the space shuttle but people who approach their careers with some optimism are much more likely to end up enjoying the experience. If you go in waiting to get screwed, I'm sure you'll be obliged eventually.

 

[militarymd]

You are absolutely right. I was simply posting a warning to those whose knowledge of military medicine is what they see on TV and what they were told by the recruiters.

It would appear that most of the people on this forum have prior service, so there is no need to tell you about what the military is like. If you're committed, you're committed.....like I thought I was about 5 years in.

I am really just giving a heads up to those fence-sitters out there. Be sure you know what you are getting into before signing any contracts. The experience can be very rewarding as reflected by the many posts, but there are downsides.

To GMO, I woudl like to clarify why I'm disgruntled...not by hardships, or sacrifice. It's the lack of honor in the senior leadership. The attitude that things need to only go well for 3 years, because after that, some other O-6 takes my job. That lying to junior officers is OK. My > 10 years of experience (seems like a lot to me, but I'm sure short to many of you) in only the medical community (not warriors) exposed to me what seems to be about 50/50 in terms of the number of senior officers that I respect. Just calling it like I see it. I'm sure everyone will have different experiences.

 

[Starcraft]

can you at least tell us the branch you are in?

 

[chillin]

I really don't see any point in having physicians in the front unless they have the equipment for them to work with. Why put someone in a position to deal with something that cannot be dealt with because the support isn't there. I think the people with the best experience would probably be better, that being an EMT. A surgeon or er physician probably couldn't do much more in the field, but I also don't have a lot of experience with this.

 

[Alli Cat]

Originally posted by militarymd

To GMO, I woudl like to clarify why I'm disgruntled... The attitude that things need to only go well for 3 years, because after that, some other O-6 takes my job. ... what seems to be about 50/50 in terms of the number of senior officers that I respect.

You know what's funny? I see this in the civilian world, too. For example, doctors aren't allowed to "just be doctors" at UCSF, (where I work) either. You had mentioned this concern in a previous post in regards to the military. I think in both civilian and military medicine, the reality today is that there are a lot of other constraints on what doctors do besides just healing the patient.

Also, the physicians in my department at UCSF are kind of like the commanding officers, and they have to deal with a lot of admin and legal crap that doesn't have anything to do with their job. They have to give direction to the staff underneath them. They're not just autonomously operating doctors, they are expected to lead their group.

I'm not drawing semi-weak parallels for fun, I'm doing it to point out that medicine ain't what it used to be. A lot of the complaints about military medicine are being made by young doctors who have never practiced in the civilian world. It's a "grass is greener" type of thing.

Regarding the quote above... I have had good bosses and bad bosses. People are people, even in the military. I can totally see how some high ranking officer would do a half assed job because he was only waiting to move on, or whatever. That's life. I bet I'll have my fair share of a-holes to contend with in my future career, too. It's the same for every civilian, though. I see a bunch of totally bitchy doctors at UCSF, and an awful lot have positions of power. It's just the way things are.

It's kind of neat that our military has such an awesome reputation that people expect so much from its individual members.

~Alli

 

[militarymd]

You are very correct in pointing out the parallels. Even the rank structures.

Medical Student ----- 2nd Lieutenant ----- Ensign

Intern ------- Captain ---- Lieutenant

Resident ----------- Captain ----- Lieutenant

Assistant Professor --- Major -------- Lieutenant Commander

Associate Professor ----LT Colonel ---- Commander

Full Professor ------ Colonel ------------ Captain

Professor Emeritus ----- RETIRED

Academic Medicine is very similar to the military, hence a lot of reservists serve at academic institutions. Remember also that academic medicine, like military medicine is a minority of physicians practicing medicine.

The other point to consider is that you can always quit at a civilian institution. You give up a lot of free choice in the military. No quitting allowed except at the end of your obligation and you need to give 9 months notice.

You are right again about people being people. There will always be dishonorable people no matter where you go, but I expect more from an Officer. I hope we all do and try to live up to the oath.

 

[Swiper]

Originally posted by militarymd
You are very correct in pointing out the parallels. Even the rank structures.

Medical Student ----- 2nd Lieutenant ----- Ensign

Intern ------- Captain ---- Lieutenant

Resident ----------- Captain ----- Lieutenant

Assistant Professor --- Major -------- Lieutenant Commander

Associate Professor ----LT Colonel ---- Commander

Full Professor ------ Colonel ------------ Captain

Professor Emeritus ----- RETIRED

Don't forget:

Senior enlisted = Experienced nurse
CIC on an aircraft carrier = ER on a Saturday night
Officer of the Deck calling the CO with a contact report = Resident physician presenting a patient to the Attending

These parallels have been extremely striking to me while volunteering in the ER...

 

[edinOH]

Originally posted by Swiper The Fox
Don't forget:

Senior enlisted = Experienced nurse
CIC on an aircraft carrier = ER on a Saturday night
Officer of the Deck calling the CO with a contact report = Resident physician presenting a patient to the Attending

These parallels have been extremely striking to me while volunteering in the ER...

That's good stuff. I'm not the only one then who has seen these similarities.

I spent 5 years active duty as a corpsman in the Navy before medical school. I decided to forgo the military the second time around since I had "been there and done that" as they like to say.

I agree with the above posters. When you commit to the military you need to realize that you are commiting to much more than military medicine. You are commiting yourself to the "military machine", for better or worse. Enlisted or officer. Medicine or supply. There will always be those who are more concerned with beurocracy and ticket punching than with what is best for the unit. That is unfortunate and often times excruciatingly frustrating. Such is life in any large organization I've found.

For those of you still in uniform, thank you. I appreciate your service.

 

[DoctorDoom]

Originally posted by bobby_chamo
Would my local recruiter know the answers to these questions?

Likely not; make sure you speak with a designated health care recruiter. Your local recruiter will point you in the right direction, but only the health care recruiters can answer your specific questions.

Good luck.

 

[usmc_jetguy]

I think one thing that both sides of the doctor-patient relationship in the military recognize is that the doctor works for the UNIT i.e maintaining unit readiness rather than the individual. While that might seem a slight disctintion, occassionally it may mean making decisions that are not always in the best interest of the patient. A minor example in my case might be trying to fight to get a crown on a tooth, but being a low priority. I'm hoping I don't lose the tooth before they decide to do the crown.

This is where the essence of officer first doctor second comes in. It's good and necessary for unit effectiveness, to ground a guy because he has a slight cold but especially in aviation it means that most guys in the squadron will see a civilian doctor first to ensure they won't get permanently grounded.
semper fi

 

[metabolite]

I just completed my physical and interview at the AF... now just awaiting. Just wondering if anyone knows how much time I have between accepting the scholarship and swearing in? I might have to wait a little while to make up my mind, due to never-ending application process, but my recruiter told me that I have total of about 2 weeks before being commissioned - is this true? Thought to ask since one of my veteran friend informed me that recruiters are the last ones to trust. Thanks for any input - !

 

[iwakuni_doc]

2 weeks might be the time they give you from when they announce that you've been accepted to when you have to decide...I couldn't tell you that.

But as soon as you accept & sign - you're getting sworn it that day! You sign your acceptance, your oath of office, & raise your right hand....at least that's the way it was for me with the Navy.

 

[texdrake]

Its really at your convience, but they like it done within a month. Remember that you can't receive any benefits until you sign.

Also, I would ask why you applied if you still have to decide. Especially considering in the interview process they ask you if you will accept it when offer and an undecided answer is never accepted. Furthermore, no that by turning down the offer you will be inelidgable to enlist in any branch of the military in the future. They look at it like you are shuning them. You also can kiss away pretty much any job that is national defense related (CIA, FBI etc...)

 

[militarymd]

Originally posted by usmc_jetguy


This is where the essence of officer first doctor second comes in. It's good and necessary for unit effectiveness, to ground a guy because he has a slight cold but especially in aviation it means that most guys in the squadron will see a civilian doctor first to ensure they won't get permanently grounded.
semper fi

That's the kind of officer I'm talking about....those who put their own wants and needs above that of the unit. If I ever find an aviator who went to see a civilian doctor first to ensure they don't get grounded, I would make it my personal mission to see him in jail.

Sadly, those officers usually become Flag officers.

 

[militarymd]

bump

 

[backrow]

bump

What's up with bumping all these old threads? ??