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Military Medicine, but no military experience?

Diocletian

Full Member
Mar 29, 2012
75
2
    Hi all,

    I've been looking into the Uniformed Services University for medical school, and the more I research the more I feel like this would be a role I would greatly enjoy.

    However, I have no military or law enforcement experience. None. I have all the typical medical stuff (shadowing volunteering etc) and LOTS of political science experience, including some prestigious internships in DC and elsewhere. But as far as military goes... nada.

    I don't know anyone in the military so can someone here help me out? If I apply to the USU, will I be at a significant disadvantage?
     

    Perrotfish

    Has an MD in Horribleness
    10+ Year Member
    May 26, 2007
    8,223
    4,539
    1. Attending Physician
      Hi all,

      I've been looking into the Uniformed Services University for medical school, and the more I research the more I feel like this would be a role I would greatly enjoy.

      However, I have no military or law enforcement experience. None. I have all the typical medical stuff (shadowing volunteering etc) and LOTS of political science experience, including some prestigious internships in DC and elsewhere. But as far as military goes... nada.

      I don't know anyone in the military so can someone here help me out? If I apply to the USU, will I be at a significant disadvantage?

      1) The majority of the class at USUHS has no prior service. Applicants with prior service are at a significant advantage, but there won't be enough of them to fill up the class. Non-military service like law enforcement provides no official advantage in the selection process, and I honestly doubt it provides much of an actual advantage either.

      2) The HPSP scholarship for a private medical school currently pays almost the same amount at USUHS with half of the obligation and none of the pseudo-military BS during your medical school years.

      3) Make sure you read through SDNs military medicine forum and know what you're getting into before you sign any papers. Are you aware that that when you join the military you can't apply to the normal match without a special waiver (which you probably can't get) and are likely instead trapped in their residency system? Are you aware that in that residency system some residencies like EM are drastically more competitive than in the civilian world, and others like PM&R and IM/Peds don't exist at all? Do you understand that many physicians will be pulled between their first and second year of residency to do a multi year 'general medical officer' tour? Are you aware that many specialties in the military medical system, like surgery and anesthesia, suffer from low patient volume? Are you prepared to deploy at a pace determined entirely by the whims of our elected officals? Do you understand that your pay in more competitive specialties like Ortho might be a small fraction of what your civilian peers make? That your pay until your initial obligation is up (7 years for USUHS) will be drastically less than your pay after you sign up again, so you can be doing the same job for the same amount of time as someone who took the HPSP scholarship while making half as much money? Are you aware that you will have no option to walk away if you think your working conditions are miserable, degrading, or dangerous? This is a serious decision.

      I'm on a Navy scholarship and so far happy with the decision. However you need to know what you're signing before you sign. Also, in general, I think you should always take the shortest commitment the military offers. If you take HPSP and hate it you could theoretically be done 5 years after graduating medical school (an Intern year + 4years as a general medical officer): that's no worse that the commitment we ask from many 18 year old marines. However the 7 year commitment from USUHS, plus the near impossibility of avoiding a residency for your entire payback period, means you're really stuck with the military for at least 10 years post graduation. That's a long commitment to an organization you've never worked for.
       
      Last edited:

      Shah Boy

      Full Member
      May 25, 2012
      47
      0
      1. Pre-Medical
        1) The majority of the class at USUHS has no prior service. Applicants with prior service are at a significant advantage, but there won't be enough of them to fill up the class. Non-military service like law enforcement provides no official advantage in the selection process, and I honestly doubt it provides much of an actual advantage either.

        2) The HPSP scholarship for a private medical school currently pays almost the same amount at USUHS with half of the obligation and none of the pseudo-military BS during your medical school years.

        3) Make sure you read through SDNs military medicine forum and know what you're getting into before you sign any papers. Are you aware that that when you join the military you can't apply to the normal match without a special waiver (which you probably can't get) and are likely instead trapped in their residency system? Are you aware that in that residency system some residencies like EM are drastically more competitive than in the civilian world, and others like PM&R and IM/Peds don't exist at all? Do you understand that many physicians will be pulled between their first and second year of residency to do a multi year 'general medical officer' tour? Are you aware that many specialties in the military medical system, like surgery and anesthesia, suffer from low patient volume? Are you prepared to deploy at a pace determined entirely by the whims of our elected officals? Do you understand that your pay in more competitive specialties like Ortho might be a small fraction of what your civilian peers make? That your pay until your initial obligation is up (7 years for USUHS) will be drastically less than your pay after you sign up again, so you can be doing the same job for the same amount of time as someone who took the HPSP scholarship while making half as much money? Are you aware that you will have no option to walk away if you think your working conditions are miserable, degrading, or dangerous? This is a serious decision.

        I'm on a Navy scholarship and so far happy with the decision. However you need to know what you're signing before you sign. Also, in general, I think you should always take the shortest commitment the military offers. If you take HPSP and hate it you could theoretically be done 5 years after graduating medical school (an Intern year + 4years as a general medical officer): that's no worse that the commitment we ask from many 18 year old marines. However the 7 year commitment from USUHS, plus the near impossibility of avoiding a residency for your entire payback period, means you're really stuck with the military for at least 10 years post graduation. That's a long commitment to an organization you've never worked for.

        Please don't be afraid of military medicine!! As long as you have a good reason for joining the military you will be fine.
        I disagree with a lot of what Perrotfish said: USUHS provides pay ($2876), BAH ($1300-$1700), and BAS ($239) per month vs. HPSP which is $2080. Way more pay/allowances (if that's what you're into).
        I also wouldn't consider USUHS's curriculum BS, it revolves around service to our country and their student's futures in military medicine.
        You can match a civilian residency if you do not match a military residency.
        I know that there are IM and Peds residencies at many Naval Hospitals...
        GMO tours are awesome!!! This is coming from 15-20 different navy docs that I know personally, you get to be operational long before your civilian peers, and you are a much stronger resident when you do get to residency because you are essentially practicing as a GP for 4 years.
        Due to bonuses for different specialities, pay works out to be a the national median for that specialty, For example the current bonus for EM is $36,000/yr, plus more bonuses for board certifications.
        I'm not sure what you mean by "That your pay until your initial obligation is up (7 years for USUHS) will be drastically less than your pay after you sign up again, so you can be doing the same job for the same amount of time as someone who took the HPSP scholarship while making half as much money?" Of course every promotion (and every 2 years of service) provides a pay raise
        As far as poor working conditions: As we like to say in the Navy regarding duty assigments: You bloom where you are planted. If something is not going well, you, as an officer, have the ability to change it
        Personally, I am applying to both programs, my only hesitance about USUHS is the location and the possibility that they can force me into a different branch if the needs of the military dictate it
         
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        Perrotfish

        Has an MD in Horribleness
        10+ Year Member
        May 26, 2007
        8,223
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        1. Attending Physician
          You can match a civilian residency if you do not match a military residency.
          This is just wrong, and you need to understand why before you apply. When you join the military you are stuck in their match system, with their odds. Applying for a civilian residency is a rare privilege that you need to apply for, and that very few people actually get. It's not an option if things don't work out the way you wanted in the military match. If you go through the military match you are going to match, although it may be something that you didn't request

          For example, say you want to match into military emergency medicine. You have a competitive application by civilian standards: a 230 on Step 1 and you've honored about half your cores. However the military's EM system is as competitive as orthopaedics, so you don't get EM. You don't get to go to the civilian world and try again. You get something else on the military's match day: an IM, Psych, transitional, or pre-surgical intern year. And you're stuck with that until you've finished the year and an operational tour. And then you're not guaranteed EM, you just get another chance to apply.

          I know that there are IM and Peds residencies at many Naval Hospitals...
          IM/Peds is a combined residency, where you do 4 years and get boarded in IM and Peds. It is an example of a residency that does not exist in the military.

          GMO tours are awesome!!! This is coming from 15-20 different navy docs that I know personally, you get to be operational long before your civilian peers, and you are a much stronger resident when you do get to residency because you are essentially practicing as a GP for 4 years.

          1) Different people have different opinions on GMO tours. Some people enjoy them, some people despise them, and it seems like most enjoy the chance to play solider/Marine but also wish they could have just focused on being a real doctor. The fact is that most people who end up doing them applied to be allowed to continue their training. An all 'voluntold' force is probably not completely awesome. I understand the operational necessity for GMO tours, and I basically support their existence, but the fact is that from the physician's perspective it is a sacrifice.

          2) You do not want to be 'operational long before your civilian peers'. Residency exists for a reason, and the reason is that someone a year out of medical school is not competent to practice independently. Again, I understand the reason the Navy does it this way, and I don't have any better ideas, but it's not something I'm looking forward to.

          3) You are not operating as a GP. Or rather, you are operating as a GP who treats only healthy, athletic adolescents. I suppose that could make you a stronger resident in pediatric sports medicine, but for every other specialty on the planet you have just spent 4 solid years away from the real diseases that are supposed to be your bread and butter.

          I'm not sure what you mean by "That your pay until your initial obligation is up (7 years for USUHS) will be drastically less than your pay after you sign up again, so you can be doing the same job for the same amount of time as someone who took the HPSP scholarship while making half as much money?"

          When you complete your initial obligation as a physician you will have the option to sign up again. At that time you will become eligible for two very large bonuses: Incentive specialty pay and Multi-year specialty pay. The higher paid your profession in the civilian world, the higher the bonus. At the extreme, an Anesthesiologist on his second obligation makes $120,000 more than than an Anesthesiologist on his first. So if you're from USUHS and you're 5 years in you will be working next to HPSP grads, who are also 5 years in, who are doing the exact same job, and who are making twice as much as you are.

          This is why you should shoot for HPSP over USUHS even if you are 100% sure your goal is a career in the military.

          Due to bonuses for different specialities, pay works out to be a the national
          median for that specialty, For example the current bonus for EM is $36,000/yr,
          plus more bonuses for board certifications.
          BTW unless you're in family medicine or pediatrics the pay with bonuses doesn't work out to be anything close to the national median. A board certified residency complete EM doc in the military might make $150,000 with bonuses. That's 100,000 below the median.

          As far as poor working conditions: As we like to say in the Navy regarding duty assigments: You bloom where you are planted. If something is not going well, you, as an officer, have the ability to change it
          NO. One thing you absolutely have to understand about being a junior physician in the military is that most problems are completely out of your control. Abusive O-5 nurse administrator running your clinic? You're stuck. Your pediatric ventilators are actually jury rigged adult ventilators that you think are monstrously unsafe? You're stuck. Your wife has a stable position in Florida but you just received orders to report to Guam on short notice? Stuck again. The military is about ACCEPTING what's thrown at you, and working with it, not about changing it. This is not to say that I think the military is more or less f-d up as an organization as your average hospital. I've seen plenty of bad medical decisions, terrible nurse administrators, and toxic work environments in the civilian world. The difference is that you can not walk away from your problems in the military if they get bad enough.
           
          Last edited:

          Barcu

          Full Member
          Jul 18, 2010
          2,149
          27
          1. Medical Student
            No military experience is no problem as more than half the class at USUHS and the vast majority of HPSP receipients have none.

            As Perrotfish said, don't worry much about the lack of experience. Worry about whether it is the right path for you. I would strongly consider looking into HPSP instead. I would only recommend USUHS if you are sure you want to spend your career in the military, which is not the smartest thing if you have no experience. HPSP gives you the experience and flexibility to decide if you want to stay or leave.

            But look seriously into both options. There is also FAP, where you graduate med school, match into a civilian residency and then join. You will then work for the military post-residency and get some money to pay back loans.

            The biggest decision is to decide if the military is for you at all. If it is money you are interested in, forget about it. It's not the way to go. If you are interested in being a doctor and officer in the military, do more research. The military medicine forum is great on this board (though very negative, gives you a good idea of the worst case scenarios). Talk with military physicians and read other sources too. It's a big life decision, and you can't get out once you've signed.

            Good luck OP.
             

            AirForceMD

            Full Member
            Jul 9, 2012
            13
            0
            1. Attending Physician
              You absolutely can get out once you've signed. Look into it further. Also, YOU SHOULD! The military is no place for a competent physician these days. Serve your country as a civilian physician in a specialty of your choosing with better pay, better employees, and overall general competency!
               

              xXIDaShizIXx

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              7+ Year Member
              Sep 18, 2011
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                1) The majority of the class at USUHS has no prior service. Applicants with prior service are at a significant advantage, but there won't be enough of them to fill up the class. Non-military service like law enforcement provides no official advantage in the selection process, and I honestly doubt it provides much of an actual advantage either.

                2) The HPSP scholarship for a private medical school currently pays almost the same amount at USUHS with half of the obligation and none of the pseudo-military BS during your medical school years.

                3) Make sure you read through SDNs military medicine forum and know what you're getting into before you sign any papers. Are you aware that that when you join the military you can't apply to the normal match without a special waiver (which you probably can't get) and are likely instead trapped in their residency system? Are you aware that in that residency system some residencies like EM are drastically more competitive than in the civilian world, and others like PM&R and IM/Peds don't exist at all? Do you understand that many physicians will be pulled between their first and second year of residency to do a multi year 'general medical officer' tour? Are you aware that many specialties in the military medical system, like surgery and anesthesia, suffer from low patient volume? Are you prepared to deploy at a pace determined entirely by the whims of our elected officals? Do you understand that your pay in more competitive specialties like Ortho might be a small fraction of what your civilian peers make? That your pay until your initial obligation is up (7 years for USUHS) will be drastically less than your pay after you sign up again, so you can be doing the same job for the same amount of time as someone who took the HPSP scholarship while making half as much money? Are you aware that you will have no option to walk away if you think your working conditions are miserable, degrading, or dangerous? This is a serious decision.

                I'm on a Navy scholarship and so far happy with the decision. However you need to know what you're signing before you sign. Also, in general, I think you should always take the shortest commitment the military offers. If you take HPSP and hate it you could theoretically be done 5 years after graduating medical school (an Intern year + 4years as a general medical officer): that's no worse that the commitment we ask from many 18 year old marines. However the 7 year commitment from USUHS, plus the near impossibility of avoiding a residency for your entire payback period, means you're really stuck with the military for at least 10 years post graduation. That's a long commitment to an organization you've never worked for.

                This is all true except for the GMO tour in the Army. They let you finish your residency (albeit still a military match). The airforce and navy do the GMO tour.
                 
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