...As for the whole thing with sending Navy docs fresh out of intern year to the front line, lets be clear: For the people getting assigned now this was a total bait and switch. ...you as much as anyone have to appreciate that it is difficult to make am informed decision when you are being outright LIED TO...
I definately appreciate what you are saying. The same goes for civilian practices as well..... Bottom line, you are signing a very costly contract. In civilian practice, when all is said and done, that contract value (depending on the math) can be worth in excess of 1 million dollars even if your yearly "salary" is under $300K. Well, a military contract is similar. You may only be seeing the $75-150k medical school costs, or the $20k stipend in residency, etc.... The actual "value" of that contract (again, depending on how & who does the math) is in excess of several 100s of thousand dollars. So, as in civilian contracts.... if it's not in the contract, it doesn't really matter much what the recruiter or CEO promised you!
So, military contracts.... how many pages are they? Not many relatively speaking. A civilian contract can be in excess of 12 pages. Military contracts spell out a few important points, as I noted before:
1. Your job is whatever is in the best interest of the military
2. The best interest of the military is determined by someone other then you (may be "dumber" then you) and can (often will) change without your input...
I don't like folks young or old getting "tricked" or "lied to". But, in all honesty, I have had some residents show me their military contracts..... frankly, they are far simpler and easier to read then the legal jargon of a civilian practice contract. Your obligation is as noted in points 1 & 2 above and it doesn't matter what recruiter a, b, c, d, etc.... says today or tomorrow. What matters is what is in the contract. If your contract specifically spells out: 1. you will get to choose your specialty (i.e. residency) and 2. you will get to complete residency after medical school and before any tour/deployment/utilization, great. But, I don't think any such contract has been drawn up.
If you look at the military medical history, numerous physicians have sat in the ranks of the reserves for several decades pre-9/11 without ever being called up or deployed. Recruiters can say "historically" most have just collected a monthly stipend and kept a uniform in the closet. That is not the reality anymore. The points that have not changed are a contract is signed and the obligation is to "whatever is in the best interest of the military" at any given point.... it does not take into consideration what you think would be best for the military or what you think is best for you or what your recruiter may have told you.... There is also usually some clause in the contract to the effect that the military may change terms of contract and or obligation... particularly during times of war or increased need. Sad, but those are just the facts.
The best we can do is encourage folks that serious contracts such as employment, mortgages, car loans, military, etc.... need to be read. they need to be taken seriously. If it is not in the contract, you have no expectation of receiving it.
...Basically it's the Assistant Secretary of Defense Health Affairs saying that GMO tours are not good medicine and they will be phased out. But that was in 1998. Don't get me wrong, I love military medicine but there has to be a better way.
I suspect in an ideal world the military truely believes that. Unfortunately, given the current numbers, I think military command is accepting the lesser of two evils.... either no physicians in the field (cause they are all caught up in residency) or fresh med-school grads with two years of "clinical experience" in med-school....
As for a better way, then there needs to be funding and physicians need to be willing to be "real soldiers". I am always surprised at the level of entitlement expressed by some attendings and residents in the military as compared to the foot soldiers and other branches of the military. I have a good number of friends in the military. I spent some of my residency next to a military hospital and did some VA rotations. I have listened to residents brag how the stopwatch was "paused" an extra 2 minutes to allow them to "pass" the 2 mile run or how the measuring tape was "stretched" to allow passage of the height/wt requirements... to avoid loosing a doctor.... Alot of rules are bent for military healthcare providers and that in and of itself hurts the credibility of any arguments. Think about it.... you have the "best & brightest", some of the most highly educated.... can't read a contract, can't eat healthy and exercise, can't maintain proper weight and fitness standards, etc.... (obviously a generalization).