Military Medicine: Pros, Cons, and Opinions

[AMEDD Officer]

I would like to call BS on this one and humbly state that the Army does indeed have GMOs. They are not like the Navy, meaning it's almost guaranteed for Navy folks to do a GMO tour, but it is still possible for someone to do a GMO tour in the Army. A couple of interns from my current hospital just departed for their GMO tour after not matching after a transitional internship. If you are in the HPSP business please let the students know the truth about matching in the Army and the possibility of GMO tours (and therefore delaying their residency for a couple of years).

Thanks.

st0rmin,
I need to draw attention to an important point about your supposed "BS call" - your intern associates failed to match! There's no free lunch in the Army or anywhere else, so they have to be competitive, and they have to be smart about which way they choose to roll the match game dice. That said, the Army does GMO on an exception basis only, for folks like your two associates who did not match, and FYI, the match rates for Army are generally better than the civilian sector.

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[nvk89]

For the past half year or so, I've been looking through these posts whenever I have time. Perhaps I haven't perused through extensively enough, but there doesn't seem to be a whole lot of discussion about the impact military medicine has on the family.

Now, I'm certainly young, and inexperienced since I'll only start applying to medical school starting this summer. I have always wanted to serve, but I desired something challenging (both physically and mentally) that didn't involve combatant primary directives. I planned out my high school years so that I would be an appealing candidate for USMA, but I determined that even though I may have the capacity to be an operational officer who (let's face it, this is what the army does best) kills or commands others to do so.

I have branched out as much as possible, and I am constantly talking with former service (corpsmen, combat medics, two captains in their residency, and one colonel). As I search, ask, and read, I am gaining a more realistic perspective on the realities of military medicine, though still a largely superficial one that only an observer and outsider can gain. Again, I'm young and still immature, but the idea of operational military medicine has an immense appeal to me. I'm not one of those guys that thinks I can or should become a Ranger-SEAL-PJ-Doctor hybrid, but if the extra training helps me help the group I'm attached to, then all the better since I believe I have what it takes physically (300++ on the APFT should be manageable, I regularly compete in BJJ, I run marathons, and used to be a competitive swimmer). If I can better serve in a more docile clinic environment, I'd love that, too.

One thing that has been irking me, however, is the idea that someday, I may want to have a stable family. Civilian doctors already have high divorce rates, and (depending on your specialty) there are now videocams you can use to watch your kids grow up. Add on the military and year-long army deployments, and it sounds like the family suffers even more. Even so, I am still young, and still want to aspire to the army. I know it will entail many sacrifices, many of which I would experience in the civilian world. From these forums, I've found out quite a bit about how much the military bothers military doctors, but what about my family? How will they be?

I don't have any experience in starting or raising a family, and honestly, I haven't ever thought about it until I started timelining military+medical training+ active duty+reserve+years if I stay on. I know this can seem like a very personal question for those that are far along, and can answer my questions, but if you could spare me some wise words, consider them more helpful to those around me rather than just me.

 

[Gastrapathy]

For the past half year or so, I've been looking through these posts whenever I have time. Perhaps I haven't perused through extensively enough, but there doesn't seem to be a whole lot of discussion about the impact military medicine has on the family.

I don't have any experience in starting or raising a family, and honestly, I haven't ever thought about it until I started timelining military+medical training+ active duty+reserve+years if I stay on. I know this can seem like a very personal question for those that are far along, and can answer my questions, but if you could spare me some wise words, consider them more helpful to those around me rather than just me.

Each family is different. It depends entirely on your spouse and your overall domestic situation. Does she (assumption) have support from friends and family? Do you have children with special needs? Does she hate the prospect of deployment? etc. Too many variables to know in advance.

In general, most families survive and some prosper within the military culture. Some, however, definitely do not.

 

[notdeadyet]

That said, the Army does GMO on an exception basis only, for folks like your two associates who did not match, and FYI, the match rates for Army are generally better than the civilian sector.

Source? This isn't true.

There are some specialties, some years, in which matching is easier in the military than civilian sector. But as a whole, this is not true.

Last data I looked at from 1-2 years ago, the Army had a 75% overall match rate for most specialties I was interested in (EM was less than that). This is lower than civilian sector.

The Army definitely has a lower GMO rate than the Navy or Air Force, but to pretend it's an exception to the rule is false. If you're interested in doing something like EM or other popular specialties, sign up knowing there is a decent chance you'll be doing a GMO tour first. This is not the case on civilian side.

 

[USNOUMED]

The GMO, although an interesting theory that would rarely fly in civilian medicine, has been a great experience for me and was the deciding factor for me to join the Navy. Several of my internship classmates have also chosen to go on to GMO/UMO/FS simply for the experiences that are hard to find as you progress and harder to execute as you age. I have been a GMO with an infantry battalion for almost 2 years. I have enjoyed the Marines (a strange and interesting breed) and will always have a fond memory of my times here. With that said, every single GMO is different. Many experiences can be terrible, some can be great. I do believe it is the mindset and the attitude you take in with you. I am not a MOTO-doctor but it is necessary to conform to the ways of your gaining command. I got the haircut (sort of), starting using the F-bomb in my medical lingo which immediately relaxes Marines and put a chew in every once in a while. With that said, I avoid running like the plague, refuse to get up at 0500 to go to the armory to clean my weapon and generally have a disdain for patello-femoral pain syndrome. It's all unique and if they keep it around, I recommend it for those of you who can make the most out of poop soup. Yes, I am ready to get back to the hospital and finish my residency...air conditioning, clean white walls, nurses (God love them) and getting in trouble when saying the F-bomb too loudly.

 

[northstate]

Casting about for information, albeit on an anonymous student forum, as I get close to going Navy Reserve. May be stupid (see what follows) but not naive, so I'll take what you give with a sober eye... Interested in most opinions though especially of the ones that come from some of the "more mature" posters.

Backstory:
-49 yo, reasonably fit
-GenSurg and PedSurg BC
-Professor, generally happy in academics
-top of my game clinically
-(I'm not running from something)
-financially secure
-no kids, supportive (AF brat) wife

Reasonable understanding of:
-milmed needs (25+% of my families are mil)
-milmed frustrations
-service to need
-corporate stupidities

Why?:
-Proven myself in civilian world, would like a new challenge
-just not interested in being an academic careerist anymore
-strong call to duty
-dad was a Marine DI
-mil families I take care of are my favorite
-want to serve in operations to guys who deserve great care
-join a club I've grown to admire
-got some flexibility with my life, so why the hell not

Questions at this point:
-how likely that detailers will misalign my skill set with my duties?
-how does one finesse this to achieve my goal of being deployed as a trauma surgeon/battalion surgeon and doing some of my US drill time as a PSurgeon?
-plan to go IRR at 3 years, so likely number of deployments in that time
-consequences of jumping command to get things done, both personally and for patients
-choosing a billet
-details of greenside alignment
-typical routine for w/e drill at NOSC (as a surgeon)
-how much paying of dues to medcorp lifers and line soldiers to gain credibility
-how far will "doing it for the right reasons" carry me

 

[IgD]

Questions at this point:
-how likely that detailers will misalign my skill set with my duties?
-how does one finesse this to achieve my goal of being deployed as a trauma surgeon/battalion surgeon and doing some of my US drill time as a PSurgeon?
-plan to go IRR at 3 years, so likely number of deployments in that time
-consequences of jumping command to get things done, both personally and for patients
-choosing a billet
-details of greenside alignment
-typical routine for w/e drill at NOSC (as a surgeon)
-how much paying of dues to medcorp lifers and line soldiers to gain credibility
-how far will "doing it for the right reasons" carry me

I think joining the reserves could be a good choice for you. You are 50, no kids and are flexible. You have low expectations and want to give back to society. The biggest concern I would have for you is deployments. What would happen if you went on a 6-12 month deployment, had a year off and then went on another 6-12 month deployment. Would you lose your university job? I think you could definitely be deployed as a surgeon, you could also work at a military hospital as a surgeon. Not sure if you would be doing any pediatrics surgery. The Navy probably doesn't have an OR or staff capable of supporting that. If you really want to sacrifice, why not go 100% active duty? The Navy desperately needs guys like you who have gray hair, lots of experience and can be a mentor for young surgeons. The other question I have is, can you stomach the bureaucracy? It has its way of breaking a lot of people.

 

[northstate]

I generally like my university job and worry some that a prolonged salary drop (more than 12 months) as well as the loss of benes and insurance will end up being a pretty hefty sacrifice, but after reality testing this for almost a year, I still want to do it. All ex-mil surgeons I know say the PITA titer is high but they thought taking care of soldiers was a career high and would do it again. As a surgeon I'm used to hierarchies and despise bureaucracies and do worry that I go to plebe status at a time when I could remain comfortable, secure and highly paid. Still not sure if I'll get much credit for what I've accomplished in civiilan life, that the military will care that their getting a good asset for cheap or how much i can trade on my doing this for the right reasons but then again wouldn't give a guy like me a free ride if I was on the other side either.

My expectations are sober and pretty realistic now. I don't expect to write my ticket any longer, but would probably regret this if I spent all my time as a backfill general surgeon doing hemorrhoids at Jacksonville. I can respect the chain of command but at my age I'm not afraid to talk back to it. This is clearly not a career move or done for financial reasons so it does give me a little margin in my mind to push for what I want.

What I hope to accomplish v. corporate inflexibility/stupidities still seems on the + side for me. But I'd be lying if I didn't say that when I look past the recruiting poster reasons I still wonder sometimes if this isn't straight up. stupid.

 

[IgD]

My expectations are sober and pretty realistic now. I don't expect to write my ticket any longer, but would probably regret this if I spent all my time as a backfill general surgeon doing hemorrhoids at Jacksonville. I can respect the chain of command but at my age I'm not afraid to talk back to it. This is clearly not a career move or done for financial reasons so it does give me a little margin in my mind to push for what I want.

The Navy has three big hospitals in San Diego, Bethesda and Portsmouth. I'd recommending calling the surgery department at any one of those facilities and ask for the department head. Tell them you are thinking of joining the Navy and want to talk to the Navy Surgery specialty leader. They can tell you what you need to know.

 

[notdeadyet]

I'm with IgD. Given your post about your expectations and hopes, you'd probably find the Reserves a good fit.

-how likely that detailers will misalign my skill set with my duties?
-how does one finesse this to achieve my goal of being deployed as a trauma surgeon/battalion surgeon and doing some of my US drill time as a PSurgeon?

I would actually consider the second an example of the first, no?

If you sign up as a BC Peds Surgeon, expect a deployment to do general surgery. And from the Army Reserve side of the house, expect frequent deployments. From the Navy side, expect the possibility of deployment to Army hospitals.

-plan to go IRR at 3 years, so likely number of deployments in that time

Or after that time. Keep in mind that you could theoretically be called up off of IRR. Highly unlikely, but go in knowing that.

It would be worth your while shopping between Army and Navy. As a board certified surgeon with experience, they'll be tripping over themselves. Army Reserves has a deployment tempo of approximately every 22 months. Deployments are 90 days boots-in-sand, no more than 120 days away from your home location. Check to see what Navy Reserves is doing. In writing.

Don't have any answers to your questions for Navy side of the house, but if you'd consider Army, let me know via PM and I can help you out.

 

[northstate]

Appreciate the feedback.

Am keying on the Navy b/c of the father who was Marine and possibility of Afgstan in their support, chance at Mercy and Comfort, hearsay and the double-breasted gold buttons.

Again, I keep hoping I'll be treated as an asset but continue to hear horror stories. Waver between making a leap of faith (expecting no organization can be that tone-deaf) or dragging this out until all my concerns are answered.

The "in writing" thing confounds me, since not just recruiters but med corp upper echelon (RADM and Surgery SLs) tell me they can't/won't do it but assure me that I'll be on their radar and not posted to Guam to do blisters.
Sure things change and I get "service to need" but is there a pattern of stupidity that I should be aware of? This forum seems to suggest so, but I try to look past it since my situation is somewhat different than a young doc with family and a now daunting payback obligation and peers making triple.

My take on it now is:
-just do it
-defer any sign on bonus (and deep financial payback obligation)
-seek a duty station, as a GenSurg that would get me towards a expeditionary hosp or shock platoon for hopefully not more than 12 m deployment (any suggestions on how to game the system for this?)
-hope they might agree to use me somewhat stateside as a PSurg as part of my drill time (lots of head nodding, but nothing in writing so far)
-ask to go IRR at three years (again not a career move in this), since at my age I figure this has met my call to duty

Reluctant to ask this since I don't want my commitment questioned, but say it blows up on me (can't pay mortgage, facing divorce over 3rd deployment, fired from univeristy, utterly misused skillset) is there any exit strategy? Have heard lots about resigned commisions on this forum. This is part of my rationale for not taking the bonus (which I don't really need anyway).

Not looking for a medal but I do feel that if I'm anteing up $hundredKs of training that the mil doesn't have to pay, 15 years of experience and $hundredsK of "lost" civilian salary for honorable reasons. Is it too entitiled in military world to expect that I'll be used to good effect and with some recognition of what I hoped for by signing on?

 

[northstate]

Am going to move this to a new thread off the sticky board.

 

[a1qwerty55]

Am going to move this to a new thread off the sticky board.

Reserve deployments are 3 months not 6-12.
The Army is more likely to use you as a surgeon especially a pediatric surgeon. More facilities, larger beneficiary pool. I'm Army so I have my bias. I appreciate your attitude and desire to serve. I think you will do well, and not taking a bonus probably does keep your options a bit more open.

 

[IAmDrP]

Hi,

I am new to SDN and I am desperately looking for some advice. So, I'm a wife, mother (I have a 15 month old daughter), I work full time (layoffs are coming before the end of this year) and just completed my first semester as a Post Bacc. I'm 27 (turning 28 soon).

I am considering joining the Air Force (especially with lay offs coming soon and not knowing where I would be) I really want to know if I should join as soon as possible or wait till I complete my Post Bacc Work?

Would I be able to complete my Premed studies once I continue/complete Basic Training?

Will my daughter see me often after Basic Training?

 

[IgD]

Would I be able to complete my Premed studies once I continue/complete Basic Training?

That's a dangerous gamble. The military is an uncaring machine and it wants you to get the mission done. Your educational goals will come a distant second. You might be able to take evening classes but what if they move you or what if you get deployed? Another thought, what if they make you work nights or weekends during your classes? If you are dead set on going into medicine I say finish your education first. If you really want to join the military, come in as HPSP.

 

[avatarftw]

a

 

[IAmDrP]

That's a dangerous gamble. The military is an uncaring machine and it wants you to get the mission done. Your educational goals will come a distant second. You might be able to take evening classes but what if they move you or what if you get deployed? Another thought, what if they make you work nights or weekends during your classes? If you are dead set on going into medicine I say finish your education first. If you really want to join the military, come in as HPSP.

Good point. I'm definitely taking what you said into consideration! I'm not sure I want to end up delaying my medical education too much longer.

 

[IAmDrP]

Mind you, each year that you delay becoming an attending physician means a big opportunity cost loss. If you make 250,000 gross for example, that's 150,000 net per year. The debt is secondary; get in as fast as possible while considering the needs of your daughter. Can your husband hold the fort while you get your MD/DO?

My husband has been the primary care giver for my daughter for almost a year. He's very willing to support whatever decision I make. He is actually encouraging me to join the military. He tried but can't. He lost his job and has tried to start a business where he can work from home (which is difficult). So I'm the only one bringing in income at the moment. My job is not too secure as there are expected layoffs before the end of the year. For this reason the military became even more of a consideration.

However, I'm really don't want to get side tracked from studies. Yeah I know, it's a lot going on.

I'm going to do my best to finish off my Post Bacc studies and the MCATs and see what opportunities there are for med school.

 

[Galo]

http://forums.studentdoctor.net/showthread.php?p=9919132#post9919132


Another clear poor experience in training and reasons to not go through HPSP, or any program that involves training in the military.

 

[Aegis]

There are a lot of strong valid reasons not to go into military medicine. But, given the right person it can be a great experience. I'm a new flight surgeon and so far I couldn't be happier with the decisions I've made. My plan is to pay my four years off and then finish my residency as a civilian after I separate. The way I look at it is that we are all going to have long fruitful careers in whatever we do, when I'm 80 years old I want to be able to tell my grand kids I did something kick ass for a few years before entering into field xxxx. You will find some people in this forum that are bitter about their GMO years, but I can assure you that the majority of people I've spoken with are very happy they did it. You can follow along with me if you like on my blog. www.whitecoatrevolt.com

 

[Holli]

It seems that most people are commenting on full active duty, is there anyone that is/was in the National Guard? I am already in a residency program, I have done a great deal of research and have decided that I like the Army National Guard program over the other two because I can still work in a civilian hospital, even after residency. I know what people say about recruiters but I really feel that my recruiter has been completely honest, especially after reading what some of you found out AFTER you joined. But I still would like to speak to someone with actual experience. More importantly, I want to know why some do not choose to stay in the military national guard long-term.

If there is any such person reading this that is/was in the Michigan Army National Guard program, I'd appreciate your 2 cents...as well as your email address

 

[EMH]

If there is any such person reading this that is/was in the Michigan Army National Guard program, I'd appreciate your 2 cents...as well as your email address

I'm an MS4 in the Arkansas ARNG. My best advice would be to talk to your recruiter and ask to come to drill and talk to the doctors that are in your state's guard. From what I've gathered, each state is quite different in what is expected and what your role will be. If you wish you can PM me and I'll send you my e-mail address.

I can only speak as to what I've seen. The two reasons I've seen or heard of people getting out before retirement: #1 You can make more money as a civilian. This depends greatly on your specialty. The docs in my state who have stayed for 20+ years all love the guard but will also agree that they are losing money when they take time off. #2 Don't want to deploy. I've only met one doc who finished residency and got out ASAP because he didn't want to deploy.

I think that with the new $ for loan repayment (and decreasing civilian reimbursement) it now makes financial sense for some specialties to join. Of course don't do it for the money or you will be disappointed. If you like the idea of the guard but don't like your state, come to Arkansas, we've got a great Medical Command here.

 

[berespectful]

Hello I am a senior in college seeking to become a doctor. I would like to do my residency in emergency medicine and I was curious about a few things.
1. If I join will I be able to complete my residency at a civilian institute or will I be required to practice as a general practitioner or will I need to attend a naval institute?
2. Will I be required to serve on a ship or can I be stationed and practice at a base for the entirety of my service?
3. If I joined what would be my rank after I finished medical school ? After I finish my residency?
4. My wife is a early childhood teacher will she be able to teach children of families who live on the base and if not will the navy help her find a job in the surrounding area?
5. While I was in high school I broke my back. It does not really effect me now except when the weather changes. I do not have any trouble lifting or moving just stiff when I wake up sometimes. Will this effect me joining the navy?
6. Will I be able to have a choice in where I am stationed?
7. While living on a base how does the housing process work? Will I need to apply and hope I get a place to live or will housing be provided or will I have to live off base?
8. I had spoken with a recruiter and in the city where I would like to attend medical school there is also an Air Force base. The recruiter had assured me that I would be able to live there if I applied and there was available room for me and my wife. I was wondering if this is a true statement and how far ahead would I need to apply?

 

[Gastrapathy]

Spend a couple of hours reading here and all this info is available ad nauseum. Brief answers below.

Hello I am a senior in college seeking to become a doctor. I would like to do my residency in emergency medicine and I was curious about a few things.
1. If I join will I be able to complete my residency at a civilian institute or will I be required to practice as a general practitioner or will I need to attend a naval institute?

Count on training at a Navy hospital and having your training broken by a GMO tour.

2. Will I be required to serve on a ship or can I be stationed and practice at a base for the entirety of my service?

Few ships, lots of Army-style deployments

3. If I joined what would be my rank after I finished medical school ? After I finish my residency?

LT/LCDR

4. My wife is a early childhood teacher will she be able to teach children of families who live on the base and if not will the navy help her find a job in the surrounding area?

Probably no help.

5. While I was in high school I broke my back. It does not really effect me now except when the weather changes. I do not have any trouble lifting or moving just stiff when I wake up sometimes. Will this effect me joining the navy?

Depends.
6. Will I be able to have a choice in where I am stationed?

No
7. While living on a base how does the housing process work? Will I need to apply and hope I get a place to live or will housing be provided or will I have to live off base?

You will want to live off base.

8. I had spoken with a recruiter and in the city where I would like to attend medical school there is also an Air Force base. The recruiter had assured me that I would be able to live there if I applied and there was available room for me and my wife. I was wondering if this is a true statement and how far ahead would I need to apply?

False.

 

[slycaper]

Can you apply for a 2nd residency while in the military since they dont have dual programs in the military? i.e. finish EM apply to IM?

 

[EMDoc0411]

Can you apply for a 2nd residency while in the military since they dont have dual programs in the military? i.e. finish EM apply to IM?

No.

 

[slycaper]

Could you elaborate a bit more, I've heard you could from a few people but I was looking for a more definitive answer.

 

[EMDoc0411]

Could you elaborate a bit more, I've heard you could from a few people but I was looking for a more definitive answer.

No.

 

[slycaper]

Why not?

 

[J-Rad]

You can reapply for a second specialty (vs. fellowship) generally only after you have completed your active duty service obligation, or at least some significant period of time in your primary specialty. I have not heard of anyone who has been allowed to apply for a second residency right after a first.

 

[DrMetal]

Can you apply for a 2nd residency while in the military since they dont have dual programs in the military? i.e. finish EM apply to IM?

If you're talking about a dual residency program, answer is no. There are none in the mil, and I doubt they'd allow you to do a civilian one.

If you're talking about re-training in something else, after you're already gone through one residency program and served as that occupation for a while . . .that might be a possibility, depending on the needs of the branch you're in (emphasize the word might). For instance, if you're a psych who wants to re-train in family medicine, that might be a go (b/c the mil always need FPs). On the other hand, if you wanna retrain in something more competitive and saturated (derm, rads), probably a no-go.

 

[AF M4]

You can reapply for a second specialty (vs. fellowship) generally only after you have completed your active duty service obligation, or at least some significant period of time in your primary specialty. I have not heard of anyone who has been allowed to apply for a second residency right after a first.

Agreed. The only people I've heard of going into residency #2 are folks who served a significant period of time in their original residency plus made a few friends along the way who helped them get into their second residency.

From the military's vantage, it allotted space and then paid for a certain amount of docs to be trained in certain types of specialties to meet the projected needs of the troops. Therefore, the military will in general wish for you to serve the amount of time in your specialty that it had projected you for when it made its original commitment to your training.

It's a good philosophy.

 

[slycaper]

Thanks for the info guys, if you were able to get a 2nd residency would your pay be affected?

 

[J-Rad]

The simplest answer would be: only if your new specialty had a different special-pay rate. For example: you are pediatrician, serve for 4 years post residency, and for some reason you decided to train-and are allowed-in OB-GYN. When you complete your residency, you will be eligible to get the $31K/yr ISP vs. the $20K that peds gets. Obviously, if you went the other way around, you could make less. I don't know if you'd be allowed to get the peds ISP during your OB-GYN residency since you wouldn't be practicing in your specialty or a related field. There are more complexities to this related to time-in-service increases in pay (that apply universally) and eligibility for other types of incentive pays, like MSP.

 

[m3nc]

I would be very careful before signing on with the US gov't just so they'll pay your med school dues. My husband and I have had a terrible military experience. I'm reading a lot abt. being a patriot, just keep a positive attitude etc... That's not the issue!

Issue is- will any military branch allow you to stay proficient in your chosen field. Is their experience they offer going to make you a good MD?
time and time again the answer is simply, NO!

We've been active duty for 7 yrs. My husband is a CT surgeon, trained at one of the top 5 hospitals in the country. (he did med school, gen. surgery, CT fellowship all at a civilian hospital, thank God). Years ago he starts paying the military back b/c of his ROTC scholarship, etc... The military hospitals he's worked in which are the largest and "best" are completely substandard in almost every specialty. It is scary.

If you want to be a specialist, beware of what the military has to offer. They can not even give my husband 100-120 cases a year. Would you want someone sawing your chest open with that kind of experience? Teaching hospitals across the country easily give their surgeons over 175 cases a year .I think not.
We are friends with neurosurgeons, urologists, ortho, even peds specialist that consistently complain about not enough patients, experiences, or OR time. My husband does his job well and with pride b/c he's honoring his commitment. It's very disappointing to know they will lie to your face just so they can get a warm body that they can deploy.

 

[Gastrapathy]

I would be very careful before signing on with the US gov't just so they'll pay your med school dues. My husband and I have had a terrible military experience. I'm reading a lot abt. being a patriot, just keep a positive attitude etc... That's not the issue!

Issue is- will any military branch allow you to stay proficient in your chosen field. Is their experience they offer going to make you a good MD?
time and time again the answer is simply, NO!

We've been active duty for 7 yrs. My husband is a CT surgeon, trained at one of the top 5 hospitals in the country. (he did med school, gen. surgery, CT fellowship all at a civilian hospital, thank God). Years ago he starts paying the military back b/c of his ROTC scholarship, etc... The military hospitals he's worked in which are the largest and "best" are completely substandard in almost every specialty. It is scary.

If you want to be a specialist, beware of what the military has to offer. They can not even give my husband 100-120 cases a year. Would you want someone sawing your chest open with that kind of experience? Teaching hospitals across the country easily give their surgeons over 175 cases a year .I think not.
We are friends with neurosurgeons, urologists, ortho, even peds specialist that consistently complain about not enough patients, experiences, or OR time. My husband does his job well and with pride b/c he's honoring his commitment. It's very disappointing to know they will lie to your face just so they can get a warm body that they can deploy.

So your husband did ROTC, then HPSP and then trained outservice in the specialty of his choice (which he knew would have case volume issues at all but the busiest centers) and now you feel lied to? Of course they want him to deploy. HE'S A SURGEON DURING A WAR. They should have deployed him after residency and made him wait for fellowship.

As for military hospitals being substandard across every specialty, that is simply false. We are decidedly average in the surgical specialties and above average in primary care and medical subspecialties. All those doctors you are so proud to know...are they all substandard or did you just mean people you don't know?

Frankly, our CT surgeons scare the **** out of me and operate on people who are supposed to get neoadjuvant chemo just to keep their numbers up. That's one specialty that I would definitely not let my family see at my MTF.

If you read my posts, you'll see that I'm no cheerleader but your post was absurd.

 

[Porthos1000]

I can't take civilian medicine any more ---- is military the answer?

-I'm tired of morbidly obese depressed unemployed unmotivated pt's asking for vicodin and disability papers and putting on pound after pound
-I'm tired of co-physicians or physician directors who have little to no concept of loyalty to each other, of sacrifice for the greater good....whose loyalties and sacrifices are only meant for their 6-figure salaries to pay for the car/mortgage/kids' tuition.
-I'm tired of patients who don't do their part when I bust my butt trying to keep them healthy
-I'm tired of being at a place where it's not enough to get the mission accomplished well, but to have to be "Dr. Smiley Nicey" and make each patient feel like King or Queen just to keep 90% satisfaction scores to maintain tenure or earn a raise
-I hate having to choose a coordinated shirt and tie combo each day that doesn't repeat the previous days'.

Plenty of reasons why I like the military (want to serve our men and women in uniform, want the camaraderie, want the challenge of deploying). Plenty of reasons why I still like being a doctor.

So is that it?

 

[Gastrapathy]

I can't take civilian medicine any more ---- is military the answer?

-I'm tired of morbidly obese depressed unemployed unmotivated pt's asking for vicodin and disability papers and putting on pound after pound
-I'm tired of patients who don't do their part when I bust my butt trying to keep them healthy
-too much gyn where I'm at --- one more speculum exam for another yeast infection and I'm gonna puke

I envy those in uniform and boots and those that medically care for them.

1. You're the dude on an SSRI right? That pretty much answers the question. Sorry.

2. Pretty sad that someone who is on medication for depression would feel the way you do about depressed patients.

3. Apparently you are unfamiliar with the average BMI of the USMC wife.

 

[Porthos1000]

1. You're the dude on an SSRI right? That pretty much answers the question. Sorry.

2. Pretty sad that someone who is on medication for depression would feel the way you do about depressed patients.

3. Apparently you are unfamiliar with the average BMI of the USMC wife.

Yes, friend, I am "the dude on an SSRI". And yes, my depression is very well controlled. So no, that doesn't answer the question. Sorry. (by the way you can review my fully thought out post, sorry wasn't done).

So sounds like you're Navy? FMF? OK, so you saw a high BMI USMC wife, maybe your own too? Just a joke, man, take it easy. Alright, but I'm talking about the average healthy population when you are deployed. Want to tell me about that, gastropathy? Or you just waiting for your discharge papers?

Any real input from somone truly committed to their duty as a professional American military physician would be appreciated.

 

[Gastrapathy]

Yes, friend, I am "the dude on an SSRI". And yes, my depression is very well controlled. So no, that doesn't answer the question. Sorry. (by the way you can review my fully thought out post, sorry wasn't done).

So sounds like you're Navy? FMF? OK, so you saw a high BMI USMC wife, maybe your own too? Just a joke, man, take it easy. Alright, but I'm talking about the average healthy population when you are deployed. Want to tell me about that, gastropathy? Or you just waiting for your discharge papers?

Any real input from somone truly committed to their duty as a professional American military physician would be appreciated.

That was real input. You don't understand what we do. Except for real combat casualty care (which doesn't happen at the BAS level), sick call is at least as boring/frustrating as your current clinic. You won't be putting in a chest tube and sending a patient on to a role 3. They are smart enough to fly the patient right over you to the trauma surgeon and the outcomes support that this is a good choice. I don't know your specialty, but based on the above post, I doubt its surgery, anesthesiology, critical care or EM. If it is, you might find a more medically challenging deployment.

And my first point remains, you can't join the Navy. The relevant reference is the MANMED Ch15-44(2). I'm in favor of this simply because I'm the guy who doesn't have any angle to keep myself from getting deployed. You're the guy who finds the prospect too stressful and...bang...I'm going on your deployment. I realize you don't think that this is you but the reason you can't join is because the odds are that it might be you.

 

[AF M4]

See below adjustments.

I can't take military medicine any more ---- is civilian medicine the answer?

-I'm tired of morbidly obese depressed unmotivated airmen asking for profiles and MEBs so that they can get disability pay while failing their PT test and putting on pound after pound
-I'm tired of commanders or physician administrators who have little to no concept of loyalty to each other, of sacrifice for the greater good....whose loyalties and sacrifices are only meant for their 5-figure salaries to pay for the car/mortgage/kids' tuition.
-I'm tired of patients who don't do their part when I bust my butt trying to keep them healthy
-I'm tired of being at a place where it's not enough to get the mission accomplished well, but to have to be "Dr. Smiley Nicey" and make each patient feel like King or Queen just to keep 90% satisfaction scores to keep various commanders off my back
-I like wearing a flight suit every day.

The grass ain't greener and on this side of the lawn they don't let you leave when you want. Don't believe what you read in the recruitment brochures.

 

[Porthos1000]

See below adjustments.



The grass ain't greener and on this side of the lawn they don't let you leave when you want.

Navy, AF... Jesus, there it is.

Army takers?

btw I am internal med residency trained, not going in as a GMO.

 

[Ascultator]

I'm getting offered civilian jobs and from what I'm hearing around here, civilian sector is the way to go buddy. Grass is always greener...

 

[lee88]

Hi everyone,

I am a senior who did NROTC to pay for ungrad, and now I am holding acceptances to USUHS and my state med school. I have been reading this thread for a while but I have a few specific questions.

I was told at my USUHS interview that the Navy does not make everyone do GMO tours anymore(I specifically asked the dean of admissions this question). She said they make some people do them, but a lot of people request them and you can definitely match into a residency if you are 'competitive'(whatever that means). Was she telling the truth?

I really want to have a family and kids, and I have heard that this is difficult in both military and civilian medicine. My dad is a Colonel in the USMC and my mom has told me that having a child as a doctor will be difficult but the military has great childcare/a more family friendly atmosphere than a competitive civilian hospital. Is this true? (she stayed at home to care for me and my brother so she is probably getting this from my dad)

Lastly, people on this thread have been saying that the military doesn't let you choose where you live. However, my dad has always been able to get his 1st or 2nd choice duty station, and we've been to some pretty glamorous places like Hawaii and Norway. Is it different for doctors who may be in higher demand and therefor have less choices? (my dad was in infantry and then switched to logistics)

I am trying to decide between going to USUHS or paying my way through state med school and doing as little Navy payback as possible, but any input would be helpful. Thanks and sorry for the really long post.

 

[ArmyFltDoc]

Actually, I'd have to say that post is right on the money. One of the great flaws with military medicine is that you have little to no say in how you do business while in garrison. While you may stay filling out AHLTA charts til 8pm, your civilian staff will depart promptly at 4:30. Got an extra 20-hour block of power-point training to do? No problem, just squeeze it in somewhere. Office staff that's incompetent? Too bad, they're on contract. CME conference to go to? Ummm, no, maybe next year. The military has a tendency to treat you like an asset that's bought and paid for, which is all fine and good while that's the case. After our obligation is up, though, they continue to treat us that way, so it's no wonder we leave in droves. It's a shame, too, because I've seen many providers who were gifted and devoted to the troops just have to give it up because they just couldn't take it anymore.

 

[Ascultator]

And about that AHTLA....so is it standardized across all Army MTFs?

haven't seen it m'self yet, but sounds like it's designed by monkeys. why's it so bad -- cluttered interface? redundant? crashes on you?

 

[AF M4]

And about that AHTLA....so is it standardized across all Army MTFs?

haven't seen it m'self yet, but sounds like it's designed by monkeys. why's it so bad -- cluttered interface? redundant? crashes on you?

All of the above. Tends to be slow, down 5% of the time (particularly if you're not at a base that houses a main server), randomly delete notes, and was designed more for use as a tool to collect metrics (i.e., how many people have shellfish allergies in the AF?) than to be used as an EMR by clinicians.

 

[wiscRD]

While you may stay filling out AHLTA charts til 8pm, your civilian staff will depart promptly at 4:30. Got an extra 20-hour block of power-point training to do? No problem, just squeeze it in somewhere. Office staff that's incompetent? Too bad, they're on contract. CME conference to go to? Ummm, no, maybe next year.

Reading this reminds me of most higher-up civilian job. Maybe it isn't the same for doctors, but my dad works 10-12 hour days as a sales executive and my father-in-law works anywhere from 9-12 hours as a head planner/manufacturing engineer. They complain about these same things in their jobs - too much to do and not enough time to do it, tons of incompetent people or newbies out of college that don't know what hard work is, and so on. Even in my job now as a dietitian I feel like these issues exist, since I am the only dietitian on when I work and I do inpatient, outpatient, long-term care, and community, depending on the day. I am not a doctor yet so I don't know what a civilian doctor's day is like aside from what I have seen in job shadowing and working with them on the floors of the hospital, but in comparison to what I have seen working in a hospital and the business world, it doesn't seem like this is much different that anywhere else.

The civilian doctors mentioned in the post are working in a gov't facility, so I am wondering if this is different than working in a civilian hospital? I was thinking that maybe since they are contractors they are held to x hours per week whereas in a civilian hospital you are done when the work is done - is this true?

 

[girl1234]

Hi there,

I am applying to med school right now and strongly, strongly considering HPSP. I've read a ton on these forums, but have yet to post anything re: mil med. I have no military background or loyalty to any one branch and am trying to decide which, if any, branch would be the best match for me. At this point, I've all but ruled out the army - while its higher chances of being able to train straight through are tempting, the longer and (seemingly) more hazardous deployments, along with the notion that the army 'doesn't treat its people as well' (mostly with regards to when i serve AD time) as the other two branches have sort of pushed me away from them

Now, I'm trying to decide whether navy or af would be a better match. The AF recruiter I've spoken with seems less-than-trustworthy, though I do have a personal friend that has helped clarify some of the discrepencies (HPSP AF guy, 5th year at a great civilian residency - he was granted a deferral for gen surg, and is now about to start his AD). The Navy recruiter I spoke with was very nice, but unfortunately was actually a nursing and dentist recruiter and had slim-to-no idea of the match process/GMOs - which is what I am most in-need of details on.

SO...

1) I know Army has higher match rates and have seen the numbers for 2010 (ratio of applicants to spots)...but for the AF and Navy I haven't been able to acquire these numbers...anyone have ANY notion of about how many applicants/year (percentage-wise?) DON'T match, and therefore funnel into FS/GMO or Transition Years?

2) IF I were to end up as a FS for the AF, what are the different tracks for flight surgery, and how does one apply to them/how are people selected for them? How long are the minimum FS commitments?

3) IF I were to end up as a GMO for the Navy, same questions as above.

ps, by "tracks" i mean flight med, dive med, with seals or marines or special forces, etc etc...apologies if I am making up random 'tracks', again NO military background here, just a bf whose father/grandfather were marines and who would flip their s if i ended up as doc for a marine battalion...

I have tons-o-questions...but figured I'd start with these and see if I get any useful feedback. Thanks in advance to anyone who tries to help!

 

[a1qwerty55]

Hi there,

I am applying to med school right now and strongly, strongly considering HPSP. I've read a ton on these forums, but have yet to post anything re: mil med. I have no military background or loyalty to any one branch and am trying to decide which, if any, branch would be the best match for me. At this point, I've all but ruled out the army - while its higher chances of being able to train straight through are tempting, the longer and (seemingly) more hazardous deployments, along with the notion that the army 'doesn't treat its people as well' (mostly with regards to when i serve AD time) as the other two branches have sort of pushed me away from them

Now, I'm trying to decide whether navy or af would be a better match. The AF recruiter I've spoken with seems less-than-trustworthy, though I do have a personal friend that has helped clarify some of the discrepencies (HPSP AF guy, 5th year at a great civilian residency - he was granted a deferral for gen surg, and is now about to start his AD). The Navy recruiter I spoke with was very nice, but unfortunately was actually a nursing and dentist recruiter and had slim-to-no idea of the match process/GMOs - which is what I am most in-need of details on.

SO...

1) I know Army has higher match rates and have seen the numbers for 2010 (ratio of applicants to spots)...but for the AF and Navy I haven't been able to acquire these numbers...anyone have ANY notion of about how many applicants/year (percentage-wise?) DON'T match, and therefore funnel into FS/GMO or Transition Years?

2) IF I were to end up as a FS for the AF, what are the different tracks for flight surgery, and how does one apply to them/how are people selected for them? How long are the minimum FS commitments?

3) IF I were to end up as a GMO for the Navy, same questions as above.

ps, by "tracks" i mean flight med, dive med, with seals or marines or special forces, etc etc...apologies if I am making up random 'tracks', again NO military background here, just a bf whose father/grandfather were marines and who would flip their s if i ended up as doc for a marine battalion...

I have tons-o-questions...but figured I'd start with these and see if I get any useful feedback. Thanks in advance to anyone who tries to help!

As you pointed out, the majority well over 50%, probably now more like >70% do not do GMO's. The Army has a much more robust medical department with more opportunity to use your skills/training. Ask the USAF surgeons how satisfied with the case volume (not very). I also wonder where you got the idea that the Army treated it people worse than the AF and Navy? I would disagree with this basic premise at least with regards to medical personnel. Lastly, I would also argue that the deployments (at least hazardwise) aren't different between the Army and Navy.

I'm not selling the Army but I do think you may want to reassess some of your assumptions about the various services.