Military Ophthalmology

[JasonDO]

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Are there any military ophthos out there? I am a pre-select for ophtho at Brooke Army Medical Center in San Antonio. Any words of advice to help "lock in" my spot for the PGY-II year and beyond? Also, what is life like as a military ophthalmologist? Any input would be greatly appreciated. I'd appreciate input from any military physician/interns/residents.

thanks,

Jason Park MS-IV
NSU-COM

 

[Andrew_Doan]

Congrats on your pre-selection to be an Army ophthalmologist. I am in the Navy Reserves and will serve the Navy after I finish my taining at Iowa.

Because you're doing a military residency, I assume you're already in the Army. I am not aware of anyway to "lock" in your spot for this training. The military may pull you from residency if they think you're needed elsewhere. A friend of mine in the Army was matched for ortho, but then was pulled to be a GMO. He then was matched for rehab medicine, but instead was deployed to the Middle East. He will return after his tour of duty and continue residency in rehab medicine.

If you eventually end up in ophthalmology, then I think you'll have a great career as a military ophthalmologist. There are many benefits of being in the military, and it's a great group of people to work with. One draw back of the military is that if you want to do fellowship work, then you must complete one in the area that the military will need. I'm not sure about the needs of the Army, but I know the Navy will need sub-specialists in all areas in the near future. A huge bonus is that if you're allowed to do fellowship training, then you may do it at a civilian training program and collect full-staff pay from the Army. We have an Army ophthalmologist coming next year for retina training. I think he'll be paid about $130K+ during fellowship because he is an O-5. This also means that you can likely get whatever fellowship you want because you'll be "free" for the training program.

I'm planning to do ocular pathology for the Navy and hope to stay involved with their academic programs. The benefits are good, we all get 30-days paid vacation per year, and the pay is equivalent to civilian academic programs.

You're not going to make a ton, but you'll have a nice life style and job security. If you make it for the full 20 years of service, then the retirement is very nice. Most military physicians retire in their mid-40s or mid-50s. After retirement, you may continue working as a civilian ophthalmologist while collecting military retirement.

I wish you luck.

 

[JasonDO]

Originally posted by Ophtho_MudPhud
Congrats on your pre-selection to be an Army ophthalmologist. I am in the Navy Reserves and will serve the Navy after I finish my taining at Iowa.

Because you're doing a military residency, I assume you're already in the Army. I am not aware of anyway to "lock" in your spot for this training. The military may pull you from residency if they think you're needed elsewhere. A friend of mine in the Army was matched for ortho, but then was pulled to be a GMO. He then was matched for rehab medicine, but instead was deployed to the Middle East. He will return after his tour of duty and continue residency in rehab medicine.

If you eventually end up in ophthalmology, then I think you'll have a great career as a military ophthalmologist. There are many benefits of being in the military, and it's a great group of people to work with. One draw back of the military is that if you want to do fellowship work, then you must complete one in the area that the military will need. I'm not sure about the needs of the Army, but I know the Navy will need sub-specialists in all areas in the near future. A huge bonus is that if you're allowed to do fellowship training, then you may do it at a civilian training program and collect full-staff pay from the Army. We have an Army ophthalmologist coming next year for retina training. I think he'll be paid about $130K+ during fellowship because he is an O-5. This also means that you can likely get whatever fellowship you want because you'll be "free" for the training program.

I'm planning to do ocular pathology for the Navy and hope to stay involved with their academic programs. The benefits are good, we all get 30-days paid vacation per year, and the pay is equivalent to civilian academic programs.

You're not going to make a ton, but you'll have a nice life style and job security. If you make it for the full 20 years of service, then the retirement is very nice. Most military physicians retire in their mid-40s or mid-50s. After retirement, you may continue working as a civilian ophthalmologist while collecting military retirement.

I wish you luck.

Thanks Andrew. I was hoping there would be someone out there to give me a "heads up" on what to expect. I am a bit worried about the situation you described with your friend being matched to ortho and then eventually ending up in PM&R. I definitely do not want to deviate from eventual goal of becoming an ophthalmologist.

I sort of had a rough idea of what life would be like as a military physician. Nonehtheless, I am glad that my assumptions are confirmed. At this time, I am interested in doing a vitreoretinal fellowship following residency. It is welcome and very good news to hear that finding a civilian fellowship will be fairly easy despite having to comply with the military's need.

thanks again...I hope I can call on you again in the future for some advice...being that I am hoping to continue along the same path as yourself...I would really appreciate that

Jason Park MS-IV
NSU-COM

 

[JA_Perez]

Ophtho_MudPhud:

I just read that you are from the Navy reserves and that you are training in Iowa. Did you studied medicine under the HPSP program? Did you got a deferment for Ophta? If so, how hard is it to get a deferment and do a residency outside the NAVY, being radiology my field of interest?

Ens P?rez

 

[Andrew_Doan]

Originally posted by JA_Perez
Ophtho_MudPhud:

I just read that you are from the Navy reserves and that you are training in Iowa. Did you studied medicine under the HPSP program? Did you got a deferment for Ophta? If so, how hard is it to get a deferment and do a residency outside the NAVY, being radiology my field of interest?

Ens P?rez

Ens P?rez:

I joined the Navy after matching for ophthalmology through the Navy FAP (Financial Assistance Program). I prefer the FAP over the HPSP because the Navy hired me as an ophthalmologist and I am locked into this program at a civilian training program. The FAP benefits are good too.

If you're in the Navy, then a deferment is difficult. If you're not yet in the Navy, then getting hired as a radiologist is no problem. You can join the Navy through the FAP as well.

 

[Primate]

Hi,

Quick question with regard to the Navy.

Background:
I've been talking to my local recruiter for a couple years about coming into the Naval Reserves. Accd to him, the only way to do Reserves is after I'm licensed (in this state it's 2 years GME before licensure - 4 more total for me). Ophtho is usually PRIMUS unit eligible (which makes doing it possible during residency).

Here's the question:
Do you know if the Navy (or other branch) can call you up to active duty AND also "reassign" you as a GMO depending on NON (needs of the Navy, for those who don't know but are still inexplicably reading 😉 )? I would like to serve, I just want to be sure that it will be as an ophtho (though as a FS would be OK too - heheh).

I've asked my recruiter about this, but want to double check (old saw: How do you know a recruiter is lying? His lips are moving. Not always true, but funny).

Any thoughts are appreciated.

Primate

 

[Andrew_Doan]

Originally posted by Primate
Hi,

Quick question with regard to the Navy.

Background:
I've been talking to my local recruiter for a couple years about coming into the Naval Reserves. Accd to him, the only way to do Reserves is after I'm licensed (in this state it's 2 years GME before licensure - 4 more total for me). Ophtho is usually PRIMUS unit eligible (which makes doing it possible during residency).

Here's the question:
Do you know if the Navy (or other branch) can call you up to active duty AND also "reassign" you as a GMO depending on NON (needs of the Navy, for those who don't know but are still inexplicably reading 😉 )? I would like to serve, I just want to be sure that it will be as an ophtho (though as a FS would be OK too - heheh).

I've asked my recruiter about this, but want to double check (old saw: How do you know a recruiter is lying? His lips are moving. Not always true, but funny).

Any thoughts are appreciated.

Primate

Primate,

Don't join the NAVY reserves if you're doing ophthalmology.

This is what you need to do. Although they're over manned at the moment, the NAVY is anticipating a shortage of eye MDs in the next decade because the physicians who have served for 20+ years are near retirement. Ophthalmologists in training are eligible for the FAP program. After matching for ophthalmology, apply for the FAP. If invited for interview, the NAVY flies you to One-stop in Bethesda, MD for a two day interview process at the National Naval Medical Center.

When I interviewed, I asked all the Captains and Commanders I met about the NON and pulling me out of residency. Although the NAVY can do this, my current status is an inactive Naval rerserve officer. They would only do this if the NAVY lost more than one-half of their current physicians. The NAVY has enough physicians to fight up to three major conflicts simultaneously; thus, physicians in the FAP are way down on the list to be a GMO. They would call up the NAVY reserve physicians first before calling up a FAP. The FAP men and women are future investments for the NAVY. The FAP physicians are filling shortages that the NAVY will have in the near future. The NAVY already has about 200-300 new interns each year to be GMOs any how. One Captain said that if I get pulled out to be a GMO, then we're "all in trouble". The FAP contract states that the NAVY is hiring you to be an ophthalmologist after your residency training.

If you get the FAP award, then you'll finish training in a civilian ophthalmology program and then get called to active duty as an ophthalmologist. It's a wonderful career path for those who enjoy the military. If you're an academic type, then you'll have a good shot for further fellowship training, which can be done during active duty to receive the full six figure salary during your fellowship. Once fellowship trained, you would likely be assigned to one of the three major teaching hospitals: Bethesda, Portsmouth, or San Diego. You'll have the opportunity to pursue research and apply for grants too. In addition, you'll likely call the shot in regards to where you'll do fellowship because you'll be FREE for the civilian program. When I interviewed in Bethesda, most of the specialists spent time at the Wilmer Eye Institute because they were so close.

The FAP package comes with a yearly cash bonus of $23,924 and monthly stipend of $1,131. This money is subjected to State and Federal taxes, but it is exempt from FICA/social security taxes. This results in more money to help pay off school loans or other financial needs. You pay the NAVY back with one year + each year you received FAP funding. Therefore, if the NAVY supports you through residency for 4 years, then you will need to serve at least 5 years. If you don't like it, then you can leave. The way I look at it, you have nothing to lose. The financial compensation may be lower in the NAVY, but you're getting paid up front when you most need the cash during residency. On the other hand, if you enjoy your NAVY career, then you can stay and move up the ladder of command. After 20 years, then you can retire from the NAVY and work in academics or private practice. After leaving the NAVY in 20 years, you'll be at least a Captain and eligible for an estimated $80-100K+ per year of retirement pay (current Captains get around $50K per year, but the compensation in the NAVY increases about 6% each year historically - you can get an estimate from this site: http://www.staynavy.navy.mil/). In the FAP, you start as an O-3 (LT). You'll receive two paychecks for the rest of your ophthalmology career. 🙂

Here is the NAVY GME/FAP website:
http://nshs.med.navy.mil/gme/NAVMEDGME.htm#FINANCIAL ASSISTANCE PROGRAM (FAP)

If you have any specific questions, then feel free to ask. Good luck!

 

[Primate]

Thanks for the prompt and characteristically thorough reply, MudPhud.

A few more questions, if that's OK. FAP sounds great for the most part. My concerns with it, relative to the Reserve and drilling in a PRIMUS unit, are two-fold.

First, my goal is to run a lab in conjunction with my clinical practice. The concern would be serving at a Naval hospital that may not have the facilities to support that, or (more likely?) the interest. I imagine that there is in some ways more pressure to see patients from the NAVY ("we paid for your clinical training, now it's time for you to see pts") than from large academic medical centers that are trying to push the wet-lab side. Not sure if this is an accurate take, though.

Second, with kids at home and hopefully more on the way, I'm not sure the moves to new duty stations would be as well received by all. I know that in the Ready Reserves I can serve at the local JRB and take care of the service members 'round here. Of course if I get called up, I get called up and would gladly go. But during non-conflict times at least we'd be around here. My family's OK with the service, but would like me to mitigate the disruptive parts as much as possible.

Also, as an MSTPer, I couldn't really take advantage of the loan repayment programs (can't decide if that's good or bad 😉 ).

I suppose I'm really interested in whether you still think that the FAP would be advisible given my particular situation. Looking forward to your opinion on the matter.

Best,
Primate

PS - do you know how much influence one has on where the AD billet would be after residency? That could make a difference. Thanks.
P

 

[Andrew_Doan]

Originally posted by Primate

First, my goal is to run a lab in conjunction with my clinical practice. The concern would be serving at a Naval hospital that may not have the facilities to support that, or (more likely?) the interest. I imagine that there is in some ways more pressure to see patients from the NAVY ("we paid for your clinical training, now it's time for you to see pts") than from large academic medical centers that are trying to push the wet-lab side. Not sure if this is an accurate take, though.

Second, with kids at home and hopefully more on the way, I'm not sure the moves to new duty stations would be as well received by all. I know that in the Ready Reserves I can serve at the local JRB and take care of the service members 'round here. Of course if I get called up, I get called up and would gladly go. But during non-conflict times at least we'd be around here. My family's OK with the service, but would like me to mitigate the disruptive parts as much as possible.

Also, as an MSTPer, I couldn't really take advantage of the loan repayment programs (can't decide if that's good or bad 😉 ).
Best,
Primate

PS - do you know how much influence one has on where the AD billet would be after residency? That could make a difference. Thanks.
P

Primate,

This is really amusing me! 🙂 We live parallel lives. I was also MSTP and have kids.

First off, I still think the FAP is good for you. It's great for me. 🙂 When I interviewed at One-Stop, one Captain asked if it's okay if I don't get a lab up and running right away. I thought about it, and said Yes. He said that it'll be likely that research would be available later in my career. On the other hand, you'd be surprised where you're able to do research. There's a Captain Eye MD who served as a Navy Seal in Florida; he's doing corneal research and the affects of deep diving on the cornea. There is a chance that you may not be able to do research right away; however, as you gain more experience, the likelyhood is high if you're relocated to a more academic location. With your MD-PhD background, this is likely to happen.

On the other hand, if you are able to complete a fellowship, then you will end up at a Naval teaching hospital. For instance, the Navy expects two ocular pathologists to retire in 5-10 years. I've received encouragement to pursue this path. I am now planning to do an ocular pathology fellowship after I'm done with my residency. An ocular pathology career will still allow me to practice general ophthalmology AND pathology. In addition, being an ocular pathologist will place me at either Bethesda or San Diego. This will also allow me to have a lab if I so desire. With your MD-PhD background, you'll likely be able to do whatever fellowship you wanted. The Navy anticipates a shortage of most specialities in the next decade too. For up and coming Naval Eye MDs, this will allow us to pursue almost any fellowship that interests us.

In regards to family, this depends on the feelings of your wife. Mine doesn't mind moving. We look at it as an adventure. Also, the Naval bases are in really nice locations. It also seems to me that the ophthalmologists in the NAVY don't move around much. The physicians in Bethesda have been there for 7-10 years. I know a retired Naval ophthalmologist who lived in San Diego for most of his 23 year career. He spent some time in FL as a FS and then a few years in Texas for his fellowship. The moving is really not that bad for the NAVY ophthalmologists. We don't have to be as mobile as the rest of the troops. I doubt that as an ocular pathologist or any sub-specialist I'd move around much in the NAVY. But again, I'm in the mind set of enjoying the move if it happens. It's an adventure, and your move is paid for by the NAVY.

The FAP money is not a loan repayment program. This is all cash for you. With funding from the FAP, my wife says that I can continue training all I want to. It allows us to be comfortable and the extra years of residency and fellowship will not be financially stressful.

In regards to picking where you're assigned, a list of open billets is published each year. You sumbit your top three choices. You'll likely get one of the top three. As a new physician, you won't be assigned over seas for your first assignment. Each assignment is three years. After three years, you have the option of renewal or reassignment.

If you enjoy the military lifestyle, I think this is a great option. I really think it's awesome that I'm able to contribute to the security of our nation and still be an ophthalmologist in the NAVY. If all goes as planned, it also appears that I'll be able to develop an academic career within the NAVY too.

Good luck!

 

[Celiac Plexus]

I really think it's awesome that I'm able to contribute to the security of our nation and still be an ophthalmologist in the NAVY. [/QUOTE]

Just curious... How does being a navy ophthalmologist contribute to the "security of our nation"?

 

[Andrew_Doan]

Originally posted by Celiac Plexus


I really think it's awesome that I'm able to contribute to the security of our nation and still be an ophthalmologist in the NAVY.

Just curious... How does being a navy ophthalmologist contribute to the "security of our nation"? [/QUOTE]

The NAVY works as a well-tuned machine. There are many branches to keep the military machine ready for battle. Everyone in the military plays a specific role in the security of this nation. Even a cook on a base is helping to protect this country. It's difficult to function as a soldier without food.

As military physicians, we care for the service men and women to keep the fighting force healthy and strong. Who is going to care for the soldiers who are hurt during conflicts? An effective fighting force is a healthy fighting force. So I may not be the one holding the pistol, but I'm still contributing to the goals of the US Armed Forces. Would you want a commander of a nuclear sub going blind because of untreated glaucoma? Or a Navy seal who goes blind because surgery wasn't done properly to remove an intraocular foreign body? There would be great loss of human life and morbidity without military physicians. Ophthalmologists were also sent to the Gulf War to help with ocular traumas.

Furthermore, as an ocular pathologist, they may call me first when there's a wierd infection, like SARS or West Nile, that attacks the eyes and blind our citizens and soldiers.

 

[Primate]

Operationally, military medicine is what is called a "force multiplier."

The line (ie "fighting") organization requires a certain amount of resources to operate or prosecute a conflict. A military physician's role is first to keep healthy the service men & women, many of whom operate some very expensive and sophisticated systems. The money spent on this is intended to save money on the personnel and equipment end (doing more with less, penny-wise pound foolish, you get the idea). Without the contributions of dedicated (meaning military specific) physicians, the country would need to spend more to attain the same level of readiness or accept a decreased military ability with the same level of spending. Thus the contribution to national security. I hope that was clear (a little rambling, I'm afraid).

In addition to the strong emphasis on preventive medicine in the military, there is expert care available to the injured or ill. This is not only part of the responsibility the service has to its members, but also works as a psychological boost to the troops. Knowing that top-notch people are going to go all out for you and yours can help the mind-set of those who volunteer to be on "the pointy end of the spear."

Military medicine is, of course, not for everyone. However, those who chose to work in that arena make a real and valuable contribution to national security.

Best,
P

 

[Yogi Bear]

hey andrew,

out of curiosity, how fit do you have to be to join the navy program? i.e. what's your mile time like? did you have to do a fitness test prior to getting in? i knew some people from hs who did airforce academy and had to work out every day just to meet the physical fitness requirements.

 

[Andrew_Doan]

hey andrew,

out of curiosity, how fit do you have to be to join the navy program? i.e. what's your mile time like? did you have to do a fitness test prior to getting in? i knew some people from hs who did airforce academy and had to work out every day just to meet the physical fitness requirements.

I joined via the FAP. The Navy flew me out to Bethesda for a 2-day interview. The Navy recruiter (Senior Chief) escorted me on the trip. There was no fitness test prior to getting in. When I start active duty, I have to do ~40 push-ups in 2 minutes, complete ~50 sit-ups in 2 minutes, and run 1.5 miles in 14 minutes to be "satisfactory".

I started working out last month in preparation for active duty starting in 1-2 years. I'm going to be okay because I can do over 50 push-ups and over 75 sit-ups in 2 minutes now. My current mile pace is about 7-8 minutes and I can run 1.5 miles in less than 12 minutes. My goal is to do 75+ push-ups, 90+ sit-ups, and run the 1.5 miles in less than 10 minutes.

You can see the table of fitness requirements here:
http://comilstd.org/Navy_PRT.htm