Military Rotations/Bases

Discussion in 'Military Medicine' started by Homunculus, Jan 11, 2005.

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  1. Homunculus

    Homunculus SDN Caveman Administrator SDN Moderator 10+ Year Member

    Jul 24, 2000
    Feel free to add your reviews of rotation sites and military bases to this thread. I'll periodically cut and paste to keep things somewhat organized for easier reading.
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  3. rotatores

    rotatores Senior Member 10+ Year Member

    Sep 26, 2002
    I guess I'll start:

    Naval Medical Center Portsmouth for general surgery:

    Consists of two teams: Gold and Blue with about 8 attendings, a chief resident, a junior resident, 3 interns, and between 2-5 med students per team.

    The typical day consisted of working from 0430-1830 mon-fri...and from 0530-1100 one weekend day. Call is usually about q5 for 3rd yrs and q6 for 4th yrs.

    Surgery was two days a week, tue's were academic days in the morning and clinic in the afternoon with clinic the remaining 3 days. Students usually scrubbed in on about 2-3 cases a surgery day.

    Students were of course expected to see their patients in the am...write the notes...present pt at rounds...and the same for afternoon rounds.

    If I had to give the rotation a grade I would give it a B-...

    Positives: Plenty of OR time, Great patient exposure, practice presenting patients, learning how to not get called on during rounds

    Negatives: I was often known only as..."hey you", I only got one compliment the entire rotation, academic days were of no value to the med students, med students did about twice as much work as the transitional interns rotating through.
  4. bobbyseal

    bobbyseal Boat boy 10+ Year Member

    Jul 6, 2003
    I did this rotation as a 4th year.

    There are 3 teams, gold, blue, and red. There are about 5-6 attendings per team. Though, many of the attendings aren't full time. They may be a shipboard surgeon on a carrier which is in port. They then take call and do a limited number of cases at the hospital while the ship is being refitted. We had about 3 attendings who were full time that did cases. We had a chief resident, an R2, and 2 interns. We had 1-2 med students per team.

    Rounds begin around 6:00-6:15 depending on the number of patients on service. Our service was typically fairly light, roughly 4-6 patients. Other services were busier.

    The week was scheduled as follows, day one = OR, day two = post-op day/clinic, day three = pre-op day. Wednesday was academic day with conferences. Pre-op day was typically rather nice. There wasn't clinic, but there'd be a pimp session on all of the cases being performed the following day in the OR. In addition, walk rounds would occur with the attendings. OR day entailed minor cases - breast bites, fistulotomies, hernias, lap choles, and colectomies. Post-op day consisted of gen surg clinic in the AM, and breast clinic in the PM.

    Call was typically once a week for a med student.

    Overall, it was one of the easier ward oriented general surgery rotations that I did. With its location in San Diego, it was also one of the more fun.

    As for personalities on the service, people were at first somewhat gruff with me. Though, once I showed that I knew my stuff in the pimp sessions and took the heat off the interns and R2 from the attending questions, the team started to like me. By the end, I got a great recommendation from one of the attendings.

    I'd recommend doing General surgery here as a 4th year student. Although the case volume isn't that great, the people are very cool, and I had a great time.
  5. hippuppy

    hippuppy Member 10+ Year Member

    Apr 19, 2000
    Anyone completed a month at Bethesda in Surgery or other surgical specialities?

  6. Walasse

    Walasse New Member

    Jan 16, 2005
    Neurosurgery at Walter Reed. I'm actually Navy, but the NCC residency program in neurosurgery is based primarily at Walter Reed. Thoroughly enjoyable time there. Like in all sub-internships, it required a complete dedication to the service. Four days of OR and a half day of clinic a week. Weekend rounds. The attendings are very interested in education and the welfare of the residents and students.
  7. warriordoc

    warriordoc Junior Member 5+ Year Member

    Mar 6, 2005
    Has anyone rotated at BAMC or TAMC in OB/GYN? I will be doing 4th year rotations at both sites and am hoping to do my residency at one of the two spots. Any comments on either location?
  8. DaveB

    DaveB Slave to The Man 10+ Year Member

    Jul 24, 2001
    I'll ditto rotatores on the structure, call schedule, etc of the rotation.


    I'd have to say that I had a very negative experience at NMCP. The caseload was weak - and the 1-2 times a big case did come up I found myself getting bumped from the table by staff starved for something other than an appy or lap chole. I got dumped on with quite a bit of scut; so much that at times I was getting sent away from potentially educational opportunities so that I could update the patient list or do some other form of menial paperwork. I had two staff tell me how unhappy they were at Portsmouth, and a PGY-3 tell me that I should stay away from general surgery training in the Navy.

    The only positive is that there is an effort made to work with students: they try to get you into the OR as much as possible, and the staff (even the unhappy ones) were very friendly and approachable.
  9. DaveB

    DaveB Slave to The Man 10+ Year Member

    Jul 24, 2001
    You are assigned to one team for the month (hand, sports, peds, etc). Your hours and schedule are very dependant on which team you're on. I did sports and was out by 3 pm most days, with no weekends. Many teams put in 12-14 hour days. A team typically consists of 1-2 staff, 1-2 residents and a student.

    Most teams would round in the am before morning report at 7:30. In general, you're in the OR 2 days/week, in clinic 2 days/week with an academic day where you go over to UCSD and have grand rounds/resident lectures with the UCSD ortho department. Call was minimal - I think I took call only twice the entire month.

    Overall the case load was decent, but I would not call this a very busy depertment. Everyone is friendly - I did not encounter any malignant personalities. The atmosphere is that of a typical ortho department. There definitely is an effort made to be nice to the students and to teach.

    I got to scrub in on most all of the cases - the only times I didn't were when there was nothing for me to do. I didn't even really have to follow patients on the floor, although I think this was mostly a function of being on the sports service and us having almost nobody stay in house post-op.

    Overall I'd say this was a good rotation. The only negative was the not-so-heavy caseload which in many ways was great because I definitely was able to get out and enjoy San Diego.
  10. DaveB

    DaveB Slave to The Man 10+ Year Member

    Jul 24, 2001
    This was sort of an atypical rotation. You are not assigned to any particular team: you show up each day and the resident working in the cast room would divide up all the interns and students amongst all the different OR and clinics. Hours were long but the time was well spent (no scut, no crap). Students do not take call but the conselation is that nobody has any qualms about keeping you late once in a while.

    You do get assigned regular patients on the floor whom you round and write notes on each day. As a 4th year I was given quite a bit of autonomy in managing my patients. Since the department is very small, you round with the entire department in the early am then head off to morning report with everyone at 7 am. Because of the small department size, the residents and staff were a particularly tight knit group. Everyone was really friendly and approachable which made the rotation very enjoyable. In clinic and in the OR teaching was abundant.

    On caseload: when I started out the month, the OR was somewhat slow, but decent. From talking to staff and residents this was typical. About a week into my rotation, the Marines invaded Fallujah and with all the casualities coming in the service got absolutely crazy. The census went from 12-14 to almost 80 patients. Since the department was stretched to its limits, I ended up spending 95% of my time in the OR as a first assist. The experience was incredible: once people got to know me I got to put in a lot of plates and screws almost completely on my own. Closures were my domain entirely. From talking with people since I've left, it seems that the service waxes and wanes like this, going from slow to busy depending on whats happening over in the sandbox.

    Overall, this is a great rotation where you learn a lot of orthopedics. What you get to see and do is hit and miss (I happened to catch things on a busy moment). I could see how you might get frustrated if you happened to rotate while things were slow, but the friendliness of the department and the willingness to teach makes even the slow times worth it. Plus, when its slow you are able to get out and have some fun in DC.
  11. echou

    echou New Member

    Mar 9, 2005
    Has anybody done an ophthalmology rotation at either NNMC or NMCSD?
  12. hippuppy

    hippuppy Member 10+ Year Member

    Apr 19, 2000
    Anyone know anything about the ENT rotation at Portsmouth?
  13. MTGas2B

    MTGas2B Cloudy and 50 10+ Year Member

    Last spring (2004) I came to San Diego for a month of OB/GYN. Overall I would say a good rotation. I split up my time with two weeks on Gyn-Onc and two weeks on Complicated OB. The Gyn-onc attendings are good. One of them is actually the Ob-Gyn specialty leader for the Navy, so he's a good one to interview with for those thinking about Ob. Days started at a typical ob kind of time, I usually arrived between 5:30 and 6, stayed until 5 or 6. Gyn-onc has a relatively light OR schedule. Clinic is very busy; most of the colposcopy for the region is done in the gyn-onc dyplasia clinic. I learned a lot about colpo. Call was on the labor deck, once maybe twice a week. Very busy OB service, lots of babies to catch. Mid-wives work side by side with the ob residents, and they are very willing to let you come follow their patients, which is nice because they are usually less complicated. Since I did this rotation they have moved the labor department into a brand new, completely remodeled area. Complicated OB had already been moved, and it was very nice. Complicated OB was okay. I had one minor run in with an MFM attending. The head of residency program is one of the MFM, he's a good guy. In all the areas you rotate the UCSD students are around, some do their core third year ob/gyn rotation at NMCSD. Teaching is good; every Friday is a protected teaching time in the morning. Residents are nice; as long as you’re easy to get along with they probably favor us (the HPSP students) to the UCSD students, just a touch. You’re expected to give a talk at the end.

    Pulmonology: So this spring, 2005 I came back for a month of Pulmonology. Fellowship program here. Very good group of attendings and fellows. Very intelligent and good teachers. Assigned to consult service, kind of slow (knock on wood), but I still have a week to go. Attend pulmonary morning report followed by medicine report in the morning, medicine conferences at noon. Teaching on Fridays, journal club every other week over breakfast at pretty neat little restaurant. Every Thursday is active duty clinic. Most of the patients are marine recruits coming over from basic because they can't keep up on their runs, our job asthma vs. out of shape vs. wants to go home. However, a lot of other surprise come up too, sarcoid patients, bizarre immune deficiencies, etc. You'll see good variety. You can join the other staff and fellows in their clinics through out the week to spice up your down time between consults. No unit time, the fellows cover the unit though. I'm sure one could request a unit rotation if they wanted it. I'm going into anesthesiology, and I'll be doing civilian residency, so when my fellow asked me what I wanted to get from the rotation I said I wanted to get some good general pulmonary background, learn a few pearls that relate to airway and operative management, and since I'm not applying to their program I don't feel the need to "show off". Just learn a little and hang out in San Diego. They have obliged nicely.
  14. Nixie

    Nixie Junior Member

    Apr 1, 2005
    I did a 3rd year OB/GYN rotation at BAMC/ WHMC (Wilford Hall). It is a joint program between the army and air force so you may spend time at both facilities. The staff and residents were helpful and very enthusiastic about OB/GYN. BAMC is a beautiful hospital and has great facilities. It also does not hurt that it is located in San Antonio which is a fun city. The rotation was pretty standard with morning report, academic day, etc. The only thing different between the 3rd and 4th year students was the 4rth year students gave a presentation during morning report.
  15. Teufelhunden

    Teufelhunden 1K Member 10+ Year Member

    Nov 7, 2000
    Avon, Ohio
    I did 6 weeks of OBGYN at Portsmouth in Spring of 2004. I did 3 weeks of nights in OB triage, and 3 more weeks on the Uro/Gyn service.

    I actually loved my first three weeks on nights (1800-0600). At Portsmouth, any patient that comes to the ED >20 weeks pregnant automatically comes to the OB dept. In OB triage, there were usually one or two students, one or two interns (usually one OB intern and one off-service intern), a nurse and a corpsman. Med students and interns function at about the same capacity in this environment, and you pretty much get to do everything, I was even allowed to do AFIs by myself once I was trained. So after you do the H&P, pelvic exam, etc, you go onto the labor deck and present to one of the residents (usually a PGY2 or PGY3). Cool thing is, if you worked up a pt who got admitted, in labor, you'd usually get to do that delivery (if the pt delivered during your shift).

    All in all, I was pretty happy with those three weeks. I got a lot of hands on experience, i.e. got to deliver a handful of babies, break a few bags, even placed a fetal scalp electrode. My last day, I got to sew up a labial tear.

    Now for the bad news. The entire department was pretty darn malignant. Honestly (and I'm now finished with all my rotations), it was the most malignant place I've been in my short 2 years in the clinical setting. Although some of the residents were cool, the majority of them were pretty unfriendly. I think this boils down to the fact that they don't really like med students there. I think this phenomenon is attributable to the fact that EVMS students (which they get a steady stream of – rotating through) have a pretty bad reputation there as being, well, a little on the immature side. During my short stay, I witnessed some pretty bad med student behavior...I was pretty shocked at some of it. However, I don't want to slam a whole school...some of the EVMS students I met were solid. I digress.

    Now here’s my personal experience. Yes. A handful of residents initially treated me like pure crap. However, if you’re not a whiny baby and just suck it up, and work hard they’ll eventually soften up. What many EVMS students would do is this: They’d present their patient to the resident, the resident would of course be mean to them (as was SOP). So, they’d simply see less and less patients in order to avoid the residents. Of course, the residents aren’t stupid; they know they’re being avoided, and they know the students are hiding.

    I did the opposite. If a resident initially treated me like I was an idiot (which as a medical student, you basically are), I’d just work harder - study more. I saw as many patients as I could. In fact, I made it a game to NOT avoid the mean residents. If I had to choose between a mean and a nice resident to present to, I’d pick the mean one. Needless to say, I got pretty good feedback from the residents…a few compliments even. (Although there was this one who seemed to hate my guts...I could never win her over...oh well, you can't win them all). In general, though, all the residents wanted was to see a modicum of work ethic and some maturity. Luckily for me, I went to Parris Island a long time ago, and I learned to function well under stress. I can keep my bearing when someone is being “mean” to me. I’m digressing again, but I’d say that this has been a more valuable asset than anything these past few years. I’ve seen so many med students (esp females…don’t get unraveled, I’m just stating an observation) fall apart at the seams during malignant pimp sessions. Hell, if you can just stand up straight, make eye contact, and speak in a full voice (no cracks, or “uhhh”)…you make a good impression even when you don’t have a clue what the attending is asking you about. It’s called “bearing” and I can thank my Drill Instructors for that.

    Before anyone thinks that all the residents were malignant: They weren’t. Some of them were really cool. Another observation…in general...the male residents were cool and the female residents were…well…rhymes with “witches.” (Again, a generalization). This was the consensus among male and female med students alike. I can’t explain this phenomenon; I can only report what I witnessed.

    The Uro/Gyn service wasn’t as good, IMHO. During my time in the OR, I was either retracting or standing in the back trying desperately to see ANYTHING. 99% of my time in the OR was spent looking at the back of the attending’s and residents’ heads. Not educational. Oh, and I got to round on the postop patients in the morning. Again, not so educational (Did you have a BM? Fart yet? Using your spirometer?)

    At the time, I was very interested in OB and was strongly considering applying to Portsmouth’s program. A few months afterwards, all I could think of was how miserable all the residents seemed. They seemed VERY TIRED all the time. Tired and miserable. In the end, I just couldn’t commit myself to four years of that.
  16. darth vegeto

    darth vegeto Junior Member

    Jan 13, 2005
    How about a clinical rotation at BAMC on General surgery. Experiences and tips. And, Is it really hard to enter into a surgery residency at BAMC?
  17. yoly26

    yoly26 Junior Member

    Mar 10, 2005
    Is anyone doing a Ph.D. in Clinical Psychology with the HPSP?
  18. threepeas

    threepeas Senior Member 5+ Year Member

    Feb 20, 2005
    anyone do army ortho rotations?
  19. bobbyseal

    bobbyseal Boat boy 10+ Year Member

    Jul 6, 2003
    I finished up a Neurology rotation at Portsmouth Naval a little while back. Overall, I really enjoyed the experience. Your day basically runs from 8:30am until about 4pm or so. Sometimes you leave a little later other times a bit earlier. You essentially do consult service and maybe see 1-2 patients in the clinic if an attending has an interesting case or a new patient. In general we got about 2-4 consults per day. These consults would be split amongst an internal medicine resident, an intern, and any med students on at the time. So, the division of labor is pretty good. There is no admitting Neurology service and so the general medical scut work is drastically minimized.

    So, the morning would generally consist of us going to the floor and seeing our consults. We would do the write up and then go back to the Neurology clinic and present the patients to the attending. There would be some minimal pimping on Neurology and then the requisite look at the MRI.

    After that, we'd either go to neuroradiology for further information about the scan or just head to the floor. This was generally late morning or early afternoon. The attending would see the patients and would point out some teaching bits.

    Once rounds were done, the attending typically had patients to see in the afternoon. So, we'd either do some more scut work on our patients or just hang out in clinic doing our reading/studying. Every now and then a consult would come in the afternoon, but that was only like 1x/week. In general, medicine was good about consulting inthe AM if they needed us. Like I said earlier, I'd be out around 4pm. There was no call and no weekends. The dress was the standard khaki uniform.

    Overall, I really enjoyed this rotation. The teaching was very good, and all of the attendings were great. Now, obviously attendings change frequently with the Navy and so a year from now, it may be different. But for me, I really enjoyed the experience. Plus, there was a fair amount of pathology to see. I saw ALS, lots of MS, brain tumors, pseudoseizures out the wazoo, neuro Behcet's, and some other stuff.

    The area is pretty good. Since I had all my nights off, I would routinely catch dinner in old town. I liked the Bier Garden and Baron's for watering holes. Lobscourser has an early bird special if you like seafood. There's a good sports bar for catching an out of town game. On saturday and sunday there are a couple good cafe's for brunch.

    Norfolk is pretty good too. I did head over to the beach once with my gf. It was about 50 and cloudy, but at least we got to go for a walk on the beach. There are a few nice restaurants in Norfolk and some good bars too.

    I'd highly recommend this rotation. My only complaint was the length of time to get my grade back which was about 8 weeks.
  20. Capt_Mac

    Capt_Mac Member 5+ Year Member

    May 23, 2005

    You are in luck... I am a PGY2, almost 3 at BAMC right now. Yes, I am on leave, and am watching my 4 year old for my wife.

    Granted, my response is biased because I am here right now and doing it:

    1) This is THE BEST surgical training program in the DOD. We are a Level I trauma center and are well trained and equiped to go out to combat situations and be able to adapt our training to the unique circumstances that we will face. We see lots of oncology, bread and butter stuff, lots of endoscopy, laparoscopy and of course trauma. You will be doing trauma from day one of internship all the way through graduation. This is unique to our instituition. You will be adept and comfortable taking care of SICK patients. You will also be able to rotate up in the Burn Unit where you will get this same experience.

    2) Progressive program. Our program director has a lot of good ideas and is dedicated to our program. As a part of this, we take the 80 hour thing seriously at our program. For example, my chief did not take a day off one week, the program director gave him a mandatory day off, and I got to do his two thyroid cases that day...Most importantly, he values resident input and emphasises that this is "our program". Another example: Our Cardiothoracic rotation used to be a painful series of months were the PGY4 "was allowed to retract the heart" for 3 hours. We weren't getting anything out of it. Last year one of the PGY4's on his own accord arranged for us to rotate with a senior CT surgeon at TexSan (he was one of Cooley's understudies) and now this is one of the best rotations of all residency.

    3) BAMC and San Antonio - good hospital, and will only be getting better. We are going to benefit greatly with the BRAC, more cases, more money. San Antonio has good cost of living and is actually a really nice city for singles and those (like myself with families).

    1) We (as well as Madigan and Walter Reed) are now obligatory 6 year programs with a research year in between the PGY2 and PGY3 year. Unless you go to Tripler (not a bad place) or Eisenhower (avoid like the plague) or Beaumont (great if you like sand... lots of sand) you will be doing a 6 year program. You can research at either the University here in town or at the Institute of Surgical Research right next door. They have a ton of funding and support, lots of exciting projects that have direct impact on the care that the troops are getting right now.

    1) We are currently finishing our programs with about 1000 - 1100 cases. This will be getting better under the current program director.
    2) Deployments are effecting the staff situation, this is not BAMC specific and will be a problem at all DOD facilities. This effects the continuity of training with the faculty.
    3) If you don't want to do a research year.

    Every program has negatives and positives. You need to search out the program that fits your personal philosophy on how you like to learn and the environment that you want to work in.

    On competitiveness:

    We had about 20 some odd 4th years come through last year. With the 80 hour deal, surgical specialties have become more enticing especially at programs that take the 80 hours seriously. (Ours) The best thing for you to do is to come over, do a rotation with us, work your tail off and see if this is the place for you. I would bet that right now we are fairly competetive. It is generally us, reed and madigan are the top 3 choices. Each one has it's strengths and weaknesses.
  21. darth vegeto

    darth vegeto Junior Member

    Jan 13, 2005

    Thank you Capt. Mac Your insight has been helpful. I had made the choice in making BAMC my first choice in FYGME. The Idea of BAMC been a level 1 trauma center is what moves me to make this decicion. I would like to contact you by email so I would ask you some questions about the program, or give me pointers on how to do a good rotation. I am already scheduled for a clerkship in General Surgery during the month of September. My email is [email protected]
  22. JWSimmons

    JWSimmons New Member

    Dec 6, 2004
    Does anyone know how many residents each army program takes in General Surgery? I believe Tripler takes 4.
  23. texdrake

    texdrake Stand-Up Philosopher 10+ Year Member

    Jun 26, 2003
    Ohio or Texas
    You can look on the Frieda website, all the military programs are on there.

    Just go to the ERAS website and find the frieda database.
  24. Capt_Mac

    Capt_Mac Member 5+ Year Member

    May 23, 2005

    We take 3 gen surg interns each year.
  25. nysurg

    nysurg A chance to cut... 10+ Year Member

    Dec 6, 2001
    NY, IL, PA, DC, WA, OK
    I am currently a 4th year Army HPSP doing my General Surgery AI at Tripler and they take 4 students. The rotation is great here. They just got a new program director who is truely concerned about everyone's well being, med students included.

    This program is quite great. There are two teams: Red (Colorectal and Vascular) and Green (Breast and Peds) as a medical student you are placed on one of the two teams for the entire time that you are here. Dr. Gagliano who is the program director is one of the attendings on the Red team.

    Here is a preview of a typical week:
    0600 Rounds with the chief resident QD (There is a night float so there are no pre-rounds for the incoming staff at 0600).
    0700 - Morning report with the entire staff (program director included) QD
    0730 - OR cases (Monday and Thursday OR days for red team and Tuesday and Friday for Green Team)
    0800 - Clinic (Tuesday and Friday for red team and Monday and Thursday for Green Team)
    - For Red Team (which I was on) - Tuesday was Vascular day and Friday was General surgery pts which included minors (lumps and bumps removal and depending on the attending you got to do everything from cutting to suturing - truely awesome!!)
    0800 - Academic Day all day (lectures and workshops) every Wednesday (last week - I was taught by my chief and program director how to knot tie!!) :D

    Typically days ends around 1900 after rounding with the night team who comes in at 1800. Call is once a week for 4th years to be determined by student and is overnight. Weekends are off for 4th years. Call for the interns are only once a month on weekends considering there are 4 interns and there is a night float system. Everyone is very serious here about the 80 hour work week.

    Hope that this helps, let me know if I forgot something that you want to know. For me this program is definitely #1 or #2, will let you know after I go to madigan. :thumbup:

    P.S. Does anyone know if madigan has a night float system for general surgery?
  26. kedhegard

    kedhegard Senior Member 10+ Year Member

    Sep 24, 2003
    Durham, NC
    I'm finishing a month of dermatology at WRAMC tomorrow, thought I'd write about my experience.

    All the residents have been very accomodating, and several of them offered to get me started on research projects pretty much as soon as I got here. The attendings all pretty much encouraged me from day one, and were great to work with.

    Typical day:
    7:45 AM (tough I know)- Slide show, mini-lecture
    8:30 - Clinic, usually see about 5 patients each morning, following those that need procedures
    12:00 - Lunch
    1:00 - More clinic or go to procedure side and do Mohs surgery/laser clinic 3 days a week
    4:00 - Home

    About two days a week, there is lecture all morning +/- catered lunch.

    The only bad thing about this rotation is that you are split pretty evenly between WRAMC and NNMC at Bethesda, and have to do a lot of driving between the two, since the Army and Navy programs have been integrated here. Well, that and I had to wear polyester pants every day.

    You really learn a lot on the rotation, and if they like you, they definitely let you know. The support staff is literally the best I've ever seen, everyone gets along. Really a dream job if you ask me. There is one attending that is pretty hardcore, but he's actually leaving soon, so no problem there.
  27. USAFdoc

    USAFdoc exUSAFdoc 5+ Year Member

    May 21, 2005
    Good to hear that there are still military med programs that live up to what military med ought to be. It was a FAm med rotation at TRAVIS I did many years ago that led me to be a FP in the USAF. The sad thing was by the time I finished my med schooling and residency and arrived at my last base,fam med in most of the USAF had fallen in the toilet (victims of TRICARE, the surgeon generals poor planning and execution,and local leadership failing to fully standup for what is right ( not that it is easy to tell the surgeon general of the USAF that his plan is crap).
  28. texdrake

    texdrake Stand-Up Philosopher 10+ Year Member

    Jun 26, 2003
    Ohio or Texas
    Madigan ARMY Medical Center - PEDIATRICS

    Finished my pediatrics rotation up at Madigan about 2 weeks ago.

    General Feel:

    Madigan seemed to be more laid back than some military areas, which fits my personality much better. The attendings and residents really went out of the way to try to make you feel welcomed and comfortable. Some of the students did mention that they noticed the resident interaction decrease as the month went on. The rotation includes a ton of didactic teaching and also very good teaching rounds. Many of the students on with me (there are quite a few interested in Pediatrics this year) were very pro-active learners.

    What a Day is Like:

    0630 - Pre-rounds
    0730 - Team didactics/rounds (entire department meets to discuss new pts, case presentation, and teaching topic)
    0900 - finish prerounds
    0930 - Team Rounds on Ward
    1200 - Student Didactic lecture
    1300 - Attend to Pt's/admissions
    1700 - Heading home

    Clinic Days start at 0730 with the team didactics and usually end around 1600

    Call is one day per week and one weekend day per week when on the ward

    I didn't do NICU on this rotation, the only real difference is that student usually start around 0600 I believe

    Third years also do some time with newborns

    Every student presents a case on the rotation, I think 3rd years have to write one up as well.

    The Area:

    Ft. Lewis is huge and a large portion of the base around Madigan feels old and a little outdated. This is probably due to the fact that rather than remodel many of the buildings in this area, the Army is moving many of the soilders to North Fort Lewis where there are brand new barracks, eateries and what not going up (looks nicer than most newer college campuses..very impressive). North Fort is also much closer to the PX, Commissary, and most of the base amenities. Madigan, while being more on the older side of the base is very new and very nice. Love the hospital.

    Ft. Lewis is south of Tacoma and has a gorgeous view of Mt. Rainier. Traffic is thick in the evenings and probably the mornings to, but not horrid. There are several new housing areas being built, but housing in the area is on the pricier side. The base is 10 minutes from Tacoma and about 35 from Seattle. Tons of stuff to do in both.


    I was very impressed with the quality of this rotation. While the ward was very slow, we made up for it with extra teaching rounds and I learned a ton. I was planning on doing FP before this rotation. I now have FP at 50% and Peds at 50% and the clock is ticking.......PRESSURE
  29. wbharris

    wbharris Junior Member 7+ Year Member

    Apr 25, 2003
    I'm doing a gen surg rotation at Wilford Hall MC w the AF in February. Any suggestions, words of wisdom, or knowledge on that rotation? Furthermore, I would eventually like to do a Gen surg residency either there or at Keessler. Any idea as to the difficulty in securing one of these residencies? Any further words of wisdom, other than rotate at both before match?

  30. mitchconnie

    mitchconnie Member 10+ Year Member

    Oct 27, 2002
    I would be careful about starting either of those surgical programs. Both WHMC and Keesler are scheduled to be eliminated in the BRAC. I know WHMC has a relationship with UT so they may be more stable long-term, but Keesler has no civilian program nearby to take the residents once they close. Even at WHMC, you have to assume that residency slots will be eliminated once they merge with the BAMC program. I know of no likely scenerio which would leave the Keesler program viable in 6 or seven years when you are a chief resident.

    You DO NOT want to be looking for a PGY 4 or 5 surgery spot after your program closes or you get downsized. The PGY 4 and 5 years are the KEY time in your operative training, and the foundation for the rest of your career. You will not have a quality experience if you are forced to learn a new system, and prove yourself to a new set of attendings in this critical time (and that's assuming you get a decent spot...very difficult as a PGY4 or 5).

    The residency directors will surely promise you that you'll be "taken care of" if the program closes, but beware. When programs and hospitals fold, NO ONE cares much about the residents left out in the cold. Selling those programs to students will be VERY difficult, and program directors may have to shade the truth significantly to get solid candidates to fill their services. The program director who you interview with will probably not even be there anymore in 5 years when you are a PGY 3 scrambling to find enough cases in a hospital which is in the process of closing. The worst case scenerio would be to end up as a GMO after doing three years of surgical residency, then trying to apply for PGY 4 spots after doing primary care for two years--impossible.

    I would look into Wright-Pat and Travis. Both are pathetic downsized military "hospitals" (clinics), but the programs have completely moved to stable, busy civilian institutions at Wright State and UC Davis (not sure about Travis details, but I know WPAFB well).

    That said, if you feel like you are a marginal candidate, WHMC might be a good opportunity to get into a "name" program. I expect the competition will be less given the BRAC. The "Wilford Hall" name still means a lot to some Air Force people, and even many civilians, who are unaware of the extent of the downsizing and impending closure.

    Feel free to PM me with any specific questions.
  31. colbgw02

    colbgw02 Delightfully Tacky 10+ Year Member

    Radiology at BAMC for 4 weeks during August, 2005.

    Days start at 0715 with morning conference and can typically end after lunch conference at 1300. That is to say that no resident or attending, save the program director, will ever expect you to stay past conference. No weekends, no call. You will have to contribute 2 teaching files that take maybe a total of 4 hours to complete.

    The program director is pretty hardcore about radiology; he expects you to be there all day, and will sometime spring random late afternoon student-only lectures to see who is still there. He also doesn't it like it if you schedule board exams during the month, but they will give you a day off to take an exam if you're so inclined.
  32. kidddoc2be

    kidddoc2be New Member

    Feb 28, 2005
    Has anyone done a Psych rotation at Walter Reed or Tripler? Does anyone have any insight into these programs? Also, what will happen to the NCC residency programs at WR, now that it is closing? Thanks! :rolleyes:
  33. threepeas

    threepeas Senior Member 5+ Year Member

    Feb 20, 2005
    just had a briefing this summer. WHMC is not being eliminated just physically moved to provide a more efficient, cohesive delivery of military medicine. same goes for walter read army medical center that is being moved to bethesda naval.
  34. Capt_Mac

    Capt_Mac Member 5+ Year Member

    May 23, 2005
    Hmmmmm, I have heard alot about the BRAC thing being in SAT and this is the first peep about a "move". Where are they moving to? What is the source?

    My impression is that they are moving all of their inpatient services to BAMC. However, I do know for a fact that they are not planning on sending their surgical residents. There is NO talk, not in the news, around the hospital, among people with parakeets on their shoulders that know, that Willy is being revamped and rebuilt, like Walter Reed is.
  35. haujun

    haujun 10+ Year Member

    Jan 21, 2002
    Does anyone know the quality of IM at BAMC ?... Is it advantageous to complete the IM there if you want to have a fellowship there?!
  36. Capt_Mac

    Capt_Mac Member 5+ Year Member

    May 23, 2005
    From what I see it appears to be decent. I would have no idea about whether or not it would help you get into a particular fellowship. I guess if the fellowship is located at the hospital with the IM dept there, it can't hurt.
  37. Heeed!

    Heeed! On target, On time! 10+ Year Member

    Oct 10, 2003
    San Antonio, TX
    Just finished up my inpatient peds rotation at Lackland. I really enjoyed it, especially since I just came of 3 months of internal medicine. You gotta be a little more relaxed to be a pediatrician, so it was a welcome change from what I had just been through.

    My ADT turned out to be 3.5 weeks since the Thanksgiving holiday was in there. I worked in the nursery for 2 weeks and was on the ward for 1.5 weeks. My school requires a month of ambulatory peds so I didn't work in the clinic. The nursery was great. I was in around 0530-0600. We'd do newborn physicals, circs, catch any problematic c-sections, bili checks, monitor pts in the NICU, etc. Basically just keeping the assembly line moving. There was some interesting pathology to see and lots to learn. We could go to morning report if nothing was going on but there was always something to do. I would leave between 1500-1700.

    The inpatient stuff was good. We had a couple of lectures during some down time, morning report was interesting most of the time, and the interns, residents, and staff were all great. All were willing to answer questions and help teach. I looked forward to showing up each day vs. dreading the slow death by rounds I had experienced during a former rotation.

    In conclusion, I highly recommend doing a Peds rotation at WHMC. Everyone I worked with was great, I learned a few things along the way, and think it would be a pretty good residency, if that's what you're interested in.
  38. DoctorDoom

    DoctorDoom Witch King 10+ Year Member

    Mar 11, 2003
    Minas Morgul
    TEX! Congrats on matching at BAMC.

    Tripler General Surgery takes four interns, and may expand all other classes to 4 as well.

    We are also a 6-year program now, one year of research mandatory.

    nypostbac, you were here with me, your schedule is a bit off though. Minor errors that don't really affect the fact that the program is moving in the right direction, but has some issues yet to be worked out.
  39. Dsessi1

    Dsessi1 Junior Member 10+ Year Member

    Jan 9, 2006
    I hope this is the right area to ask these questions. I attend LSUHSC in New Orleans, LA. Prior to Hurricane Katrina, our hospital, Charity, was an amazing place to do an Emergency Medicine clerkship/residency. Sadly, it no longer exists.
    Can someone discuss the pros/cons of an army EM program? I am mainly concerned with caseload, caseload, caseload.
    I am halfway through my second year and want to set up my 4th year elective rotations asap.
  40. PainlessChancre

    PainlessChancre im losing my perspicacity 5+ Year Member

    May 11, 2005
    Exiled to Des Moines, IA
    Capt Mac, why should EAMC be avoided? I only ask b/c I'm interested in gen surg or possibly ortho there, but have read nothing on this forum about the place. Any info would be appreciated.
  41. timberlnd3

    timberlnd3 New Member

    Feb 8, 2006
    I am a 3rd year Army HPSP student. I have been trying to schedule a 4th year ENT clerkship at WRAMC or with the NCC. I have not been able to find any information on who I need to contact to do this. Anyone have any information. Thanks
  42. RichL025

    RichL025 Senior Member 5+ Year Member

    Feb 6, 2005
  43. snman31

    snman31 Junior Member 10+ Year Member

    Jan 1, 2005
    I'm HPSP looking to match deferred in radiology. Wanted to go to NMCSD as specialty leader is there, but didn't really want to do radiology as I thought it's kind of hard to distinguish oneself as a student on rads. I thought maybe Rad-Onc or Emergency would provide a chance to prove myself competent, while at the same time give me enough time to meet and check out the rads department. Any thoughts on this plan from people who've been out there? Thanks in advance.
  44. s1250408

    s1250408 New Member

    Mar 7, 2006
    I will be taking the COMLEX this May and I am debating taking the USMLE as well. Does anyone know if your USMLE score will automatically get sent to the military match (via your school or otherwise) or will you be able to leave it out and just use your COMLEX? I have been told that if you have your COMLEX, that will be all they need and if you don't turn in the USMLE it won't matter, but I have also been told that it may be required to report the scores. Anyone know?
  45. RichL025

    RichL025 Senior Member 5+ Year Member

    Feb 6, 2005
    I'm pretty sure you have to "designate" each program you want everything sent to - letters of recc, board scores, etc. This should give you a chance to "choose" which scores you want programs to see.
  46. bbawco1

    bbawco1 Senior Member 7+ Year Member

    Jul 21, 2003
    Any opinions on any AF FP rotation programs? Particularly at Eglin?

  47. buglady

    buglady We need more cowbell 10+ Year Member

    Jun 7, 2001
    Evergreen State
    Any Navy folk out there have any comments about experiences in doing a Peds rotation at Balboa? I know Peds will be eventually phased out of the Navy (or at least all the rumors have said so), but just curious to see how the attitude and feel of Navy Peds is these days...

    Also, anyone do any Family Practice rotations at either Camp Pendleton or Bremerton? Would love to hear any and all advice about either of these programs...
  48. RugbyFool

    RugbyFool Junior Member 2+ Year Member

    Apr 22, 2006
    wish i'd known about this forum a long time ago....
    could anyone comment on any of the ortho programs at the Army hospitals?
  49. mac61

    mac61 Junior Member 2+ Year Member

    Apr 11, 2006
    From the lowly MS1:

    Glad I bumped into this thread. Most folks in my class are pretty much in a haze about the next 2 years. The current 2nd years have us sufficiently freaked out about Path, Pharm, etc., that even asking questions about rotations seems ludicrous. All the same...

    Really happy to see that good G2 is being put out with minimal trashing of military medicine. Please keep this thread going. Our rotation lottery starts in December, and the more info we have the better.

    Thanks again.

    USUHS 2009
  50. Capt_Mac

    Capt_Mac Member 5+ Year Member

    May 23, 2005
    Disclaimer: I am not an ortho resident. (I did sleep at a Holiday Inn.)

    I am a general surgery resident and work a lot with them.

    Right now ortho is a hot area in the Army. At least 3/4 of military casualties have orthopedic injuries and there is a lot of those going around right now. The departments at BAMC and WRAMC are very well funded right now and operate like it was nobody's business. If you have specific questions call the program directors yourself. At least here at BAMC, they are all very nice guys and would be more than happy to answer your questions. Granted, when I was starting med school, I didn't know what the "right" questions were. Maybe you do.
  51. RugbyFool

    RugbyFool Junior Member 2+ Year Member

    Apr 22, 2006

    thanks Cpt_Mac! your posts are always very helpful.
    btw, i didn't quite get the Holiday Inn comment...maybe an inside joke?

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