My yearly community service announcement:

[AFRadiolgist]

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Hey future docs,

Just wanted to give you a heads up and little warning about joining military as a doctor. I'm a USUHS grad and active duty radiologist (not radiolgist). Yea, the HPSP money sounds good and USUHS is a pretty good medical school, and I sure fell for it. I have never regretted any decision in my life more.

You see, the Air Force is not serious about delivering medical care to patients - at least not up to any standards that exist in the civilian community. How do I know this? I live it every day. I work in a large military clinic and moonlight extensively in the civilian community. I have documented dozens of examples of substandard care, poor outcomes, mismanagement, and blatant disregard for patient safety. In the Air Force, medical care is treated like the proverbial red-headed step child.

For example, just this week I learned that I was being called up for a week of jury duty for a court martial. Being the only radiologist on base, that would seem to be a problem for our busy clinic here. We do 100+ exams a day, including 20-30 stat exams. "No problem.", I thought. I'll just get my CO (a former pediatrician) to write a letter explaining the situation and postpone my participation until my partner gets back from Iraq in a few weeks. That way, radiology services could continue for the patients and clinicians. I would serve my duty with my partner covering the clinic. My squadron commander had different ideas. He refused to excuse me from my appointed duty to the court martial, even though there are many officers of my rank available to do it.

"The needs of the Air Force outweigh the needs of the patients," he said. After I explained the disruption to patient care that would occur, he shrugged and said "...those considerations are secondary." "Besides," he said. "This will be a good excercise of how our clinic will operate without radiology support." Oooookaaaaaay. At least I got him to admit out loud what we doctors already know.

Once the word got out that no radiologist would be available to our clinic for a week, the doctors and other 'providers' revolted, even calling the base commander. Our idiot CO was forced to reverse his decision (by a non-physician), thankfully for the patients.

Now this is but one example of hundreds of boneheaded decisions, extremely bad judgement, and otherwise poor leadership in the medical corps. Nearly every week there is a major (bad) decision from the leadership that negatively affects patient care in my clinic. I have to fight constantly to try to uphold basic standards of care.

"Why don't you change the system?" I've heard. Believe me, better men and women than I have butted their heads against the system and lost, leaving the Air Force behind, spent and exhausted. As a rule with few exceptions, Good doctors get out...Bad doctors become Air Force bureaucrats.

Military medicine in the States should be shut down. Medicine is not the sort of profession that lends itself well to half-assed effort. You see, people get hurt. Otherwise manageable cased get mismanaged. Treatable conditions go untreated or misdiagnosed. Patient's suffer needlessly. By joining the military, you will perpetuate a system which deserves no support and should not exist.

You don't have to believe me or the hundreds of other active and former military docs. Obviously it's your choice. At least you have been warned, which I something I wish I could say.

 

[a1qwerty55]

Hey future docs,

Just wanted to give you a heads up and little warning about joining military as a doctor. I'm a USUHS grad and active duty radiologist (not radiolgist). Yea, the HPSP money sounds good and USUHS is a pretty good medical school, and I sure fell for it. I have never regretted any decision in my life more.

You see, the Air Force is not serious about delivering medical care to patients - at least not up to any standards that exist in the civilian community. How do I know this? I live it every day. I work in a large military clinic and moonlight extensively in the civilian community. I have documented dozens of examples of substandard care, poor outcomes, mismanagement, and blatant disregard for patient safety. In the Air Force, medical care is treated like the proverbial red-headed step child.

For example, just this week I learned that I was being called up for a week of jury duty for a court martial. Being the only radiologist on base, that would seem to be a problem for our busy clinic here. We do 100+ exams a day, including 20-30 stat exams. "No problem.", I thought. I'll just get my CO (a former pediatrician) to write a letter explaining the situation and postpone my participation until my partner gets back from Iraq in a few weeks. That way, radiology services could continue for the patients and clinicians. I would serve my duty with my partner covering the clinic. My squadron commander had different ideas. He refused to excuse me from my appointed duty to the court martial, even though there are many officers of my rank available to do it.

"The needs of the Air Force outweigh the needs of the patients," he said. After I explained the disruption to patient care that would occur, he shrugged and said "...those considerations are secondary." "Besides," he said. "This will be a good excercise of how our clinic will operate without radiology support." Oooookaaaaaay. At least I got him to admit out loud what we doctors already know.

Once the word got out that no radiologist would be available to our clinic for a week, the doctors and other 'providers' revolted, even calling the base commander. Our idiot CO was forced to reverse his decision (by a non-physician), thankfully for the patients.

Now this is but one example of hundreds of boneheaded decisions, extremely bad judgement, and otherwise poor leadership in the medical corps. Nearly every week there is a major (bad) decision from the leadership that negatively affects patient care in my clinic. I have to fight constantly to try to uphold basic standards of care.

"Why don't you change the system?" I've heard. Believe me, better men and women than I have butted their heads against the system and lost, leaving the Air Force behind, spent and exhausted. As a rule with few exceptions, Good doctors get out...Bad doctors become Air Force bureaucrats.

Military medicine in the States should be shut down. Medicine is not the sort of profession that lends itself well to half-assed effort. You see, people get hurt. Otherwise manageable cased get mismanaged. Treatable conditions go untreated or misdiagnosed. Patient's suffer needlessly. By joining the military, you will perpetuate a system which deserves no support and should not exist.

You don't have to believe me or the hundreds of other active and former military docs. Obviously it's your choice. At least you have been warned, which I something I wish I could say.

Please replace military with Air Force and you'll get no gripe from me. I have made the point time and time again that the most egregious reports of leadership failures seem to consistently eminate from the USAF side. I'm not deluded enough to believe there aren't similar stories from some in the Army or Navy (although the Navy does some pretty bizarre stuff as well) but they seem to be far less common. In well over 10 years of service in several Commands, I have never seen anything like what I read from former and current USAF physicians. The only totally psychotic thing I have seen actually came from a USAF Commander so the issues raised ring true with me.

The USAF medical establishment vigorously fights any move towards a joint Medical Department. I really don't understand that nor the ethos of the USAF Medical Dept. I am sorry about your experiences and those of Galo, Mirrorforum, Orbitsurg, medical corpse etc... these are all former USAF members. I would strongly argue against equating USAF medicine and all Military Medicine, especially as it pertains to the Army.

 

[IgD]

For example, just this week I learned that I was being called up for a week of jury duty for a court martial. Being the only radiologist on base, that would seem to be a problem for our busy clinic here. We do 100+ exams a day, including 20-30 stat exams. "No problem.", I thought. I'll just get my CO (a former pediatrician) to write a letter explaining the situation and postpone my participation until my partner gets back from Iraq in a few weeks. That way, radiology services could continue for the patients and clinicians. I would serve my duty with my partner covering the clinic. My squadron commander had different ideas. He refused to excuse me from my appointed duty to the court martial, even though there are many officers of my rank available to do it.

"The needs of the Air Force outweigh the needs of the patients," he said. After I explained the disruption to patient care that would occur, he shrugged and said "...those considerations are secondary." "Besides," he said. "This will be a good excercise of how our clinic will operate without radiology support." Oooookaaaaaay. At least I got him to admit out loud what we doctors already know.

That's a great scenario you described. One of the most pressing needs of the Air Force from a medical readiness perspective is to maintain a functioning radiology department. The job of leadership is to maintain that. Your scenario illustrates a typical military medicine problem. The military physician is left on the sideline with their hands tied frustrated knowing that they are prevented from doing what is right because of a B.S. policy or leadership decision.

I bolded the former pediatrician part because my impression reading your scenario was that a physician was responsible for this decision. That is pretty shocking to me because he should have known better. A lot of times I observed that leaders were afraid to make decisions because of a fear how they would be perceived by senior leadership. If the medical commander gives you a pass on the courts martial how will that make him look to his wing commander for example?

 

[IgD]

Please replace military with Air Force and you'll get no gripe from me. I have made the point time and time again that the most egregious reports of leadership failures seem to consistently eminate from the USAF side...

I wouldn't agree with that at all. I think some of the biggest and widely publicized failures have been on the Army side. I remember as a resident a patient who was being processed for 3 years for a medical board around 2003. I've also read reports of patients with outrageous medical conditions who never should have been deployed showing up in theatre. I like your posts but I think its all equally bad. I think it is unfortunate because the Army has an extra duty/responsibility for military medicine because they are the 900 lb gorilla. They have a lot of influence in DoD policies and are in a unique position to set the standard for military medicine.

 

[deuist]

The Army may very well treat its patients poor, but I can't find many examples of physician mistreatment. The Army HPSP students constantly talk about how positive their experience with the military has been, including during the match.

 

[BigNavyPedsGuy]

The Army may very well treat its patients poor, but I can't find many examples of physician mistreatment. The Army HPSP students constantly talk about how positive their experience with the military has been, including during the match.

They have an N=3 months. That's a pretty small sample size. I'm not saying they're wrong, I just wouldn't call their data statistically significant.

 

[narcusprince]

Sounds like I hear the Ghost of Medicalcorpse!!!

 

[Habeed]

What do you think the root problem is?

I mean, you can point to the specific branches or specific bases or specific commanders.

But isn't the real problem the fact that military medicine is a large organization with guaranteed funding and absolute power?

Any organization that cared about efficiency at all wouldn't do something so boneheaded as to waste the time of the most expensive employees with beauracratic tasks.

If healthcare reform called for expanding the VA to cover the entire United States, you'd have a similar problem.

 

[a1qwerty55]

I wouldn't agree with that at all. I think some of the biggest and widely publicized failures have been on the Army side. I remember as a resident a patient who was being processed for 3 years for a medical board around 2003. I've also read reports of patients with outrageous medical conditions who never should have been deployed showing up in theatre. I like your posts but I think its all equally bad. I think it is unfortunate because the Army has an extra duty/responsibility for military medicine because they are the 900 lb gorilla. They have a lot of influence in DoD policies and are in a unique position to set the standard for military medicine.

If you are referring to the Washington Post Walter Reed story, it serves to restate that there was never a claim of poor care. The failings were in case management and coordination of care. The barracks portion of the story was complete baloney - the soldiers involved had been offerred to relocate and declined b/c of the convenience of being accross the street. Frankly having been in the building it was in better shape than my college dorm. Congress stopped the funds for building maintenance b/c Walter Reed was "closing". Soldiers fell through the cracks no doubt.

MEB's taking 3 years - this happens often because the patient keeps developing new problems and if we try to wrap it up, before addressing the newest nonspecific complaint - they go to their Congressman complaining the Army just wants to kick me out without taking care of me... rarely the case.

There are many many things which could be better about healthcare in the Army and Military no doubt and some horribly broken but when you have to provide care for 1 million active duty plus another couple million dependents/retiree's you won't have any trouble finding disgruntled patients and families especially if the media has an axe to grind. Talk to some Kaiser patients - but when you dig into the complaints the patients perceptions are not always valid. Let me restate that which some don't seem to get. There are tremendous cultural differences between the Army, AF and Navy. Contrary to what people would like to believe the AF is way more draconian and hung up on rank/rules/regulations. They even allow their physicians in leadership roles to have UCMJ authority - great use of phyiscian time.

The Navy has the "Captain is always right" mindset. Aye aye sir, full steam ahead.

I think the Army is the most pragmatic, has the most robust training programs, offers the most opportunity for uninterrupted training, and believe it or not places way less emphasis on rank in the AMEDD than the Navy or USAF.

 

[a1qwerty55]

I think it is unfortunate because the Army has an extra duty/responsibility for military medicine because they are the 900 lb gorilla. They have a lot of influence in DoD policies and are in a unique position to set the standard for military medicine.

I hate to bash the USAF because after all we are on the same team but there are some legitimate stones to throw here. I don't think your assertion that the Army has some leverage on the AF is accurate -

The AF has consistently tried not to play with the other services - they maintain that somehow AF medicine is different - no doubt in many bad ways, but they seem to not get that the navy and army have flight surgeons so really there isn't ANYTHING unique about the USAF system.

A joint Medical Command could effect some of the changes you argue for but ultimately the Army only controls the Army regardless of the size of the force. My take is that Sec Gates needs to lower the boom on the USAF medical leadership as he did with the nuclear guys, and force a unified medical command. It offers too many positives to discount to include tremendous cost savings, more assignment and training options, the chance to standardize care accross all services, true jointness etc. etc. etc. , but somehow the AF opted out. Time to drop the hammer I believe. My opinion as a American citizen and not as an Army officer.

 

[crazybrancato]

I hate to bash the USAF because after all we are on the same team but there are some legitimate stones to throw here. I don't think your assertion that the Army has some leverage on the AF is accurate -

The AF has consistently tried not to play with the other services - they maintain that somehow AF medicine is different - no doubt in many bad ways, but they seem to not get that the navy and army have flight surgeons so really there isn't ANYTHING unique about the USAF system.

A joint Medical Command could effect some of the changes you argue for but ultimately the Army only controls the Army regardless of the size of the force. My take is that Sec Gates needs to lower the boom on the USAF medical leadership as he did with the nuclear guys, and force a unified medical command. It offers too many positives to discount to include tremendous cost savings, more assignment and training options, the chance to standardize care accross all services, true jointness etc. etc. etc. , but somehow the AF opted out. Time to drop the hammer I believe. My opinion as a American citizen and not as an Army officer.

wow. it was exactly the same in the line side. every time we had a joint exercise to plan/execute, the AF guys (their egos, their ridiculous desire to adhere to every stupid reg) would get in the way. my captain (an O-5 at the time) threatened to kick a one-star AF off of the ship if he didn't shut his trap. he remained silent for the rest of the underway!

perhaps it's b/c the AF has an inferiority complex, being the most junior service?!

 

[Habeed]

What about the nature of the different services? I mean, the Navy have to exist in big groups aboard ships, many months out of the year. The Army goes to Iraq and Afganistan and fights on the ground. What does the average airmen do?

Also, aircraft cost a stack of money, and I thought that the whole culture is that whenever an aircraft is lost, it is because someone skipped a step.

 

[pgg]

perhaps it's b/c the AF has an inferiority complex, being the most junior service?!

Hah, I don't know what it is, but it sure as hell isn't an inferiority complex. 🙄

 

[Galo]

Hey future docs,

Just wanted to give you a heads up and little warning about joining military as a doctor. I'm a USUHS grad and active duty radiologist (not radiolgist). Yea, the HPSP money sounds good and USUHS is a pretty good medical school, and I sure fell for it. I have never regretted any decision in my life more.

You see, the Air Force is not serious about delivering medical care to patients - at least not up to any standards that exist in the civilian community. How do I know this? I live it every day. I work in a large military clinic and moonlight extensively in the civilian community. I have documented dozens of examples of substandard care, poor outcomes, mismanagement, and blatant disregard for patient safety. In the Air Force, medical care is treated like the proverbial red-headed step child.

For example, just this week I learned that I was being called up for a week of jury duty for a court martial. Being the only radiologist on base, that would seem to be a problem for our busy clinic here. We do 100+ exams a day, including 20-30 stat exams. "No problem.", I thought. I'll just get my CO (a former pediatrician) to write a letter explaining the situation and postpone my participation until my partner gets back from Iraq in a few weeks. That way, radiology services could continue for the patients and clinicians. I would serve my duty with my partner covering the clinic. My squadron commander had different ideas. He refused to excuse me from my appointed duty to the court martial, even though there are many officers of my rank available to do it.

"The needs of the Air Force outweigh the needs of the patients," he said. After I explained the disruption to patient care that would occur, he shrugged and said "...those considerations are secondary." "Besides," he said. "This will be a good excercise of how our clinic will operate without radiology support." Oooookaaaaaay. At least I got him to admit out loud what we doctors already know.

Once the word got out that no radiologist would be available to our clinic for a week, the doctors and other 'providers' revolted, even calling the base commander. Our idiot CO was forced to reverse his decision (by a non-physician), thankfully for the patients.

Now this is but one example of hundreds of boneheaded decisions, extremely bad judgement, and otherwise poor leadership in the medical corps. Nearly every week there is a major (bad) decision from the leadership that negatively affects patient care in my clinic. I have to fight constantly to try to uphold basic standards of care.

"Why don't you change the system?" I've heard. Believe me, better men and women than I have butted their heads against the system and lost, leaving the Air Force behind, spent and exhausted. As a rule with few exceptions, Good doctors get out...Bad doctors become Air Force bureaucrats.

Military medicine in the States should be shut down. Medicine is not the sort of profession that lends itself well to half-assed effort. You see, people get hurt. Otherwise manageable cased get mismanaged. Treatable conditions go untreated or misdiagnosed. Patient's suffer needlessly. By joining the military, you will perpetuate a system which deserves no support and should not exist.

You don't have to believe me or the hundreds of other active and former military docs. Obviously it's your choice. At least you have been warned, which I something I wish I could say.

Welcome to hell, where depending on the moon cycle you may get blamed for what's happened to you in the AF.

Thank you for your post, as yet another dissatisfied physician who sees the problems only getting worse, and wants people to realize one of the only ways to stop this madness is to not join the system.

As for the AF and Navy having a monopoly on mediocrity in medicine and the army being the best, well, that's certainly the interpretation of a senior officer who is exceedingly vocal, and has been able to affect change in his immediate area. However, the problems for military medicine are DoD wide, and no one should take one person's advice as gospel. Neither should they take mine, or the multiple other attendings who post here regularly about how screwed up military medicine is.

People with interest in joining need to do theri homework and dig deep. Call up bases, talk to multiple physicians, avoid higher ranking ones, DO NOT DO IT FOR THE MONEY!, be aware that there is a chance your training may be interrupted for 2-4 yrs, be aware that your skills may rot while you are in a place where you can't practice them, you cannot choose where you live, who you work for, what vaccines you can take................YOU become property of the US goverment.

Nothing that has not been covered here on a weekly basis, but worth repeating.

 

[BOHICA-FIGMO]

Just one example of why I got out of the USAF to join the USN. They have problems too, but not quite like what the USAF is doing to the MC.

 

[IgD]

The Army really is the 900 lb gorilla compared to the Navy and Air Force. The Army has so much political clout it pretty much gets whatever it wants. I observed the Army to have 50-100 personnel working on various programs while the Navy had about 5 personnel working on equivalent programs. Someone told me once the Army is really good at creating and packaging all these programs but struggles with execution and I found that to be true. I've heard/experienced the most difficult outcomes with Army stuff. A Navy Surgeon General said that the Army had a soldier show up on deployment asking for a refill of transplant meds and another asking for methadone for heroin addiction. The Navy and Air Force just don't encounter those types of situations.

The Army didn't release any selection list at all so it is impossible for me to speculate about their GME numbers.

My take is the Army is like a massive 1,000,000 lb ugly steam roller. No matter how much it tries to be elegant, it plows over enemies and itself in the most bureaucratic and inefficient way possible and is apparently effective at doing so.

I agree with the remarks about the Air Force. I observed it to be very micromanaging and detail oriented. I hypothesized that airmen are OCD about aircraft maintenance/parts so the same mentality extends to the medical system. I've actually been impressed with the way the Air Force tries to take care of its own including its physicians.

As far as the Navy having "the Captain is always right" mentality I'm not so sure. I'll have to think about it I think there is some truth to that. While the Air Force seemed very organized and methodical the Navy came across as not having much planning at all. At times I felt like Navy medicine was 100% crisis driven and reactionary.

 

[EMDoc0411]

Please replace military with Air Force and you'll get no gripe from me. I have made the point time and time again that the most egregious reports of leadership failures seem to consistently eminate from the USAF side. I'm not deluded enough to believe there aren't similar stories from some in the Army or Navy (although the Navy does some pretty bizarre stuff as well) but they seem to be far less common. In well over 10 years of service in several Commands, I have never seen anything like what I read from former and current USAF physicians. The only totally psychotic thing I have seen actually came from a USAF Commander so the issues raised ring true with me.

The USAF medical establishment vigorously fights any move towards a joint Medical Department. I really don't understand that nor the ethos of the USAF Medical Dept. I am sorry about your experiences and those of Galo, Mirrorforum, Orbitsurg, medical corpse etc... these are all former USAF members. I would strongly argue against equating USAF medicine and all Military Medicine, especially as it pertains to the Army.

You can add the Navy with the AF.

 

[EMDoc0411]

That's a great scenario you described. One of the most pressing needs of the Air Force from a medical readiness perspective is to maintain a functioning radiology department. The job of leadership is to maintain that. Your scenario illustrates a typical military medicine problem. The military physician is left on the sideline with their hands tied frustrated knowing that they are prevented from doing what is right because of a B.S. policy or leadership decision.

I bolded the former pediatrician part because my impression reading your scenario was that a physician was responsible for this decision. That is pretty shocking to me because he should have known better. A lot of times I observed that leaders were afraid to make decisions because of a fear how they would be perceived by senior leadership. If the medical commander gives you a pass on the courts martial how will that make him look to his wing commander for example?

I'm glad you specified FORMER pediatrician. All of these wack jobs in leadership can't be referred to by their specialty designation if they haven't practiced in years.

 

[a1qwerty55]

I had the opportunity to watch each of the services Surgeons General in action. I thought is was illustrative.

The AF SG - crazy, tech heavy multimedia presentation (spinning airforce logos, jets, the whole deal) with really nothing tangible, no attempt to address any problems only a puff piece that went 15-20 minutes over his allotted time. Then grandstanded with a CCAT team totally neglecting the really broken aspects of the case he was presenting - essentially everyone works well together (false), everything is great.

Then the Army SG goes - more traditional powerpoint, some puff stuff but definite discussion of tangible issues, such as physician retention, staff burnout, and attempts to improve physician acceptance and satisfaction with AHLTA - by deploying "As you type", and Dragon - overall a useful presentation, tangible but not sexy.

Navy SG - stands up, no slides, no real message I could discern. Spoke for awhile and sat down after taking a swipe at the AF surgeon generals grandstanding.

 

[bogatyr]

The Army really is the 900 lb gorilla compared to the Navy and Air Force. The Army has so much political clout it pretty much gets whatever it wants.

Except when it comes to increasing the ISP, in which case it doesn't happen because the Navy and Air Force won't go along.

 

[IgD]

Except when it comes to increasing the ISP, in which case it doesn't happen because the Navy and Air Force won't go along.

The pays are set at the DoD level right? What does the Navy and Air Force have to do with it?

 

[a1qwerty55]

Except when it comes to increasing the ISP, in which case it doesn't happen because the Navy and Air Force won't go along.

100% accurate - the CNO has killed this annually. Another cultural issue between the services is the incredible animosity towards increasing physician bonuses by the Navy Line. The USAF in general has supported this.

 

[a1qwerty55]

The pays are set at the DoD level right? What does the Navy and Air Force have to do with it?

All three services have to go along as theortically pay is the same between all services. Intersingly because of the USAF abject failure at retaining physicians, they are offering bonuses exceeding those of the other services, 100K I believe for surgeons 20K extra for several other specialties, his however is not via ISP which are the same with all services. There are so many layers to this onion.

 

[IgD]

100% accurate - the CNO has killed this annually. Another cultural issue between the services is the incredible animosity towards increasing physician bonuses by the Navy Line. The USAF in general has supported this.

I don't have any knowledge about the Navy's role in negotiating physician bonuses. I will say this though: Towards the end of my last tour, I heard senior Navy medicine leaders mention that we were "red lined" in terms of staffing. Then they went on to shrug their shoulders, act helpless and say there is nothing we can do and that it is bad all over the country. I wanted to spit out my coffee when I heard comments like that!

I think a lot could be done without increasing salaries (untie the hands of physicians for example).

Did you see my post about Admiral Mullen when he was CNO in the other thread? I heard him strongly criticize Navy Medicine in an officer's call in 2006.

 

[IgD]

All three services have to go along as theortically pay is the same between all services. Intersingly because of the USAF abject failure at retaining physicians, they are offering bonuses exceeding those of the other services, 100K I believe for surgeons 20K extra for several other specialties, his however is not via ISP which are the same with all services. There are so many layers to this onion.

This onion needs to be thrown out and restructured I think.

The DoD issued policies all the time I wonder why they couldn't unilaterally set the salaries.

 

[grotto]

Are there any prior line officers (specifically Navy if possible) who can comment on the difference between the bureaucracy and nightmares of the med corps and and the bureaucracy and the nightmares of the line?

I understand how the cultures and systems of different parts of the military can be drastically different, but I would like to have some idea of what I am getting myself into from the perspective of someone who dealt with the military and its annoyances before getting into the medical field.

 

[DrMetal]

Are there any prior line officers (specifically Navy if possible) who can comment on the difference between the bureaucracy and nightmares of the med corps and and the bureaucracy and the nightmares of the line?

I understand how the cultures and systems of different parts of the military can be drastically different, but I would like to have some idea of what I am getting myself into from the perspective of someone who dealt with the military and its annoyances before getting into the medical field.

great question. I'm not in milmed yet (am in the same boat as you probably, prior line (restricted), applying for this fall). I have talked to some current docs, prior line (some swo's, some pilots). They say there's a considerable amount of admin and beuracracy, but it's not as bad as their respective line communities (especially swo).

I've been told that my prior service will come in real handy, in the sense that I'll be better about rolling with the flow of things, taking on leadership roles, knowing when to lead, when to follow, will be better about picking/chosing battles, etc etc. I hope they're right!

I can't speak for all, but it seems like the people have the most heartaches about military stuff are the non-priors (I don't blame them, first time I was told to go to some bs O-call, i was mad too). . . or even worse, the kids who have never been out of school, never even had a job.

Ive been told that prior service ascribes a lot of maturity to you, and that'll make the experience easier and more enjoyable.

now, having said all of that, I've also been told the navy doc still has to deal with a considerable amount of admin, much more so than his civi counterparts.

So if you really can't stand the military admin, probably best not to go into Military Medicine. It's just a personality thing, I think!

 

[Rudy]

I also am a USUHS grad, AF. Going to USUHS was also the worst decision I have ever made. With one swipe of the pen, I obligated myself from 1998 to 2014, literally spanning three decades, with no way out.

The AF doesn't care about medicine. That is the bottom line. Funny thing was, I trained in a joint Army/AF residency in San Antonio, and the Army actually treated their residents a lot worse than the AF in terms of approving leave, providing funding for training opportunities, and general admin stuff. But that said, the admin/bureaucracy is downright painful. I moonlight at various civilian practices, and compared to milmed, it feels like being on vacation.

The AF needs to close its medical service. Likewise, USUHS needs to close, as it is unethical to commit so many naive, inexperienced pre-med students to years of servitude within a broken and toxic system. Yet, as you USUHS students will find out, USUHS does NOTHING to ensure that GME training is adequate or that their graduates can practice the full spectrum of their specialty after their residencies are over. Yes USUHS is a decent medical school, but you end up spending only a small percentage (25% for me) of your military career at USUHS; the majority of your time is in the dysfunctional AF medical service. It is a disgrace that the leadership at USUHS sit idly by while the AF medical service, to which they will be sending 55 students a year, continues its downward spiral.

I wish there were some way to get this information to someone who could really make a difference, but I honestly don't know who that would be. I have yet to see a senior AF med leader who "gets it".

 

[Galo]

I wish there were some way to get this information to someone who could really make a difference, but I honestly don't know who that would be. I have yet to see a senior AF med leader who "gets it".

Have you tried to waste your time on the official page where the people who are supposed to "get it" are the ones who started this debate:

http://www.health.mil/Debates/Debate.aspx?ID=9&a=1

The problem is that I don't think anyone gets it, or gives a hoot. Perfect example is this official website that has not had a responce of significance or even acknowledgement for over a year.

I hope you can make the best of a bad situation with such a long commitment. Best of luck.