navy anesthesia

[sparkplug]

Does navy anesthesia program take any intern straight through? Is there any one knows about recent acceptancce?

A.M, Pgy-1

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[ravager135]

My a few years back at Portsmouth when I was an intern one person was picked up directly from our transitional program for anesthesia at Bethesda. He was probably one of if not the smartest interns in our class and he was older with children (I dunno if that mattered at all). Another was picked up during his stash for DMO school for residency the following year. He was stashed with me, awaiting the second DMO class when he got picked up. I believe he just finished another stash job for an additional six months and went into residency. He had it really lucky as he never truely filled a billet for a year. He was however a LCDR and there were concerns he had residency done before putting on CDR. He obviously had many years of service in before going to med school and becoming an intern. I dunno whats happened since then.

The vibe around town during internship was that one or two spots were around every year for someone to get into anesthesia directly. If that's changed, I am not aware. We had alot of transitional and even medicine interns interested atleast at NMCP so I remember it being hotly debated. The smartest kid our year got it and deserved it.

 

[BOHICA-FIGMO]

Does navy anesthesia program take any intern straight through? Is there any one knows about recent acceptancce?

A.M, Pgy-1

I graduated internship in 2010 at NMCP. The short answer is: nope. Maybe one or two in the history of the program went straight through.

Plan on doing a GMO. At least for the next year or two until the recruiting "bathtub" from 2005-2007 gets to the fleet.

 

[epidural man]

Does navy anesthesia program take any intern straight through? Is there any one knows about recent acceptancce?

A.M, Pgy-1

In the last four years maybe, maybe five, we have had maybe 2 at NMCSD. Some residents have been able to leave their GMO tour a year early for residency - maybe 2 or 3 of those.

Going straight through in any specialty is going to be tough. Across the board GME2+ spots were reduced because of the high need for GMO's. We usually have 6 spots, now only have 5, because the fleet needs the extra bodies.

I know ortho is pressured by the national (not military) GME people to do away with the GMO spots. They are trying to take people straight through a lot. It hasn't happend with anesthesia yet.

Also, be aware that anesthesia is considered (at this time) fully manned - I think at 100% or more of it's billets. What that means is that it is unlikely that deferments are probably hard to get. I don't know that for sure, just guessing based on the numbers.

 

[pgg]

If someone goes straight through in the Navy, it's usually at Bethesda. They took 3 straight through the year I applied as an intern in the early 00s. Even then though it was practically unheard of at NMCP or NMCSD.

I think the last time someone went straight through at Portsmouth was in 2005 (class of 2008), and as I recall that was kind of a fluke since he was originally an ALT. Though I can't say for sure since three new classes have arrived since I left in 2009.

Also, be aware that anesthesia is considered (at this time) fully manned - I think at 100% or more of it's billets. What that means is that it is unlikely that deferments are probably hard to get. I don't know that for sure, just guessing based on the numbers.

That's my understanding too - it also means that fellowship slots are at a low. This cycle there are two inservice pain billets per year (NMCP and the new program at NMCSD), with just ONE projected funded FTOS fellowship for 2012 with the Navy's needs generally prioritized as follows

1. Pain
2. Pediatrics
3. Regional
4. OB
5. Critical Care
6. Cardiothoracic

(Plus a pre-select for 2013.)

So anyone interested in CT in the near future is outta luck. These things have a way of changing drastically in just a few years though, so I wouldn't put my name on a firm prediction of how things will look in 2015.

 

[i want out]

I think the last time someone went straight through at Portsmouth was in 2005 (class of 2008), and as I recall that was kind of a fluke since he was originally an ALT. Though I can't say for sure since three new classes have arrived since I left in 2009.

/QUOTE]

This fluke probably wouldn't have happened if one returning GMO hadn't wanted out so bad that he didn't even apply for that spot...

 

[Navyanesdoc]

Just heard we are overmanned and they are cutting residency slots back for the FTIS programs, not sending any out so prob very hard to go straight through this year and maybe the near future.

 

[pgg]

Just heard we are overmanned and they are cutting residency slots back for the FTIS programs, not sending any out so prob very hard to go straight through this year and maybe the near future.

Email from Navy specialty leader yesterday -

1) Staffing: We are as well-staffed as we have ever been. Currently, we are
about 12% over our manning requirements. FY12, according to my predictions
(which are different from BUMEDs) will represent the pinnacle of staffing
and then we will see a gradual decline in staffing over the next few years
back to our authorized numbers. The overmanning (a good problem to have,
IMO) resulted from an influx of NADDS selectees a few years ago and a very
desirable MRB program. In the last couple of years, I have not recommended
any new direct accessions that have come across my desk. Further, we (BUMED
to a greater degree than I) have scaled down the number of trainees coming
through the pipeline--specifically, no NADDS/FAP trainees have been
selected for the last couple of years and the three FTIS residency programs
have seen their numbers go down slightly (while they are approved for 18
trainees per site from an ACGME standpoint, we will only be selecting 13 for
next year's starting class). The ebb and flow of Navy anesthesiologist
staffing is not new and will always be a dynamic entity. What I and others
need to be mindful of in the long view is that there is not an
overcorrection, as occurred in the early 2000's. Further, we need to ensure
that our three teaching centers are staffed with an appropriate number of
subspecialists to keep them as thriving as they currently are. As an FYI,
the Navy CRNA community is undermanned to the tune of about 90% manning.

 

[BOHICA-FIGMO]

Email from Navy specialty leader yesterday -

Uggh. As a future FITS anesthesia applicant, this is not good news. Has there ever been an occasion where training slots were "cut" that did not result in massive undermanning later on?

As an aside, anyone know the historical selection rates for anesthesia for those coming off their GMO tour? How greatly are FITREPS vs. board scores vs. GPA vs. intern evals weighted?

 

[bogatyr]

Email from Navy specialty leader yesterday -

Correct me on the exact numbers, but there are around 150 anesthesiologists in the Navy, and they're only 12% overmanned? I'm not sure why the Navy would require 50% more anesthesiologists than the Army or Air Force, but way to go.

 

[pgg]

Uggh. As a future FITS anesthesia applicant, this is not good news. Has there ever been an occasion where training slots were "cut" that did not result in massive undermanning later on?

As an aside, anyone know the historical selection rates for anesthesia for those coming off their GMO tour? How greatly are FITREPS vs. board scores vs. GPA vs. intern evals weighted?

I don't think Navy anesthesia has had the usual 18 slots/year for a couple years now. I believe funding for one of the slots was diverted to create the new FTIS pain fellowship at NMCSD two yrs ago (or was it 3 yrs ago?), and I'm pretty sure NMCP only took 5 new CA1s a year ago. Still, a drop to 13/year is substantial.

This years GME2+ memo says 14 slots though.

http://www.usuhs.mil/ane/resident/pdf/bumednote1524.pdf

Historical selection rates are wildly variable. In the span of my PGY1 and GMO years when I was paying close attention, there were years when interns went straight through (ie, 0 GMOs failed to select) and years when there were 30+ alternates on the list (though many of those were surely intern applicants not returning GMOs).

Somewhere in this forum there's a breakdown of the point system. I don't think it's changed much. GMOs always beat out interns because they get full points for completing their intern year, and the points for being a GMO. As I recall, preclinical grades were worth up to 2 pts, clinical grades up to 2 or 3, board scores 2 ... GMO time aka 'professional potential' 0-5. Operational time was very heavily weighted.

 

[epidural man]

Correct me on the exact numbers, but there are around 150 anesthesiologists in the Navy, and they're only 12% overmanned? I'm not sure why the Navy would require 50% more anesthesiologists than the Army or Air Force, but way to go.

Airforce needs a lot less because they don't have hospitals (or that many).

Army needs many more, but no one stays in the Army - cuz it's the Army. They are way undermanned.

I don't know Army numbers, but I would guess that if they were fully manned, they would have more anesthesiologsits than Navy. However, manning for anesthesiologists depends on how many hospitals there are. You can't run a hospital without anesthesia. Are there more Navy hospitals than Army?