Navy EM & IM

[BamaMedik]

Greetings,

I just wanted to get some quick insight on the possibilities or trends of matching Navy EM or getting a civilian deferment for EM. I've read some older threads regarding this but I wanted the opinions of people who just matched recently into Navy EM or got a civilian deferment for EM. Should I even request for a deferment or just take my chances with the match? or both?

The same goes for IM which I'm considering too. I'm a Navy HPSP who graduates in 2012 if that helps a little.

Thanks!

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[J-Rad]

I think buried within other threads you will find recent posts talking of a near zero% (or some othere ridiculously low number) selection for EM for anyone other than a returning GMO.

 

[ActiveDutyNavy]

At the 2009 JSGMESB 2 were selected for EM deferment.
At the 2008 JSGMESB 1 was selected for EM deferment

2009 JSGMESB 0 were selected for IM deferrment
2008 JSGMESB 1 was selected for IM deferment


I don't have statistics before 2008 so I can't speak to any trends. I do know IM typically tries to fill all of their spots before they select anyone for a deferment. On the other hand, the 2009 selection board defied that logic by selecting 2 med students for EM deferment but allowing 0 interns the opportunity for straight through training.

 

[BOHICA-FIGMO]

At the 2009 JSGMESB 2 were selected for EM deferment.
At the 2008 JSGMESB 1 was selected for EM deferment

2009 JSGMESB 0 were selected for IM deferrment
2008 JSGMESB 1 was selected for IM deferment


I don't have statistics before 2008 so I can't speak to any trends. I do know IM typically tries to fill all of their spots before they select anyone for a deferment. On the other hand, the 2009 selection board defied that logic by selecting 2 med students for EM deferment but allowing 0 interns the opportunity for straight through training.

On the other hand, if you want to do IM straight through, you have a better than 50% shot. I know a couple of interns selected for straight through chose other things, so >2/3 of the IM interns who wanted to go straight through got it.

As for ED, they ranked some interns higher than those returning from the fleet but were forced to rank the fleet people higher....meaning zero interns go straight through. I'd say, if you are young, do 3 years IM, do 3 year utilization tour, then if you don't like it you will have MEGA points to apply for another residency (e.g., EM). That of course depends on whether your specialty will release you to do that Or, you could bail to civie land where I'm sure any EM program would love to have a board certified internist in their EM residency.

 

[tkim]

Or, you could bail to civie land where I'm sure any EM program would love to have a board certified internist in their EM residency.

Not necessarily. If you've already completed a residency, your funding 'clock' is done, and any further training will be at reduced funding. While there are many residencies that will take on people with previous training, some simply will not be able to afford to do so.

Additionally, there are some residencies that will not want to 'retrain' IM trained people to an EM mindset.

 

[J-Rad]

Not necessarily. If you've already completed a residency, your funding 'clock' is done, and any further training will be at reduced funding. While there are many residencies that will take on people with previous training, some simply will not be able to afford to do so.

But does that also go for someone who completed a military residency? I don't know, but it's pretty common for .mil docs to retrain in another field and there never seems to be heartburn over the 1/2 funding thing, so I wonder if that principle is as applicable to those formerly trained in the .mil.

 

[tkim]

But does that also go for someone who completed a military residency? I don't know, but it's pretty common for .mil docs to retrain in another field and there never seems to be heartburn over the 1/2 funding thing, so I wonder if that principle is as applicable to those formerly trained in the .mil.

I wasn't sure if that was the case. If it is, then the funding is a non-issue.

 

[Gastrapathy]

But does that also go for someone who completed a military residency? I don't know, but it's pretty common for .mil docs to retrain in another field and there never seems to be heartburn over the 1/2 funding thing, so I wonder if that principle is as applicable to those formerly trained in the .mil.

It does apply. People here have posted the reference. Don't have time to look right now but I'm pretty darn sure about this.

 

[Classic17]

Also Class of 2012, also am going to apply for an EM deferment, and am also not holding my breath on it actually happening. If I am not able to train straight through and do a 2 year GMO tour, I am fine with that. However, I think I am going to try and do another 2 year tour to finish my commitment and then apply for civilian match in, yikes, 2017. Anyone know how they view military members in the match coming off of four years as a primary care military doc?

 

[BamaMedik]

Thanks to all for your replies. I think you all have confirmed what I suspected and not to hold my breath for EM residency or deferment. I'm prior service so I'm flexible when it comes to this type of thing. Like someone suggested I think I will probably go with the higher probability and apply for IM. I'm not real young but I guess I can always do a 3yr EM civilian residency later after my commitment is up. It would be nice if I can pick up a IM residency spot or IM deferment. So let me get this straight when it's time to apply for residency do we apply both for the IM residency and the IM deferment at the same time? or is it one or the other?

 

[BamaMedik]

Also Class of 2012, also am going to apply for an EM deferment, and am also not holding my breath on it actually happening. If I am not able to train straight through and do a 2 year GMO tour, I am fine with that. However, I think I am going to try and do another 2 year tour to finish my commitment and then apply for civilian match in, yikes, 2017. Anyone know how they view military members in the match coming off of four years as a primary care military doc?

Yeah I wanted to do an EM residency or EM deferment too but the more I hear from people that it's more of a zero probability of getting either I'm going with IM so I can at least go straight through possibly. All the best.

 

[Gastrapathy]

Yeah I wanted to do an EM residency or EM deferment too but the more I hear from people that it's more of a zero probability of getting either I'm going with IM so I can at least go straight through possibly. All the best.

This is a really lousy reason to pick a specialty. If you aren't happy as a general internist, you'll end up subspecializing (which is almost as long as another entire EM residency).

Also, you don't get to apply for straight-through IM training at the PGY-1 board (so far). You apply for internship and then apply immediately again for residency. Nonetheless, you do have a good shot at straight-through IM training. Then a utilization tour. Then subspecialty training to free you from clinic hell.

 

[BamaMedik]

This is a really lousy reason to pick a specialty. If you aren't happy as a general internist, you'll end up subspecializing (which is almost as long as another entire EM residency).

Also, you don't get to apply for straight-through IM training at the PGY-1 board (so far). You apply for internship and then apply immediately again for residency. Nonetheless, you do have a good shot at straight-through IM training. Then a utilization tour. Then subspecialty training to free you from clinic hell.

Hey thanks for the reply. I know shooting for IM sounds bad if you want EM but I'd actually would do a combine IM/EM if I could but I know the military doesn't permit it. EM is my #1 choice but given the probability of getting it I'll go with my #2 IM. The thing is I don't graduate from med school til I'm 35 and I'd rather not be starting residency at 38 if I can help it. My background is in public health and I was also a medic with the AF for many years. So I have a general love and appreciation for EM and IM both. I'd like to avoid the GMO tour if I can help it and would definitely be happy in IM versus GMO.

So PGY-1 board is when we apply for deferment as well? or do we apply for deferment immediately after that board?

 

[BOHICA-FIGMO]

This is a really lousy reason to pick a specialty. If you aren't happy as a general internist, you'll end up subspecializing (which is almost as long as another entire EM residency).

Also, you don't get to apply for straight-through IM training at the PGY-1 board (so far). You apply for internship and then apply immediately again for residency. Nonetheless, you do have a good shot at straight-through IM training. Then a utilization tour. Then subspecialty training to free you from clinic hell.

I agree. But I would add, given my limited experience, if you are an ER physician who already has a background in IM (i.e., gen IM board cert), you will be a rock star. Given all the +/- admits from the ED and BS transfers from OSH we take, having the perspective of an internist (who you will admit most of your patients to) in the ED will be invaluable.

 

[Gastrapathy]

I agree. But I would add, given my limited experience, if you are an ER physician who already has a background in IM (i.e., gen IM board cert), you will be a rock star. Given all the +/- admits from the ED and BS transfers from OSH we take, having the perspective of an internist (who you will admit most of your patients to) in the ED will be invaluable.

To a point, yes. But probably not as invaluable as if you spent those 2 years as as staff EM doc. More training is always better but there are diminishing returns and at some point its really nice to work for a living (says the former PGY6).

 

[jabreal00]

I would be depressed at the reality of having a good chance of being sent out as a GMO after my PGY-1 on some utilization tour.

If I were in your shoes, I would go with IM. Hopefully you go straight through your training. At that point you can finish your obligation. If you like medicine you could stay on as an internist. If you don't like general internal medicine you could sub-specialize. The good thing about sub-specializing is that you are building off your baseline knowledge rather than starting from scratch in a new specialty. Or in the unlikely chance that you absolutely hate medicine, apply for EM in the Navy or as a civilian.