Navy/GMO and family issues

[velouria]

Hi,

I'm currently (strongly) considering doing Navy HPSP. I'm female, married with 2 young kids.
Presumably I'll have to do a GMO tour. I'm more than willing to go abroad or do whatever, but I would like to know what the odds are that my family could accompany me?? I understand that you can opt for a 3-yr GMO at a hospital, but I'm not sure that's a good option. Anyone here with kids or care to comment on Navy GMO/residency life with kids?
Also curious about how others' spouses adjust if they're not military. My husband is 100% supportive, but I feel like I'll be asking him to drop his goals and move around with me at the Navy's whims for the foreseeable future. How do others address this? Just a fact of military life?
Finally, if you're at a Navy hospital can your kids go to school on base and what's the overall quality of those schools (realizing I'm asking for a gross overgeneralization)?

Thanks!

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[DD214_DOC]

I think you have forgotten that some Navy GMO tours are onboard a ship. There is no guarantee that you will (a) not be on a ship for 6 months to a year and (b) not be stationed in a non-accompanied location.

What you do as a GMO will likely determine where you are. Flight Surgeon, Dive Medical Officer, and whatever is left dictates whether you will be in a hospital, on an aircraft carrier, a surface warfare ship, or attached to a Marine unit in Craphole, Middle East. As a female you lucked out of submarine duty.


By the way, "non-accompanied" means what it says: you are unable to bring your family. I do not know the exact locations, but I'm pretty sure most of the middle east areas are like this.

Also one more caveat: as someone with dependents, you cannot choose to do a 3-year GMO tour -- you WILL do a 3-year GMO tour.

I have some prior experience with the Navy, and as forewarning I will tell you this: of all the military branches, the Navy is probably the harshest on a marriage and family. More than likely you will do a cruise at some point.

If you decide to stay in after your GMO tour, and I'm not sure if the GMO tour counts towards payback, your specialty will dictate where you are stationed, deployed, and how often.

I'm not trying to scare you, but out of an entire battalion I only knew one officer who wasn't divorced or single and that was the Captain -- it was his third wife.

Good luck.

 

[velouria]

Thanks for your response!

Also one more caveat: as someone with dependents, you cannot choose to do a 3-year GMO tour -- you WILL do a 3-year GMO tour.

Does this mean that I couldn't choose to do a shipboard GMO if I wanted to get it over and done with in a year? (without family along)

Also, if you did a 3-yr GMO, does that time count as payback? So if you had a 4-yr HPSP and did a 3-yr GMO, you would only owe 1 year post-residency? Somehow I imagine that's not all there is to it.

Thanks again for the feedback. It's a difficult decision for me & I appreciate your comments.

 

[DD214_DOC]

The fine print in HPSP is that you pay back either the time subsidized for medical school or the time for your residency. I'm not positive if GMO counts towards payback, but I *think* it does.

Let's say I wanted to do some surgical specialty that was a 6 year residency, but before entering residency I spent 3 years as a GMO. After residency, I would owe the Navy 3 additional years. Also, never never never forget that after your active duty time you are an inactive reserve for X number of years. This means that if something happens and they need you, you're pulled out of your practice and head back to active duty. Lots of people forget this part.

You would really have to ask someone who is in the navy about how the GMO tours exactly work. I can only infer that yes, you probably could get your cruise out of the way early. Most cruises are six months if I remember correctly, but if your ship is called out for some defense purpose you could end up being stuck on it for much longer than six months. Look how long it took some of the ships to return home after being deployed to Iraq.

The Navy is a great experience, but it takes its toll on the family. I, too, am debating between Navy or Air Force. My loyalties lie with the Navy for obvious reasons, but my wife insists I do the Air Force. I would LOVE to do a 3-year GMO tour as a Flight Surgeon, but alas I must reach a compromise.

A final note: you really should consider why you're doing HPSP. If it's just a way to fund med school then for God's sake don't do it. If you feel a calling to serve your country and accept the possibility of dying while out at sea or in a foreign country (yes, it can happen even to doctors: USS Cole ring a bell?) then go for it. I'm not trying to sound insulting, but many people seem to forget that the military fights wars.

 

[militarymd]

jkdmed has made most of the points that I make.

On the residency issue. The new rules are that payback after a residency with be at a minimum the length of the residency. Meaning if you have only 1 year of committment left because you have served a GMO tour, and you do a 3 year residency....you will owe 3 years again after residency,.

 

[FliteSurgn]

If you return to residency after serving as a GMO, you have a minimum 2 year payback period after your residency. If you get redeferred to do a civilian residency, you incur 6 months of payback for each year of residency. Once again, this is with a minimum of 2 years.

You could just serve all of your committment as a GMO and then return to residency in the civilian sector, if you wanted. This is especially true if you want a specialty that is scarce in the military...Derm comes to mind.

 

[DaveB]

GMO time does count towards payback. However, if you a GMO tour and then a Navy residency, you will most likely inccur more obligation time for your residency.

For example: you do a 4 year HPSP, thus owing four years payback. You do your internship (which does not count for or against you), then a 3 year GMO tour. At this point, you owe one more year. Then, for example, you do a Navy general surgery residency over four years. At this point, you now owe one year for HPSP and 4 for your general surgery training. The fine print in your HPSP contract stipulates that at this point you essentially owe whatever obligation is longer, i.e. 4 more years.

And miraculously, the "4 year payback" quoted to me by my recruiter means I've sold my soul to the Navy for at least 12 years.

 

[Demosthenes_7]

I believe the Navy also has a transition year your first year out of medical school where you rotate through different areas in order to prepare you for your GMO duty (add another year to the "4 year payback" YUK YUK). This does not count toward your payback time...but it might count towards retirement time?

 

[Homunculus]

Originally posted by Demosthenes_7
I believe the Navy also has a transition year your first year out of medical school where you rotate through different areas in order to prepare you for your GMO duty (add another year to the "4 year payback" YUK YUK). This does not count toward your payback time...but it might count towards retirement time?

yeah, that first year out of medical school has a name-- it's called your internship

 

[Demosthenes_7]

Thanks for the info...but the Air Force doesn't have an internship--you go straight from school to your residency.

 

[DD214_DOC]

The navy is the only branch with a mandatory* GMO tour. I say mandatory with an asterix because I have heard rumors of the navy letting certain specialties such as psych avoid the GMO tour. The AF and Army have them but they're not required.

 

[FliteSurgn]

Demosthenes_7,

The Air Force certainly does have internships. It's totally their call whether they allow you to complete a full residency before entering payback or if they'll make you start paying back after your internship. After your internship, you can function as a GMO or flight surgeon (after completing a 6 week course in aerospace medicine).

The majority of the flight surgeons in the Air Force have only completed internships. At my previous assignment, of the 5 flight surgeons...one completed psych internship, one medicine, one ortho, and me general surgery. The last one had completed a full residency in family practice.

Any amount of time that you spend on active duty will count towards retirement. You do not incur any extra payback obligation for your first year of post-graduate training...nor does any part of residency or internship constitute any portion of your payback.

 

[militarymd]

Originally posted by rgporter
Please explain the options/requirements for GMO in a little more detail. My recruiter said you didn't need to perform one but I think he was misinformed (he's prettty new) or he was LYING. I want to do ortho, what kind of GMO tour would I have to do if any?

Oh....Recruiters don't lie....that would be behavior unbecoming...they just stretch the truth.

GMO tours are not mandatory in any of the services. It's just that the Navy has a lot more GMO billets than the other services, so your chances of doing a GMO is much more likely.

If the stars are properly aligned, the moon is in the right phase, and you walk on water, you will have a chance of going straight into your PGY-2 year in the the Navy...

Oh, I forgot about those who have a great shot at going straight into their PGY-2 year of training....those who have flag officers for a parent or who know important people (not congressmen, but powerful senators and the like).

 

[Homunculus]

Originally posted by Demosthenes_7
Thanks for the info...but the Air Force doesn't have an internship--you go straight from school to your residency.

the air force uses non-licenced physicians for GMOs? that's news to me. can you even prescribe medications without doing an internship first?

 

[Globus P]

Recruiters and detailers don't lie. The truth changes.

 

[tman]

Originally posted by Demosthenes_7
Thanks for the info...but the Air Force doesn't have an internship--you go straight from school to your residency.

ummmmm let's see where to start...ok, first it would appear that you do not have a good understanding of the graduate medical education process. The first year of medical training after graduating medical school is an internship. These days most allopathic residencies have the internship year built into their program and the "internship" is nothing more than your first year of residency. Some specialties such as anesthesiology require you to do a seperate internship prior to begining the residency. Homunculus is pointing out that in order to be a licensed to practice medicine in the U.S. you must complete an internship and pass step 3...Being in the Air Force has nothing to do with it.

As for the Air Force graduate medical education program, there certainly are stand alone internships in surgery, medicine and transitional years. Not everyone in the Air Force goes directly from medical school into their residency. Some people end up doing GMO/flight medicine tours, either by choice or virtue of not matching in their desired specialty. A typical example is someone wanting to do ortho...a highly competitive specialty with only a few slots per year. Often people who want to do an ortho residency are not picked up after med school and so they opt to do a tour as a flight doc (which gives them extra "points" with the GME selection board) and then reapply for an ortho residency as they are completing their GMO tour. Many people opt to do a tour as a flight doc simply because they are interesed in operational/flight medicine and want some experience in that arena. Others either want a break from training or can't decide what they want to be when they grow up and take a couple extra years to decide. In short, the Air Force DOES have internships and not everyone goes directly from medical school to residency.

This has been a public service announcement, now back to your regularly scheduled program....

 

[referee]

Originally posted by ToddE
Recruiters and detailers don't lie. The truth changes.

Those detailers, some of the shadiest people I know.

 

[Demosthenes_7]

Thank you to everyone for straightening me out and enlightening me about this whole process. I'm going to hit our local Air Force and Navy HPSP recruiters with some good questions come Monday morning. Payback is not as straightforward as they make it out to be.

A question about the Navy HPSP (or even AF)...so you do your transition/intern year, GMO years, and then you finally get to do residency...with allopathic residencies building the transition year into the residency, will you have to repeat your transition year? If you do a military residency, will you have to repeat your transition year? If you don't have to repeat your transition year, then you're a PGY2?

 

[DaveB]

In general, you do not usually have to repeat your intern year. From what I've seen, Navy residency programs expect you to do your GMO tour, come back and be a little rusty during your PGY-2 year without having to re-do your intern year.

That said, I have seen people who come back to training from doing 2-3 GMO tours and have had to do a few extra months of intern-level work, basically an extended PGY-2 year. However, I've yet to get a good answer as to how this comes to be from any residency director. Fortunately, these people seem to be the exception rather than the rule.

 

[FliteSurgn]

Most of the Air Force residencies have a fair percentage of their interns leave for a GMO/FS stint after that first year. If you return to residency in the Air Force after you tour, you will start as a PGY-2. They expect their 2nd year residents to need a little remediation at the onset.

In contrast, if you return to the civilian sector for residency, you will either need to find a vacancy somewhere or repeat your internship. Since the civilian residency expects their second-year residents to be on par with the others that haven't had a gap in training, you may need to put in some extra time to get caught up. Personally, I took leave during the Spring and then separated in early June so that I could spend some time in the ICU, wards, reading, etc. before I jumped back into general surgery with both feet.

 

[r90t]

Can you be away from your kids for 8 months, be home for 6 months, then deploy again for another 8?

If the answer in no, or I don't think so. Don't join the navy for the cash benefit. Payback is in time and sometimes blood.

Joint stationing with family almost always happens unless you are going someplace bad, i.e. Iraq. We have families living in Bahrain with their active duty families.