Navy GMO station question

[TxsMed14]

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Hi,

I am starting med school 2014, and going Navy because I would like to do a 4-year GMO. Ideally, my first choice would be an overseas deployment with Marine unit, second ship, third flight surgeon stationed abroad.

Could you guys describe your GMO placement experiences, particularly, for those in overseas deployments, what is the likelihood that I won't get any of these options, and end up somewhere stateside (last choice)? Would being a woman make it harder or easier to get deployed with, say, a (female) marine unit.

If there are any ladies docs out there, please PM me, I would love to chat with you.

Thanks,
TxsMed

 

[orbitsurgMD]

Everything is going to depend on what the op-tempo is in six years, the time when you would be taking a billet, at the earliest. No one can tell you what that would be. You cannot determine what jobs will be available at that time. A wish list is fine, if it makes you content to have one, but don't waste your time or anyone else's thinking you can make plans this far out, even if you want nothing more than to be a GMO.

Military policies change. Except for the most restrictive platforms, women can be stationed as doctors just about anywhere.

 

[bricktamland]

I admire your desire to serve. Though I am curious about your motivations to serve specifically as a GMO, and wonder if you may have misconceived notions about the true nature of the job. In many cases, a GMO deployment is not a very glamorous or especially rewarding experience.

I deployed with a Marine infantry unit to Iraq in 2006. Building up to the deployment, I had all these ideas in my head that I would be dashing around on the battle field dodging mortars while I run from one Marine casualty to the next, dropping in chest tubes and placing tourniquets and pouring Quickclot into gushing wounds. It was nothing like that. It was just one long, dull, drawn-out sick call experience, going to boring meetings everyday, and eating crappy canned food.

The real medical heros, IMO, are foremost the Line Corpsmen, and then the providers at the Level 2 forward surgical team. These are the people that handle the real trauma and the ones who save lives. As a GMO, sure, there is always a possibility that you'll find yourself in a true trauma situation or mass casualty scenario, but it's infrequent. I didn't, but I know a few a guys who have some stories.

So, if you still want to be a GMO, go for it. The Marines and Sailors will always need someone to address their sniffles, ankle pains, crotch rash, toe fungus, and anxiety disorders. And sadly, that's the most interesting part of the job. The majority of a GMO's job involves some truly heart pounding administative activities, such as tracking "medical readiness", coordinating shot stand-downs, and going to meeting after meeting.

The long and short of it is that I still respect your interest in deploying, but I think there are other more fullfilling opportunites besides a GMO tour.

Also, to address your other question, I don't think being female limits your opportunities to deploy. Rather, it will limit your deployment opportunites to the less austere options (such as a ship, or Marine Wing). You won't be attached to an infantry unit.

Good luck.

 

[deleted228599]

I just arrived as a GMO with the Marines. I have been open about my desire to deploy. WIth things winding down in Afghanistan, they have basically said "good luck". I may get the opportunity during my 2 years, but it certainly seems that it is not a given. As a previous post said, it all depends on the op-tempo.

 

[TxsMed14]

I admire your desire to serve. Though I am curious about your motivations to serve specifically as a GMO, and wonder if you may have misconceived notions about the true nature of the job. In many cases, a GMO deployment is not a very glamorous or especially rewarding experience.

I deployed with a Marine infantry unit to Iraq in 2006. Building up to the deployment, I had all these ideas in my head that I would be dashing around on the battle field dodging mortars while I run from one Marine casualty to the next, dropping in chest tubes and placing tourniquets and pouring Quickclot into gushing wounds. It was nothing like that. It was just one long, dull, drawn-out sick call experience, going to boring meetings everyday, and eating crappy canned food.

The real medical heros, IMO, are foremost the Line Corpsmen, and then the providers at the Level 2 forward surgical team. These are the people that handle the real trauma and the ones who save lives. As a GMO, sure, there is always a possibility that you'll find yourself in a true trauma situation or mass casualty scenario, but it's infrequent. I didn't, but I know a few a guys who have some stories.

So, if you still want to be a GMO, go for it. The Marines and Sailors will always need someone to address their sniffles, ankle pains, crotch rash, toe fungus, and anxiety disorders. And sadly, that's the most interesting part of the job. The majority of a GMO's job involves some truly heart pounding administative activities, such as tracking "medical readiness", coordinating shot stand-downs, and going to meeting after meeting.

The long and short of it is that I still respect your interest in deploying, but I think there are other more fullfilling opportunites besides a GMO tour.

Also, to address your other question, I don't think being female limits your opportunities to deploy. Rather, it will limit your deployment opportunites to the less austere options (such as a ship, or Marine Wing). You won't be attached to an infantry unit.

Good luck.

I can't lie that you nailed part of it.. although I am going in prepared for the very likely possibility of a mind-numbingly boring post. But deployment or overseas at least has the *potential* for a more hands-on mil experience. The other reason is that I'm interested in a military career, but don't have prior service experience. I figure putting my time in on a GMO tour will give me more legitimacy later down the road, and make me more relatable with the troops. At the very least, it seems like being stuck in 'med readiness' would be way more interesting on a ship than (...ugh) a MEPS station.Im also the kind of person that ranks interesting experience > comfort level or internet access.

When you say fulfilling opportunities, do you mean after residency? I was under the impression our only options were 2/4 year GMO or going straight through.

I just arrived as a GMO with the Marines. I have been open about my desire to deploy. WIth things winding down in Afghanistan, they have basically said "good luck". I may get the opportunity during my 2 years, but it certainly seems that it is not a given. As a previous post said, it all depends on the op-tempo.

Well, awesome you got with a marine unit at least. Where are you stationed, and what will your role be?

 

[pgg]

I figure putting my time in on a GMO tour will give me more legitimacy later down the road, and make me more relatable with the troops.

It might give you a better appreciation for them, but it probably won't work the other way.

Especially if you wind up in a scrub-wearing specialty, they'll have no way of knowing. Even if you wear a non-camo uniform when seeing patients, I think it's a stretch to think that they'll respond differently if you've got a warfare device or sea service deployment ribbon or a [insert conflict here] campaign ribbon.

 

[bricktamland]

I would look into the FAP program, if you still have the opportunity. That way, you can bypass the whole GMO situation. Then, if you're still determined to go operational and deploy, you can do it as staff. Plenty of people complain about staff deployments, but I think it would be more fulfilling than deploying as a GMO.

 

[deleted228599]

Well, awesome you got with a marine unit at least. Where are you stationed, and what will your role be?

Getting a billet with the Marines is not difficult. Some have limitations on females but you should be able to find a spot easily.

As said above, I see clinic, track down readiness, go to meetings to discuss the readiness and fumble though explaining why readiness is low. However right now my job is great and I'm still in the honeymoon phase of just being happy that I work M-F, coming from internship.

 

[DrMetal]

Getting a billet with the Marines is not difficult. Some have limitations on females but you should be able to find a spot easily.

As said above, I see clinic, track down readiness, go to meetings to discuss the readiness and fumble though explaining why readiness is low. However right now my job is great and I'm still in the honeymoon phase of just being happy that I work M-F, coming from internship.

Can you moonlight? I have this crazy idea of moonlighting somewhere, like a hospital floor or a busy urgent care clinic....if GMO life proves to be less than stimulating. Is it possible to moonlight with a CA license, after only Pgy1???

 

[BigNavyPedsGuy]

Can you moonlight? I have this crazy idea of moonlighting somewhere, like a hospital floor or a busy urgent care clinic....if GMO life proves to be less than stimulating. Is it possible to moonlight with a CA license, after only Pgy1???

1) your command has to approve it, and most won't
2) If the only training you have is an internship then please tell me where you're moonlighting so I can NEVER go receive care there. One year of training doesn't prepare anyone to practice independently and it's dangerous to think otherwise. Especially in an environment where you see something other than healthy active duty folks.
3) Because of #2 opportunities for moonlighting (especially densely in populated SoCal) would be rare.

 

[Ziehl-Neelsen]

2) If the only training you have is an internship then please tell me where you're moonlighting so I can NEVER go receive care there. One year of training doesn't prepare anyone to practice independently and it's dangerous to think otherwise. Especially in an environment where you see something other than healthy active duty folks.

Nailed it.

Most experienced military physicians don't hate the GMO position because we hate the line and never want to deploy. Most of us know what we signed up for, and despite the problems that it causes for family and career, gain a small sense of satisfaction by deploying and doing our part to serve the line.

And I slightly disagree with the notion that a deployment will consist only of craptastic bread and butter medical complaints while the corpsmen/combat medics do all the cool stuff treating trauma on the battlefield. To be sure there will be mountains of administrative drudgery, and if there is any trauma the medics/corpsmen will do all the "cool stuff" prior to the evacuation bypassing the level I and heading straight for the level II; however, there is a chance to seriously help indivudal soldiers and marines in a deployed setting as a GMO.

In my wife's last deployment she dealt with:
1) Hodgkin's Lymphoma
2) Cutaneous Leishmaniasis
3) Stevens Johnson Syndrome
4) Unstable Angina
5) Acute Kidney Injury due to rhabdomyolysis
6) Acute Renal Failure due to ethylene glycol consumption
7) Asystole that required a code and resulted in death (found on the post-mortem exam to be virtual total occlusion of the LAD)

My wife dealt with thse as a board certified internist who had completed a year as staff before her deployment. An intern who has completed a TY is not equipped to recognize or begin management of these conditions. And in fact, a couple of these conditions had been "glossed over" by the PA on previous visits--a PA who I might point out actually had more on-the-job experience than an a GMO coming out of internship.

Be a GMO if that is your heart's desire. But become a GMO because you want to "conserve fighting strength" and tend to the medical issues of unit, not because you think it will make a great bullet point on an OER or give you better "cred" with the line. But understand that the best way you can serve as a GMO is (ideally) after doing a full residency. If it looks like you will be serving as a GMO after internship, amke sure your internship prepares you as much as possible (i.e. no rads, path, or gas electives).

 

[bricktamland]

Nailed it.

Most experienced military physicians don't hate the GMO position because we hate the line and never want to deploy. Most of us know what we signed up for, and despite the problems that it causes for family and career, gain a small sense of satisfaction by deploying and doing our part to serve the line.

And I slightly disagree with the notion that a deployment will consist only of craptastic bread and butter medical complaints while the corpsmen/combat medics do all the cool stuff treating trauma on the battlefield. To be sure there will be mountains of administrative drudgery, and if there is any trauma the medics/corpsmen will do all the "cool stuff" prior to the evacuation bypassing the level I and heading straight for the level II; however, there is a chance to seriously help indivudal soldiers and marines in a deployed setting as a GMO.

In my wife's last deployment she dealt with:
1) Hodgkin's Lymphoma
2) Cutaneous Leishmaniasis
3) Stevens Johnson Syndrome
4) Unstable Angina
5) Acute Kidney Injury due to rhabdomyolysis
6) Acute Renal Failure due to ethylene glycol consumption
7) Asystole that required a code and resulted in death (found on the post-mortem exam to be virtual total occlusion of the LAD)

My wife dealt with thse as a board certified internist who had completed a year as staff before her deployment. An intern who has completed a TY is not equipped to recognize or begin management of these conditions. And in fact, a couple of these conditions had been "glossed over" by the PA on previous visits--a PA who I might point out actually had more on-the-job experience than an a GMO coming out of internship.

Be a GMO if that is your heart's desire. But become a GMO because you want to "conserve fighting strength" and tend to the medical issues of unit, not because you think it will make a great bullet point on an OER or give you better "cred" with the line. But understand that the best way you can serve as a GMO is (ideally) after doing a full residency. If it looks like you will be serving as a GMO after internship, amke sure your internship prepares you as much as possible (i.e. no rads, path, or gas electives).

Totally agree with above. Though I did want to clarify my post as it seems some of the themes I discussed were referenced.

I didn't mean to imply that as a GMO you have a zero chance of actually seeing any real pathology, or that you don't make a difference. As a GMO, I was absolutely confronted with a few life-threating cases, including such things as 23 yo presenting with ankle swelling (leukemia) and a 25 yo rushed in after a syncopal event and altered mental status (acutely ruptured cerebral aneurysm).

I probably misspoke by insinuating that GMOs aren't "heroes," as they definitely make life-saving decisions. My apologies go out to all prior and current GMOs. What I meant to say is that the vast majority of combat trauma cases bypass the GMO, and are handled first by the Corpsmen, followed by a medevac to the forward surgical team. This is where all the "action and excitement" takes place, if that's what you're after.

In my opinion, a GMO deployment is 95-99% drudgery. Yes, you are still doing an important job, because someone has to slog through sick call, manage the BAS, track medevac cases, and do all the other mundane admin duties. I guess I don't know for sure what the OP's motivations are. It sounded to me like she was a real hard-charger, so I made the assumption, perhaps falsely, that she was looking to get involved in the "cool high-speed stuff." But maybe she's just fine handling more of the low acuity cases.

So what then about that 1-5% of non-drudgery? As was touched upon above, a GMO will undoubtedly encounter some very serious and complicated cases. Even though these cases are infrequent, they will happen. Does one year of intership training adequately equip you to recognize and diagnose these cases? Maybe, maybe not. I think the Navy is gambling with this one. This is another good reason, if you have the choice and are looking for a deployment experience, to skip a GMO stint and instead look for opportunities to deploy as staff.

 

[pgg]

In ye olden days, pre-9/11, when the GMO life was a 7 AM - noon kind of job, and a deployment was a MEU cruise with port calls and drinking contests, it wasn't uncommon for PGY-1 trained GMOs to moonlight at urgent care clinics, or doing FAA flight physicals, or other stuff like that.

I bet you'd have to look far and wide to find one who's done it in the last 10 years though.

 

[bricktamland]

I know a former flight surgeon who was stationed somewhere pretty rural as a GMO, just a few years ago. He was moonlighting like crazy at a local ER. During the night shifts he was the only doctor in the entire ER clinic. I think they diverted all the trauma, but otherwise he was managing serious stuff like MIs, seizures, etc. I guess he found time during his day job to catch up on his sleep. Anyway, he told me he cleared an extra 100-150k per year.

 

[DrMetal]

1) your command has to approve it, and most won't
2) If the only training you have is an internship then please tell me where you're moonlighting so I can NEVER go receive care there

You would love to have me as your physician on a hospital floor ... q2hr rectal exams and much TLC is all I would have for you.

C'mon, spare me the D-bag lecture. I understand what you are saying, and I wasn't quite sure of my intentions...hence my question. If I were to moonlight, I presume it would be under some sort of supervision, perhaps at another teaching institution, like UCSD, or even NMCSD itself (voluntary of course).

 

[DrMetal]

In ye olden days, pre-9/11, when the GMO life was a 7 AM - noon kind of job, and a deployment was a MEU cruise with port calls and drinking contests, it wasn't uncommon for PGY-1 trained GMOs to moonlight at urgent care clinics, or doing FAA flight physicals, or other stuff like that.

I know a former flight surgeon who was stationed somewhere pretty rural as a GMO, just a few years ago. He was moonlighting like crazy at a local ER. During the night shifts he was the only doctor in the entire ER clinic. I think they diverted all the trauma, but otherwise he was managing serious stuff like MIs, seizures, etc. I guess he found time during his day job to catch up on his sleep. Anyway, he told me he cleared an extra 100-150k per year.

Thank you both for pointing this out ...hence the origin of my question.

 

[pgg]

I was a GMO at Camp Lejeune from 2003-2006. Toward the end of my intern year, when it came time to pick a state to get an unrestricted license, I specifically chose NC in the hopes of doing some moonlighting there.

I looked, but there were essentially zero opportunities. It didn't help that I was deployed or out on workups for about 20 of the 36 months I was there, but there just wasn't anyone looking to hire.

 

[DrMetal]

It didn't help that I was deployed or out on workups for about 20 of the 36 months I was there, but there just wasn't anyone looking to hire.

it's a good point. If you're in a unit with a high optempo, I don't imagine you'd have much time to moonlight. And if I go gmo, I hope to be in such a unit . . . .but If I end up in a mundane 8 to 5 job, I might try to find some work on the side, just to try to stay in touch with medicine. Or, I could take up more drinking and catch up on the tv that I've missed over the past decade.

 

[deleted228599]

I do not disagree that the GMO is a scary position. Our differential diagnosis is lacking and therefore would be more prone to missing pathology. I don't know what I don't know and have a low threshold for asking for help.

However, I don't think the danger of a GMO holds a candle to that of an IDC. The IDCs at my clinic see the same schedule load as me, with the only limitations being the ridiculous paperwork that must be signed by a medical officer. I had one ask me if I thought a referral to dermatology for a neck mass and dysphagia was appropriate...

 

[155HE]

I was stationed in Okinawa with 3d MarDiv. Okinawa gets mixed reviews on this forum, but I had a good time there. I never deployed to a combat zone, but my battalion did field ops off of the island every other month. Our optempo was pretty grueling--I was constantly readjusting to being back in Okinawa, getting used to being around my family again, and then finding myself in the field. I'm now a resident, but in retrospect I truly enjoyed working with/mentoring/teaching my Corpsmen and taking care of the Marines in my battalion; it was a rewarding experience. The acuity of the pathology in garrison was not very high--the usual primary care type stuff--musculoskeletal injuries, rashes, URIs. Had one case of leptospirosis (with complete with jaundice and renal failure), one person come to my BAS unresponsive with a low glucose, and one case of smallpox vaccine-related myopericarditis. In the field, had a few exciting cases to include penetrating thigh trauma with an M4 barrel (Marine fell into a 10 foot ditch and the barrel went into his thigh...he required surgery and a long rehab course), finger amputation, seizure, peritonsillar abscess, and lots and lots of heat-related injuries. One of the most important lessons I learned as a GMO was to know my limitations. Fortunately, I had a good working relationship with the hospital and specialists, and I felt comfortable calling them with questions. When I went to the field, I did site surveys of the host-nation medical facilities to learn their capabilities. Any time a patient made my spidey-sense tingle, I sent them to a higher echelon of care.

If you go overseas for a GMO tour, you will not be allowed to moonlight (nevermind that it's a bad idea for a GMO with one year of training). You will have a state license in the US, but that won't work overseas.

Okinawa itself I thought was a great place. It's a tropical island with beautiful beaches and some of the best scuba diving you could ever find. It's somewhat isolated, but a short flight to most major destinations in Asia. I had a chance to visit go to Korea, mainland Japan, and Singapore with my family. I wanted to go to Thailand, Vietnam, and China, but due to optempo it didn't work out. The Okinawan people are very friendly despite all the protests you hear about in the news. The food is great. If you're single, it may not be the best place because the dating pool is a little bit thin.

Lastly, most Marine units are now accepting females as their Battalion Surgeons. The few exceptions include Recon and Infantry units. Artillery units will accept women.

Hope this helps...