Neurology residency done-advice in active duty or reservist?

[CYmd1980]

Hi! I recently completed by Neurology residency training and now completing my fellowship training.

I am on a crossroad whether to continue to be a civilian Neurologist or joining active duty or as a reservist. I love and enjoyed Neurology, and want to practice as one.

1. How different is it, if one compares a civilian practice to a military service? (number of work hours, on-call nights).

2. When one joins military service - can you give a city/state preference where to practice? if stationed in a different state, how long would that be?

3. How often and how long are physicians in active service deployed? How about Reservists?

4. If ever deployed, do they consider your specialty training or you will be required to practice a general physician seeing diarrhea and colds?

I am a Newbie at the crossroads after training, I had an awesome journey in my career, enjoyed my pre-med as a Physical Therapist, inspired me to be a Neurologist, went to the best and tough residency training program, now carefully looking at the next step.

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[DrMetal]

Hi! I recently completed by Neurology residency training and now completing my fellowship training.

I am on a crossroad whether to continue to be a civilian Neurologist or joining active duty or as a reservist. I love and enjoyed Neurology, and want to practice as one.

1. How different is it, if one compares a civilian practice to a military service? (number of work hours, on-call nights).

2. When one joins military service - can you give a city/state preference where to practice? if stationed in a different state, how long would that be?

3. How often and how long are physicians in active service deployed? How about Reservists?

4. If ever deployed, do they consider your specialty training or you will be required to practice a general physician seeing diarrhea and colds?

I am a Newbie at the crossroads after training, I had an awesome journey in my career, enjoyed my pre-med as a Physical Therapist, inspired me to be a Neurologist, went to the best and tough residency training program, now carefully looking at the next step.

I think it all depends on your personal and professional desires. You like treating TBI? That might work out for you in the military healthcare system, as we seem to have plenty of TBI and mild TBI after a decade of war. You looking for a lot of zebra seizure pathology? If so, then you might not like the mil system, as we do a good job of blocking people with such disorders from joining, or we separate them if new onset (of course, you might get to treat dependents or retirees with such cases). There seems to be plenty of dementia though, especially as the baby boomer military population ages.

Civilian vs active-duty vs reservist: all depends on your personal desires. If you wanna be in the military, and are willing to deploy--and yes you might be deployed doing something other than neurology--then consider going AD or reserves. The latter option seems to work out nicely for those who wanna keep a civilian practice (but you still have to be ready to deploy . . . when and how much is anybody's guess . . .they try to space them out, making sure everybody goes once before anybody goes twice . ...). You could always go to work at an MTF as a civilian . . .talk to folks to get more info, then join the reserves at a later date.

 

[deuist]

1. How different is it, if one compares a civilian practice to a military service? (number of work hours, on-call nights).

Hours are about the same. Get ready for a steep pay cut, though.

2. When one joins military service - can you give a city/state preference where to practice? if stationed in a different state, how long would that be?

You can give preferences all you want, but you can still be stationed wherever they need you. An assignment can be at one location for up to 4 years, but you can try to request a change if you want to go somewhere else.

3. How often and how long are physicians in active service deployed? How about Reservists?

Depends on the service. The Air Force typically sends docs for 4 months at a time. I've heard of some Army docs leaving for 15 months.

4. If ever deployed, do they consider your specialty training or you will be required to practice a general physician seeing diarrhea and colds?

You could indeed end up practicing general medicine. Also, you mentioned that you are completing a fellowship. If the military does not have your sub-specialty, you might end as a general neurologist as part of your daily practice.

 

[BlackFrancis33]

1. How different is it, if one compares a civilian practice to a military service? (number of work hours, on-call nights): No MEDCEN or MEDDAC is as busy as a civilian institution of similar size. You can be a 1 person shop (I've been there) but the volume makes it manageable. I never work as hard as I do when moonlighting covering stroke call etc. at civilian hospitals.

2. When one joins military service - can you give a city/state preference where to practice? if stationed in a different state, how long would that be? Well, you probably can but I can tell you that the open slots are at the places we have large troop numbers. That means Texas and the South primarily, also Korea and Germany. As you are just out of training these MEDDACs would be your most likely location. Your fellowship may help you get to a MEDCEN sooner, especially if we don't have one of whatever you are now (we don't have a neuroimmunologist for example).

3. How often and how long are physicians in active service deployed? How about Reservists? Active duty folks get deployed. Deployments right now range from 4-9 months, average around 6 months.

4. If ever deployed, do they consider your specialty training or you will be required to practice a general physician seeing diarrhea and colds? Neurologists were protected from doing general medicine for a few years, but that expired so this is a possibility. Neurologists do deploy as neurologists in the Army and Navy with the concussion care centers. Folks actually volunteer (sort of) for the latter.

I also PM'd you, I can give you way more info offline.

 

[bustbones26]

1. How different is it, if one compares a civilian practice to a military service? (number of work hours, on-call nights): No MEDCEN or MEDDAC is as busy as a civilian institution of similar size. You can be a 1 person shop (I've been there) but the volume makes it manageable. I never work as hard as I do when moonlighting covering stroke call etc. at civilian hospitals.

2. When one joins military service - can you give a city/state preference where to practice? if stationed in a different state, how long would that be? Well, you probably can but I can tell you that the open slots are at the places we have large troop numbers. That means Texas and the South primarily, also Korea and Germany. As you are just out of training these MEDDACs would be your most likely location. Your fellowship may help you get to a MEDCEN sooner, especially if we don't have one of whatever you are now (we don't have a neuroimmunologist for example).

3. How often and how long are physicians in active service deployed? How about Reservists? Active duty folks get deployed. Deployments right now range from 4-9 months, average around 6 months.

4. If ever deployed, do they consider your specialty training or you will be required to practice a general physician seeing diarrhea and colds? Neurologists were protected from doing general medicine for a few years, but that expired so this is a possibility. Neurologists do deploy as neurologists in the Army and Navy with the concussion care centers. Folks actually volunteer (sort of) for the latter.

I also PM'd you, I can give you way more info offline.

1. I've seen more neurology as a civilian than I ever saw as an active duty neurologist. TBI? This is not "real" TBI. The majority of cases are questionable.

2. Fellowship will not necessarily help you get a MEDCEN spot.

3. Colleague of mine in the Reserves told me that he is not busy, they are not giving preference for neurologists at this time. Sometimes a "deployment" in the reserves involves backfilling 90 days at a military hospital. Right now, the Army is deploying neurologist in 6 month slots to Afghanistan. I deployed for 12 months as a GMO in my time. Yes, I saw diarrhea, shoulder pain, skin problems, etc.

Whenever I was on active duty, I worked with a civilian contractor. He was paid roughly 100K more per year than I was. At least twice per year, he would "run out of hours" and take up to 6 weeks off. This was in addition to his regular time off. Because he was a civilian, he always got out of the "stat" consults: SRP, medical evacuations, etc. That type of stuff always fell onto me since I was the man in uniform. So, getting paid roughly 240K per year for 8 to 10 weeks off per year and getting out of the operational stuff was not bad. I'd consider that an option. If you are looking to "serve" and receive some decent benefits, then consider GS employment.

On of the major reasons I got out was because I figured that if I stayed in, as I gained rank and time, I would see less and less and watch my skills atrophy. I will sadly admit, there were things I had not seen over a four year period of time and it hurt, e.g. Parkinsons, MS management (will diagnose and med board many), Alzheimers/Dementia (but plenty of 20 somethings on 20+ psych meds claiming memory loss), and the list goes on.

DO NOT be fooled into thinking that just because you are fellowship trained that you will get a spot at Walter Reed or SAMMC.

Final word, if you completely ignore my advice and seek a uniformed position, go Air Force.

 

[notdeadyet]

3. How often and how long are physicians in active service deployed? How about Reservists?

For the Reserve Corps side, on the Army, policy is 90 days boots-on-ground, with up to an additional 30 days total pre-/post-mobilization. The pre-/post-mob is more typical of the Reservists (who more often deploy with their home unit) than the National Guard (where you would most likely deploy as an augmentee). The 15 month deployments people always mention when mentioning the Army refers to active duty physicians (including the Navy and AF docs who have been slotted into those roles in the past). Policy for reserve corps has been 90 days for quite a while and I wouldn't anticipate that changing until another war of harder tempo than the ones we've been fighting for the past 5 years.