Neurosurgery in the military

[Handsome1]

I noticed on the army GME list that neurosurgery has consistently had a 1 applicant to 1 position ratio. I am not ignorant enough to believe it is that simple. Are the applicants hand picked out of the PGY 1 surgery spots after expressed interest? Are they self selected? I mean the training opportunities are so small. What is the step I am missing here? How overworked are these guys/gals?

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[NavyFP]

I noticed on the army GME list that neurosurgery has consistently had a 1 applicant to 1 position ratio. I am not ignorant enough to believe it is that simple. Are the applicants hand picked out of the PGY 1 surgery spots after expressed interest? Are they self selected? I mean the training opportunities are so small. What is the step I am missing here? How overworked are these guys/gals?

There is only one neurosurgery start in all of DoD per year. They do work hard. It is also the reason neurosurg is the most likely specialty to have a full deferment or two. DoD certainly needs more than 1 neurosurgeon per year.

 

[Ziehl-Neelsen]

In general, the individual who gets the military spot is a USU grad who is self-selected. USU classmates know which one of them is going to get the spot and the rest bug out to other specialties. The ones who really want it bide their time in GMO land until the spot opens up and they can get it. HPSP students who want it and are competetive will generally get a full deferment to pursue the training.

 

[narcusprince]

On a rotation I heard of a certain intern who was apparently given a defermant in neurosurgery but was yanked back by the navy and stashed in a fp internship kind of a disgrunted fellow.

 

[NavyFP]

On a rotation I heard of a certain intern who was apparently given a defermant in neurosurgery but was yanked back by the navy and stashed in a fp internship kind of a disgrunted fellow.

He may have requested a deferment, but I have not heard of ANYONE being yanked back from a deferment unless it was by request of the student.

 

[RugbyJC]

On a rotation I heard of a certain intern who was apparently given a defermant in neurosurgery but was yanked back by the navy and stashed in a fp internship kind of a disgrunted fellow.

perhaps he didn't match?

 

[NavyFP]

perhaps he didn't match?

That would be my guess. Wanted Neurosurg. Not competitive for it. Ended up in FM.

 

[AFDuck]

For what its worth, a student from my civilian medical school successfully matched into a deferred USAF neurosurgery spot last year. He thought there were only 4 applicants for 2 spots (1 AF, 1 deferred).

 

[Handsome1]

Thanks for the replies.

I am getting the impression it is an even more self-selected field within the military then civilian....IF you can match civ you are in better shape then ortho, ENT, etc...

It is interesting that such a competitive speciality sees so many deferments. If they could train them you think it would be to the military's advantage to keep the NS for the 6-7 years (b/c of the military residency) rather then the 4 (or even 3) years of just HPSP with deferment.

 

[sethco]

It is interesting that such a competitive speciality sees so many deferments. If they could train them you think it would be to the military's advantage

But that's the whole point of deferments. The particular branch realizes they have a need for X amount of Neurosurg docs. However, the docs needed to train these number are not currently available due to separation, deployments, PCS, whatever. So, the solution is to let them be trained on the outside where there are enough academic physicians to properly train this X number of Neurosurg docs needed

 

[NavyFP]

Last I checked, the AF didn't train Neurosurgeons.

The spot at Bethesda is open to all 3 services.

 

[NavyFP]

Interesting. I thought it was only Army and Navy. Never met any Neurosurg residents or staff in the NCA.

There is a lot of politics associated with the position.

 

[CoolRunnings]

so if you were in hpsp and wanted to go neurosurgery but didn't get one of the military spots, would you be defered to a civilian residency or changed to a different specialty? also, what would the odds of a GMO be before deferment, for each different branch?

thanks

 

[NavyFP]

On a rotation I heard of a certain intern who was apparently given a defermant in neurosurgery but was yanked back by the navy and stashed in a fp internship kind of a disgrunted fellow.

The Navy would not yank back a Neurosurg deferment into an FP internship. What you have is a Neurosurg wannabe who didn't make the cut. (and probably never will)

 

[del Sol DOHC]

Sending via PM.

Share the full story with the rest of us.

 

[narcusprince]

Do share

 

[Milamber]

I 3rd it this would be interesting to hear.

 

[NavyFP]

The simple answer is that there is no story. No one has been given a deferment by the GMESB only to be pulled back into a Navy internship unless specifically requested by the applicant. Some ask for deferments and are told no. They are often assigned to Navy internships they did not ask for.

 

[freelancer]

I noticed on the army GME list that neurosurgery has consistently had a 1 applicant to 1 position ratio. I am not ignorant enough to believe it is that simple. Are the applicants hand picked out of the PGY 1 surgery spots after expressed interest? Are they self selected? I mean the training opportunities are so small. What is the step I am missing here? How overworked are these guys/gals?

Seems there is alot of mis info here.

Well generally how it works is there is one DOD match for neuro surg.
then there is also 2 reserved DOD slots that are not trained at the NCA. One at UW and one at UF. (these are reserved spots for DOD.)
Aside from that if you match civilian neuro surg, it won't be a problem for you to get a deferment.

 

[BlueIsis]

One at UW and one at UF. (these are reserved spots for DOD.)

Is this true? I had not heard of this before. Where can I get more info about this?

 

[freelancer]

Is this true? I had not heard of this before. Where can I get more info about this?

The best person to ask is when you are rotating through your neuro surgery rotation ask the residents. IF you need contact info sooner I can try to get it for you.

 

[freelancer]

Seems there is alot of mis info here.

Well generally how it works is there is one DOD match for neuro surg.
then there is also 2 reserved DOD slots that are not trained at the NCA. One at UW and one at UF. (these are reserved spots for DOD.)
Aside from that if you match civilian neuro surg, it won't be a problem for you to get a deferment.

another thing to add to that is, if you match via the UW UF route, I don't htink you'll get your time in service through that path. Personally, education wise that won't matter to much but I feel as though you may be missing out of 7 years of military service that you may have had, and you don't get time for retirement with it, which I think is the biggest draw back.

 

[BrainBox]

hey

I'm OMS 2 now. I love neurosurgery and definitely going into the field. I'm also on Navy's HPSP. Can someone elaborate on the Navy's match process to neurosurgery?

Thanks

 

[pgg]

hey

I'm OMS 2 now. I love neurosurgery and definitely going into the field. I'm also on Navy's HPSP. Can someone elaborate on the Navy's match process to neurosurgery?

Thanks

You're a couple months into your second year of med school, haven't done any clinical rotations, but it's neurosurgery or bust, eh?


It's competitive. There's a lot of self-selection in the applicants, so don't be misled by the applied:matched stats, should you ever find them.

Last I heard there was one slot per year in DC for Army/Navy.

Odds are you'll change your mind. If not, odds are you'll GMO your service obligation and then get out to go after the civilian match. And then, odds as a DO will be stacked against you.

You have an uphill road to say the least. Good luck!

 

[BrainBox]

Hi

I know I'm just few months into my 2nd year but I've been in the field for 8 years as a PA. So I can't see myself doing anything other then NS. I realize that I will be fighting an uphill battle to get an allopathic spot, but I'm hopeful. If it was easy, anyone would do it.

Do you have any advice on bettering my chances?

Thank you,

 

[pgg]

Hi

I know I'm just few months into my 2nd year but I've been in the field for 8 years as a PA. So I can't see myself doing anything other then NS. I realize that I will be fighting an uphill battle to get an allopathic spot, but I'm hopeful. If it was easy, anyone would do it.

Do you have any advice on bettering my chances?

Thank you,

Well like all competitive fields in the military match, there's enormous year-to-year variability in the # of applicants and their strength. Your odds in any given year may range from impossible to doable, but this is beyond your control.

Just control what you can control, namely grades and board scores, make attempts to rotate with the program, good impression etc, and don't be frustrated or dismayed by the probable GMO tour, or multiple application cycles it will probably take. And have a plan B.

If it was easy, anyone would do it.

Everything worth doing is hard.

 

[NavyFP]

Hi

I know I'm just few months into my 2nd year but I've been in the field for 8 years as a PA. So I can't see myself doing anything other then NS. I realize that I will be fighting an uphill battle to get an allopathic spot, but I'm hopeful. If it was easy, anyone would do it.

Do you have any advice on bettering my chances?

Thank you,

Well like all competitive fields in the military match, there's enormous year-to-year variability in the # of applicants and their strength. Your odds in any given year may range from impossible to doable, but this is beyond your control.

Just control what you can control, namely grades and board scores, make attempts to rotate with the program, good impression etc, and don't be frustrated or dismayed by the probable GMO tour, or multiple application cycles it will probably take. And have a plan B.




Everything worth doing is hard.

I agree with pgg. You will need great grades and board scores. While there is ONE position in DoD, it is very competitive and all three services compete. The Navy will usually defer 1-2 per year for Neurosurg, so it is more likely you would be offered a deferment. If that is the case, you need to have a civilian program that wants you. The specialty leader picks who is offered deferments (if any are). Try to do a NS rotation with the SL to impress him/her (I forget who the current SL is).

I will say it is an extreme long shot to do it via the Navy. In the past 10 years, I have yet to see a DO student get into the NCA slot or be given a Navy deferment.

 

[Gastrapathy]

I agree with pgg. You will need great grades and board scores. While there is ONE position in DoD, it is very competitive and all three services compete. The Navy will usually defer 1-2 per year for Neurosurg, so it is more likely you would be offered a deferment. If that is the case, you need to have a civilian program that wants you. The specialty leader picks who is offered deferments (if any are). Try to do a NS rotation with the SL to impress him/her (I forget who the current SL is).

I will say it is an extreme long shot to do it via the Navy. In the past 10 years, I have yet to see a DO student get into the NCA slot or be given a Navy deferment.

There are no DOs among the neurosurgeons at my MTF.

Expand your horizons. There are lots of great procedural fields with better lifestyles, good income and interesting cases. Neurointerventional rads, ENT, GI , etc

 

[bleeker10]

I agree with pgg. You will need great grades and board scores. While there is ONE position in DoD, it is very competitive and all three services compete.

I may be confused by what you mean by DoD. I assume you mean the .mil and not a VA program. According to Army match stats from last year, there were 3 spots available for NSG with 4 applicants. The spots are at WRNMMC/NCC and also available at a VA sponsored civilian program at UTSA and the University of Florida. I know this isn't Navy specific, but I just wanted to clarify.

 

[BrainBox]

I agree with pgg. You will need great grades and board scores. While there is ONE position in DoD, it is very competitive and all three services compete. The Navy will usually defer 1-2 per year for Neurosurg, so it is more likely you would be offered a deferment. If that is the case, you need to have a civilian program that wants you. The specialty leader picks who is offered deferments (if any are). Try to do a NS rotation with the SL to impress him/her (I forget who the current SL is).

I will say it is an extreme long shot to do it via the Navy. In the past 10 years, I have yet to see a DO student get into the NCA slot or be given a Navy deferment.

Hi

thank you all for the info. I spoke to the current specialty leader for NS. He told me that I need to rotate via Bethesda on the NS service. He said that he is not the one who makes the final decision on who is chosen for the spots. I was under impression the person in charge of the NS residency makes that decision or am I wrong?

Thank you.

 

[bleeker10]

If you do a search for the Joint Services GME Board (JSGMEB) you will learn more about the process. Basically after the applicants submit their rank list, all of the program directors of the various specialties from all services meet after Thanksgiving to pick the spots. There's a score sheet that each applicant is ranked with.

Check out this thread: http://forums.studentdoctor.net/showthread.php?t=863607 for a better explanation

 

[pgg]

There's a score sheet that each applicant is ranked with.

It's supposed to be a very rigidly objective point system, and I believe it probably is for most programs of 'normal' size. Every year each internal med program, for example, surely takes an applicant or two that only matched because of GMO-weighted or prior-service weighted points ... and the PDs just accept that because they also get a half-dozen great people.

When it comes to the outlier programs (like neurosurgery, with only 1/3 of an inservice spot per year), I suspect that at the end of the day the program directors simply pick who they want. I just don't believe for a second that a bunch of neurosurgeons in the NCC are going to let some stupid point system pick their ONE resident for them, or let it exile someone they WANT to GMO-land for a couple years. All because there's a prior-enlisted 3-tour GMO out there with good fitreps and four abstracts from his undergrad days published in throwaway journals, who kinda feels like doing neurosurgery.


Anyway, control the things you can control, have a plan B, and see what happens. The Navy may surprise you with the magnificent undeserved opportunities it drops in your lap, or it may indifferently screw you 9 ways from Sunday, or both.

 

[bleeker10]

When it comes to the outlier programs (like neurosurgery, with only 1/3 of an inservice spot per year), I suspect that at the end of the day the program directors simply pick who they want. I just don't believe for a second that a bunch of neurosurgeons in the NCC are going to let some stupid point system pick their ONE resident for them, or let it exile someone they WANT to GMO-land for a couple years. All because there's a prior-enlisted 3-tour GMO out there with good fitreps and four abstracts from his undergrad days published in throwaway journals, who kinda feels like doing neurosurgery.
.

I guess the reason they meet (and please correct me if I'm wrong) is because they want to make any last minute adjustments or changes to the rank list that's based off the point system. This is where they have the ability to pick a "lower ranked" person who had a better interview or a better rotation or fit the personality the PD was looking for. It seems like the point system is just a skeleton or a filter for them to make the final picks based on. In the end it's more about how you fit into that program, especially if you will be a part of it for 5 years.

 

[Gastrapathy]

I guess the reason they meet (and please correct me if I'm wrong) is because they want to make any last minute adjustments or changes to the rank list that's based off the point system. This is where they have the ability to pick a "lower ranked" person who had a better interview or a better rotation or fit the personality the PD was looking for. It seems like the point system is just a skeleton or a filter for them to make the final picks based on. In the end it's more about how you fit into that program, especially if you will be a part of it for 5 years.

My subspecialty picks 3-4 folks a year and I've seen the magic in action. Everyone scoring knows who the specialty leader and PDs want. They all scratch each others backs (ie the Army rater makes sure the right Navy applicant is tops and vice versa). There is the "potential as a military physician" category and since everything else is so close, it takes only a little fudging that number to get exactly the results you want.

pgg is right. The fix is in. I'm sure its worse in even more competitive specialities.

 

[BrainBox]

thnx for the info