Number of cases as ortho resident mil vs civil

[Sthpawslugger]

---

Members don't see this ad.

Anyone have perspective into 1) how many surgical cases a military ortho resident may expect to do throughout training, and 2) if you felt your training was adequate/satisfactory to the point you felt your skillset prepared you for either military or civilian practice?

 

[i want out]

'All the depth of the kiddy pool at the Ramada Inn'

You would have to be old enough to remember the 1 foot deep kiddy pools that some places had, to fully get the reference.

You may get adequate case volume in a .mil residency but what you will miss most places is learning how to operate on a darn near dead 80 year old with critical aortic stenosis that fell and broke his hip.

That case is not uncommon in even a small civilian hospital, but because of the push in the 90's to send all Medicare out into town and the fact that most .mil hospitals don't get much ambulance traffic incoming you will have to rotate outside to get some of those cases.

Are some enough, or do you want to maximize your training and see lots of cases?

Good luck

I did a civilian program after 4yrs as a GMO, and I'm glad for a multitude of reasons that I didn't do a .mil residency

 

[dwb8p]

Low case volume and complexity are the reasons most military surgical residency programs require their residents spend approximately 1/3 of their training at outside civilian hospitals. The real issue isn't during residency; it's after you become staff somewhere outside of the major medical centers and lose all the skills you spent 5+ year acquiring.

 

[pgg]

You may get adequate case volume in a .mil residency but what you will miss most places is learning how to operate on a darn near dead 80 year old with critical aortic stenosis that fell and broke his hip.

With respect, that's a problem for the anesthesiologist, not the hammer swinger who isn't going to deal with the AS preop, intraop, or postop. 🙂

 

[Sthpawslugger]

I'm 36, so I definitely remember the Ramada kiddie pools. Lol.

I want to maximize my training and see lots of cases, no doubt. I have no problem serving my country, repaying my time, traveling, etc... fiancée and I talked a lot about it...but I do fear my skills would atrophy and make it difficult to find a job in a quality practice upon leaving, based on what I've read. Not to mention, being relegated to a more non-clinical role as I advance in rank.

'All the depth of the kiddy pool at the Ramada Inn'

You would have to be old enough to remember the 1 foot deep kiddy pools that some places had, to fully get the reference.

You may get adequate case volume in a .mil residency but what you will miss most places is learning how to operate on a darn near dead 80 year old with critical aortic stenosis that fell and broke his hip.

That case is not uncommon in even a small civilian hospital, but because of the push in the 90's to send all Medicare out into town and the fact that most .mil hospitals don't get much ambulance traffic incoming you will have to rotate outside to get some of those cases.

Are some enough, or do you want to maximize your training and see lots of cases?

Good luck

I did a civilian program after 4yrs as a GMO, and I'm glad for a multitude of reasons that I didn't do a .mil residency

 

[Sthpawslugger]

Low case volume and complexity are the reasons most military surgical residency programs require their residents spend approximately 1/3 of their training at outside civilian hospitals. The real issue isn't during residency; it's after you become staff somewhere outside of the major medical centers and lose all the skills you spent 5+ year acquiring.

THAT is what I'd be afraid of. I did read that Walter Reed has an orthopedic oncology dept...was kind of shocked. Yet, I'm not sure if the surgeon does a little of everything...trauma, amputations, excision of tumors, joint reconstructions and revisions, etc etc....or if it's highly specialized much like in the civilian world. Then again, if the volume isn't there, it would be a disservice to myself as a physician and especially to those who I would treat.

 

[dr zaius]

THAT is what I'd be afraid of. I did read that Walter Reed has an orthopedic oncology dept...was kind of shocked. Yet, I'm not sure if the surgeon does a little of everything...trauma, amputations, excision of tumors, joint reconstructions and revisions, etc etc....or if it's highly specialized much like in the civilian world. Then again, if the volume isn't there, it would be a disservice to myself as a physician and especially to those who I would treat.

The ortho onc guys (2) are good surgeons, but the volume really didn't seem to be there when I rotated as an intern. They devoted a lot of their time, and developed a lot of skill, at amputation revisions and worked with new advances in osseointegration. They also did the IM nails etc for mets, but there just wasn't a lot of bone/soft tissue sarcoma type stuff then. Based on what I see in S3 I don't think much has changed.

We send them a lot of impending pathologic femur fractures likely thanks to USPTF PSA crap. They're both really good guys.