**Official 2016 JSGMESB Thread**

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Anyone got a Navy list lol!
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Deleted over an abundance of caution.
 
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Looking at the Navy list, there is one O-6, and it is someone for a path fellowship. Would you guess that that is someone that was out in practice, and went back, or someone with prior service who has just been in the training pipeline FOREVER?

Not trying to dox anyone, or skyline anyone. Strictly curious.
 
bldavis11 said:
Here's the navy list.
Click to expand...


In today's world I don't necessarily agree with posting a listing of names of people who are active duty and their duty locations. Recommend you remove the list.



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backrow said:
In today's world I don't necessarily agree with posting a listing of names of people who are active duty and their duty locations. Recommend you remove the list.



Sent from my iPhone using SDN mobile app
Click to expand...

List should be removed. Or at least have names removed. Moderator?
 
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grotto said:
List should be removed. Or at least have names removed. Moderator?
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At least they don't publish lists with social security numbers any more ...

I agree that names should probably be stripped from lists posted here, but the services themselves post the lists publicly. Not sure it's that big a deal.

(I'm a moderator but have no direct power in this forum; the anesthesiology forum is my domain.)
 
Apollyon said:
Looking at the Navy list, there is one O-6, and it is someone for a path fellowship. Would you guess that that is someone that was out in practice, and went back, or someone with prior service who has just been in the training pipeline FOREVER?

Not trying to dox anyone, or skyline anyone. Strictly curious.
Click to expand...
Don't know, but there weren't any funded spots for that fellowship this year. She's one of 3 alternates for that subspecialty.

One of the stranger things about the military match is that the services have to perceive a need for a given subspecialty before they'll fund anyone to train in it. It's possible this O6 has been applying to the GME selection board to do this fellowship for years and years, and may be a stellar candidate.

As for why? I can just say, as an O5 >14 currently doing a FTOS fellowship, that the only thing that could make this year any more awesome than it is, would be if I was an O6 >18 doing a FTOS fellowship ... :) Good work if you can get it. I'm surprised more senior medical corps officers don't do fellowships.
 
Second year in a row that it's pretty grim for navy physicians who wanted an IM sub besides Pulm/CC.

Cards 1
GI 2
ID 2
HO 1
Allergy 1 (and not IM)
Endo 1
Rheum 0
Nephro 0

Crazy demand for occ med and aerospace med.
 
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pgg said:
I'm surprised more senior medical corps officers don't do fellowships.
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Agree, I wish I had. It counts towards your twenty and you are making good money. What is the harm besides either moving or being away from family for a year.
The Air Force requires a waiver for an 0-6 to train but I have seen it granted, I have seen some resistance at our board for someone doing multiple fellowships but sometimes
there is only one applicant.
 
MirrorTodd said:
The email from the 7th said that we'd get an email in January to download/upload the acknowledgement form and match letter. Don't think contracts will be released for some time.
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But don't we have to sign something saying we agree to the results so that they can free up the slots for those who don't agree?
 
Slevin said:
But don't we have to sign something saying we agree to the results so that they can free up the slots for those who don't agree?
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It's possible I'm wrong, but I don't think so. The impression I got was that the only slots people can get now are those listed that didn't fill in the match email on the 7th. Anybody know for sure?
 
Kind of off topic a bit for this thread but ancillaryly related. What does everyone think about the wording in the new NDAA about getting rid of GME programs that don't directly support readiness?
 
SirGecko said:
Kind of off topic a bit for this thread but ancillaryly related. What does everyone think about the wording in the new NDAA about getting rid of GME programs that don't directly support readiness?
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1) I have no idea how they sell the scholarship if they go through with this. The GME was always a big selling point for the military scholarship: unlike the NHSC and the state scholarship programs, with the military you retained almost all your options for which residency to choose. Without that its just the same as the NHSC with deployments.

2) I'm not sure which residencies will be left if this is implemented. Obviously Peds and Ob/Gyn are the main targets, but what about IM? ENT? Urology? Pathology? This could be interpreted very broadly.

3) I wonder if this will actually save the military any money. I don't think commands like mine could attract contractors for any amount of money. The community around me has been looking for a Pediatrician for months now. They are offering twice the national average salary for Pediatricians and not a single person has even applied. I'm not sure how we could staff many of our hospitals without military physicians, or how the community could support our dependants' healthcare if we closed the hospital down.
 
Perrotfish said:
1) I have no idea how they sell the scholarship if they go through with this. The GME was always a big selling point for the military scholarship: unlike the NHSC and the state scholarship programs, with the military you retained almost all your options for which residency to choose. Without that its just the same as the NHSC with deployments.

2) I'm not sure which residencies will be left if this is implemented. Obviously Peds and Ob/Gyn are the main targets, but what about IM? ENT? Urology? Pathology? This could be interpreted very broadly.

3) I wonder if this will actually save the military any money. I don't think commands like mine could attract contractors for any amount of money. The community around me has been looking for a Pediatrician for months now. They are offering twice the national average salary for Pediatricians and not a single person has even applied. I'm not sure how we could staff many of our hospitals without military physicians, or how the community could support our dependants' healthcare if we closed the hospital down.
Click to expand...
I agree. I think it depends on how broadly it gets interpreted. It seems like you'd have trouble with recruiting but then again I'm sure there are quite a few premed that will convince themselves they probably wouldnt want to do "x" specialty. It also sort of depends on how fast they roll this out. Who would be the last class through? What happens to the people currently in the residency? So if it's just that they get rid of peds and ob that might not hurt their recruiting numbers but they will have a bunch of mad scholarship recipients that thought it would be an option for a while. (Not that they will care)

One question I would pose: does getting rid of the GME program mean they'd still train people but they'd all be FTOS? Or does getting rid of the residency mean they want to get rid of the specialty? Hard to tell with the information I have. They do have other language in there about converting more physician positions to civilian jobs though. (Which is also not necessarily going to result in decreasing costs)

If the ultimate goal of congress is to get rid of military pediatricians and ob/gyns (and other specialists?) I agree that they should probably look real hard to see if that is actually a feasible plan. Right now it seems kind of like someone decided it was weird that the military devotes services to taking care or the manufacture and maintanence of babies since babies don't go to war and then they decided to make policy on it.
 
SirGecko said:
I agree. I think it depends on how broadly it gets interpreted. It seems like you'd have trouble with recruiting but then again I'm sure there are quite a few premed that will convince themselves they probably wouldnt want to do "x" specialty. It also sort of depends on how fast they roll this out. Who would be the last class through? What happens to the people currently in the residency? So if it's just that they get rid of peds and ob that might not hurt their recruiting numbers but they will have a bunch of mad scholarship recipients that thought it would be an option for a while. (Not that they will care)

One question I would pose: does getting rid of the GME program mean they'd still train people but they'd all be FTOS? Or does getting rid of the residency mean they want to get rid of the specialty? Hard to tell with the information I have. They do have other language in there about converting more physician positions to civilian jobs though. (Which is also not necessarily going to result in decreasing costs)

If the ultimate goal of congress is to get rid of military pediatricians and ob/gyns (and other specialists?) I agree that they should probably look real hard to see if that is actually a feasible plan. Right now it seems kind of like someone decided it was weird that the military devotes services to taking care or the manufacture and maintanence of babies since babies don't go to war and then they decided to make policy on it.
Click to expand...

The only way this makes even a tiny amount of sense is if they get rid of the specialty entirely and replace us with civilians.
 
anyone land PM&R for navy this year?
 
Gastrapathy said:
I must have missed what we closed.
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We closed a lot of labor decks, converting hospitals to super clinics and sending the OB out into the community. We also cut a ton of staffing from the handful of hospitals we that remained full scope, which is why I now get to take Q3 call. I don't think we completely closed any hospitals.
 
teacherman84 said:
I was under the impression Pensacola and Bremerton were closed or closing.
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The FM residency programs closed as a direct result of what Perrotfish said. The "hospitals" remain open.
 
Cooperd0g said:
The FM residency programs closed as a direct result of what Perrotfish said. The "hospitals" remain open.
Click to expand...
Gotcha. I knew some folks who were at these programs when they closed and they gave the impression this was the first step on the road from hospital to super-clinic. I assumed the change had happened by now.
 
teacherman84 said:
Gotcha. I knew some folks who were at these programs when they closed and they gave the impression this was the first step on the road from hospital to super-clinic. I assumed the change had happened by now.
Click to expand...

It did happen. They are essentially super clinics as they don't have emergency services and little to no inpatient. But they haven't shuttered the doors completely.
 
teacherman84 said:
Gotcha. I knew some folks who were at these programs when they closed and they gave the impression this was the first step on the road from hospital to super-clinic. I assumed the change had happened by now.
Click to expand...

No...but it has to at some point. They lost their residency program...they lost their ICU...and they lost their ER. They replaced the ER with an urgent care clinic. Ambulances won't bring patients to urgent care clinics for care. So...in other words, the only way that NHP is admitting patients is through the clinic and patients who get themselves to the urgent care clinic. There is no way that a hospital can survive like that.

I asked the question about five years ago, "why don't we create a "fast-pass" like every other ED in the country that would allow different coding"? I got shut down...and instead the hospital put an insane amount of pressure on their primary care docs to keep their patients well and go out of their way with educating their patients to prevent ER utilization. Of course...though pretty sure most of the docs were on the brink of a nervous breakdown with the amount of stress what went into keeping the medical home model alive...the plan still failed...and they lost the ED. Horrible leadership...horrible morale...and it's sad, because it was once a great FP program and hospital.
 
j4pac said:
I asked the question about five years ago, "why don't we create a "fast-pass" like every other ED in the country that would allow different coding"? I got shut down...and instead the hospital put an insane amount of pressure on their primary care docs to keep their patients well and go out of their way with educating their patients to prevent ER utilization.
Click to expand...

I'll never understand why they think people won't use the ED for everything when the military guarantees that every ED will provides immediate care for free. No amount of education will ever equal a $50 copay.

pgg said:
There were some net reductions in contract staff at Lemoore when they closed the urgent care clinic, inpatient ward, and L&D.
Click to expand...

Questions:
1) What are they doing with all the Ob/GYns now that they have shut down all of the labor decks?
2) If they've shut down almost all the labor decks, why do they feel the need to understaff the handful that still exist?
 
Perrotfish said:
Questions:
1) What are they doing with all the Ob/GYns now that they have shut down all of the labor decks?
2) If they've shut down almost all the labor decks, why do they feel the need to understaff the handful that still exist?
Click to expand...
I don't know the details of the current arrangement - I left Lemoore 2 1/2 years ago. At that time, the OBs were doing pre / post natal care and outpatient GYN surgery at Lemoore. They did the deliveries via ERSA at nearby civilian hospital.

At that time the civilians couldn't absorb our case load - hence the argument for keeping OB sorta at Lemoore won out. But about a year ago the civilians opened a new womens health wing to their hospital. I suspect the end game there will be 100% deferral of OB care to that hospital. When that happens, presumably there'll be no need for OBs at Lemoore, so no GYN surgery will get done either, and the surgical caseload at Lemoore will drop by 1/5th or so (?), and then maybe it won't make sense to keep even the downsized Lemoore surgicenter going. So will ortho and general surgery and anesthesia get closed too?

Before the SHS changes, we were paying $7000 per delivery in contract nursing costs alone. Not counting the cost of AD nurses, physicians, supplies, equipment, anesthesia personnel, supplies, equipment, OR staff and supplies, equipment. What does Tricare pay for a delivery? $1500 or something like that?

The SHS recs were unpopular, but something had to give.
 
pgg said:
I don't know the details of the current arrangement - I left Lemoore 2 1/2 years ago. At that time, the OBs were doing pre / post natal care and outpatient GYN surgery at Lemoore. They did the deliveries via ERSA at nearby civilian hospital.

At that time the civilians couldn't absorb our case load - hence the argument for keeping OB sorta at Lemoore won out. But about a year ago the civilians opened a new womens health wing to their hospital. I suspect the end game there will be 100% deferral of OB care to that hospital. When that happens, presumably there'll be no need for OBs at Lemoore, so no GYN surgery will get done either, and the surgical caseload at Lemoore will drop by 1/5th or so (?), and then maybe it won't make sense to keep even the downsized Lemoore surgicenter going. So will ortho and general surgery and anesthesia get closed too?

Before the SHS changes, we were paying $7000 per delivery in contract nursing costs alone. Not counting the cost of AD nurses, physicians, supplies, equipment, anesthesia personnel, supplies, equipment, OR staff and supplies, equipment. What does Tricare pay for a delivery? $1500 or something like that?

The SHS recs were unpopular, but something had to give.
Click to expand...
I have no issue with them shunting more care to the community and downsizing or shutting down the military hospitals. I do have an issue with them trying to bring their full service hospitals more in line with community costs and staffing without accounting for the inexperience or frequent turnover of our providers and nurses. They are staffing us so that we just barely equal the staffing at the local community hospital, but with no regard to the fact that that staffing is routinely cut in half by training, deployments, and the fact that we turn over 33% of our staff every summer. They also don't seen to realize that efficiency increases with experience, and they only send people here straight out of residency or nursing school while the average community provider or nurse has been here for 20 years. Planning for inexperienced small hospital providers to take q3 call in a best case scenario and q2 call every PCS season isn't appropriate
 
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