Air Force Pilot-Physician Program (Engineering)

[EngineerMedic]

Hello, this is my first post on the forums and I wanted to get some information/advice about the USAF’s Pilot-Physician Program (PPP). For background: I am currently an undergraduate student, and I still have enough time to shuffle majors/minors around, take certain electives over others, etc. My current declared majors are Physics (basically pre-graduate-engineering at my school) and Biology (I’m loosely on a pre-med track with that), but, as I said, I still have enough semesters left to drop one, pick up a minor or two, whatever.

I have already done some amount of online research about the PPP and I have turned up the following major information:

• The most recent USAF publication on the topic is AFI11-405, revised 2014, available here (http://static.e-publishing.af.mil/production/1/af_sg/publication/afi11-405/afi11-405.pdf).
  
  
• There are a handful of members on this forum who are familiar with the program either because they have been in it (paging @Eagledoc) or because they are familiar with USAF stuff in general.
  
  
• Usually, Pilot > Physician > Pilot-Physician is easier than Physician > Pilot > Pilot-Physician (Although both are possible, as @Eagledoc has proven) (Particularly helpful SDN thread: https://forums.studentdoctor.net/threads/usaf-pilot-physician-program.573033/)

Now, were I the typical hopeful, I could probably gather all the information that I need from that and be on my way. But (like many people who are interested in such a niche program, I reckon) I am not really the typical case. Unlike most everyone here, I do not primarily want to pursue a career in practicing medicine. The end-goal career I am most interested in is the application of Biomedical Engineering to aerospace systems: think of life support and preventative medical technology for astronauts and high-altitude pilots. As such, PPP would be more of a stepping-stone for me in the really long-run (albeit a large one, and I am definitely interested in the job on its own merits as well—I have always been interested in medicine, aviation, military).

With these goals in mind, I think the PPP would be a really great way for me to not only get intimately familiar with the scientific and medical aspects of astro/aeromedicine (I am not aware of very many civilian opportunities to be trained specifically in aerospace medicine), but also give me first-hand experience in the most vital parts of the space/high-altitude flight experience, which would inform design decisions from an engineering standpoint (not to mention the “coolness” of the job and the fun of flying ). With my training as an engineer, I could be all the more effective in helping communicate between aviators, medical professionals, and engineers.

Because my long-term goals are a bit different than most shooting for the PPP (adding engineering to the mix, which seems to be unusual even by PPP standards), I figure I probably have different considerations to make when looking at the program and how/whether to approach it.

Specific oddities of my plans that might make me want to approach this one way or the other:

• Since one my chief interests is in spaceflight, I’d like to try to fly U-2’s (since, to my knowledge, they are the only aircraft that the USAF currently flies that require a spacesuit [SR-71 r.i.p.]). However, the U-2 is probably going to be retired within the next decade or two as drones begin to take over the role of high-altitude reconnaissance. I do not know how much longer they will be training new pilots for the U-2, so that may make it worth going in sooner rather than later. The other option may be to try to become a test pilot of some sort? (? = I know even less about the test pilot programs than “normal” USAF pilot training, and I am not at all familiar with that.)
  
  
• Since I am interested in engineering as well, I would like to try to dual enroll in engineering graduate school while I am in medical school (something similar to MD/PhD programs, but probably more likely to end up with MD/MS or MD/MEng). If I had to guess, I have a feeling that the military would not want me to do this if I were to go through one of the programs in which they would be paying for me (HPSP, etc). I am not completely opposed to paying for school myself (and shouldering some loans, etc.), but it would be imprudent not to consider all the options.

Sorry for such a long post, but I hope you understand my position. Let me know what you think!

For those who just skimmed this, a brief summary of my questions:

• Is this even a good idea? Do you think PPP would be a good experience in making me more qualified for (for lack of an established term of sufficient specificity) astromedical engineering?
• If I should approach this, what would be the best strategy for someone in my position?
• Do you have any advice/information for me on training as a pilot, USAF flight surgeon, etc? What do I need to know?

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[Clap MD]

Man, I had this really long reply typed out then basically edited it down to the point that it would be a long time spent training to be a physician and to be a pilot, and to be owned by the military, for a guy who really wants none of those three. Med school would not be enjoyable for someone who does not want to pursue a career in practicing medicine.

Seems like you'd get to that dream career with a engineering degree from an excellent school, then a great internship, networking, connections, moving up through jobs, meeting the right people--and then even though that all sounds like a lot, you'd get there sooner than if you went through med school, military, PPP, etc.

 

[The Buff OP]

I want to follow this path (pilot to physician) if I have my degree before the age limit. Can you choose another specialty besides flight surgeon? @Clap MD

 

[EngineerMedic]

@Clap MD I'm in the middle of drafting a more in-depth response drafted for your comments. Thank you for sharing your advice

I want to follow this path (pilot to physician) if I have my degree before the age limit. Can you choose another specialty besides flight surgeon? @Clap MD

All of the information I have read implies that you cannot. Which specialty are you be interested in doing instead?

 

[The Buff OP]

@Clap MD I'm in the middle of drafting a more in-depth response drafted for your comments. Thank you for sharing your advice



All of the information I have read implies that you cannot. Which specialty are you be interested in doing instead?

I have an open mind of course, but I like EM, invasive cards, and surgery. Basically anything that requires procedures.

 

[j4pac]

Why don't they add lawyer and international man of mystery as well?


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[DeadCactus]

While you're screwing around learning to manage a COPD exacerbation and how to land on an aircraft carrier at night, your peers will be finishing graduate school and landing their first RO1 to actually do the thing you say you want to do. Afterwards, you will be hoping the military finds it in its best interest to have you spend time doing biomedical engineering instead of flight clinic and administrative meetings while your peers will continue to develop their research careers, establishing their labs and winning more grant.

I have a generally more positive outlook on the PPP than many here but I don't think it's good fit for your stated goals.

 

[Shikima]

While you're screwing around learning to manage a COPD exacerbation and how to land on an aircraft carrier at night, your peers will be finishing graduate school and landing their first RO1 to actually do the thing you say you want to do. Afterwards, you will be hoping the military finds it in its best interest to have you spend time doing biomedical engineering instead of flight clinic and administrative meetings while your peers will continue to develop their research careers, establishing their labs and winning more grant.

I have a generally more positive outlook on the PPP than many here but I don't think it's good fit for your stated goals.

You can call the ball if you can recite the latest literature recommendations for PSAs.

 

[SirGecko]

I have an open mind of course, but I like EM, invasive cards, and surgery. Basically anything that requires procedures.

If you like procedures the program is probably not for you. To be good at procedures you need to continually do procedures and taking significant time away from being a surgeon in order to go fly is probably not going to make you a good surgeon. (Heck low case volume/acuity is already a problem for normal surgeons in the military!) It can be argued that there is a place in the military for a limited number of pilot physicians but a pilot- interventional cardiologist is not and will not be a thing for what should be pretty obvious reasons. The pilot part of the job would benefit nothing from being an interventional cardiologist and the interventional cardiologist part of the job would benefit nothing from being a pilot. If you want to be both a pilot and an interventionist do one and then the other.

 

[EngineerMedic]

Man, I had this really long reply typed out then basically edited it down to the point that it would be a long time spent training to be a physician and to be a pilot, and to be owned by the military, for a guy who really wants none of those three. Med school would not be enjoyable for someone who does not want to pursue a career in practicing medicine.

Seems like you'd get to that dream career with an engineering degree from an excellent school, then a great internship, networking, connections, moving up through jobs, meeting the right people--and then even though that all sounds like a lot, you'd get there sooner than if you went through med school, military, PPP, etc.

Thank you for your advice. That was one of my main concerns, whether the PPP route would take too long to be worth it and whether I would be better off just getting a PhD in engineering instead. I will be 22 when finishing my bachelor’s degree, so it's definitely an important consideration--I shouldn't bother going through all the training to enter a career field if I would just as well retire before getting to the end!

However, let me play devil's advocate for a few minutes:

If I were to go the grad-school route, I would be looking at something like the following:

1. 5-6 years of graduate school to get a PhD in Biomedical Engineering (which is not all that different in academic content or difficulty from medical school, and I likely would not even have a research focus very close to what I really want to study, it being such a multi-disciplinary field with a small target market)
2. 4-5 years of postdoctoral work (hopefully closer to my final target work)
3. 4+ years of working my way up through a company (Like Boeing or SpaceX) or a government agency (like NASA... or a civilian employee of USAF) to become some kind of senior engineer in an astronautical department, where I could actually direct my work towards the field I am most deeply interested.

This adds up to 15+ years. However, the structure is much, much less predictable in this route, and it could easily end up being 5-10 years shorter (or longer), depending (mostly?) on factors outside my control.

If I were to do PPP (as far as I understand; I'm still a bit foggy on some of the details since I find it a bit difficult as an uninitiated civilian to find the most up-to-date military information):

1. 1 year of training (OTS, UPT, etc -- Is this a reasonable estimate, assuming I were to get lucky and get in at the first chance after finishing my bachelors?)
2. 3 years of operational flying (out of the 10 owed on my ADSC according to 2012's AFI36-2107)
3. 4 years of medical school & graduate school
4. 1 year of AMP, etc. (is this the only post-MD training needed to become a flight surgeon?)
5. (Edit: Insert ~3 years of aerospace medicine residency here)
6. 1 year practicing as a flight surgeon (would this count towards the 10-year ADSC from UPT? Or would it add new flight surgeon years to my ADSC?)
7. 7 years finishing ADSC as a full Pilot-Physician

This adds up to 17 years. Assuming I have the correct estimates for things (I'm not 100% sure of some of the trainings required along the way or exactly how ADSC works), this is roughly 2 years longer than going the traditional route above. Within the range of total years involved, that is a difference of about 10%-15%, which is significant but not overwhelmingly so.

A TL;DR list of some pros/cons of each:
PhD Pros:

• Potentially much shorter
• Better chances to network with potential employers (meet with industry scientists instead of staying in the military fold)
• Basically zero occupational hazards (compared to deployed military)
• Not locked-in at any point; can leave at any point
• A bit more freedom with research focus

PhD Cons:

• Much less predictable path (potentially even longer than PPP)
• Not as medically-involved (less input with setting design guidelines myself since I would not have the medical experience)

PPP Pros:

• Get to personally fly (a great experience in its own right, and would make me a viable candidate for being an astronaut myself, a definite side benefit)
• Much more predictable path
• Serving my country
• Allow me to get closer to the medical side rather than strictly the engineering side
• Closer to career goals sooner (Pilot-Physicians seem to play the role of a consultant on aerospace medical issues, which is very similar what I really want to do (assuming I am able to be stationed somewhere that my abilities would be most useful to the USAF [and, coincidentally, of most interest to me]) -- I might even stay in USAF after ADSC if it’s going well

PPP Cons:

• Minimum length of 17 years is a very long commitment
• Serious hussle to get through MD/MS in 4 years (edit: I'm dumb. Probably not possible, expect more like 5-6 years for both degrees)
• Have to put up with military administration
• Locked in for most of it (obligated to 10 years ADSC)
• Edit: Probably little/no engineering work. Final opinion—this is not a good route for me.

Summary of Questions:

• Is this a reasonable assessment of the two paths? I know I am a bit biased towards PPP, but I tried to be relatively objective.
• Several italicized questions along the way: Would OTS/UPT/etc take only 1 year from finishing bachelors? What post-MD training is needed to become a flight surgeon? Does practicing as a flight surgeon count towards the ADSC from UPT? Does joining as a flight surgeon/pilot-physician add new years to the ADSC?

While you're screwing around learning to manage a COPD exacerbation and how to land on an aircraft carrier at night, your peers will be finishing graduate school and landing their first RO1 to actually do the thing you say you want to do. Afterwards, you will be hoping the military finds it in its best interest to have you spend time doing biomedical engineering instead of flight clinic and administrative meetings while your peers will continue to develop their research careers, establishing their labs and winning more grant.

I have a generally more positive outlook on the PPP than many here but I don't think it's good fit for your stated goals.

I was under the impression that Pilot-Physicians tend to spend more time in a consultant type of role than actually practicing medicine or flying (although they continue to do a bit of those). The classic example I'm thinking of would be the investigation of the F-22's hypoxia problems. Am I terribly far off the mark?

 

[The Buff OP]

If you like procedures the program is probably not for you. To be good at procedures you need to continually do procedures and taking significant time away from being a surgeon in order to go fly is probably not going to make you a good surgeon. (Heck low case volume/acuity is already a problem for normal surgeons in the military!) It can be argued that there is a place in the military for a limited number of pilot physicians but a pilot- interventional cardiologist is not and will not be a thing for what should be pretty obvious reasons. The pilot part of the job would benefit nothing from being an interventional cardiologist and the interventional cardiologist part of the job would benefit nothing from being a pilot. If you want to be both a pilot and an interventionist do one and then the other.

Thanks for the input, that would look odd. My second plan (probably y'all would say it's a better plan) is to go for Navy flight surgeon. I would finish my service with that and move onto civilian residency. We will see.

 

[DeadCactus]

You're in the military. Your role is whatever they tell you your role is. Much of this will likely be providing administrative and clinical leadership to aviation medicine issues. Or maybe it's going to Syria for 7 months. Maybe it's staffing a flight clinic a few days a week. Maybe it's reviewing flight physicals for waiver approval. Maybe it's travelling the US with the Blue Angels to try to recruit people into being Air Force physicians. But it's unlikely that anywhere close to the majority of your time is going to be aeromedical engineering because if the Air Force wants aeromedical engineers they will go give funding to people who spent the last decade learning to be aeromedical engineers, not the guy who spent 10 years learning to be a pilot and a physician.

I see a number of flaws in your plan.

1) Flying planes and practicing medicine do not teach you to make medical equipment for people who fly planes. It's a different skill set. It's like wanting to be a farmer but going to culinary school. The PPP is a great program if you want to advice the Air Force on whether people taking Drug X should be allowed to fly, treat pilots for minor health concerns, do public health/epidemiology for the aviation community, and fly a jet. It's really a cool job for the right person. But you say you want to do engineering. If you want to design equipment, validate it, implement it into a bigger system, and run a research lab, then this is a terrible program for you.
2) You drastically underestimate the value of personal freedom in pursuing your career goals and how much of that freedom entering a decade long contract with the military will cost you. You have a lot more freedom to tailor graduate level work to you goals than you will ever have to tailor your military career to your goals.
3) I don't know where you are getting this 4 year MD/MS thing from. I don't know it to be a part of the PPP, I don't know of any medical school offering any degree in combination with the MD that doesn't add an extra year to the curriculum, and your schedule is not flexible enough as a medical student to just do it on the side. Maybe I'm wrong, but it seems you have an unrealistic expectation here. This ignores the unrealistic nature of completing medical school and a worthwhile graduate degree at the same time.
4) I would expect the PPP to require to complete a 3 year residency in aerospace medicine after medical school. At the very least you will need a 1 year internship at the 6 week flight surgeons course but I doubt they're going to spend 2 million dollars on flight and medical training only to have you not go through the gold standard for aerospace medicine training.

You seem to have a specific passion and a clear goal. I would encourage you to focus on it. Early focus and concentrated effort is an amazing asset for a successful career. Finish a STEM degree, go to graduate school, get a private pilot license, intern are aerospace companies, and focus on building a career doing what you want instead of trying to do a bunch of peripherally related things and hoping it turns into what you want.

 

[Apollyon]

Maybe it's travelling the US with the Blue Angels to try to recruit people into being Air Force physicians.

Air Force are Thunderbirds. Blue Angels are Navy. I forget what branch you are!

 

[SirGecko]

OP, I think you need to decide if you actually want to be an engineer or if you just want to talk to engineers. I get that its hard to narrow down exactly what you want to do (heck I nearly feel like I'm talking to myself back in high school/college) but you can only fence split on this so many times. The career pathway that you laid out for the pilot-physician-engineer in your hypothetical is probably not feasible and will likely not happen. Even if the Air Force were to let you add on another year to med school in the pilot-physician program so you can get a masters in engineering you probably wouldn't actually use the degree very much.

Also you said that a PhD in biomedical engineering is "not all that different in academic content or difficulty from medical school". That simply isn't true. Who told you that? They may share some of the basic foundational knowledge but the actual experience of a BME PhD candidate and a medical student are very different. It's apples and oranges really. It sounds like you don't actually have an engineering school at your college. Is there another school nearby with an engineering school that you could talk to and get some advice about pursuing this career goal?

 

[deleted480308]

The PPP sounds cool as hell and I would do it in a heart beat just on fun factor, but I really don't see the efficient use of resources in it from a .mil perspective

 

[EngineerMedic]

You're in the military. Your role is whatever they tell you your role is. Much of this will likely be providing administrative and clinical leadership to aviation medicine issues. Or maybe it's going to Syria for 7 months. Maybe it's staffing a flight clinic a few days a week. Maybe it's reviewing flight physicals for waiver approval. Maybe it's travelling the US with the Blue Angels to try to recruit people into being Air Force physicians. But it's unlikely that anywhere close to the majority of your time is going to be aeromedical engineering because if the Air Force wants aeromedical engineers they will go give funding to people who spent the last decade learning to be aeromedical engineers, not the guy who spent 10 years learning to be a pilot and a physician.

I see a number of flaws in your plan.

1) Flying planes and practicing medicine do not teach you to make medical equipment for people who fly planes. It's a different skill set. It's like wanting to be a farmer but going to culinary school. The PPP is a great program if you want to advice the Air Force on whether people taking Drug X should be allowed to fly, treat pilots for minor health concerns, do public health/epidemiology for the aviation community, and fly a jet. It's really a cool job for the right person. But you say you want to do engineering. If you want to design equipment, validate it, implement it into a bigger system, and run a research lab, then this is a terrible program for you.
2) You drastically underestimate the value of personal freedom in pursuing your career goals and how much of that freedom entering a decade long contract with the military will cost you. You have a lot more freedom to tailor graduate level work to you goals than you will ever have to tailor your military career to your goals.
3) I don't know where you are getting this 4 year MD/MS thing from. I don't know it to be a part of the PPP, I don't know of any medical school offering any degree in combination with the MD that doesn't add an extra year to the curriculum, and your schedule is not flexible enough as a medical student to just do it on the side. Maybe I'm wrong, but it seems you have an unrealistic expectation here. This ignores the unrealistic nature of completing medical school and a worthwhile graduate degree at the same time.
4) I would expect the PPP to require to complete a 3 year residency in aerospace medicine after medical school. At the very least you will need a 1 year internship at the 6 week flight surgeons course but I doubt they're going to spend 2 million dollars on flight and medical training only to have you not go through the gold standard for aerospace medicine training.

You seem to have a specific passion and a clear goal. I would encourage you to focus on it. Early focus and concentrated effort is an amazing asset for a successful career. Finish a STEM degree, go to graduate school, get a private pilot license, intern at aerospace companies, and focus on building a career doing what you want instead of trying to do a bunch of peripherally related things and hoping it turns into what you want.

1) This is a well-written and conclusive response. Exactly the kind of information I came here to look for. Thank you.
2) Your advice is sound, and I think I'll have to look for other ways to achieve my goals.
3) Medical School = 4 years. MS = 1 to 2 years. I am sure that I am capable of doing both at the same time (assuming the administration of the school would let me), but as I noted, it would require some extreme effort. That's a lot of learning and work to pack into 4 years. I meant it as a best-case scenario, if I were to go through as quickly as possible.
4) Also the kind of information I came looking for. Although I don't think this is the path I will actually follow, out of curiosity, what would an aerospace medicine residency look like? What kind of places would host it?

I also appreciate the encouragement

OP, I think you need to decide if you actually want to be an engineer or if you just want to talk to engineers. I get that its hard to narrow down exactly what you want to do (heck I nearly feel like I'm talking to myself back in high school/college) but you can only fence split on this so many times. The career pathway that you laid out for the pilot-physician-engineer in your hypothetical is probably not feasible and will likely not happen. Even if the Air Force were to let you add on another year to med school in the pilot-physician program so you can get a masters in engineering you probably wouldn't actually use the degree very much.

Also you said that a PhD in biomedical engineering is "not all that different in academic content or difficulty from medical school". That simply isn't true. Who told you that? They may share some of the basic foundational knowledge but the actual experience of a BME PhD candidate and a medical student are very different. It's apples and oranges really. It sounds like you don't actually have an engineering school at your college. Is there another school nearby with an engineering school that you could talk to and get some advice about pursuing this career goal?

Thank you for your advice. After reading through the other posts, I think you're right and that this program is not the best way for me to do what I want to do.

When I said a BME PhD is "not all that different in academic content or difficulty from medical school", I meant that both have the same "basic foundational knowledge" and that getting a PhD is not any more/less difficult than getting an MD. I am fully aware that the experience and process is quite different.

Thanks again for your input, I really do appreciate all the information and advice that you and the others have put in this thread.

 

[deuist]

I'm glad that you have such impressive goals, but they aren't going to happen. I have a masters degree in biomaterials and am currently a practicing emergency physician. I can tell you right now there is not one thing I learned in graduate school that was useful to me at any point from the first day of medical school on. The coursework that you take in a graduate engineering program – even for a medically focused one – involves writing lots of mathematical proofs and learning the minutia of polymers. None of the classes you would take in a graduate biomedical engineering program are going to directly apply to medical school. Likewise, rounding, making clinical decisions, and performing procedures as a medical student or physician do not translate into bench work when designing new testing equipment. In fact, the only thing I could say about earning a PhD in engineering and earning a doctor of medicine is that they are both hard. I particularly take offense at the idea that you think you could somehow earn a masters degree in engineering during the same four years it's going to take you to complete medical school. The time commitment is simply too great for both of them to pull that off.

There is, however, the medical scientist training program whereby you can earn a doctor of medicine and a PhD in a particular field over the course of 7 to 8 years. If you really have an interest in translational research, you should look into this NIH-funded program as you would be able to attend medical school for free.

As for becoming a pilot-physician, I think the program is a total waste of time for pilots and physicians in that you don't typically become competent enough to do either field. I want you to look through the biographies of the leaders in the Air Force Medical Service who have gone through the pilot physician program. Many of them have never completed residency training beyond a one-year internship. If I recall correctly, the previous Surgeon General of the Air Force was not board-certified in anything. I don't think he ever even worked clinically. Taken a medical school spot and then planning on seeing patients for less than four years is a huge slap in the face to someone who cannot get into medical school, yet had the desire to be a lifelong practicing physician.