Post-military practice

[DOswag]

Anyone on here that served active duty psychiatry? I'm still in and have a little less than 2 years left on my ADSC. Looking at separating after completing my commitment. When did you start really looking at civilian jobs? Any specific services you used for job search? Any assistance with you CV etc? Anything helps at this point just looking for resources. I'm inerested in VA after I get out but open to just about any options and/or suggestions.

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[AcronymAllergy]

From an outside perspective, I can say the need in VA for psychiatry is huge (it's essentially always in the top 3 of critically-understaffed positions). Especially with military service, I suspect if you apply somewhere, with perhaps limited exception, you'll get an offer. But depending on the VA, I would plan on giving yourself (or, more accurately, HR) a solid 6 months to actually complete the application and hiring process.

 

[Bartelby]

Agreed, pretty much any VA would be thrilled to hire a psychiatrist who is also a veteran. If the VA in the area you want does not have an opening in the area you want (outpatient, inpatient, CL, whatever) consider taking an open position and then applying for a transfer when your preferred setting has an opening.

 

[robellis]

From an outside perspective, I can say the need in VA for psychiatry is huge (it's essentially always in the top 3 of critically-understaffed positions). Especially with military service, I suspect if you apply somewhere, with perhaps limited exception, you'll get an offer. But depending on the VA, I would plan on giving yourself (or, more accurately, HR) a solid 6 months to actually complete the application and hiring process.

If it’s so critically understaffed why don’t they increase the pay so people will do it

 

[WisNeuro]

If it’s so critically understaffed why don’t they increase the pay so people will do it

Depends on the region, the large VA here has been hiring more NPs for certain roles.

 

[AcronymAllergy]

If it’s so critically understaffed why don’t they increase the pay so people will do it

You'd have to ask the higher-ups about that. I have no clue what VA compensation for psychiatry looks like relative to AMCs or other large hospital systems. Physicians are on a different pay scale with a different set of rules than many other employees, so I don't know what sort of flexibility any individual VA has. For the earlier career folks, I do know they relatively recently increased the amount of loan repayment possible through EDRP to 200k, and I'd be surprised if nearly all psychiatry positions aren't EDRP-eligible.

 

[clausewitz2]

I have never seen a VA psychiatrist job announcement in my neck of the words that was not EDRP-eligible. Right now there is one up for an inpatient psychiatrist that offers salary between 240k and 269 k + performance incentives. The posting also emphasizes the lack of restrictions on moonlighting and expects you to work M-F 8-4. Not for me but not the worst job for some folks.

 

[Stagg737]

If it’s so critically understaffed why don’t they increase the pay so people will do it

Agree that it depends on region. There's 2 VAs near me and one offers base salary of $250k for a regular outpatient load (~12/day) and the other starts at $300k for a much smaller patient volume (6-8/day). Standard benefits with a strict non-compete (when you work for them, you don't work anywhere else, but can leave with no non-compete after leaving).

 

[AcronymAllergy]

Agree that it depends on region. There's 2 VAs near me and one offers base salary of $250k for a regular outpatient load (~12/day) and the other starts at $300k for a much smaller patient volume (6-8/day). Standard benefits with a strict non-compete (when you work for them, you don't work anywhere else, but can leave with no non-compete after leaving).

Wow, that's honestly the first time I've ever heard of a VA having any type of non-compete. Typically it's just, "don't refer VA patients to your own non-VA practice" and, "don't use VA resources for any non-VA work from which you derive profit."

 

[comp1]

Come to the VA!!! It is indeed critically short staffed and the VA IS raising salaries! EDRP is almost always available for psychiatrists and there are usually hiring bonuses too. As a veteran, there are extensive upsides to continuing in federal service in regards to pensions. The VA does not have moonlighting restrictions, so I think you may have been told something incorrect if you were told otherwise. Perhaps that was a contracting and not a federal job? Moonlighting restrictions would likely violate master agreements with the union.

 

[Stagg737]

Come to the VA!!! It is indeed critically short staffed and the VA IS raising salaries! EDRP is almost always available for psychiatrists and there are usually hiring bonuses too. As a veteran, there are extensive upsides to continuing in federal service in regards to pensions. The VA does not have moonlighting restrictions, so I think you may have been told something incorrect if you were told otherwise. Perhaps that was a contracting and not a federal job? Moonlighting restrictions would likely violate master agreements with the union.

Nope, I’ve seen the contract myself. It’s a federal position. At our VA the one or two contracted docs I know have their own separate clinic.

 

[DOswag]

Yes I'm aware of being able to buy back active duty time toward pension (one of the benefits of working VA after I separate). And the areas I'm looking at returning to are in the ball park of 230-270K with bonuses and what not. Also it seems the benefits overall are great working for VA. Definitely interested in the loan repayment as well. I know the VA that I spent time at during training does not have restriction on moonlighting as several attendings were able to find weekend inpatient coverage gigs to pull some extra money. I would say definitely the VA is at the top of my list following separation but if anyone has gone a different route, PP, or anything else, I'd be interested to hear your experiences as well.

 

[comp1]

Seriously, if they are trying to restrict moonlighting, show them this and ask them to explain that is going on because I'm very confused and would personally like to know. https://www.va.gov/HEALTH/docs/20ReasonsVHA_508_IB10935.pdf

 

[Helpful Troll]

Seriously, if they are trying to restrict moonlighting, show them this and ask them to explain that is going on because I'm very confused and would personally like to know. https://www.va.gov/HEALTH/docs/20ReasonsVHA_508_IB10935.pdf

That's a marketing document. "No significant restriction on moonlighting". I reviewed the referenced US Code title 38 Public Law 108-445 and found no reference to outside employment or protected moonlighting - admittedly I could have missed it. Do you have a US Code or Public Law for 'protected' moonlighting?

 

[starbuck2]

Anyone on here that served active duty psychiatry? I'm still in and have a little less than 2 years left on my ADSC. Looking at separating after completing my commitment. When did you start really looking at civilian jobs? Any specific services you used for job search? Any assistance with you CV etc? Anything helps at this point just looking for resources. I'm inerested in VA after I get out but open to just about any options and/or suggestions.

Hijacking this thread a bit. OP, do you feel that you had a positive experience as a military psych? My uncle was a psychiatrist in the army for over 20 yrs. I've asked him occasionally but he has tried to discourage me. Understandably--he resigned just a couple months before 9/11, shipped out to the middle east 3 times including right into Baghdad when they stormed Saddam's palaces. Sounds cool but he had to treat some serious PTSD and got a bit of it himself. It also was not fun to be a psychiatrist who got shot at by Iraqis...

Anyways, I'm curious if you would recommend it as a route. Long story short I went for HPSP but got disqualified for a health issue. I eventually got a waiver but by then it was too late (Navy) and I missed the window. I am in my 2nd year of med school and am thinking about going into psych --> civilian residency w/ FAP --> 4-5 years active duty --> separation. Would be interested in working at a VA afterwards as my uncle does now.

 

[ridethecliche]

@DOswag
vegeta huh?

 

[DOswag]

@DOswag
vegeta huh?

My favorite DB character lol

 

[DOswag]

Hey Starbuck, yeah definitely interested in the VA after I get out and utilizing the buy back option for my active time. As far as a positive experience goes, yes I'd say over all I've had a positive experience as far as places I've lived because of going the military route. I don't know who would put 2 and 2 together to identify on here if there's even anyone I know. But I did my training in Texas (kind of vague I know) and I'm at my first duty station which I was fortuante to get a desirable location. As far as practicing psychiatry in the military, that's a little more challenging to answer. The military puts a lot of emphasis on you being an officer, taking leadership positions, and bowing to the productivity demands of high up bean counters that are very removed from patient care all while squeezing every bit of time out of you to get you out of patient care. All the while knowing you'll have to move every 3 years, possibility of deployment, and getting paid much less than your civilian counterparts. Depending on where you're stationed you can have a good group or clinic to work with, but still leadership at the Sq and Gp level can make or break your spirit depending on how supportive they are vs how much politicking they do.

Much of your time as a psychiatrist is spent dealing with Sq leadership of your patients as well, dealing with the occupational aspect of military (meaning you're constantly having to answer the question of "can this member perform their duties or are their mental health concerns impacting their ability to perform the mission?"). The documentation is an absolute beast, the administrative things you have to take care of is a burden, and meetings upon meetings upon meetings to discuss future meetings upon meetings....... Sorry where was I?

Truth be told, I'd say only go military if you absolutely WANT to be an officer in the military. Don't do it if you want to practice medicine and get some sort of financial benefit out of it, and maybe just kind of want to be an officer because you won't have much of a say in that. If you stay in long enough and promote, generally you trend towards more administrative and leadership positions to serve the military and get pulled even further from patient care (not always the case but generally speaking this seems to be the case). Also, you could end up in a terrible location for a few years where everybody is miserable. All up to the needs of the military.

 

[starbuck2]

Hey Starbuck, yeah definitely interested in the VA after I get out and utilizing the buy back option for my active time. As far as a positive experience goes, yes I'd say over all I've had a positive experience as far as places I've lived because of going the military route. I don't know who would put 2 and 2 together to identify on here if there's even anyone I know. But I did my training in Texas (kind of vague I know) and I'm at my first duty station which I was fortuante to get a desirable location. As far as practicing psychiatry in the military, that's a little more challenging to answer. The military puts a lot of emphasis on you being an officer, taking leadership positions, and bowing to the productivity demands of high up bean counters that are very removed from patient care all while squeezing every bit of time out of you to get you out of patient care. All the while knowing you'll have to move every 3 years, possibility of deployment, and getting paid much less than your civilian counterparts. Depending on where you're stationed you can have a good group or clinic to work with, but still leadership at the Sq and Gp level can make or break your spirit depending on how supportive they are vs how much politicking they do.

Much of your time as a psychiatrist is spent dealing with Sq leadership of your patients as well, dealing with the occupational aspect of military (meaning you're constantly having to answer the question of "can this member perform their duties or are their mental health concerns impacting their ability to perform the mission?"). The documentation is an absolute beast, the administrative things you have to take care of is a burden, and meetings upon meetings upon meetings to discuss future meetings upon meetings....... Sorry where was I?

Truth be told, I'd say only go military if you absolutely WANT to be an officer in the military. Don't do it if you want to practice medicine and get some sort of financial benefit out of it, and maybe just kind of want to be an officer because you won't have much of a say in that. If you stay in long enough and promote, generally you trend towards more administrative and leadership positions to serve the military and get pulled even further from patient care (not always the case but generally speaking this seems to be the case). Also, you could end up in a terrible location for a few years where everybody is miserable. All up to the needs of the military.

Interesting, thanks for taking the time and giving a detailed reply. Your description of the administrative hassles/meetings sounds like a big headache. And I imagine it is often tough to be at the mercy of your superiors, especially non-medical. I suppose one component of psych that has drawn me in is the flexibility of practice setting, potential to be independent of a hospital (i.e. open up a private practice), etc. which certainly does not seem viable when you are stuck in the bureaucratic beast of the military. Also, one aspect of it that has intrigued me is my interest in PTSD and trauma in general. But your reply isn't the first time I've heard that a lot of military psych these days is evaluating whether someone is fit to serve or trying to catch underlying disorders that slipped through initial screening processes.