Psychiatry after USUHS?

[KittycooMD]

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So I'm applying this year and received a secondary from USUHS. I'm so excited about med school and would be honored to be accepted to ANY SCHOOL...I was wondering about USUHS specifically though. I have an open mind and realize people's speciality decisions change several times in med school, but for now I'm considering psychiatry.
How hard is it to get a residency in psych coming from USUHS, and is the training good? I have read lots of negative things about the school and military medicine in general from this site...It's not my dream school, but I am interested. Anyone have any opinions? Is it true that I should stick to Family practice if I did go to USUHS?

 

[WhoisJohnGalt]

So I'm applying this year and received a secondary from USUHS. I'm so excited about med school and would be honored to be accepted to ANY SCHOOL...I was wondering about USUHS specifically though. I have an open mind and realize people's speciality decisions change several times in med school, but for now I'm considering psychiatry.
How hard is it to get a residency in psych coming from USUHS, and is the training good? I have read lots of negative things about the school and military medicine in general from this site...It's not my dream school, but I am interested. Anyone have any opinions? Is it true that I should stick to Family practice if I did go to USUHS?

Bear in mind: I did not go to USUHS, and I didn't take the AF scholarship. That said, I was very interested in the scholarship program, and spent a lot of time talking to recruiters. What they always told me was that I could apply for any residency that the military had need of, and they definitely use psychiatrists. There aren't too many fields that are off-limits; plastics is pretty limited, as an example, but that's about it. The military still needs OB/GYNs, Urologists, ENTs, etc. But, like I said, take that as you would anything a recruiter tells you 😀

 

[colbgw02]

So I'm applying this year and received a secondary from USUHS. I'm so excited about med school and would be honored to be accepted to ANY SCHOOL...I was wondering about USUHS specifically though. I have an open mind and realize people's speciality decisions change several times in med school, but for now I'm considering psychiatry.
How hard is it to get a residency in psych coming from USUHS, and is the training good? I have read lots of negative things about the school and military medicine in general from this site...It's not my dream school, but I am interested. Anyone have any opinions? Is it true that I should stick to Family practice if I did go to USUHS?

if you haven't already, then you should post this (or ask a mod to move it) in the military medicine forum.

my advice is to not go to USUHS or accept HPSP unless you are willing to be in the military not as a physician. don't get me wrong, you won't be in the "real" military, in all likelihood, but there is a much higher level of BS you have to deal with than in the civilian world.

if you decide to go the military route, then psychiatry is definitely a possibility, as it is not very competitive in the military or otherwise. i would re-stress what you already know - that you are overwhelmingly likely to change your mind during medical school with regards to your specialty, unless you have some sort of pre-med experience in that field.

the principal issue with gme, in my mind, in the military is interruption of training. in general the army will allow more folks to train continuously through residency, as it is the largest service. in any case, i'm sure many psychiatrists go straight through irrespective of service, as it's not particularly popular.

 

[Church]

my advice is to not go to USUHS or accept HPSP unless you are willing to be in the military not as a physician. don't get me wrong, you won't be in the "real" military, in all likelihood, but there is a much higher level of BS you have to deal with than in the civilian world.

LMFAO... how much time do you have in the military (pick a branch) ? Now, how much time working in a real job as a civilian (either health professions, or other professional work)? Now, how the HELL can you tell me (without laughing) that the military has "more bull****"? I spent 14 years in the military, quite a few less as a civvie, but no sh**, you can get away with all kinds of crap in the military that would get you fired in a heartbeat as a civilian.

Or does wearing a uniform and having to get up early not appeal? Oh, wait, we're in medicine...

Lest anyone give me sh*te about getting huffy, I am, as I said earlier, LMAO.

 

[colbgw02]

LMFAO... how much time do you have in the military (pick a branch) ? Now, how much time working in a real job as a civilian (either health professions, or other professional work)? Now, how the HELL can you tell me (without laughing) that the military has "more bull****"? I spent 14 years in the military, quite a few less as a civvie, but no sh**, you can get away with all kinds of crap in the military that would get you fired in a heartbeat as a civilian.

Or does wearing a uniform and having to get up early not appeal? Oh, wait, we're in medicine...

Lest anyone give me sh*te about getting huffy, I am, as I said earlier, LMAO.

4 years, if you don't count the first 18 years of my life constantly being uprooted and moved around the country and the 4 years i spent as a cadet

0 years, but i do have plenty of friends that are civilians.

just off the top of my head, here are some things that i've had to deal with that none of my civilian MD friends have faced.

1) orders - getting them too late to arrange household goods shipment, getting them amended to include my wife, getting them amended to include my proper report date

2) pay - i have yet to get paid the correct amount and there are no less than 4 levels of bureaucracies in charge of the issue, each one pointing the finger at the other - or how about a buddy of mine, whose mortgage payment just disappeared magically out of her pay - now she's at risk of defaulting on her loan

3) mandated training - BMAR, eUCAPERS, CBRNE, not to mention the quarterly EO training that i'm going to this afternoon

4) passes - i'm a prisoner because i can't leave without a pass and i can't get a pass until i've "earned" one, which can only be done twice a year at each APFT, which brings me to...

5) APFT - where in the civilian medical world is your performanced based on how fast you can run?

6) GMO training - luckily i've been able to avoid this, but how many qualified civilian MDs don't get to do their residency (and fellowship training, if they so choose) right after medical school? it happens all the time in the military

7) deployments - yeah, you know that little thing going on over there in iraq? well, they're not sending civilian physicans over there.

8) mandatory fun - oh, how i just love using my precious few weekends off spending time at the CG's going away party. there's no way i'd rather spend that time with my family.

i just came up with these off the top of my head. i'm sure if i were inclined to think about it some more, i could provide a more comprehensive list. these i've listed above are principally inconveniences, and they in no way address the often critical shortages of personnel and funding affecting many of the military medicine billet slots worldwide.

maybe you and i are/were in different branches. maybe you were in the AF where it was all cocktails and beach volleyball, i don't know. i also have no idea how serious you were being, but if you are honestly contending that there is less BS in the military as a physician than in the civilian world, then you are doing a disservice to the folks reading this thread.

 

[chocomorsel]

4 years, if you don't count the first 18 years of my life constantly being uprooted and moved around the country and the 4 years i spent as a cadet

0 years, but i do have plenty of friends that are civilians.

just off the top of my head, here are some things that i've had to deal with that none of my civilian MD friends have faced.

1) orders - getting them too late to arrange household goods shipment, getting them amended to include my wife, getting them amended to include my proper report date

2) pay - i have yet to get paid the correct amount and there are no less than 4 levels of bureaucracies in charge of the issue, each one pointing the finger at the other - or how about a buddy of mine, whose mortgage payment just disappeared magically out of her pay - now she's at risk of defaulting on her loan

3) mandated training - BMAR, eUCAPERS, CBRNE, not to mention the quarterly EO training that i'm going to this afternoon

4) passes - i'm a prisoner because i can't leave without a pass and i can't get a pass until i've "earned" one, which can only be done twice a year at each APFT, which brings me to...

5) APFT - where in the civilian medical world is your performanced based on how fast you can run?

6) GMO training - luckily i've been able to avoid this, but how many qualified civilian MDs don't get to do their residency (and fellowship training, if they so choose) right after medical school? it happens all the time in the military

7) deployments - yeah, you know that little thing going on over there in iraq? well, they're not sending civilian physicans over there.

8) mandatory fun - oh, how i just love using my precious few weekends off spending time at the CG's going away party. there's no way i'd rather spend that time with my family.

i just came up with these off the top of my head. i'm sure if i were inclined to think about it some more, i could provide a more comprehensive list. these i've listed above are principally inconveniences, and they in no way address the often critical shortages of personnel and funding affecting many of the military medicine billet slots worldwide.

maybe you and i are/were in different branches. maybe you were in the AF where it was all cocktails and beach volleyball, i don't know. i also have no idea how serious you were being, but if you are honestly contending that there is less BS in the military as a physician than in the civilian world, then you are doing a disservice to the folks reading this thread.

Good return!!! 😉 I love it when people assume that others are giving advise without any experience behind it. Way to stand up for yourself. And he thought you were pulling this s*** out of your ass!!!!

 

[colbgw02]

deleted - repeat post because the system is screwy

 

[MossPoh]

I considered the USUHS too...until I went on the boards here and read what the guys who were going through it said. There is b.s. in both....one would be stubborn to think otherwise....but the crap that the docs get put through in the military versus the payment they receive is quite a bit. The general advice I have seen is that if you would've gone into the military without this stuff then you'll be ok. If it really takes a "scholarship" to make you want to go to their school...then it probably isn't the best fit. I am in the same boat about honored by whatever school as well....but you just have to ask yourself (taking money away from the equation) whether it is a good fit for you. If it is..then yes you can probably do psych...plenty of people need it after the stuff they have seen/experienced and it is generally not that popular of a speciality.

 

[paradude]

Is it true that I should stick to Family practice if I did go to USUHS?

No. The military needs all kinds of docs and while a family practice residency is a good fit, primarily for the Army (due to their ability to be used outside of hospitals in a battalion or brigade surgeon role) you aren't pushed into any one specialty at this school. We've had interest group meetings for specialties like Anesthesiology Internal Med and Emergency Medicine at lunches 2 or 3 times a week.

By the way, I'm really enjoying USUHS so far. Good luck!

 

[Church]

1) No, the 18 years of being a military dependent don't count, nor the 4 years of being a cadet. But you knew that when you typed it.

2) It certainly sounds like you've had more than your share of bad experiences in the US-everlovin'-Army, but them's the breaks. They honestly make officers have a pass to leave post? LMFAO. Shoulda gone Navy or USAF medical corps. I hear the Air Force gives you a set of golf clubs when you check in.

3) Deployments? I've done 4, thanks, and not in the air-conditioned comfort that our colleagues int he Air Force enjoy, nor anyplace nice where you Army dogs get satellite phone calls home, air conditioners on your barracks rooms, nor freaking internet access. 4 years is good. Thank you for serving your country, that's better than most. But don't get on a f**king high horse over spending some time in the sand on a lousy 4 year contract. There are men and women serving with more deployments than you and I put together.
*If you have pay problems, take it up in the proper forum, we can't fix it on SDN. Talk to someone who can. Everybody has pay problems at some point, civilian and military. Don't make it out to be a special "servicemembers only" thing. If you have that big a problem, you can request office hours. Not like a punishment, but to get your complaint on record, and it goes up the chain. Never seen that done and fail to get positive results. But from the sound of your rant, you didn't spend any time figuring out how to help yourself.
*Mandated training? Only in the military? NOT. welcome to the professional world, where even as civilians you have mandated training, yes, even on EO. On that note, are you telling me that you love every inservice you've gone to? It's just the military required training that's annoying?
*APFT? Oh, no, you have to be physically fit. The horror. I'm not that big a fan of going running full tilt 2 times a year, but hey, it's only two times per year. Really. APFT takes what, an hour at most, not counting PT shower afterwards? So, over spending 2 hours a year (paid time), you're bent out of shape?

4) No, I wasn't in the ever-lovin USAF, I graduated from Parris Island in 89. Did a damn sight more than 4 years, but as I said, thanks for doing 4, it's more than most citizens do. I appreciate that you have bad feelings about your time, and that you had/are having some unpleasant times. But to suggest that the civilian world is any better is to do the people on this board a disservice.

4) Chocomorsel... you clearly are out of your depth. Here's a cinderblock.

 

[mac61]

I purposely stopped reading the military medicine forum because every thread turned into the military medical system is broken, so stay away from it.

I will not say that any of the opinions/experiences are invalid or inaccurate, however they are very forceful.

That being said:

I have been in the Army for 14 years (no cadet time, no "other" time)...wait sorry...13 years because I've been at USUHS for a year. This is important because I have some idea about the silliness that accompanies committing yourself to military service, which is definitely not for everyone. The military is not even close to a perfect system, and is a very easy target for ridicule.

The bottom line: USUHS is a place for people who want to be military physicians, not physicians in the military. Not including time at USUHS, you will spend a minimum of 7 and likely at least 11 years in the military after USUHS just to fulfill the obligations that attending USUHS and a residency require (That's 15 years before you're allowed to leave the military including your time at USUHS). That is more than half of a career, so accepting a position at USUHS and thinking that you'll either learn to love the military or just ride it out for the "free" education is a VERY BAD IDEA. You must be committed to serving in the military, or you could be looking at a decade of your glass being half empty (or full).

So... on to psych. It's been my experience that everyone who wants psych has a pretty good shot of getting psych. I would not call it a competitive residency, if your branch allows you to complete a residency directly after internship. The Navy and Air Force are notorious for sending physicians to a General Medical Officer position for 2-4 years after internship prior to residency. The Army pretty much requires graduates to attend residency upon completion of internship.

I am looking seriously at the combined MED/PSYCH program at Walter Reed, and as I grease the cogs, it looks like a matter of who knows you, as much as what you know.

The idea that you should stick to FP or IM if you attend USUHS is a little ridiculous. EM is extremely competitive and all 3 army EM residency programs are ranked in the top 10 nationally. Further, read CNN and PTSD issues surrounding current military operations and consider the importance of psychiatry. Even further, in the current environment, orthopods/general surgeons are saving lives daily and evidenced by the number of casualties turned amputees as opposed to fatalities. The military offers a diverse environment, in diverse environments, and EVERYONE gets deployed. (e.g. Perinatologist now on staff at USUHS was sent to Iraq...if he's going, you're going.) If you're ok with that mindset, then USUHS might be for you after all.

For the record. USUHS has been a phenomenal experience for me. I would recommend attending USUHS to anyone that is seriously interested in military medicine. As suggested however, I would VERY SERIOUSLY recommed shadowing at a military hospital or clinic before making the decision to attend USUHS.

Feel free to shoot me a PM with any questions, or contact info with the psych programs around the country.

Good Luck.

 

[colbgw02]

1) No, the 18 years of being a military dependent don't count, nor the 4 years of being a cadet. But you knew that when you typed it.

2) It certainly sounds like you've had more than your share of bad experiences in the US-everlovin'-Army, but them's the breaks. They honestly make officers have a pass to leave post? LMFAO. Shoulda gone Navy or USAF medical corps. I hear the Air Force gives you a set of golf clubs when you check in.

3) Deployments? I've done 4, thanks, and not in the air-conditioned comfort that our colleagues int he Air Force enjoy, nor anyplace nice where you Army dogs get satellite phone calls home, air conditioners on your barracks rooms, nor freaking internet access. 4 years is good. Thank you for serving your country, that's better than most. But don't get on a f**king high horse over spending some time in the sand on a lousy 4 year contract. There are men and women serving with more deployments than you and I put together.
*If you have pay problems, take it up in the proper forum, we can't fix it on SDN. Talk to someone who can. Everybody has pay problems at some point, civilian and military. Don't make it out to be a special "servicemembers only" thing. If you have that big a problem, you can request office hours. Not like a punishment, but to get your complaint on record, and it goes up the chain. Never seen that done and fail to get positive results. But from the sound of your rant, you didn't spend any time figuring out how to help yourself.
*Mandated training? Only in the military? NOT. welcome to the professional world, where even as civilians you have mandated training, yes, even on EO. On that note, are you telling me that you love every inservice you've gone to? It's just the military required training that's annoying?
*APFT? Oh, no, you have to be physically fit. The horror. I'm not that big a fan of going running full tilt 2 times a year, but hey, it's only two times per year. Really. APFT takes what, an hour at most, not counting PT shower afterwards? So, over spending 2 hours a year (paid time), you're bent out of shape?

4) No, I wasn't in the ever-lovin USAF, I graduated from Parris Island in 89. Did a damn sight more than 4 years, but as I said, thanks for doing 4, it's more than most citizens do. I appreciate that you have bad feelings about your time, and that you had/are having some unpleasant times. But to suggest that the civilian world is any better is to do the people on this board a disservice.

4) Chocomorsel... you clearly are out of your depth. Here's a cinderblock.

I) so, you actually only provided retorts for a few of my points - pay and the mandated training. regardless of what you say, being physically fit and being deployed are two issues that civilian physicians simply don't have to worry about. the differences between military and civilian medicine was the issue at hand, and any other commentary is irrelevant.

a) APFT - you're right. big deal that i have to be physically fit - it's something i should do anyway. the point is that it's a non-issue for civilian physicans.

b) deployments - i thank you for your service both at home and abroad. again, the point is that it's a non-issue outside of the military.

c) pay - i still contend that fixing these issues is more difficult in the military.

1) i've had financial issues outside of the military before, and it typically took 1 or 2 phone calls to correct - not repeated trips to the PAC, MILPO, & finance offices in addition to repeated phone calls to DFAS in DC and/or Ohio over a period of months. and it's not just me, i'd say that about 40-45% of people i know have had pay issues large enough that it affects their ability to pay their bills.

2) i obviously know that no one on SDN can fix my pay problems. in any case, i only brought it up as an example of the BS i have to deal with. once again, you're not focusing on the relevant point.

d) mandatory training - sure the civilian world has these, that point i concede, but do they revoke your passes, deny you leave, make you ineligible for promotion, and flag your entire record when you don't go to learn about sexual harrassment once every 13 weeks?

II) i definitely should not have gone navy or AF, then i'd be stuck in diego garcia or some other forgotten corner of the world schlepping it as a GMO. i'm an army guy, always have been, always will be.

III) were you a physician in the military? you obviously know that being in the military is a whole different animal than being a civilian, but - at the risk of being redundant - the point of this discussion is to highlight the differences in military and civilian medicine. not between military and civilian life. the medical corps is somewhat unique insofar as its mission doesn't really jive with what the rest of the military is doing. being a good physician and being a good officer don't necessarily mix, and we're expected to comply with both civilian and military standards. it's a mix that i'll gladly put up with, but let's call a spade a spade - it's like oil and water.

IV) please don't assume that i have/will only serve 4 years just because that's what i've done already. by the time i get out, i will have more like 14-16 years.

i think it's stupid if we keep this up. my point is simply that military physicians have to put up with crap that civilians don't. i'm not trying to say that the military sucks, or that it's completely unmanagable, or that i hate it and wish i could get out right now. but i still think it's a misrepresentation to say that military medicine is the same as civilian medicine.

 

[roach]

I purposely stopped reading the military medicine forum because every thread turned into the military medical system is broken, so stay away from it.

I will not say that any of the opinions/experiences are invalid or inaccurate, however they are very forceful.

That being said:

I have been in the Army for 14 years (no cadet time, no "other" time)...wait sorry...13 years because I've been at USUHS for a year. This is important because I have some idea about the silliness that accompanies committing yourself to military service, which is definitely not for everyone. The military is not even close to a perfect system, and is a very easy target for ridicule.

The bottom line: USUHS is a place for people who want to be military physicians, not physicians in the military. Not including time at USUHS, you will spend a minimum of 7 and likely at least 11 years in the military after USUHS just to fulfill the obligations that attending USUHS and a residency require (That's 15 years before you're allowed to leave the military including your time at USUHS). That is more than half of a career, so accepting a position at USUHS and thinking that you'll either learn to love the military or just ride it out for the "free" education is a VERY BAD IDEA. You must be committed to serving in the military, or you could be looking at a decade of your glass being half empty (or full).

So... on to psych. It's been my experience that everyone who wants psych has a pretty good shot of getting psych. I would not call it a competitive residency, if your branch allows you to complete a residency directly after internship. The Navy and Air Force are notorious for sending physicians to a General Medical Officer position for 2-4 years after internship prior to residency. The Army pretty much requires graduates to attend residency upon completion of internship.

I am looking seriously at the combined MED/PSYCH program at Walter Reed, and as I grease the cogs, it looks like a matter of who knows you, as much as what you know.

The idea that you should stick to FP or IM if you attend USUHS is a little ridiculous. EM is extremely competitive and all 3 army EM residency programs are ranked in the top 10 nationally. Further, read CNN and PTSD issues surrounding current military operations and consider the importance of psychiatry. Even further, in the current environment, orthopods/general surgeons are saving lives daily and evidenced by the number of casualties turned amputees as opposed to fatalities. The military offers a diverse environment, in diverse environments, and EVERYONE gets deployed. (e.g. Perinatologist now on staff at USUHS was sent to Iraq...if he's going, you're going.) If you're ok with that mindset, then USUHS might be for you after all.

For the record. USUHS has been a phenomenal experience for me. I would recommend attending USUHS to anyone that is seriously interested in military medicine. As suggested however, I would VERY SERIOUSLY recommed shadowing at a military hospital or clinic before making the decision to attend USUHS.

Feel free to shoot me a PM with any questions, or contact info with the psych programs around the country.

Good Luck.

who keeps this list of "top ten" residencies??😕

 

[mac61]

who keeps this list of "top ten" residencies??😕

To be honest, now that I've been called on stating a "fact" I don't know. This information was given to me by a program director, and I did not research the information myself. After an hour, I can't find anything about rankings of all schools nationally, except individual programs boasting thier ranking, which I do not consider objective. I will continue looking and let you know what I find.

Until then my statement pertaining to the ranking of EM residencies is respectfully retracted. Thank you for the critique, I employ others to keep the thread on track and not use my error as an opportunity to criticize military medicine.

Thanks.