Pulled out of residency for flight surgery

[Dr Fleischman]

I was going to ask about this on my previous thread, but I thought it was a separate topic that needed to be brought up.

I heard today about residents, and even fellows, getting pulled out of their residency or fellowship and being told they were going to be flight surgeons for some years. Does this happen often? How do they choose who will be a flight surgeon when they need one - the top performers or is it random? Is the AF always short on flight surgeons? I just can't imagine people want to take that option, my guess is more are forced into it.

Ugh, that would be ridiculously frustrating just because it delays your career further.

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[AF M4]

I was going to ask about this on my previous thread, but I thought it was a separate topic that needed to be brought up.

I heard today about residents, and even fellows, getting pulled out of their residency or fellowship and being told they were going to be flight surgeons for some years. Does this happen often? How do they choose who will be a flight surgeon when they need one - the top performers or is it random? Is the AF always short on flight surgeons? I just can't imagine people want to take that option, my guess is more are forced into it.

Ugh, that would be ridiculously frustrating just because it delays your career further.

The AF is always short on flight surgeons. Really, really short.

I have not heard of anyone being pulled from a residency involuntarily. I have heard of people doing a year of FP/Peds/surgery and deciding it wasn't for them, then doing a GMO so they could turn and burn their service time and separate and go for a civilian residency. That was by choice.

They could always make you do it though. Welcome to the service.

 

[Droopy Snoopy]

I was going to ask about this on my previous thread, but I thought it was a separate topic that needed to be brought up.

I heard today about residents, and even fellows, getting pulled out of their residency or fellowship and being told they were going to be flight surgeons for some years. Does this happen often? How do they choose who will be a flight surgeon when they need one - the top performers or is it random? Is the AF always short on flight surgeons? I just can't imagine people want to take that option, my guess is more are forced into it.

Ugh, that would be ridiculously frustrating just because it delays your career further.

In my limited experience I've never heard of this happening. It is however extremely common to be selected for Flight Med rather than being allowed to go 'straight through' residency training, but you'll know this coming out of med school. It's also common to be delayed between residency and fellowship (for an operational tour in IM prior to being able to accumulate enough points for a GI fellowship for example). Occasionally you'll have someone with issues passing boards or fit tests etc. who will be pulled to fulfill some non-MD capacity.

 

[Perrotfish]

The military GME system works the way that the civilian GME system used to work about a generation ago: you initially apply for just your intern year, and then at the end of your intern year you apply again for residency programs (what you mean by 'the rest of residency'). If you are not selected to continue residency you do what is called a general medical officer tour, or GMO, instead. In the Air Force General Medical Officers are almost exclusively flight surgeons. Unless you fail out of residency, you can't be 'pulled' from residency to be a flight surgeon at any time other than in between your intern year and GME 2. You also can't be pulled midway through a fellowship. Again, you CAN fail out, but that has nothing to do with the AF's need for flight surgeons,just your own medical inadequacies.

How likely you are to be selected for GME 2 depends on the residency you want. As a general rule the more competitive the residency the more likely you are to need to do a GMO tour between intern year and GME 2. For some of the least competitive residencies (FP, Psych) there are opportunities to apply for 'catagorical' residencies, meaning you're guarenteed straight through training just like in the civilian world, rather than having to apply for GME 2. At the other extreme, in the Navy Emergency medicine actually had a 0% of the interns given straight through training (EM is crazy competitive in at least the Army and Navy, not sure about AF). Right now in the AF about 30% of physicians serve a GMO tour overall (I think, I'm actually Navy, and just an MS2).

I'm not sure about the AF, but in the Navy physicians are selected for GME 2 on the basis of a point system. Your given points for research, grades, USMLE scores, the recommendations of you residency director in internship, prior service, etc. Whoever has the most points gets the GME-2 position. BTW doing a GMO tour doesn't guarentee you straight through training when you're done, it just adds more points. If your application is bad enough it's very possible that the military will NEVER want to fully train you in your residency of choice, you'll need to wait to finish your obligation and then get trained in the civilian world (make sure you have the Montgomory GI bill, if that happens, you can apply it towards your pay). Also, be aware that your obligation to the military at the end of your residency will always be, at a minimum, the length of the residency you just completed, so if you just did a 3 year GMO tour, only owe one more year, and then start a 4 year GME-2 like ortho at the end of your residency you're going to owe 4 years, just like if you'd had straight through training.

Yes it adds time until you can start your career. Yes it sucks.

 

[AFDuck]

The military GME system works the way that the civilian GME system used to work about a generation ago: you initially apply for just your intern year, and then at the end of your intern year you apply again for residency programs (what you mean by 'the rest of residency').

Perrotfish is pretty spot on if the OP was asking about the Navy, but the AF GME process works differently. Importantly, about 70-75% of AF residency applicants match directly into their categorical residency position (3-5 years depending on specialty), not just their PGY-1 year. The rest do match into a military or civilian intern year and are then allowed to reapply to residencies during that year. However, the general consensus is that most of these folks will do at least one 2-yr tour as a FS/GMO after their internship. So, to the OP, they are NOT pulled out of a residency position they previously matched into, they generally know what is coming although it still may not be what they want. The more competitive the specialty, the more likely an applicant is going to heading towards FS/GMO.

 

[Dr Fleischman]

Thanks, guys. It's relieving to know that doesn't happen very often, if at all. It seems like I might be looking at a couple years as a FS since my field is so competitive, though I like to think I'm a competitive student. However, I know how the points system works so I'm not sure how it will work out. I appreciate all the input, it was very helpful.

Jake

 

[Teufelhunden]

How likely you are to be selected for GME 2 depends on the residency you want. As a general rule the more competitive the residency the more likely you are to need to do a GMO tour between intern year and GME 2.

Do you happen to know what this formula is? I recall seeing something that explained how all these things were numerically factored in, but that was years ago. I'm a Navy Psychiatrist. I trained at Portsmouth, and went straight through from Internship to PGY-2. I'm thinking of reapplying for another residency in a few years when my 'utilization tour' is finished. I'm wondering if my utilization tour would count the same as the points people get for their GMO/FS/UMO tour. Anyone know the answer to that one?

 

[Perrotfish]

Do you happen to know what this formula is? I recall seeing something that explained how all these things were numerically factored in, but that was years ago. I'm a Navy Psychiatrist. I trained at Portsmouth, and went straight through from Internship to PGY-2. I'm thinking of reapplying for another residency in a few years when my 'utilization tour' is finished. I'm wondering if my utilization tour would count the same as the points people get for their GMO/FS/UMO tour. Anyone know the answer to that one?

The form I saw was for GME-2 match for people who had just finished their internships. I have no idea if the same formula is used for people reapplying for a second residency.

 

[Gastrapathy]

Do you happen to know what this formula is? I recall seeing something that explained how all these things were numerically factored in, but that was years ago. I'm a Navy Psychiatrist. I trained at Portsmouth, and went straight through from Internship to PGY-2. I'm thinking of reapplying for another residency in a few years when my 'utilization tour' is finished. I'm wondering if my utilization tour would count the same as the points people get for their GMO/FS/UMO tour. Anyone know the answer to that one?

Your tour will get you the requisite points but there is extra scrutiny on anyone who wants to retrain. Exactly what that means, I don't know. You really need to get this done before you are approaching promotion to CDR. Since you went straight-through, that is probably not too big an issue. I heard about someone who is an internist in a staff tour who was rejected for Rads last year. Not sure what the particulars were. What residency are you looking at?

 

[AF M4]

Your tour will get you the requisite points but there is extra scrutiny on anyone who wants to retrain. Exactly what that means, I don't know. You really need to get this done before you are approaching promotion to CDR. Since you went straight-through, that is probably not too big an issue. I heard about someone who is an internist in a staff tour who was rejected for Rads last year. Not sure what the particulars were. What residency are you looking at?

My impression from limited second-hand experience (comments from PDs, knew a guy who went to rads from FP) is that it becomes much more of a subjective process. Military PDs don't want a bunch of lazy O-5s and O-6s clogging up their residencies by sitting around sipping coffee and pulling rank to avoid taking call. So if someone who has a residency already re-applies for another one, they need a good reason. What's more, they need to be able to convince the PD as to why they'd be worth the trouble to re-train instead of one of those bright young med studs who doesn't have a residency at all.

And typically, the PD will call around to the re-applicants' former bosses and colleagues to find out just how legitimate this guy is. The med corps tend to be a small world once you reach this level, and they'll find out pretty quickly what kind of person you are to work with.

 

[Jet915]

As a current Navy flight doc, I've never heard of this happening, I do know we are short on flight doc's (40-50 spots according to another flight doc). My duty station has a few flight docs covering multiple squadrons. Honestly, my job could probably be done by a good PA or IDC. It's not rocket science on how to do a flight physical and most of my marines are healthy.