Question about Navy residencies

[Perrotfish]

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When do Navy residencies actually start? How much time do I have off between the end of match and the beginning of Navy residency? Is there any kind of military training I need to go to before Navy residencies?

Basically I'm considering taking a really hard elective for my last month of medical school, and I don't know if I want to do that if I'm starting Intern year 2 weeks later.

 

[NavyFP]

When do Navy residencies actually start? How much time do I have off between the end of match and the beginning of Navy residency? Is there any kind of military training I need to go to before Navy residencies?

Basically I'm considering taking a really hard elective for my last month of medical school, and I don't know if I want to do that if I'm starting Intern year 2 weeks later.

Internship orientation typically starts around the 15th of June. Usually starts on a Monday, but varies by a couple of days year to year. Your time of is from the time you are done with med school and when you have to report for internship. If your school ends on the 15th of May, you get about a month off. If it ends on the 14th of June, you get a couple days.

Is the rotation you want to take something in which you have significant interest? If not, why kill yourself in the last month of Med school?

 

[Perrotfish]

Is the rotation you want to take something in which you have significant interest? If not, why kill yourself in the last month of Med school?

It's a month of Trauma overseas. I want to do it because:

1) It is something I am interested in and might never get the chance to do again.

2) I want to do somthing hard and medical to help me get used to the idea of work again after 4 extremely light post-Match months.

3) I am slightly worried that, though the military, I will have a single opportunity to manage a major trauma on some poor civilian in a warzone and will F- it up royally. BTW I would like to thank whoever posted that story about amputating a hand as a GMO for giving me a new irrational fear.

Anyway my school is over May 1st, so 6 weeks of recovery sounds just fine. BTW when does C4 happen? Also when do we actually start working in the hospital and what do we do in the meantime?

 

[NavyFP]

It's a month of Trauma overseas. I want to do it because:

1) It is something I am interested in and might never get the chance to do again.

2) I am slightly afraid that, though the military, I will have a single opportunity to manage a major trauma on a civilian in an overseas warzone and with F- it up royally. Thank you to whoever posted that story about amputating a hand as a GMO for planting this fear in my head.

Anyway my school is over May 1st, so 6 weeks of recovery sounds just fine. BTW when does C4 happen?

1) Cool. Do it.

2) Don't worry about combat trauma. It happens, you will do your best, and move on. So far, have not had any of my GMOs F--k it up royally, and some of them are pretty green.

C4 will happen sometime during intern year. Depends on your schedule when you go. Mid/late fall is nice weather typically.

 

[SeminoleFan3]

Fairly certain internship this year starts June 6, so I'm not sure why it's so much earlier than normal.

 

[blee]

While our intern year officially started around June 7th, the first three weeks were full of orientation, military style -- lots of presentations, registration rodeos, and even a day or two of free time, depending on the status of your BLS/ACLS certifications. We became full-time working interns on July 1.

 

[Perrotfish]

Another question about Navy residency: is it possible to get a true catagorical residency in the Navy, where they tell you you're a catagorical match at the end of fourth year? Or does everyone apply to an Intern year and then apply again?

 

[BrickHouseMD]

I got one. Family Medicine. But only 17 were given out for the entire Navy and they were all FM or Psych I believe.

 

[Roshario]

Another question about Navy residency: is it possible to get a true catagorical residency in the Navy, where they tell you you're a catagorical match at the end of fourth year? Or does everyone apply to an Intern year and then apply again?

The told us at the start of the application process that categorical matches were only given out for FM and Psych and you found out like everyone else in Dec. The rest of us gets to apply for either a GMO or completing our residency late summer/early fall again like this past cycle.

 

[Perrotfish]

Anyone know if there are any plans to add more catagoricals this coming cycle? Like in Peds?

Also, if you want a catagorical, do you need to apply for it vs. just an Internship?

 

[Gastrapathy]

Not plugged in to Peds but haven't heard any rumors about categorical IM slots anytime soon.

 

[NavyFP]

A few years ago, the Navy put continuous contracts in place in FM and Psych. The prime reason was that interns in these residencies tend to go straight through anyway and it made a selling point for the residencies (both of which were drawing lower numbers).

The hope was that as GMO requirements diminished with the transition, the Navy could expand the number of continuous contracts and include more and more residencies. Although the graduating numbers have improved with 2005-07 recruiting years being put behind us, the demand signal for GMOs has not decreased significantly in the past 2 years. Additionally the prime movers of this process have left their respective positions in GME and I don't know if the replacements have pushed for expansion. I would not hold my breath at this time though.

 

[DrMetal]

A few years ago, the Navy put continuous contracts in place in FM and Psych. The prime reason was that interns in these residencies tend to go straight through anyway and it made a selling point for the residencies (both of which were drawing lower numbers).

The hope was that as GMO requirements diminished with the transition, the Navy could expand the number of continuous contracts and include more and more residencies. Although the graduating numbers have improved with 2005-07 recruiting years being put behind us, the demand signal for GMOs has not decreased significantly in the past 2 years. Additionally the prime movers of this process have left their respective positions in GME and I don't know if the replacements have pushed for expansion. I would not hold my breath at this time though.

Dr. NavyFP, question regarding the GME process: Does the Navy spell out (in an instruction, or pub) exactly how the point system works, for the GME applicant??? We often hear (by second hand) that you get 2 point of pre-clinical, 1 point for research, 1 point for standing on your head, etc etc etc. But I've never seen this in writing. Do you know if such a reference exists, or do they keep this hush hush? [I tried looking at the documents posted here: http://www.med.navy.mil/sites/navme...alEducationProgramsReferenceInstructions.aspx particularly the first document listed there, no joy.]

 

[NavyFP]

Dr. NavyFP, question regarding the GME process: Does the Navy spell out (in an instruction, or pub) exactly how the point system works, for the GME applicant??? We often hear (by second hand) that you get 2 point of pre-clinical, 1 point for research, 1 point for standing on your head, etc etc etc. But I've never seen this in writing. Do you know if such a reference exists, or do they keep this hush hush? [I tried looking at the documents posted here: http://www.med.navy.mil/sites/navme...alEducationProgramsReferenceInstructions.aspx particularly the first document listed there, no joy.]

The scoring sheet is just one of those things you take for granted when you are on this side of the table. I have seen it countless times and never thought about where I might find it on the web. I suspect it is part of the precept, but I can't seem to find the precept online. It is not a secret, but in the end, good students get what they want.

 

[Gastrapathy]

Dr. NavyFP, question regarding the GME process: Does the Navy spell out (in an instruction, or pub) exactly how the point system works, for the GME applicant??? We often hear (by second hand) that you get 2 point of pre-clinical, 1 point for research, 1 point for standing on your head, etc etc etc. But I've never seen this in writing. Do you know if such a reference exists, or do they keep this hush hush? [I tried looking at the documents posted here: http://www.med.navy.mil/sites/navme...alEducationProgramsReferenceInstructions.aspx particularly the first document listed there, no joy.]

Its not in any Navy instruction that I'm aware of. I've seen the form but I don't have a copy handy either. I'm convinced that while a points system exists, the factors are subjective enough that the outcome is whatever the PDs want it to be.

You want to do medicine, right? And I assume given your priorness that you would like to get on with training and go straight through. The most important factor in training straight-through is the PD's impression of you over the first few months of internship. You are a little at the mercy of the schedule in this regard but you need to perform well on inpatient rotations in the first few months.

Another great way to get attention (with a fairly minimal effort IMHO) is to do a case report or small case series for Navy ACP. The deadline for this is shortly after arrival for internship and a better plan is to find a case to write up during an MS4 rotation. The PD will notice that you had an accepted abstract and all of that happens before the board.

Its also possible to present a case as a medical student but takes a little forethought. You can predict which site will hold ACP each year in Oct with the following rotation: San Diego 2011, Bethesda 2012, Portsmouth 2013, repeat. If you rotate at one of the other sites before the ACP poster deadline (July) and then rotate at the site of the meeting in Oct, you can get a poster in and then be there to present it. Usually 1-2 studs manage to make this happen and it makes a great impression.

Your prior service does provide a marginal advantage but its really how those first few months go that matters most.

You also have to be willing to wait it out after the GMESB. It seems to me over the past few years that they select a couple folks up front and then the list moves (and it isn't a list in that you don't know which alternate you are).

If you do go straight-through and want fellowship thereafter, its a total crapshoot. But worry about one hurdle at a time.

 

[Perrotfish]

question regarding the GME process: Does the Navy spell out (in an instruction, or pub) exactly how the point system works, for the GME applicant??? We often hear (by second hand) that you get 2 point of pre-clinical, 1 point for research, 1 point for standing on your head, etc etc etc. But I've never seen this in writing. Do you know if such a reference exists, or do they keep this hush hush? [I tried looking at the documents posted here: http://www.med.navy.mil/sites/navmed...tructions.aspx particularly the first document listed there, no joy.]

The document for people applying to residencies and fellowships (but not Intern years) is called "JSGMESB Scoring Guidance", I have a copy of the 2008 guidelines on my desktop but have no idea how to link it so, instead, I'll type out the point system:

1)Preclinical medicine/Step 1: top 25% gets 2 points,everyone else gets 1
2) Clinical Medicine/Step 2: top 25% gets 3 points, next 25% gets 2 points, everyone else get 1
3) Internship/Step 3: Top 25% get 3 points, everyone else gets 2, 1, or 0 depending on performance. If you've finished intern year (meaning you're applying after a GMO tour) you get an additional 2 point bonus, i.e. max score of 5 and min score of 2.
4) GMO Tour or utilization tour: 1-5 points, depending on performance
5) Potential as a future officer: 1-5 points
6)Prior service: 2 points for prior medical service (Nurse/Corpsman), 1 point for any other military service
7) Research: 4 points for two or more peer reviewd journal articles, 3 points for one peer reviewed journal article, 2 points for two or more poster presentations/in house journal pubs, one point for one poster presentation/in house journal pub. Premed publications don't count. You can also get a bonus point for research during difficult conditions (during Intern year or deployment) but the max score is still 4.
8) Residency: (for fellowship applicants only) maximum of 10 points, maximum of 7 if applying while in residency.

Interesting guidance: According to this sheet, you need a score of at least 10 to get a residency. For an Intern who doesn't have priorservice or research that's actually a pretty high score.

Lessons learned:
1) Prior service is an advantage but is not a huge deal
2) The military cares surprisingly little about your step 1 score
3) There is a tremendous overemphasis on GMO tours. A GMO can earn a maximum of 26 points and and the best Interns can only earn 19. Therefore the very best possible intern would have a very hard time getting more points than an average GMO.
4) There is an incredible overemphasis on published research
5) Research experience doesn't count unless it ends in a poster presentation or a publication.

Take home lesson: If you want straight through training, get two publications!

I would still like someone to tell me whethers those publication need to be first author, though.

BTW: If this system has changed drastically since 2008 I apologize

 

[Gastrapathy]

Perrot: #3 actually understates the advantage GMOs have over current interns because current interns cannot max the internship points. Basically, it is impossible for a current intern to compete with a GMO.

 

[DrMetal]

The scoring sheet is just one of those things you take for granted

Ok thanks. Perhaps its not meant to be in the public domain or something set in stone.

Another great way to get attention (with a fairly minimal effort IMHO) is to do a case report or small case series for Navy ACP.

Thanks, good advice. Aside from a poster, if I want to submit something for publication, to what journals should I be submitting? Does Navy ACP have a favorite pub (Military Medicine?), or should I go for the typicals (JAMA, Annals, NEJM)? I'm looking to write something up as early as this Fall (beginning of MSIII, during some of my lighter rotations, perhaps.)

Take home lesson: If you want straight through training, get two publications!

Thanks, good info. I found something similar here:
http://navyhpsp.net/wiki/Joint_Service_GME_Selection_Board_Scoring_System#APPLICANT_SCORE_SHEET
although of course this isn't official, looks right though.

Do publications (biomedical related) before medical school/training (say in a separate graduate program) count towards these points? [I think I've asked this question 5 times, no one seems to know definitively.]

 

[Perrotfish]

Do publications (biomedical related) before medical school/training (say in a separate graduate program) count towards these points? [I think I've asked this question 5 times, no one seems to know definitively.]

I've never seen it in writing, but everyone I've asked said the publications need to be from medical school or residency.

 

[Gastrapathy]

I've never seen it in writing, but everyone I've asked said the publications need to be from medical school or residency.

Nope. Just on your CV.

Metal: We read the same journals as everyone else. Military Medicine doesn't come up at journal club too often (never that I can remember). The advantage of Navy ACP is that your are presenting at their meeting and the expected quality is lower than at a real meeting.