xmsr3

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If it turns out I loath clinical medicine as much as some people I have read on these boards and decide to go down the non clinical route, such as Radiology, anesthesiology or pathology, I was wondering how easy this to do for a career navy doc?

For example I know that most navy docs have to do GMO after GME1 unless they match their navy residency, which is rare for non clinical specialties. But I have heard that GMO have it better than most civilian FP or IM residents. So I was thinking the following and was hoping someone here could confirm that my plan is allowed under the navy med system.

Finish GME 1, apply to radiology, anesthesiology or pathology residency in navy, don't get in.

Do GMO and reapply after 2 years to the same residencies. If I can't get in then I can apply to a civilian program and extend my committment correct?

Then when I am done with civilian residency and am board certified radiologist, the Navy would station me somewhere to be used as a radiologist, correct?

Do I understand the basic system correctly? And how exactly does a civilian residency program work? Would I still be considered active duty and paid by the navy? I have heard that this is the case which makes navy docs more competative in civilian residency programs but I may be mistaken.

Any answers to these questions would be greatly appreciated.
 

psychbender

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If it turns out I loath clinical medicine as much as some people I have read on these boards and decide to go down the non clinical route, such as Radiology, anesthesiology or pathology, I was wondering how easy this to do for a career navy doc?

For example I know that most navy docs have to do GMO after GME1 unless they match their navy residency, which is rare for non clinical specialties. But I have heard that GMO have it better than most civilian FP or IM residents. So I was thinking the following and was hoping someone here could confirm that my plan is allowed under the navy med system.

Finish GME 1, apply to radiology, anesthesiology or pathology residency in navy, don't get in.

Do GMO and reapply after 2 years to the same residencies. If I can't get in then I can apply to a civilian program and extend my committment correct?

Then when I am done with civilian residency and am board certified radiologist, the Navy would station me somewhere to be used as a radiologist, correct?

Do I understand the basic system correctly? And how exactly does a civilian residency program work? Would I still be considered active duty and paid by the navy? I have heard that this is the case which makes navy docs more competative in civilian residency programs but I may be mistaken.

Any answers to these questions would be greatly appreciated.
Ok, lots of misconceptions here. First one being the concept of a nonclinical specialty. While Rads and Path don't generally see real, live patients, Anesthesiology most certainly does, and is quite clinical (actually, all of them are quite clinical). You might want to add Preventive Medicine to your list of "nonclinical" specialties, as they deal with populations, rather than individuals.

If you fail to get your residency choice after doing a GMO tour, you do not get to apply to a civilian residency; the Navy still owns you. You are not allowed to apply to a civilian residency unless they tell you that you can (deferrment), or you have fully paid the service back, and are now a civilian.

If you were granted a deferrment to a civilian residency for training, then yes, you would be active and sent somewhere once finished and back in the Navy.

There are generally two kinds of deferments: sponsored and non. In a sponsored deferment, you are officially active duty (and are paid as such), but are allowed to train at a civilian program, and incur double the normal training obligation (if your program is 4 years, you now owe an additional 8 after residency). In a non-sponsored deferral, you are not active duty, are paid by your program (not the Navy) as a regular civilian resident, and do not incur an additional training obligation.

I hope that helps. Try to better elucidate just what it is that you don't enjoy about "clinical" medicine, as you put it.
 

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another note - with your interest in USUHS, a civilian deferment is even more unlikely.
 
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Thanks for all the great advice.

So here is my deal with "non clinical medicine". Currently my plan is to go IM, because as I understand it, you are a "doctor's doctor" meaning, when in a hospital setting, you pretty much act as a diagnostician, which is my dream job and what I always imagined myself doing.

Of course I may be completely wrong about what a Navy IM does, and also there is the fact that almost all med students change their minds about their preferred specialty after doing clinical rounds.

I have always loved the scientific aspect of medicine, the detective work of taking down symptoms, narrowing the possible conditions down and then useing advanced tech like CT, PET and MRIs as well as blood tests to deduce the true condition. Though I can deal with patients, there is a concern that, in the long run I may end up loathing clinical work, (where you are constantly seeing patients).

I am hoping that IM is what I'm looking for and obviously I'll find out what's my exact cup of tea during clinicals in year 3 and 4, but I just want to make sure that if I go the Navy Med route I will be able to pursue a non primary clinical speciality, which I believe is FP or IM.

I have heard other people in similar situations mention pathology, radiology and anesthesiology as specialties that better suit them. I know that anesthesiologists, due to the nature of their work deal with patients, but only one at a time and for most of the time the patient is asleep.

TheGoose, I am curious, when you say that USUHS grads are unlikley to get civilian deferements do you mean that someone who went to USUHS and wanted to be a pathologist radiologist or anesthesiologist, lets say, would spend their entire career in GMO limbo, applying every 2 years to the very competative Navy path, rad or anesthesiology residency?

And regarding preventative medicine, I really like the idea of that but don't you have to get a Masters in Public Health in addition to your MD?

Of course, if my initial understanding of IM is correct than it truely is my sweet spot and I will love it and then there shouldn't be a problem getting a navy residency match, (IM has the 2nd most residency spots after FP).
Does anyone have any knowledge of how Navy Internal Medicine looks? Is it mostly diagnostics work, with some clinical patient care thrown in, or is it basically the same kind of primary clinic work as FP?

As always any knowledge is greatly appreciated.
 

DrMetal

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Though I can deal with patients, there is a concern that, in the long run I may end up loathing clinical work, (where you are constantly seeing patients).
Why do you have such a concern? Have you ever worked or been around pts? In a clinical setting? I mean, at this point, even before you've taken the plunge into medicine, if you really think you're going to loathe patient contact, then you might wanna reconsider your decision to go to medical school.

I will be able to pursue a non primary clinical speciality, which I believe is FP or IM.
This makes absolutely no sense. You wanna do something non-primary-clinical, so you're going to go into the most clinical thing possibe (FP, or IM)??? If you go into FP, you'll have patients from all age groups. If you go into IM, you'll still have lot of patients (adults), you'll maybe even become a hospitalist.

TheGoose, I am curious, when you say that USUHS grads are unlikley to get civilian deferements do you mean that someone who went to USUHS and wanted to be a pathologist radiologist or anesthesiologist, lets say, would spend their entire career in GMO limbo, applying every 2 years to the very competative Navy path, rad or anesthesiology residency?
I'm not sure if it's the exact letter of the law, but USUHS students are generally not allowed to pursue civilian deferments (I think someone mentioned it happened once, for an AF guy). If you don't match into what you want after your GMO tour, I think give you your second or third pick of specialty. I'm not sure how often this happens; most of the GMOs I've talked to matched into their first choice of specialty (I think the Navy gives recent GMOs a slight advantage in the GME2 application process).
 

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Why do you have such a concern? Have you ever worked or been around pts? In a clinical setting? I mean, at this point, even before you've taken the plunge into medicine, if you really think you're going to loathe patient contact, then you might wanna reconsider your decision to go to medical school.



This makes absolutely no sense. You wanna do something non-primary-clinical, so you're going to go into the most clinical thing possibe (FP, or IM)??? If you go into FP, you'll have patients from all age groups. If you go into IM, you'll still have lot of patients (adults), you'll maybe even become a hospitalist.



I'm not sure if it's the exact letter of the law, but USUHS students are generally not allowed to pursue civilian deferments (I think someone mentioned it happened once, for an AF guy). If you don't match into what you want after your GMO tour, I think give you your second or third pick of specialty. I'm not sure how often this happens; most of the GMOs I've talked to matched into their first choice of specialty (I think the Navy gives recent GMOs a slight advantage in the GME2 application process).

USUHS students are permited to apply for deferments. This changed 3 years ago. The problem USUHS students face is that the have little to no face time with civilian programs, so they are at a disadvantage for those programs. Conversely, they tend to have a lot of face time with military programs which is to their advantage. With the overall lack of military med school grads, the opportunities for deferments is low which adds to the difficulty.


I would suggest that anyone who enters med school with a strong dislike for clinical medicine is making a mistake. Most physicians are clinical and it is a lot of work to go through medical school to hate what you do in the end.
 
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xmsr3

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1. I have extensive experience with patients, as I have hundreds of hours volunteering and shadowing in an ER. I only mentioned this as a possible concern because of several posts I have read from absolutley miserable residents who went into FP.

I am not forseeing this to be a problem as I have already adopted the demeanor of the ER docs I shadow regarding patients, most of which use our ER as a primare care facility, drunk tank, free drugs dispensory,ect.

I suppose I just got a bit spooked by reading post after post from residents who seem to absolutely loath clinical med.

2. I apologize for forgeting the comma, I meant that second paragraph to say that I consider the embodiment of clinical medicine to be FP and IM, with rad, anesthesia and path to be non clinical, (although again Anesthesia only because your patient is asleep and you see them one at a time).

Again I apologize for even starting this post, as I am not actually scared of clinical/primary care as I stated. I wrote that while distraught. Today I got my rejection from U of Chicago, (which I assumed to be as competative as most of the schools I applied to). It turns out that U of Chicago is like the third most competative school to get into, so it is actually totally fine that I got rejected.

My other schools are all pretty much mid tier and a whole bunch are saftey schools including some really exciting ones, such as OSHU and U of VT, which are ranked #3 and #6 in terms of IM education. I just applied to these two schools, as they are schools I would love to go to under HPSP and I should have applied in the first round.

BUT what really gets me pumped is this: the school that I am most competative in, in terms of LizzyM score, that has over 60% oos and no ethnicity preference is..........USUHS! My number 1 choice and dream school is my safest of saftey schools!

So again, I apologize for the needless thread but sincerely thank those who so kindly donated their time to answer my questions. I am much wiser for your generous deeds and perhaps others will benefit from it as well.

Thanks again everyone for your time and consideration. Please have a wonderful weekend, a terrific summer and may you and yours know only health, joy and prosperity in the days to come.
 

DrMetal

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Ah yes, commas can be important. Well, dont let peoples' rants on SDN discourage you so much. Sounds like youve done a good amount of volunteering, you'll definitely have more significant pt contact in med school, and you can determine what you want to pursue then. Dont sweat it so much right now.
 

psychbender

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Thanks for all the great advice.

So here is my deal with "non clinical medicine". Currently my plan is to go IM, because as I understand it, you are a "doctor's doctor" meaning, when in a hospital setting, you pretty much act as a diagnostician, which is my dream job and what I always imagined myself doing..
Yeah...ummm...that's not what IM is like...at all. If you want to be a "doctor's doctor," then be a Pathologist, or Radiologist. IM is a lot of clinic and general ward medicine, in which you spend hours rounding, ordering tests, dealing with social issues, talking to the patient and their families, trying to get ahold of consultants, etc. From what you've described, you will not be happy in IM.

I have always loved the scientific aspect of medicine, the detective work of taking down symptoms, narrowing the possible conditions down and then useing advanced tech like CT, PET and MRIs as well as blood tests to deduce the true condition. Though I can deal with patients, there is a concern that, in the long run I may end up loathing clinical work, (where you are constantly seeing patients).
Seriously...path, rads, or rad onc...

I have heard other people in similar situations mention pathology, radiology and anesthesiology as specialties that better suit them. I know that anesthesiologists, due to the nature of their work deal with patients, but only one at a time and for most of the time the patient is asleep.
The best patients are sedated, intubated, and ventilated. :D

And regarding preventative medicine, I really like the idea of that but don't you have to get a Masters in Public Health in addition to your MD?
The MPH is part of your residency. You spend the first year as a regular Transitional Intern (alongside those going into such fields as Anesthesiology, Dermatology, Pathology, PM&R, Radiation Oncology, and Radiology), then spend a year obtaining an MPH, then return to residency training for another 1-2 years in Preventive Medicine. After your intern year, you really won't be seeing many patients.

There's a really good book that you should check out called The Ultimate Guide to Choosing a Medical Specialty. Each chapter deals with each of the medical specialties, and is written by someone actually in that field.
 
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xmsr3

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Psychbender thank you so much! I have ordered the book and shall read it with great anticipation. To get the real facts about all the different specialties will greatly help me in making some imporant upcoming decisions.