Questions about GMO with FMF

[NishikiCycles]

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I'm a former USNA grad and now an MSIV who will be graduating in May. A majority of my friends (including my roommate) selected USMC when we graudated from USNA, and have since been deployed to Iraq/Afghanistan 2-3 times. I never thought that I'd actually find myself in this position, but I sort-of feel left out from that whole process. I've been in Baltimore (which is a war zone in it's own right) for the past 4 years, and I am curiously drawn to the thought of doing a GMO tour with the FMF after internship. It's not a gung-ho, do-or-die thought of heroism, but rather a gut feeling that this is what I went to the Academy for in the first place.

In that respect, I had some questions:

1. Who here has done a GMO tour with the Marines?
2. At which bases (besides Lejune, Pendleton, and Okinawa) can you be stationed?
3. What's the day-to-day life like? Specifically, are you encouraged to PT with the Marines and go on field exercises, or does sick-call pretty much dominate your existence?
4. What are the command environments like, in your experience?
5. Is it possible to go to Benning to get your jump wings? Has anybody done this?
6. When deployed as a GMO, what is your role? Is it mostly sick-call, or is there any chance of participating in higher acuity care?
7. Any recommendations (besides "On Call in Hell") for further reading?
8. Any thoughts on how to best work with the detailers to get what you want?

Any comments about your experiences would be most welcome. Thanks.

 

[pgg]

Lots of threads on this topic, do a search for more.

1. Who here has done a GMO tour with the Marines?

2003-2006 with 3/6 in Camp Lejeune.

3. What's the day-to-day life like? Specifically, are you encouraged to PT with the Marines and go on field exercises, or does sick-call pretty much dominate your existence?

When I was there, each infantry battalion had two GMOs and an IDC. That may be changing in coming years.

You can certainly PT with the Marines every day if you like. They'll be delighted to have a medical officer who participates. My BAS Corpsmen had daily PT separate from the Marines, but usualy 1-2x/week they'd PT with the H&S Marines, and every once in a great while, there'd be battalion-wide PT. I didn't participate often, but that was lack of motivation not lack of opportunity.

Occasionally the battalion officers would have some kind of PT together, usually in the form of a very contact-heavy derivative of some sport. After a couple of these I thought I was better off waiting for the casualties to come in for post-PT treatment than risking my own limbs.

Sick call for a few hours each morning. If you have a good IDC (and most of them are) a lot of the really painful routine sick call can be turfed off to them. Lots of boring routine physicals to do ... the Marines make people get pseudo-physicals for just about everything (to cut hair, to prepare food, to drive a Humvee, to drive a Humvee with ammo in it, to drive a truck, to go to the brig after their NJP at 1645 on Friday, on and on and on).

Lots of admin work, especially before/after deployments.

Most of the job is not difficult. Every once in a while some horrible life-threatening pathology walks into sick call, but mostly it's what you'd expect from a primary care clinic that takes care of the healthiest 18-35 year old people in the country.

4. What are the command environments like, in your experience?

Mine was very good. Had a LtCol who let me do my job and rarely tried to push line interests ahead of medical recommendations regarding individual Marines.

It helps to go in understanding that medical is there to serve the kill-people/break-things mission of the Marines, and that medical's wants will never be at the top of their list of priorities. You can always get what you need if you argue for it long enough.

6. When deployed as a GMO, what is your role? Is it mostly sick-call, or is there any chance of participating in higher acuity care?

Mostly sick call, though a lot less than while in garrison because (1) you don't deploy with all of the broken Marines who are frequent fliers, (2) a lot of your Marines won't be colocated with you and will be seen by their company Corpsmen, (3) Marines who have real Marine work to do while deployed have less incentive to kill working hours hanging out at sick call (back home, when their days are filled with floor polishing and trash pickup, a couple hours in the BAS is a nice break).

Usually very little higher acuity care. Wounded Marines in both theaters get flown straight to echelon 2 these days and get seen by residency-trained physicians. If you happen to be colocated with a FRSS or the like, you could help out.

Most of the really independent high-acuity care I personally delivered was to local nationals who were denied CASEVAC.

7. Any recommendations (besides "On Call in Hell") for further reading?

No. I wouldn't even read too much into that book, as it is not at all representative of a typical Marine GMO tour. No current/near-future GMO should expect to be part of any operations on the scale of invading Afghanistan or Iraq, or even Fallujah. Might happen, of course, but probably not.

8. Any thoughts on how to best work with the detailers to get what you want?

Tell them you want Marine infantry and they will give it to you. Beyond that I have no real insight.


Most of us have very positive things to say about our time with the Marines. It was nice to get away for a while from the big Navy hospital where people like to pretend they're not in the military, and actually serve the people who carry the guns in those dirtholes.

 

[NishikiCycles]

Pgg, thanks for the response.

Anybody out there know what kind of training you get as a Marine GMO before you report to your unit?

 

[almostfamous]

Internship.
Field Med School for Officers.
A quasi-orientation at DSO.
Then lots of OJT.

Pgg, thanks for the response.

Anybody out there know what kind of training you get as a Marine GMO before you report to your unit?

 

[Ascultator]

I'm a 3rd year resident in FM. I've wanted to join the services for some time now. If I go Navy I want an FMF billet. In 2011 can I expect good chances for getting assigned to one?
What are FMF billets like these days?

Can anyone here comment on this one: how well can you maintain your clinical skills in Navy? I've heard different things overall -- there are superb opportunities for training and continuing education..vs. your skills diminish in a way since your population is a lot healthier and you see less pathology, etc.

thanks

 

[NavyFP]

I will parrot comments above.

Fair amount of admin. The most frustrating is the Limited Duty/ Medical Board process. Partly because there are a few rotten apples in the barrel trying to milk the system and partly because the docs at the hospital have no great motivation to make the system better.

There is plenty of time to PT. You will get to deploy. Not particularly medically interesting.

For Ascultator-
Yes, you can join and go to the Marines. You would likely be a Battalion Surgeon and take care of about 1000 very healty young men. There can be some skill atrophy and you will be very limited in the procedures you can do.

 

[Jet915]

1. Who here has done a GMO tour with the Marines?
I am doing a flight surgeon tour w/HMH-464 at New River, NC.

2. At which bases (besides Lejune, Pendleton, and Okinawa) can you be stationed?
Marine wing bases are mainly New River, NC, Miramar, CA or Beaufort, SC.

3. What's the day-to-day life like? Specifically, are you encouraged to PT with the Marines and go on field exercises, or does sick-call pretty much dominate your existence?
Sick call pretty much dominates atleast here, if you make an effort, you could probably PT w/the Marines. After sick call, you do all sorts of physicals until lunch time. Afterwards, usually I'll see squadron Marines. Typically 4-5 days a month, I will have "squadron" time.

4. What are the command environments like, in your experience?
My command is great, let me do my thing and don't really bother me or get in my business. They trust my judgement and usually almost always do what I recommend. That can vary w/command of course.

5. Is it possible to go to Benning to get your jump wings? Has anybody done this?
Not sure, doubt it. Depending on what type of squadron you are in, you can get your aircrew wings if you want to be an aerial observer.

6. When deployed as a GMO, what is your role? Is it mostly sick-call, or is there any chance of participating in higher acuity care?
I worked in a tent taking care of "sick call" for aviation Marines in Afghanistan. Nothing major, but I was proactive and volunteered at the British Role 3 Hospital and got to aid in doing some trauma there.

7. Any recommendations (besides "On Call in Hell") for further reading?
Nope

8. Any thoughts on how to best work with the detailers to get what you want?
If you want greenside, you will probably get it. Not sure about the other GMOs but flight surgeons are in high demand, the next couple years, there will be about a 50% shortage.

 

[pgg]

You would likely be a Battalion Surgeon and take care of about 1000 very healty young men.

How's the transition from PGY1 GMOs to board-eligible/certified GMOs going?

A few years ago a residency trained guy would've been very likely to get placed at the Regiment level - with its shift toward more admin work, more med-board-pending Marines, less field time. At least compared to the battalion level billets.

 

[Ascultator]

1. Who here has done a GMO tour with the Marines?
I am doing a flight surgeon tour w/HMH-464 at New River, NC.

2. At which bases (besides Lejune, Pendleton, and Okinawa) can you be stationed?
Marine wing bases are mainly New River, NC, Miramar, CA or Beaufort, SC.

3. What's the day-to-day life like? Specifically, are you encouraged to PT with the Marines and go on field exercises, or does sick-call pretty much dominate your existence?
Sick call pretty much dominates atleast here, if you make an effort, you could probably PT w/the Marines. After sick call, you do all sorts of physicals until lunch time. Afterwards, usually I'll see squadron Marines. Typically 4-5 days a month, I will have "squadron" time.

4. What are the command environments like, in your experience?
My command is great, let me do my thing and don't really bother me or get in my business. They trust my judgement and usually almost always do what I recommend. That can vary w/command of course.

5. Is it possible to go to Benning to get your jump wings? Has anybody done this?
Not sure, doubt it. Depending on what type of squadron you are in, you can get your aircrew wings if you want to be an aerial observer.

6. When deployed as a GMO, what is your role? Is it mostly sick-call, or is there any chance of participating in higher acuity care?
I worked in a tent taking care of "sick call" for aviation Marines in Afghanistan. Nothing major, but I was proactive and volunteered at the British Role 3 Hospital and got to aid in doing some trauma there.

7. Any recommendations (besides "On Call in Hell") for further reading?
Nope

8. Any thoughts on how to best work with the detailers to get what you want?
If you want greenside, you will probably get it. Not sure about the other GMOs but flight surgeons are in high demand, the next couple years, there will be about a 50% shortage.

Sorry if this is posted elsewhere:

what is sick call like? we're talking telephone messages / urgent care / hospital admissions overnight? nothing like residency call I hope.

 

[pgg]

Sorry if this is posted elsewhere:

what is sick call like? we're talking telephone messages / urgent care / hospital admissions overnight? nothing like residency call I hope.

Sick call isn't "call" ... it's your regular, every (weekday) morning, no appointment walk-in clinic for guys with URIs, back pain, a rash, whatever. Hospital admissions are extraordinarily rare in the young AD population and GMOs don't have admitting privileges anyway so there's nothing for you to do except visit the hospital and say hello on those rare days when someone does get admitted.

Corpsmen should be doing your sick call, seeing the patients, writing up at least the first half of the note, and then presenting the patients to you. (Because in the field, they'll be doing a lot of this without you to help.)

 

[Drhenney3]

I just returned from the Southern Helmand Province, Afghanistan(11/2009-06/2010) with 4TH Light Armored Reconnaissance USMCR . I'm a USNR Hospital Corpsman(FMF). We took a CMDR(cardiothoracic surgeon, USNR Direct Commission) and a LCDR(prior AD HPSP FS). They both were in control of our multiple BAS's(Battalion Aid Station) and the LCDR was on quick reaction force and was pushed out to the "front line" during a mass casualty but nothing like "On Call in Hell" which I've read. A GMO tour will usually be boring when it comes to action but a rewarding life experience and you can support the Marines/Sailors medically.

 

[NavyFP]

How's the transition from PGY1 GMOs to board-eligible/certified GMOs going?

A few years ago a residency trained guy would've been very likely to get placed at the Regiment level - with its shift toward more admin work, more med-board-pending Marines, less field time. At least compared to the battalion level billets.

I can't see them putting a brand spankin new LT into a regimental job. I got tagged to be a regimental surgeon as an O5 with prior marine service. My regiment turned down LTs for the job. As for field time....will be off in the field for 365.

 

[pgg]

I can't see them putting a brand spankin new LT into a regimental job. I got tagged to be a regimental surgeon as an O5 with prior marine service. My regiment turned down LTs for the job. As for field time....will be off in the field for 365.

They put my brand spankin new LT classmate into the 6th Reg job a couple months after we got there. He was promoted to O4 about the same time (prior service pilot) but it looked like a rough job.

365 in the field ... ick.

Coming up on 5 years since I left the green side so I'm out of touch. 🙂

 

[NavyFP]

They put my brand spankin new LT classmate into the 6th Reg job a couple months after we got there. He was promoted to O4 about the same time (prior service pilot) but it looked like a rough job.

Yeah, but your classmate wasn't a straight off the street civilian as Auscultaor would be. Having the prior commissioned experience would make him a better candidate.

 

[pgg]

Yeah, but your classmate wasn't a straight off the street civilian as Auscultaor would be. Having the prior commissioned experience would make him a better candidate.

I guess. Prior experience as an officer sure didn't hurt, but the medical job at the Regiment level was certainly more complicated, and medically he was just like me - a couple months out of internship. At the time GMOs were still doing med boards (I'm pretty sure this has changed) and he did many more than I did. All of my sick and broken Marines got transferred to Regiment.

 

[NavyFP]

I guess. Prior experience as an officer sure didn't hurt, but the medical job at the Regiment level was certainly more complicated, and medically he was just like me - a couple months out of internship. At the time GMOs were still doing med boards (I'm pretty sure this has changed) and he did many more than I did. All of my sick and broken Marines got transferred to Regiment.

At present, I am not allowed to write boards. Apparently I have a conflict of interest as I represent the command. I have about 300 broken Marines and many REALLY need boards, but the docs at the hospital find it easier to put them on 2nd and 3rd LimDus.

 

[pgg]

At present, I am not allowed to write boards. Apparently I have a conflict of interest as I represent the command. I have about 300 broken Marines and many REALLY need boards, but the docs at the hospital find it easier to put them on 2nd and 3rd LimDus.

I'll tell ya, I felt really inadequate as a GMO writing up med boards. I think they quit letting GMOs do boards at all around 2005 or 2006?

As I recall their reason for doing so at the time was that they felt med boards should be done primarily by the specialist or subspecialist closest to the issue on the med board. Which makes some sense but they weren't often motivated to do all the leg work to get the boards processed. I was relieved when it wasn't my responsibility any more, but yeah ... progress on actually getting them done wasn't great.

 

[backrow]

At present, I am not allowed to write boards. Apparently I have a conflict of interest as I represent the command. I have about 300 broken Marines and many REALLY need boards, but the docs at the hospital find it easier to put them on 2nd and 3rd LimDus.

I forget exactly where in the ManMed it states it, probably in the Medical Boards section, haha, but I'm too lazy to look it up right now; however, only physicians assigned to MTF's may initiate Medical Boards (ie LimDu). This means any Navy physician whose orders are not to an MTF cannot do them.

This eliminates about 99% of the GMO's.

 

[IgD]

At present, I am not allowed to write boards. Apparently I have a conflict of interest as I represent the command. I have about 300 broken Marines and many REALLY need boards, but the docs at the hospital find it easier to put them on 2nd and 3rd LimDus.

How many of those are mental health? I suspect at least half of them are.

I was a Division Psychiatrist and I wrote med boards all the time. I did it because I had to and it was very effective and supported by the leadership all the way up to the MEF level. We were always very careful to give the Marines an adequate treatment trial and the benefit of the doubt. We would never write a PEB or put a Marine on LIMDU without consulting their command first to gain support.

I got some vacation time coming up, I'll come for a visit and clear up your logjams for you🙂

 

[NavyFP]

How many of those are mental health? I suspect at least half of them are.

I was a Division Psychiatrist and I wrote med boards all the time. I did it because I had to and it was very effective and supported by the leadership all the way up to the MEF level. We were always very careful to give the Marines an adequate treatment trial and the benefit of the doubt. We would never write a PEB or put a Marine on LIMDU without consulting their command first to gain support.

I got some vacation time coming up, I'll come for a visit and clear up your logjams for you🙂

Our division psych can and does write boards, but the Current CO at the Naval Hospital, who is the local convening authority, requires specialists to do the boards and as a lowly FP, alas, I am not a specialist. It is a mess, but grinding through it.

 

[IgD]

Our division psych can and does write boards, but the Current CO at the Naval Hospital, who is the local convening authority, requires specialists to do the boards and as a lowly FP, alas, I am not a specialist. It is a mess, but grinding through it.

So are you a Regimental Surgeon?

I remember that fitness for duty stuff very well. A lot of what we had to do was liaison with the MTF docs to coordinate care to discuss limited duty, med boards etc.

 

[NavyFP]

So are you a Regimental Surgeon?

I remember that fitness for duty stuff very well. A lot of what we had to do was liaison with the MTF docs to coordinate care to discuss limited duty, med boards etc.

Yep, Regimental. This is a new phenomenon. When I was in Group a number of years ago, boards were not an issue like they are today. We did have a change of command at the hospital, so this may change.

 

[NeuroJ]

Random question pertaining to Navy GMO/FS billets: do docs assigned to Marine aviation units go through FS or FMF training? Both?

Does anyone know any HPSP recipients who have done 2 years of FS, then go greenside for the last 2 years of their payback? Or is that something that USUHS grads are more likely to do since they have more payback time?

 

[Jet915]

Random question pertaining to Navy GMO/FS billets: do docs assigned to Marine aviation units go through FS or FMF training? Both?

Does anyone know any HPSP recipients who have done 2 years of FS, then go greenside for the last 2 years of their payback? Or is that something that USUHS grads are more likely to do since they have more payback time?

All flight docs will go through FS. FMF is optional for officers, required for corpsmen. I got my FMF as well as my naval aircrew wings out in Afghanistan. Alot more time to learn about Marine Corps doctrine there than CONUS where there isn't much time w/all the sick call and admin. A good number of FS just finish all their paypack and get out ie extend their orders. Because of the huge FS shortage coming up, all orders are gladly extended if wanted.

 

[IgD]

Our division psych can and does write boards, but the Current CO at the Naval Hospital, who is the local convening authority, requires specialists to do the boards and as a lowly FP, alas, I am not a specialist. It is a mess, but grinding through it.

Thinking about this more, you might be able to force their hand. If you had a Marine with 3 consecutive LIMDU boards you could write a med board outlying the treatment course and diagnosis. This would force the subspecialists to write addendums to the board.

 

[pgg]

Random question pertaining to Navy GMO/FS billets: do docs assigned to Marine aviation units go through FS or FMF training? Both?

What do you mean by FMF training?

The Fleet Marine Force qual for the warfare device (what Jet915 was talking about)? Anyone can do that if they've got the time, inclination, and can tick off the requirements. Lots of docs do it while deployed.

Or Field Med Service School (2 week class new greenside GMOs take before reporting to units - an abridged and slightly different version of the one new Corpsmen take)? I don't think greenside flight surgeons have to go through field med. At least, there weren't any FS guys in my class, and I think the physician course is only offered once per year.

 

[NeuroJ]

pgg and Jet915, thank you for your answers.

I typed out "FMF" not knowing if docs had to go through FMSS/FMSO.

Is FMSS/FMSO strictly for those who finished at least internship, or can that be used as one of the ADTs for HPSP/USUHS? I thought that the Marines were more wary of who they call "Doc", hence it seems to me that FMSO for medical students might be a premature rotation unless the student knows that serving greenside is the ultimate goal.

(I'm not sure if I read that somewhere in this forum, but I think second year ADTs can be done doing dive research, aerospace research, FMSO, or school orders......however I haven't seen any more info besides the single page on the NOMI aerospace med site.)

 

[pgg]

Is FMSS/FMSO strictly for those who finished at least internship, or can that be used as one of the ADTs for HPSP/USUHS?

[...]

(I'm not sure if I read that somewhere in this forum, but I think second year ADTs can be done doing dive research, aerospace research, FMSO, or school orders......however I haven't seen any more info besides the single page on the NOMI aerospace med site.)

Apparently it's possible for med students to arrange to take the field med school class. We had a short discussion about it a while ago.

I wouldn't waste an elective as a student there, but others see it differently. YMMV.

 

[Gastrapathy]

Apparently it's possible for med students to arrange to take the field med school class. We had a short discussion about it a while ago.

I wouldn't waste an elective as a student there, but others see it differently. YMMV.

This can't be a med school rotation. What a waste of tax dollars and time.

 

[NeuroJ]

Gastrapathy.., do you believe so b/c the training would be too far in advance from actual time of deployment? I would figure it might be a factor in influencing a student to go greenside and get a small taste of what a GMO tour with the Marines would be like.

When I do a google search for "navy hpsp research ", a nice word document pops up listing a number of possible research rotations. It lists FMSO as one, specifically pointing to Lejeune (I guess Pendleton isn't available). However, not much more info int terms of the FS rotation.

 

[pgg]

This can't be a med school rotation. What a waste of tax dollars and time.

To be frank, I thought it was mostly a waste of tax dollars and time when I took it as a GMO.

I took the class in 2003 and my memory is fading, but I don't think there was anything important that my battalion Chief didn't/couldn't teach me. Field sanitation, gear familiarization, overwrought "you're a doctor AND and officer" talks, etc.