Questions re: Navy Anesthesia and more

[Disse]

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Hello,

I used to be a frequent ghost of these forums during medical school but stopped visiting during residency. However, lately I have been keeping up with a few of the forums as time allows—particularly this one—and was wondering if anyone could help answer a few questions regarding Navy anesthesia.

Some background on me, I am a soon-to-be CA-3 currently in NADDS and will also be continuing my deferment for fellowship training (pain). I have communicated a bit with my specialty leader but was hoping to have some additional “voices” that could provide me some information on what I can expect when I enter the fleet in a few years (2007).

1st set of questions: I was basically told by my specialty leader that being fellowship trained I will likely be stationed at the three major Navy tertiary care centers (SD, Portsmouth or Bethesda). Is this true? Additionally, I was told that I would not be required to participate in either cardiac or peds cases unless I have additional training or a strong desire to participate? Is this also true (this is important because of the schedule I’ve made for my CA-3 year)? Furthermore, I’ve also been told that as the low man on the totum pole I can pretty much guarantee being deployed, which makes me wonder were (ship etc.) I’d be deployed and for how long (having two young kids this worries me the most). Also, is there anything I can do to “help” decide which coast I’ll be stationed on (wife has a strong preference)?


2nd set of questions: What type of cases do you usually perform in the Navy? And what type of cases do you usually perform while on-call? Similarly, how is OB covered (same or different call team)? As a pain doc I know I’ll be in clinic as well as the OR…anyone know what the split between the two generally is?

Last set of questions: Congeniality. Currently at my residency we have CRNA’s with which we (attendings and residents) have a fabulous relationship with. Is this similar in the Navy or are things more antagonistic (just curious). Finally, is there anything you wish you had done to prepare or wish you had known prior to entering the fleet that you’d like to share?

Thanks in advance to any information (hopefully someone can answer some of these as I know there is at least one ex-Navy anesthesiologist floating around here) as well as providing some interesting reading to a forum ghost!

 

[militarymd]

First off, I was a Navy anesthesiologist for 11 years. I was fellowship trained in CCM, and was stationed at one of the big 3's for 5 years.

1) You will most likely be stationed at one of the big threes.

2) Location (east vs west coast) will be dependent on which coast has shortages.....you have no control unless both coasts are evenly manned.

3) As the low man on the totem pole.....expect to be deployed....any platforms....you have no say....however, as a subspecialist, you will most likely be spared.....a non-subspecialist will be sent first.

4) all types of cases will be performed....be prepared to do all types of cases

5) CRNA relationships are center dependent. NMCP was good.

 

[Monty Python]

First off, I was a Navy anesthesiologist for 11 years. I was fellowship trained in CCM, and was stationed at one of the big 3's for 5 years.

1) You will most likely be stationed at one of the big threes.

2) Location (east vs west coast) will be dependent on which coast has shortages.....you have no control unless both coasts are evenly manned.

3) As the low man on the totem pole.....expect to be deployed....any platforms....you have no say....however, as a subspecialist, you will most likely be spared.....a non-subspecialist will be sent first.

4) all types of cases will be performed....be prepared to do all types of cases

5) CRNA relationships are center dependent. NMCP was good.

I've been a Navy reserve CRNA for 10 years and, from my perspective, thoroughly enjoyed everything about it. I'm hoping to start med school next August on HPSP scholarship (despite all the moaning and groaning about it on this forum - I know full well what I'm getting myself into both good and bad).

I've been almost everywhere in Navy anesthesia: all over CONUS, Iceland, Guam, Naples Italy, and aboard the USS Geo Washington as the sole provider. I have seen absolutely nothing but completely collegial, supportive, respective, and helpful MDA/CRNA relations - we're all in this together and we help each other out. No politics over AAs, reimbursement, TEFRA compliance etc etc.

For further information on your above questions (which I can't answer) let me provide you with two names. Sorry I don't have their emails handy but their work phone numbers are easily obtainable going through the hospital switchboard.

== Current specialty advisor for Navy anesthesiology: CDR Ivan Lesnik at USUHS.

== His immediate predecessor, CAPT Scott Tezza at NavHosp Pensacola. He's about to retire so don't wait too long to contact him there.

 

[Disse]

Thanks for the replies. I've been lucky enough to have been in contact with both CAPT Trezza (during the app. process for residency) as well as CDR Lesnik (during app. process for fellowship). Both have been extremely helpful. However, it is always useful to get as much information from as many different individuals as possible 🙂

militarymd, if you (or anyone else) could explain what this means I'd appreciate it:
"expect to be deployed....any platforms"

Thanks again for the replies.

 

[militarymd]

"expect to be deployed....any platforms"

Which ever duty station you ultimately get orders to, it will be your secondary duty station. Your primary duty station will be some operational platform....mine was CRTS and on "loan" to NMCP...meaning a LHD ship...that "loans" you to your hospital.

It could be with the marines, aircraft carrier, fleet hospital...etc.

and in this day and age, they may change that, and deploy you as fill in for any other platform.

 

[GMO_52]

Which ever duty station you ultimately get orders to, it will be your secondary duty station. Your primary duty station will be some operational platform....mine was CRTS and on "loan" to NMCP...meaning a LHD ship...that "loans" you to your hospital.

It could be with the marines, aircraft carrier, fleet hospital...etc.

and in this day and age, they may change that, and deploy you as fill in for any other platform.

We see "augmentees" of various stripes out here in the fleet all the time, but here are where I've seen anesthesia providers recently:
1. Forward Surgical Unit in Iraq/Afganistan (FRS, Fleet Hosp, CASH, FSSG, etc)
2. Fleet Surgical Team/CRTS (assigned to a large deck amphib (LHA/LHD) and deployed on that unit, has always been a CRNA in my limited experience who was actually sent but I'm sure that's not a rule)
3. Aircraft Carrier Medical Dept.
4. random strange places backfilling for someone who went to one of the above.