Reality of Military Medicine

[preMedDonut]

Hey all,

I am pretty sure this is the right place to ask/post this and I looked at the stickys above, but most of them are very outdated. Now with budget cuts and Obama making a rampage on the military side I just would like some recent thoughts on military medicine and my choice. I was in the Marine Infantry and did all that jazz and looking at applying to medical school next summer. I was leaning towards the HSPS program ( not USUHS, I can't do 7 years after...nooo way) if my Vocational Rehabilation, Chapter 33, doesn't pay for medical school.

Now coming from a the infantry side of things, I don't mind deployments. Hell, sometimes I wish I could go back. I was looking more into the political side of things. Even as a E-3,E-4 I saw so much of it in the military that I couldn't take it anymore. How are your own supervisors? That's one thing that the military always seemed to do: get the horrible leaders and the good ones would leave. On another note, do you feel the government skimming down on your pay/training/facilities?

One last thing, as prior enlisted, I always looked at the officers with a glowing radiance (except for the boot Lts). Do you feel you get treated that same way? I know this may seem more egotistical but as a leader of my own and someone that loves to cultivate and motivate relationships I would still like that ability to be looked up on and help other peers and colleagues.

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[tabascosauce]

the love you take is equal to the love you make.

 

[Kilgoretrout 65]

As far as being treated with glowing radiance? I keep waiting for that but all I get is another email saying my computer training is overdue. The lack of subordinates doing what you perceive as their job would undoubtedly drive a Marine crazy. The current budget crunch is being felt and could possibly impact your education depending on where you do residency. It is also possible that the bonus and retirement structure will be remade in the interest of some crazed politicians. As far as leadership? I have had more good bosses than bad but those bad ones do stand out in my mind. Good luck.

 

[TheTruckGuy]

If you're planning on doing Navy HPSP, I would look into Navy HSCP instead. If you go to a school with a low tuition ($25,000/year or less) and especially if you have a family, it would be worth financially while in school. I think you might get paid more because of your prior service while in school, and time in med school will also add to your time in service for when you commission.

 

[bobbyseal]

How are your own supervisors?

On another note, do you feel the government skimming down on your pay/training/facilities?

One last thing, as prior enlisted, I always looked at the officers with a glowing radiance (except for the boot Lts). Do you feel you get treated that same way?

Some are good, some are bad. I mostly just want to be left alone to practice. My current DSS is all fired up about passing out BS collaterals. He probably got passed over and is passing his misery upon the rest of us.

Gov't sure is skimming down. I've heard that there are 10 year cycles of military funding booms/busts. We just finished a long cycle of military funding boom, and now we are in for a decade of bust. Another boom is probably on its way down the road.

As for glowing radiance, I could care less. I would be ecstatic for some consistent performance. I am still looking for my "second" day on the job because it seems like everyday is my first day here. No one seems to remember how I like to do things.

 

[orbitsurgMD]

It is 50 first dates all around.

 

[Shikima]

Have you considered taking your active duty time and convert it to Federal Service while going to work at the VA? If you still want to wear a uniform, you can join the reserves afterwards.

 

[Gastrapathy]

First time everytime.

 

[goamerica]

long time lurking will start posting on mil med.

I am a resident, Navy reserve. I wanted to chime in. I agree "100% with the love you get is the love you give response." The program for navy has you drilling twice a year in residency so your distant from the detachment. If you respect what the enlisted guys do and try to take care of them its a nice relationship. In other words, if a guy is trying to brake into pharmacy school you can offer to set him up with a pharmacist at the hospital to get some experience etc... Then its not as callous when they are running all over the place and calling places to find the last hep A vaccine shot for you etc or get your basic stuff done when your not at drill... Some look up to your because your a doctor, some don,t and most don't care.

I can only speak from my own experience in my own detachment but I would say the most awkward dyamic is among the NC and the MSC. There are alot of people who don't understand medical residency and hold a small but present general animosity that you come in 0-3 with a double standard. It's very possible you will get promoted faster to 0-4. (ie it's happening in our unit right now). And we know Its probably not unheard of that some MD in the civ world is a tool to them. This has been stated in other forums but you have 0-5 or even 0-4 nurses who run your life in the detachment which can be annoying. In all fairness, the 0-6 MD leader for my specialty specifically approached me and stated if anything unfair is happening so that they can have a checklist knocked off for some more shoulder weight to let him know. It becomes a strain on residency and he would speak to them and take care of it. Its never come to that at all.

All in all my experience has been extremely positive (still in residency). You just have to want to be there or these things will bother you as you ride to retirment or a paycheck etc..

 

[preMedDonut]

the love you take is equal to the love you make.

Interesting?

Some are good, some are bad. I mostly just want to be left alone to practice. My current DSS is all fired up about passing out BS collaterals. He probably got passed over and is passing his misery upon the rest of us.

Gov't sure is skimming down. I've heard that there are 10 year cycles of military funding booms/busts. We just finished a long cycle of military funding boom, and now we are in for a decade of bust. Another boom is probably on its way down the road.

As for glowing radiance, I could care less. I would be ecstatic for some consistent performance. I am still looking for my "second" day on the job because it seems like everyday is my first day here. No one seems to remember how I like to do things.

Thanks for your insight! It's interesting that everyone else has said the same things concerning it's the same day over and over again. I know I, as a veteran, have been hit by this 10 year bust already so not really looking forward to the next 6-7 years.

Have you considered taking your active duty time and convert it to Federal Service while going to work at the VA? If you still want to wear a uniform, you can join the reserves afterwards.

Wow I have not heard about this at all! The only thing is that I should of mentioned I am already honorably discharged. Will it affect this and do you possibly have a link (forum topic or official site) so I know more of what you are talking about.

It is 50 first dates all around.

First time everytime.

Doesn't really sound like fun to me, thanks for your insights though, I do appreciate it.

 

[colbgw02]

Wow I have not heard about this at all! The only thing is that I should of mentioned I am already honorably discharged. Will it affect this and do you possibly have a link (forum topic or official site) so I know more of what you are talking about.

Don't have a link, sorry, but it shouldn't be a problem. My understanding is that you "buy back" your years of military service in order to apply them toward a GS position. Typically, the sooner you buy them back after separating, the less expensive it is, but it could still be worthwhile.

As to the OP...

I feel like there's going to be a rapid increase in the BS factor as the military returns to a garrison force, which is unfortunate for physicians because so little of it is relevant to our jobs. I also have a very sour taste in my mouth regarding financial austerity. Contrary to what some commanders think, you really can't do less with more, and it's frustrating to have to navigate more and more administrative hurdles set up in the name of penny pinching just to maintain adequate access to care.

Officership in the medical corps is a different animal from what you're used to. Rank correlates relatively loosely with experience in the medical corps. So you can't really assume too much about an officer based on his rank. In contradistinction, one knows a good deal about - oh, let's say - a (Army) major in the infantry solely based on rank. That guy will have led a platoon, been a company commander, served as a battalion staff officer, and there's a good chance he's either been or will be a battalion XO. On the other hand, a major in the medical corps could be anyone from an intern who got promoted due to prior officer credit to a fellowship-trained staff with years of experience. Both deserve respect, but they're worlds apart, which explains why sometimes I have to over-rule a LTC (I'm a junior MAJ).

I think what's more instructive (and more frustrating) is how we're treated as compared to our civilian counterparts, and I think being a military doc falls way short in the respect-o-meter there. I've seen ancillary staff freely talk back to attendings at MTFs in a manner that would have gotten them an immediate pink slip on the outside. They can do it and get away with it because firing a GS employee takes an act of Congress and everyone knows it.

 

[UltimateDO]

Officership in the medical corps is a different animal from what you're used to. Rank correlates relatively loosely with experience in the medical corps. So you can't really assume too much about an officer based on his rank. In contradistinction, one knows a good deal about - oh, let's say - a (Army) major in the infantry solely based on rank. That guy will have led a platoon, been a company commander, served as a battalion staff officer, and there's a good chance he's either been or will be a battalion XO. On the other hand, a major in the medical corps could be anyone from an intern who got promoted due to prior officer credit to a fellowship-trained staff with years of experience. Both deserve respect, but they're worlds apart, which explains why sometimes I have to over-rule a LTC (I'm a junior MAJ).

I think what's more instructive (and more frustrating) is how we're treated as compared to our civilian counterparts, and I think being a military doc falls way short in the respect-o-meter there. I've seen ancillary staff freely talk back to attendings at MTFs in a manner that would have gotten them an immediate pink slip on the outside. They can do it and get away with it because firing a GS employee takes an act of Congress and everyone knows it.

True that...nothing like being a senior resident CPT supervising my O-6 intern doing a second residency and flogging him in the MICU. It was surreal, and possibly mindblowing for a prior service.

Totally agree with the second point...especially since hearing rumors that hospital commanders are going to soon be line officers due to MC "f'ing up" the MTFs. Reasons I am going operational......

 

[Slevin]

True that...nothing like being a senior resident CPT supervising my O-6 intern doing a second residency and flogging him in the MICU. It was surreal, and possibly mindblowing for a prior service.

Totally agree with the second point...especially since hearing rumors that hospital commanders are going to soon be line officers due to MC "f'ing up" the MTFs. Reasons I am going operational......

So are you doing a GMO your and then getting out and going Civ side?

 

[haujun]

and I think being a military doc falls way short in the respect-o-meter there. I've seen ancillary staff freely talk back to attendings at MTFs in a manner that would have gotten them an immediate pink slip on the outside. They can do it and get away with it because firing a GS employee takes an act of Congress and everyone knows it.

Yeah, we (military docs) are called providers and we are just here to provide service. I criticized a RN (contractor) and my nurse supervisor was not pleased...

 

[Kingfisher]

I think what's more instructive (and more frustrating) is how we're treated as compared to our civilian counterparts, and I think being a military doc falls way short in the respect-o-meter there. I've seen ancillary staff freely talk back to attendings at MTFs in a manner that would have gotten them an immediate pink slip on the outside. They can do it and get away with it because firing a GS employee takes an act of Congress and everyone knows it.

Especially the GS employee.

 

[d2305]

I would rather have a line officer as a CO than a nurse.

 

[Kingfisher]

I would rather have a line officer as a CO than a nurse.

It's kind of like asking whether you would like to either get punched in the face or punched in the nut$.

With the line you get the leaders who don't understand or care about how you do business but still respect what you do.

With the Nursing Corps you will likely get that nurse who was working that night on call when you were an intern and thought it would be a good idea to give oral magnesium repletion in large amounts to the the severely obese patient with limited mobility. "It's payback time!"

 

[Kingfisher]

True that...nothing like being a senior resident CPT supervising my O-6 intern doing a second residency and flogging him in the MICU. It was surreal, and possibly mindblowing for a prior service.

Totally agree with the second point...especially since hearing rumors that hospital commanders are going to soon be line officers due to MC "f'ing up" the MTFs. Reasons I am going operational......

Ultimate DO

Your quote from Winston Churchill has always been one of my favorites. However, thanks to YouTube and a program on it called "Mental Floss", I have learned that it was actually his assistant that said that. Bummer

 

[Mirror Form]

I would rather have a line officer as a CO than a nurse.

Hmm, that's a tough call. Military medicine is already completely focused on metrics. At least most nurses have some small clue about patient care. I don't even want to think about what a disaster it would be to have some of the super idiot MSC officers I've met put in charge of a hospital. No doubt their main objectives would be things like APFT, drill & ceremony, etc.

 

[NavyFP]

I would rather have a line officer as a CO than a nurse.

As long as they are not bucking for a star...agree. Line guys know they don't know my job.

 

[UltimateDO]

As long as they are not bucking for a star...agree. Line guys know they don't know my job.

Hmmm, how many O-6 hospital commanders are NOT going to be bucking for a star?

 

[UltimateDO]

Ultimate DO

Your quote from Winston Churchill has always been one of my favorites. However, thanks to YouTube and a program on it called "Mental Floss", I have learned that it was actually his assistant that said that. Bummer

now I have to change it

 

[UltimateDO]

So are you doing a GMO your and then getting out and going Civ side?

I have a unique opportunity operationally that will allow me to moonlight to maintain skills and will re-eval mil med when ADSO is up. Going to try to swing a civ sponsored fellowship once I get some leverage...we'll see

 

[NavyFP]

Hmmm, how many O-6 hospital commanders are NOT going to be bucking for a star?

For the line, there are a lot of commands where it is the accepted truth that you are not in the running for a star. If we had line guys in these billets, those would not be kingmakers.

 

[UltimateDO]

For the line, there are a lot of commands where it is the accepted truth that you are not in the running for a star. If we had line guys in these billets, those would not be kingmakers.

Though that might be reality...they may not percieve it as such. If they made O-6 on the line, there is a decent likelihood they still have the mentality that "just one more OER bullet" that might be hard to break out of.

 

[d2305]

My best CO at a NH was a HCA, and the worst was a Preventive Medicine MC who never practiced medicine past residency. I did have an excellent OIC nurse at a BMC, but that was a fluke.

 

[zeedarkjster]

Hello long time lurker. Thought this would be a good place to post my question:
Unlike premeddonut, I'm a straight up "square" civi haha

What would you guys recommend to a civi to get a feel for military life?
Is there any advice or tips to avoid the gripes about in milmed (I've read many of the stickies and posts by 61Nov., pgg, etc.? Or are the just simply out of your hand and you have no say? (such as doing a GMO and loosing your internship skills)
My only experience is being a civilian premed aboard the USNS Mercy for 2012 in Vietnam and Cambodia, which I DO Understand is considered a cruise versus other Naval vessels. After talking to many of the physicians who were on HPSP or USUHS there seems to be a mixed result of likes and dislikes. The posts on here pretty much emulate the pros and cons on this forum.

I was accepted again to be a team lead (whatever that means) for 2013, but due to the sequester this mission was cancelled. I would have loved to have traveled to Central America, but more so the opportunity to talk to more physicians about their experience in HPSP or milmed.
Any idea what I can do to understand if I'm cut out for the lifestyle of the military?

 

[BOHICA-FIGMO]

I would rather have a line officer as a CO than a nurse.

Mega, mega, dittos, kind sir!!!!