Realization

[BigNavyPedsGuy]

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So I was able to define it the other day:

I want to want to stay in the military.

It's just really frustrating that I can't think of any possible scenario for my (long-term) career goals to match the Navy's needs and vice versa.

 

[crazybrancato]

So I was able to define it the other day:

I want to want to stay in the military.

It's just really frustrating that I can't think of any possible scenario for my (long-term) career goals to match the Navy's needs and vice versa.

i misread your op. i see you want to want to stay in. well im not sure what your long term goals are exactly. what's your commitment? in any case, stay in or get out, at least you served. there's no shame in getting out . . . everybody (including the CNO) get's out eventually. if everybody stayed in, the military would go bankrupt

im a little curious about your career path, b/c im interested in peds. were you usuhs or hpsp? have you already done your peds residency? or are waiting to do it after your GMO? and is it hard to get a sea GMO billet?

 

[The White Coat Investor]

So I was able to define it the other day:

I want to want to stay in the military.

It's just really frustrating that I can't think of any possible scenario for my (long-term) career goals to match the Navy's needs and vice versa.

I want the military to want me to stay in.

 

[IgD]

I was talking about this with a former colleague yesterday. It's like a domestic abuse cycle. We are like the battered spouse. The military medical system abuses us repeatedly but every once and awhile throws us a bone. We want to stay in the relationship. We are convinced we can fix it or things will change. After awhile the abuse gets comfortable.

It was very difficult for me to leave the military. Just ask my wife🙂 She wanted to hit me over the head repeatedly.

 

[edmadison]

I want the military to want me to stay in.

That's it, right there.

 

[CodeBlueMD]

I was talking about this with a former colleague yesterday. It's like a domestic abuse cycle. We are like the battered spouse. The military medical system abuses us repeatedly but every once and awhile throws us a bone. We want to stay in the relationship. We are convinced we can fix it or things will change. After awhile the abuse gets comfortable.

It was very difficult for me to leave the military. Just ask my wife🙂 She wanted to hit me over the head repeatedly.

Nail on the head.

 

[Kingfisher]

So I was able to define it the other day:

I want to want to stay in the military.

It's just really frustrating that I can't think of any possible scenario for my (long-term) career goals to match the Navy's needs and vice versa.

Is this because the military thinks of its pediatricians as internists that only work with kids in certain billets?

 

[AF_PedsBoy]

Don't you mean administrators that only work with kids in certain billets? Air Force is down to two programs now, woot! Wright Patt or Wilford Hall hmmmm....

 

[BigNavyPedsGuy]

Is this because the military thinks of its pediatricians as internists that only work with kids in certain billets?

No. It has little to nothing to do with being a pediatrician. It's a medicine in general thing. Some aspects of it are peds related (obviously given my screen name) but for the most part it's just general stuff.

 

[orbitsurgMD]

No. It has little to nothing to do with being a pediatrician. It's a medicine in general thing. Some aspects of it are peds related (obviously given my screen name) but for the most part it's just general stuff.

Congratulations, you're expendable. The Navy really doesn't value you because you are replaceable by the same methods you were obtained, the HPSP. Since there is no penalty to them if you leave, happy or not, and another bulb in the box for the socket you are in (metaphorically, they hope), they will just screw someone else into your job.

The Navy and others services really don't suffer the loss of disappointed GMOs. Magic budget money--that can't be used for anything else anyway--trains those doctors out of sight in civilian institutions. All they have to do is ensure that everyone becomes license-able under the minimum terms available and that there are enough warm bodies to fill the operational side demands. Filling the training slots at PGY2 and above is the least of their worries as there are relatively few of them to begin with compared to internship and GMO slots. You being wanted, appreciated for your sacrifice of delay to your training, or being happy, doesn't fit into their equation.

The only way there becomes a problem is if there aren't enough raw numbers of accessions (they don't even complain much that the quality has dropped to "any willing applicant" levels, go figure) or if some authority outside their self-certifying circle says using incompletely-trained doctors who have been denied opportunity for full residency training is unethical and thus forbidden.

A little while back, poster i want out posed a hypothetical that the Navy might offer wholesale FP training (too bad if you had your heart set on ortho) which you might have to refuse and which by refusing you might find yourself legally declaring yourself to be adequately trained for your assignment (one you had not done, so how would you know?) With the crummy ethics I know the Navy medical department to operate under, and the way I know they treat professionals in their employment, I would not put it past them. They are that mendacious.

 

[notdeadyet]

They are that mendacious.

mendacious: adjective - not truthful; lying or false

(to save others the time. I know I had to look it up)

 

[BigNavyPedsGuy]

Congratulations, you're expendable. The Navy really doesn't value you because you are replaceable by the same methods you were obtained, the HPSP. Since there is no penalty to them if you leave, happy or not, and another bulb in the box for the socket you are in (metaphorically, they hope), they will just screw someone else into your job.

The Navy and others services really don't suffer the loss of disappointed GMOs. .

I actually have every intention of going back and finishing my residency in the Navy (keep in mind that my residency won't incure more payback- would I rather pay it back as a pediatrician or a GMO . . . pretty easy) I'm talking beyond that, about the lack of fellowship availability, about the lack of practice choice, about the lack of control, about the lack of all kinds of things.

I have a peds subspecialist friend (Neo) that now only makes 3K a year more than a general pediatrician and literally works 80hours a week with constant threat of deployment. The day she gets out she can double or triple her salary and work half the hours. She can be with her family and choose where to live.

I want to want to stay in, but with all of that against it, I just can't make it make sense in my head.

IgD's analogy is a good one. It is so possible that things could work out great long term. But an abuser is an abuser.

 

[crazybrancato]

well just do what you're thinking . . . go back and finish up your resid, finish your payback and get out. nothing wrong with that. if you make a commitment to the military and you've paid it back, there's nothing wrong with making the decision to get out. I did that once!

What is wrong is becoming that jaded crazed dude, who makes it his sole ambition in life to deter others from service, always bad-mouthing our military/gov't and never rationalizing that military service (in whatever job) may fit some people's needs and particular circumstances . . . don't become that jaded guy.

do your time, get out, voice your constructive criticisms, and be proud of your service.

 

[orbitsurgMD]

well just do what you're thinking . . . go back and finish up your resid, finish your payback and get out. nothing wrong with that. if you make a commitment to the military and you've paid it back, there's nothing wrong with making the decision to get out. I did that once!

What is wrong is becoming that jaded crazed dude, who makes it his sole ambition in life to deter others from service, always bad-mouthing our military/gov't and never rationalizing that military service (in whatever job) may fit some people's needs and particular circumstances . . . don't become that jaded guy.

do your time, get out, voice your constructive criticisms, and be proud of your service.

And whatever you do, don't become the apologist for bad policies, always rationalizing one way or another how dissatisfaction with mil/gov is really only the result of a flaw in a particular individual, as if service on any terms were inherently something good and above criticism.

Whatever you do, don't become that apparatchik guy.

 

[crazybrancato]

And whatever you do, don't become the apologist for bad policies, always rationalizing one way or another how dissatisfaction with mil/gov is really only the result of a flaw in a particular individual, as if service on any terms were inherently something good and above criticism.

Whatever you do, don't become that apparatchik guy.

I knew I'd bait someone! Anyway . . . I agree with you! Nothing in the gov't is above criticism . . . should be criticized, should be kept in check. At least in our gov't, we have means to criticize. Do you think a forum like this exists in China?! hell no.

 

[crazybrancato]

This is a common comment intended to make our system look good, but ultimately it's silly.

The existence of dissent does not validate the system.

The responsiveness of the system to the dissent validates it.

I agree with you. the existence of dissent is a good thing . . .responsiveness is the next step

Yes, there are forums like this in China, though they are underground.

no actually, there aren't. The Chinese gov't goes to great lengths to shut down any servers in their country that host websites like this one . . .they also go to great lengths to restrict access to foreign websites. we have plenty of intel on this (if you have sipr access, google about it sometime on intelipedia, it's pretty startling! by 'shutting down servers', i mean they take out the whole building, civilians inside and all)

In China, the criticism is ignored and the authors punished. In America, the criticism is ignored and the authors are tolerated.
Same end result.

agree/disagree somewhat. sometimes the criticism is ignored, but change does happen in our military/gov't, although sometimes at a snail's pace.

 

[notdeadyet]

The existence of dissent does not validate the system.

The responsiveness of the system to the dissent validates it.

Yes, there are forums like this in China, though they are underground.

In China, the criticism is ignored and the authors punished. In America, the criticism is ignored and the authors are tolerated.

Same end result.

I don't always agree with you Tired, but this is as spot-on a summary of the problem as I've seen in a long time...

 

[Galo]

agree/disagree somewhat. sometimes the criticism is ignored, but change does happen in our military/gov't, although sometimes at a snail's pace.

It's this snails pace, or "glacial" as it was once quoted to me by the deputy to the surgeon general, that is one of the "nails on the coffin" of milmed. (an indirect quote from the 0-6 duschbag who made our collective live's hell for 2 years). That slow pace is not a good fit for medicine, ever!