Reserves vs Guard

[Groove]

Ok, my apologies if this topic has been worn into the ground but I was wanting some opinions and clarification after talking to an army guards recruiter today.

Here's my situation and my long term goals. I'm 36, have about 2 yrs left in an EM residency and have always wished to serve my country. Every male in my family has served and I would be the first who didn't. That being said, I don't desire active duty, nor do I plan on remaining in the military for 20 yrs for retirement. I have an enormous amount of med school debt, but have researched the incentives to know that financially I do not come out ahead by joining the military, however, the incentives should keep it from becoming a complete financial mistake. So... I'm at the point where I'm pondering the advantages of National Guard vs Army Reserves. I have no prior service, which if I understand correctly, automatically dictates 8 years total of service or commitment. The financial incentives seem very similar to the point where I can't really tell a clear advantage of one vs the other. I'm not particularly interested in a stipend during residency since I can moonlight at this point.

Ultimately, I want to practice as a civilian EM physician, but I want to be active in the military. Deployment doesn't bother me, but at the same time I'd rather it not be 3-4 months every year. That takes a severe dent on my financial income, with or without the LRP. I'd also be interested in any military specific specialized training for physicians that could possibly change the context of how I was utilized when deployment occurred. I have no idea if this is possible, nor did the recruiter.

When I finally just asked him the primary differences from a physician joining the guard vs reserves, he just basically boiled it down to the fact that I could have drill in other states or another part of the country every month where I'd have to fly there if I wasn't attached to a unit nearby.

Philosophically, I find the Reserve more appealing than the Guard, but can someone break down for me the simple differences for someone like me that would help me decide which pathway to choose?

The incentives seem similar, the deployments seem similar, what's the catch?

Also, I'm afraid that future employers will not want to hire me as an EM doc since I would be military and therefore subject to deployment at any time. I'm not really concerned with losing patients because again, I'm EM, so it's not like I get referrals.

Any help would be appreciated. Apologies if this has been discussed before, but I've read through countless threads and I can't really find what I'm looking for. Thanks.

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[DeadCactus]

Main big picture difference between the two is that the Guard can be deployed by the state for local emergencies while the Reserves are only federal.

For physicians, my understand is that the major difference would be that:

1) Guard physicians generally deploy to fill GMO/FS roles at aid stations while Reservists generally fill in as specialists at hospitals either in theater or in the US (filling in for active duty physicians who deployed to the theater). Probably a big deal for a Cardiologist or Urologist. I wouldn't think it makes as big of a difference for an EM physician.

2) Guard physicians drill with their line unit, doing mostly things like physicals. Reservists drill at medical units working in a hospital or clinic type setting.

Basically, the Guard is mainly the combat arms portion of the reserve component and so their physicians are filling roles within those units. The Reserve mainly houses the support infrastructure and so their physicians generally in a medical unit.

The Guard is a good choice if you want to be the unit physician "taking care of the team" and want to (or at least don't mind) deploying to helping stateside in a natural disaster. The Reserves are a good choice if you want to be a physician in a military hospital and don't mind being "deployed" to an Army base in the US.

That's my interpretation based on the briefings and information I've been given.

There probably will be people weary of hiring you with a Guard commitment. You'll have to limit your employment to larger groups that can absorb the burden of you being randomly gone for a few months.

If the potential for a 15 month deployment or is a deal breaker for you, you may want to reconsider joining. I would count on deploying at least 4 months out of ever 2 years (the current policy) and be accepting a 15 month deployment as a remote but possible situation...

 

[penguinluvinman]

Thanks! I have been looking for the main differences as well, and that is one of the best explanations I've come across.

 

[Groove]

Thanks, very helpful.

 

[notdeadyet]

Nice summary, DeadCactus. I have little to add to this.

Another difference is that in the Guard, you are eligible for stateside missions, which you will not see with the Reserve. Another difference is that you'll likely find that the bureaucracy of the National Guard (while sometimes weary-ing), is a lot more palatable than you find with the Reserve.

 

[MTGas2B]

I've kind of wondered about this. Convenient this thread came up.

So, what does the guard do with prior service non-primary types if they try to transfer in after active duty? Say for example anesthesiologists?

 

[notdeadyet]

So, what does the guard do with prior service non-primary types if they try to transfer in after active duty? Say for example anesthesiologists?

The Guard doesn't use anesthesiologists or radiologists or the like. If you're in one of these specialties, your choices are to go into the Reserve, or serve in the Guard as Battalion Surgeon or Flight Surgeon.

 

[Groove]

So, I'm still having a difficult time deciding between the two. The incentives seem very similar, almost identical.

It seems that the Guard comprises most of the combat arms units, and Reserves is more support...which leads me to another dilemma. From a physician standpoint, working a medical unit seems that it would be more stimulating vs doing physicals or responsible primarily for the health within my Guards unit. Also, I'd like to be deployed overseas, but fulfilling that obligation by being deployed stateside in a military hospital isn't that bad either.. At least my wife would be able to travel with me in that event.

Does a physician in the Reserves get deployed THAT much more frequently vs the Guard?

I'm interested in getting some non-medical training, jumping out of planes, etc.. , some combat training, etc.. Would I be able to do that just as easily in the Reserves vs the Guard?

If there is a local disaster in your state, are you prohibited from helping the Guard as a Reservist or are you simply forced to go help in a civilian context?

Thanks.

 

[notdeadyet]

So, I'm still having a difficult time deciding between the two. The incentives seem very similar, almost identical.

They never differ all that much, since both are Department of Army. The Guard seems to have a slight advantage for students, since some states give some very nice bennies to Guardsmen.

It seems that the Guard comprises most of the combat arms units, and Reserves is more support...

This is more of a distinction for the non-medical folks. For physicians, when you deploy, you'll likely be activated to fill a medical slot needed wherever. Most Guard and Reserve docs I know were augmentees in active army units, reserve units, and guard units. Since we only deploy 90 days, we don't do so on the same tempo as the regular line units. So the combat arms vs. support unit stuff isn't all that important, unless you're looking at a specialty not offered in the Guard.

From a physician standpoint, working a medical unit seems that it would be more stimulating vs doing physicals or responsible primarily for the health within my Guards unit.

Yeah, if you're not interested in acting as primary medical support for a combat arms unit, I'd think twice about the Guard. The Guard specializes in combat arms and Army physicians specialize in supporting soldiers. So there you go.

Also, I'd like to be deployed overseas, but fulfilling that obligation by being deployed stateside in a military hospital isn't that bad either.. At least my wife would be able to travel with me in that event.

I wouldn't sweat that one too much. You can get plenty of overseas time as a Reservist.

Does a physician in the Reserves get deployed THAT much more frequently vs the Guard?

The deployment tempo is the same, at least in theory.

I'm interested in getting some non-medical training, jumping out of planes, etc.. , some combat training, etc.. Would I be able to do that just as easily in the Reserves vs the Guard?

Probably more easily in the Guard, just because you're working directly with more hooah type units.

That said, be it Reserve or Guard, your command will know what is necessary and not necessary for your training. Combat training comes very low on that list. I can't speak for the Reserve, but I know in the Guard they are very supportive of me going to CME and advanced medical training. If I asked for ranger or sniper school, I'd be laughed at and rightly so. You're a doctor. Your attendance at most combat courses will do little other than rob a soldier whose attendance could save their life.

If there is a local disaster in your state, are you prohibited from helping the Guard as a Reservist or are you simply forced to go help in a civilian context?

Reservists are not called up for domestic disasters. That is the Guard's role.

 

[Groove]

Much thanks for the reply, that clarified things.

 

[beans66]

Very nice thread, having been searching (before becoming a member) for this breakdown for some time.

I am a 2nd year Family Doc also interested in joining the Guard for pretty similar reasons as listed in the original post, except I would be interested in the stipend during residency. I had a few further questions:

- If joining the Guard during residency, are we required to drill during residency or is that postponed until afterwards? From what I've read on other posts, the Reserves seems to allow you to wait until after residency to begin the drills.

- If allowed to postpone drilling until after residency, what about a fellowship? I'm considering a Rural Medicine or OB Fellowship, would the Guard recognize these as a true fellowship and allow me to postpone drilling (if that's a possilibity) or would drilling commence immediately after residency is complete?

- If we have not yet attended Officer Training, do we still drill?

- Last one: do other military med courses like C4 count toward drilling time or are they separate?

Would appreciate any responses. Thanks for the time.

 

[notdeadyet]

- If joining the Guard during residency, are we required to drill during residency or is that postponed until afterwards? From what I've read on other posts, the Reserves seems to allow you to wait until after residency to begin the drills.

You are required to drill during residency. You are on flexi-training, which means that you can drill as little as once every three months, depending on your work schedule.

For the Reserve, you are required to drill unless you are attached to APMC, which you can be assigned to only if you are more than 50 miles from the nearest drill location.

- If allowed to postpone drilling until after residency, what about a fellowship? I'm considering a Rural Medicine or OB Fellowship, would the Guard recognize these as a true fellowship and allow me to postpone drilling (if that's a possilibity) or would drilling commence immediately after residency is complete?

As above, you don't usually get out of drilling during residency.

As for fellowship, whether or not you are deployable is going to decided on a case-by-case basis. Whether or not the fellowship is AB-whatever -recognized makes a difference, I don't know.

- If we have not yet attended Officer Training, do we still drill?

Yes. You can drill once you are commissioned as an officer in the Army. This can pre-date your actual attendance at BOLC (officer training) by 2 or 3 years.

- Last one: do other military med courses like C4 count toward drilling time or are they separate?

They are separate. Since docs have a lot of flexibility others in the Guard or Reserve do not, you can negotiate having something like C4 count towards the two weeks a year you owe in addition to the one weekend/month (the two weeks a year can be reduced to once every two years while in residency).

Hope this helps.

 

[notdeadyet]

At the risk of editorializing (a risk pretty much every time I open my mouth), folks who seem to be happiest with their decision to join the Guard or Reserve are those who join wanting to do more than the minimum. Folks who seem to regret their decision are folks who join asking "how little can I do?"

My experience, and that of most docs I've met, is that the Army or Reserve ends up taking up more of your time than you'd expect. If you want to do your job well, it just ends up requiring more time than the hours allocated to drill.

 

[schrute]

Every state (and every unit) has some variability with their approach to the training requirements of med students and residents.

For me (and all the other residents from my Guard unit), the requirement was 1 drill per quarter (q3 months), as the reg goes. Obviously you can drill more if you'd like; if you don't you're ~required to "prove" your absence is justifiable, eg, you're on call...doing research...something besides sleeping. Different units have different approaches to this, but the requirement is once a quarter. Each drill I still submit a "split train" form with "equivalence training checked". ie. you still get paid every drill.

Per someone elses' comments, the Guard doesn't retain slots for some specialties: anesthesia, rads and pathology come to mind.

Granted, one can occupy a flight surgeon slot and get around the issue that way, if Guard is the way you want to go, but only if your desire to be in the Guard supercedes your desire to actually practice in your specialty (ie. if you get deployed as a flight surgeon, which you would, you'd be doing flight medicine...ie, taking care of pilots & crew).

Guard docs, particularly FP and EM, get deployed REGULARLY. The Guard is currently funcitoning as a branch of active duty now, regardless of what anyone else wants to say (inter-deployment safe time is not necessarily a hard & steady rule).

All the docs in my unit--most of which are either EM of FP--have been deployed a number of times. The career 20-yearers have been over at least 3 or 4, sometimes 5.

The Guard is shouldering the majority of the deployment burden, or at least it has been for the past 10 years, so keep in mind that a commitment with the Guard essentially guarantees you'll get deployed, bottom line. WHEN depends on your rapport with your unit & the state command...they might give you a year to settle into a practice, or want you to go right away. If you're already in a practice, you'll be gone pronto.

The whole "Guardsmen assist with natural disasters, etc" pans out to be a rather uncommon scenario. So maybe once a year, a handful of units get "activated" to assist with natural disaster clean-up. Even then, it's often taken on a volunteer basis, at least initially.

PM me if you have any more specific questions...in 4th yr of residency and been in the Guard--as both enlisted and officer, combat and medical units--for 14 years now.

 

[kingcer0x]

Every state (and every unit) has some variability with their approach to the training requirements of med students and residents.

For me (and all the other residents from my Guard unit), the requirement was 1 drill per quarter (q3 months), as the reg goes. Obviously you can drill more if you'd like; if you don't you're ~required to "prove" your absence is justifiable, eg, you're on call...doing research...something besides sleeping. Different units have different approaches to this, but the requirement is once a quarter. Each drill I still submit a "split train" form with "equivalence training checked". ie. you still get paid every drill.

Per someone elses' comments, the Guard doesn't retain slots for some specialties: anesthesia, rads and pathology come to mind.

Granted, one can occupy a flight surgeon slot and get around the issue that way, if Guard is the way you want to go, but only if your desire to be in the Guard supercedes your desire to actually practice in your specialty (ie. if you get deployed as a flight surgeon, which you would, you'd be doing flight medicine...ie, taking care of pilots & crew).

Guard docs, particularly FP and EM, get deployed REGULARLY. The Guard is currently funcitoning as a branch of active duty now, regardless of what anyone else wants to say (inter-deployment safe time is not necessarily a hard & steady rule).

All the docs in my unit--most of which are either EM of FP--have been deployed a number of times. The career 20-yearers have been over at least 3 or 4, sometimes 5.

The Guard is shouldering the majority of the deployment burden, or at least it has been for the past 10 years, so keep in mind that a commitment with the Guard essentially guarantees you'll get deployed, bottom line. WHEN depends on your rapport with your unit & the state command...they might give you a year to settle into a practice, or want you to go right away. If you're already in a practice, you'll be gone pronto.

The whole "Guardsmen assist with natural disasters, etc" pans out to be a rather uncommon scenario. So maybe once a year, a handful of units get "activated" to assist with natural disaster clean-up. Even then, it's often taken on a volunteer basis, at least initially.

PM me if you have any more specific questions...in 4th yr of residency and been in the Guard--as both enlisted and officer, combat and medical units--for 14 years now.

Can they guarantee you no deployments during residency, if say, you leave AD and go into the guard as a flight doc?

Does the Air Guard work similarly?

 

[horhay1241]

I'm trying to figure out the main diff between the ANG and AF reserve. I met with a recruiter for the ANG recently and he told me that no physician in the ANG has been involuntarily deployed. This sounded a bit unusual to me. Is this true? I'm not against being deployed-its one of the reasons I want to join, but it seems strange that nobody would get involuntarily deployed. Thanks.

 

[Mr. Freeze]

This has been a pretty good overview. I have been drilling for awhile now, and some of the other subspecialists and I have been talking about our role in the Guard. We are part of an ASMC. I don't see the utility in assigning surgeons to staff a Role II BAS, and it seems like that's what we would be doing if deployed.

For this reason, I have been considering transferring to the Reserves, as there is a CSH unit much closer to my home. If I understand everything correctly, there are no CSH's and no FST's in the Guard.

I think I have seen it discussed here before, but is there a difference in PROFIS assignments between the NG and Reserves? Seems like I remember that NG physicians attached to a unit don't typically get pulled to augment other units and that Reserves are more likely to, but this may just be those USAR docs assigned to APMC and not to a particular unit.