Residency after GMO tour?

[Marjoe]

I am very close to signing with the Navy for the HPSP. My question is, after doing my internship year and four years of a GMO tour, how hard is it to get a civilian residency?

My thought process is: Take the Navy HPSP scholarship and plan on doing a GMO tour, hopefully as a flight surgeon. After paying back my time with the GMO tour, decide if I like the Navy enough to stay in and do a Navy residency. But, if I decide I want to be done with the Navy, I want to make sure I won't have a lot of trouble getting into a civilian residency.
Thanks for your help.

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[orbitsurgMD]

I am very close to signing with the Navy for the HPSP. My question is, after doing my internship year and four years of a GMO tour, how hard is it to get a civilian residency?

My thought process is: Take the Navy HPSP scholarship and plan on doing a GMO tour, hopefully as a flight surgeon. After paying back my time with the GMO tour, decide if I like the Navy enough to stay in and do a Navy residency. But, if I decide I want to be done with the Navy, I want to make sure I won't have a lot of trouble getting into a civilian residency.
Thanks for your help.

A lot is going to depend on the specialty you are applying for. Things can change greatly in four or five years. On the whole, if you are contemplating a civilian training--and with the relative dearth of Navy opportunities in certain fields, that is being realistic--ask yourself what advantages you will have over the recent non-military graduate when it comes time to apply.

Some commentators have said that the GMO time makes for more mature residents (I hope so, four years ought to give you something) and that programs find this more desirable. I am not so sure I agree with this. Recent graduates have recent LORs from their schools and perhaps from key and current contributors to the particular residency field; military GMOs have much more difficulty getting these. Recent grads have more recent board scores. Some civilian programs don't necessarily see military experience as all that relevant to their objectives of getting a good residency class from the civilian match, and may not prefer military grads who by their time out of the training cycle come to them with less familiar experiences and qualifications. In medicine, having a military background is still not all that commonplace. Moreover, some of those familiar with the military system who are now in academic practice may be all too familiar with the GMO experience, and while they may be sympathetic to someone who was compelled to serve as a GMO, they may not see that experience as being all that valuable to the training objectives of a civilian program. Others may correctly or incorrectly assume that you were unsuccessful in getting a military training slot and thus see you as a less attractive applicant.

There are some benefits to GMO experience, but on balance, I think it does not help in getting competitive civilian residency offers and probably is a relative disadvantage. As a former Navy flight surgeon and HPSP grad who despite a full payback as a GMO/FS was successful anyway in getting both a desirable residency and fellowship, I would still suggest you consider an alternative route to your specialty training. If you have to consider HPSP for financial reasons, consider Army or Air Force before Navy, or FAP before Navy HPSP. At this point, the Navy has morally bankrupted itself when it comes to its duty to properly train the civilian graduates it takes in by the HPSP program, promising training it can't and doesn't deliver and continuing to task on its woefully outdated GMO model. There are better options the Navy could pursue, but won't. There are better options you could choose, and should.

 

[chickendoc]

I am very close to signing with the Navy for the HPSP. My question is, after doing my internship year and four years of a GMO tour, how hard is it to get a civilian residency?

My thought process is: Take the Navy HPSP scholarship and plan on doing a GMO tour, hopefully as a flight surgeon. After paying back my time with the GMO tour, decide if I like the Navy enough to stay in and do a Navy residency. But, if I decide I want to be done with the Navy, I want to make sure I won't have a lot of trouble getting into a civilian residency.
Thanks for your help.

As a Navy flight surgeon applying for civilian match I can give you my perspective. In my opinion the experience put me well above other applicants. All my interviewers where impressed that I was able to evaluate and treat patients idependently; obviously with consultations from specialists. I think it is proof that you have the ability to get information from patients and formulate a working differential diagnosis already. Also, that fact that I was also a leader and had experience teaching corpsman really impressed program directors. I am a known quantitiy in their eyes. Having letters of recommendations from my commanding officer helped give them an idea as to how I am as an employee, working in a team. There are a lot of advantages that I had, I disagree with the previous poster.
I would agree that your medical skills do deteriorate but you will get them back. Program directors aren't concerned with that - if you did well on your boards they know you have the knowledge - just need to dust it off. What they are really concerned about is how the applicant will function as an employee and as part of a team. Having the history in the Navy gives them an idea how you will be. Just my two cents.

 

[usnavdoc]

As a Navy flight surgeon applying for civilian match I can give you my perspective. In my opinion the experience put me well above other applicants. All my interviewers where impressed that I was able to evaluate and treat patients idependently; obviously with consultations from specialists. I think it is proof that you have the ability to get information from patients and formulate a working differential diagnosis already. Also, that fact that I was also a leader and had experience teaching corpsman really impressed program directors. I am a known quantitiy in their eyes. Having letters of recommendations from my commanding officer helped give them an idea as to how I am as an employee, working in a team. There are a lot of advantages that I had, I disagree with the previous poster.
I would agree that your medical skills do deteriorate but you will get them back. Program directors aren't concerned with that - if you did well on your boards they know you have the knowledge - just need to dust it off. What they are really concerned about is how the applicant will function as an employee and as part of a team. Having the history in the Navy gives them an idea how you will be. Just my two cents.

I agree with this statement for the most part. There are certainly specialties that you will need to repeat your internship.(Who after 4 years as a GMO is ready to walk into an ICU as a PGY2 as well as any surgical field), but for the most part everyone I interviewed with was very positive.

I wound up getting to choose amongst several acceptances, which is a nice feeling compared to matching. I also turned down several interviews at top programs as well as mid tier simply b/c I already had acceptances in top prgrams in places I would rather live.

That said all in all It is much better to go straight through, But dont worry as much about applying post GMO.

 

[Mirror Form]

Out of curiousity, which specialties did you guys apply to? I can see a GMO tour being helpful for specialties in which the pgy-2 year is not closely linked to the pgy1 year. However, If you're thinking of going into internal medicine, surgery, ob-gyn, ortho, etc., I'd be worried that I wouldn't know enough starting out as a pgy2 after having done 4 years as a gmo.

Also, if you have to repeat your internship, I've heard that will cause medicare to not fund you for a year of residency. Do program directors take that into account?

 

[usnavdoc]

Out of curiousity, which specialties did you guys apply to? I can see a GMO tour being helpful for specialties in which the pgy-2 year is not closely linked to the pgy1 year. However, If you're thinking of going into internal medicine, surgery, ob-gyn, ortho, etc., I'd be worried that I wouldn't know enough starting out as a pgy2 after having done 4 years as a gmo.

Also, if you have to repeat your internship, I've heard that will cause medicare to not fund you for a year of residency. Do program directors take that into account?

That is exactly why I said in some fields you would likely need to repeat internship. Im going into anesthesiology so I never considered repeating.

I have heard others talk about the funding issue as well. The majority of people seem to be getting out and pursuing civ residency after GMO, so this may be a factor that we all should investigate some. Id love to hear from a PD how this really affects their decision. The reality that I have seen is 6 people who have gotten out in the last year who have matched as a PGY1 in gen surg, ortho, IM(2), Peds, and EM.

Also another caveat may be this. Do MTFs recieve medicare funding for its residents since we are US Military employees? Our salaries are not dependant on medicare funding neither are the MTFs. If medicare does not fund for our internship then you would be starting out with a fresh slate and this would be a mute point to begin with.

Also another example of programs not worrying about funding is all the people who go back and complete a second residency. I know of several attendings who have done this. FP then OB, IM then Anesthesia, IM then Gen Surg, FP with sp med fellowship then Ortho. These people that I know (some better than others) were paid as a resident because ive talked to them about salary reduction.

 

[helo doc]

I can appreciate both sides of this argument but tend to favor chickendoc's point of view. If you're a strong medical student with good USMLE scores, strong LOR's and dean's letter, who interviews for a competitive residency after completing a military obligation, then you should be sought after by the PD's. Conversely, if you're a chronic underperformer and you apply for a competitive program after a GMO tour.... guess what? You won't get picked. I don't view that as being punished for serving in the military, I view that as being punished for your poor performance.

Getting older and more bitter by the minute....

 

[orbitsurgMD]

I can appreciate both sides of this argument but tend to favor chickendoc's point of view. If you're a strong medical student with good USMLE scores, strong LOR's and dean's letter, who interviews for a competitive residency after completing a military obligation, then you should be sought after by the PD's. Conversely, if you're a chronic underperformer and you apply for a competitive program after a GMO tour.... guess what? You won't get picked. I don't view that as being punished for serving in the military, I view that as being punished for your poor performance.

Getting older and more bitter by the minute....

The question should be addressed: are you more competitive for a hard-to-obtain civilian residency slot having first done your payback as a GMO/FS/DMO than you would be applying straight out of medical school with the expectation of the program that you will be following through to completion?

Despite accounts of successes of former GMOs in getting slots, I would still say the answer is no. Most successful former GMOs would probably have been at least as successful coming straight out of med school as they were coming off of payback. I would even speculate that many would have been even more successful. This makes neither winners nor losers of GMOs--I think some are forgetting this and taking my observations personally--my point is that it probably doesn't help you. The ex-GMO isn't going to change board scores or med school LORs. They might get a LOR from a military specialist, which shouldn't hurt, but probably won't do any more for an application than an equally good civilian LOR.

Of course it pays to put as much positive spin on the GMO time as you can, and you should. But no one should go into the Navy or any other service with the expectation that their GMO time is going to improve their chances at getting a residency slot in the civilian world. About the only place where the GMO time does help you is in getting a military residency.

 

[militarymd]

I was told that certain surgical subspecialties (ENT for example)....you have essentailly no chance after a gmo if you go civilian....


True or not...I don't know.

 

[AFSmiley]

I was told that certain surgical subspecialties (ENT for example)....you have essentailly no chance after a gmo if you go civilian....


True or not...I don't know.

No idea how common this is but an ENT at my local hospital spent four years as a Navy Flight Surgeon (mid 1990's) and got out to do residency. He said it was a little difficult transitioning back into residency, but not impossible.

 

[chickendoc]

The question should be addressed: are you more competitive for a hard-to-obtain civilian residency slot having first done your payback as a GMO/FS/DMO than you would be applying straight out of medical school with the expectation of the program that you will be following through to completion?

Despite accounts of successes of former GMOs in getting slots, I would still say the answer is no. Most successful former GMOs would probably have been at least as successful coming straight out of med school as they were coming off of payback. I would even speculate that many would have been even more successful. This makes neither winners nor losers of GMOs--I think some are forgetting this and taking my observations personally--my point is that it probably doesn't help you. The ex-GMO isn't going to change board scores or med school LORs. They might get a LOR from a military specialist, which shouldn't hurt, but probably won't do any more for an application than an equally good civilian LOR.

Of course it pays to put as much positive spin on the GMO time as you can, and you should. But no one should go into the Navy or any other service with the expectation that their GMO time is going to improve their chances at getting a residency slot in the civilian world. About the only place where the GMO time does help you is in getting a military residency.

I think the question was - if someone wanted to do HPSP in order to forgo debt would this hurt their chances at getting a civilian residency after serving their required payback.

The answer is no, it will not hurt. But, they must realize that in doing this they may need to repeat internship.

 

[usnavdoc]

Not that this affects me but the financial aspect is interesting.

Are MTFs given funding for Military residents even though their salaries are not dependant on govt funding?

MilMD do you have any insight on this from your experience at portsmouth with running a military GME program?

 

[militarymd]

Not that this affects me but the financial aspect is interesting.

Are MTFs given funding for Military residents even though their salaries are not dependant on govt funding?

MilMD do you have any insight on this from your experience at portsmouth with running a military GME program?

No, Military GME does not receive medicare money for residents.

 

[IgD]

If you plan to pursue a civilian residency after a GMO tour make sure you sign up for the GI bill. You can cash it in during the residency. My friend was a flight surgeon and is now a civilian orthopedic surgery resident. The GI bill pays him over $1000 a month for about 3 years.

 

[Poseidon]

Can anybody elaborate on the specifics of this? Are HPSPers eligible for the GI bill after completion of their active duty requirement/GMO? Any additional obligations or requirements tied to this?

If you plan to pursue a civilian residency after a GMO tour make sure you sign up for the GI bill. You can cash it in during the residency. My friend was a flight surgeon and is now a civilian orthopedic surgery resident. The GI bill pays him over $1000 a month for about 3 years.

 

[usnavdoc]

Can anybody elaborate on the specifics of this? Are HPSPers eligible for the GI bill after completion of their active duty requirement/GMO? Any additional obligations or requirements tied to this?

do a search about 2-3 months back there was a long thread that I posted on regarding this topic.

There are no additional obligations tied to the GI Bill. It is actually a Dept of Veterans Affairs benefit not a DOD benefit.

 

[Marjoe]

I think the question was - if someone wanted to do HPSP in order to forgo debt would this hurt their chances at getting a civilian residency after serving their required payback.

The answer is no, it will not hurt. But, they must realize that in doing this they may need to repeat internship.

This was exactly what I was looking for. Thank you so much for the feedback. I am excited for the chance to do things with the Navy that I wouldn't normally have a chance to do. But, I don't want to hurt my chances of getting a residency in the future if I don't want to stay in the Navy.

 

[medivac]

I can say having just completed the interview trail, being a GMO (i'm finishing up my commitment as a FS), and trying to get into EM, all of the programs have remarked that I am a valuable commodity, being that I have completed Step 3, have emotional maturity, and are dependable. One interviewer at one program badmouthed my prior training, but the PD denied that this would have any ill effects on my acceptance chances.

I will second the GI bill. That wonderful little program should take care of my mortgage during residency!!

If you have any questions about navy, flight surgery, etc, feel free to PM me!

 

[IgD]

...One interviewer at one program badmouthed my prior training, but the PD denied that this would have any ill effects on my acceptance chances.

Having a successful tour in the military means you survived the system. If you can do that you have the leadership and experience to do anything. You can deal with red tape and bureaucrats!