Skill atrophy

[twinning]

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Hi all,

I have been reading this military medicine forum for a couple months now and a lot of things that I see popping up include skill atrophy because the military will put you into duties where you don't use your medical knowledge and "if you don't use it, you lose it" types of situations happen.

I am entering USUHS for the class of 2018 and I wanted to hear from those of you who are in specialties where you can actually practice medicine and be a doctor to see if these are specialties that I may consider. I don't want to payback my 7 years and then lose the opportunity to be able to be employed outside of the military because I lost all my skills doing administrative work.

Thanks for helping me out




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[colbgw02]

Let's not forget being a brigade surgeon. It's predominantly an administrative job, so everyone who actually wants to practice medicine risks skill atrophy. And recent history has shown that no specialty is safe from it.

FWIW, the Army doesn't assign radiologists to locations without CT, and I can only think of 2 places that don't have a magnet.

 

[twinning]

Excuse my naviete but why does the military recruit non military doctors with hefty contract pay when it has lots of doctors already in the military and instead has the military doctors do administrative duty?


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[colbgw02]

Excuse my naviete but why does the military recruit non military doctors with hefty contract pay when it has lots of doctors already in the military and instead has the military doctors do administrative duty?


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"Theirs not to reason why, Theirs but to do and die"

Seriously though, you're attempting to apply logic and reason to an organization that is short on both. Don't overthink it. Your head might explode.

 

[twinning]

"Theirs not to reason why, Theirs but to do and die"

Seriously though, you're attempting to apply logic and reason to an organization that is short on both. Don't overthink it. Your head might explode.

Did you go to Usuhs? How long have you been in the military for? Would you do it again if you could?


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[colbgw02]

Did you go to Usuhs? How long have you been in the military for? Would you do it again if you could?


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No, I was commissioned through ROTC. I've been in the Army for 12 years, only 8 of which have been active duty. I grew up an Army Brat.

I would not do it again, but that's not to say I regret my choice. I understand I'm parsing the language here, but the distinction is important in my mind. I place great value on the places I've been, the people I've met, and the patient's I've treated while in uniform. I just think that I would have been happier if I had taken the purely civilian route.

 

[met19]

"Theirs not to reason why, Theirs but to do and die"

Seriously though, you're attempting to apply logic and reason to an organization that is short on both. Don't overthink it. Your head might explode.

I have to tell myself this on a regular basis...the military wastes so much on admin BS its not funny and if you try to understand it....see above

When I first joined as an attending (HPSP deferred residency). when i checked in i did a bunch of annual traning, then just less than a year later there was a command annual training push. I showed my certificates and the response was everyone at this command has to do this....

Learn not to ask why, if you do you go insane 🙂

 

[Droopy Snoopy]

The AF does a decent job of utilizing the skills they paid for you to learn during your first few years, however after that you will be expected to move into more administrative roles as your rank increases.

 

[Gastrapathy]

I did plenty of GI in the navy but deployed as an internist. I think I hated that more than being in the sand box. It's too late, pick a specialty u like and deal with the consequences. No one knows what life will be like in a decade when your skill atrophy will start to be an issue.


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[deuist]

I wanted to hear from those of you who are in specialties where you can actually practice medicine

We all practice medicine---at least right out of residency. However, the acuity is usually so low that skills decay with lack of exposure. For example, as an emergency physician in the community, 5% of my patient population should be critical, and I should have ample opportunities for intubations, central lines, medical resuscitations, trauma stabilizations, and... well... those things just don't happen in the military. Sure, I can see lots of sprained ankles, colds, urinary tract infections, healthy men with chest pain, and other things that keep the troops healthy, but those things aren't keeping my skills up.

 

[Doctor Bob]

For example, as an emergency physician in the community, 5% of my patient population should be critical, and I should have ample opportunities for intubations, central lines, medical resuscitations, trauma stabilizations, and... well... those things just don't happen in the military. Sure, I can see lots of sprained ankles, colds, urinary tract infections, healthy men with chest pain, and other things that keep the troops healthy, but those things aren't keeping my skills up.

Yea; when our commander put ODE on hold, all of us EM folks here raised a clamor over this exact point. We all felt the need to do ODE, not for the money (although that's always a good bonus) but to avoid the skill atrophy. If the military wanted us to be effective in a deployed environment we needed to keep these skills sharp.

With that being said, we didn't do a whole lot in the deployed environment either, but that's another story.

 

[idq1i]

FWIW, the Army doesn't assign radiologists to locations without CT, and I can only think of 2 places that don't have a magnet.

Unfortunately, you are incorrect about the 1st.

 

[colbgw02]

Unfortunately, you are incorrect about the 1st.

Location, please.

 

[idq1i]

Location, please.

PMed

 

[Homunculus]

I did plenty of GI in the navy but deployed as an internist. I think I hated that more than being in the sand box. It's too late, pick a specialty u like and deal with the consequences. No one knows what life will be like in a decade when your skill atrophy will start to be an issue.


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this.

i know several peds subspecialists currently in 2 year brigade surgeon billets. it happens, and they have no qualms about sending people out for this. best advice is do what you want and let the cards fall there they may.

--your friendly neighborhood pragmatist caveman