Hey all. I'm prior service, and remember all about army stuff, so i don't need any lectures on that. All i'm looking for is an honest description of Army EM practice. Even info on the army's EM residency would be nice. However, let me throw this out there....DO NOT B*TCH AND MOAN IN RESPONSE TO THIS. I'm asking because I've grown tired of looking at previous threads and seeing nothing but people crying about their negative experiences in the AF or saying that patriotism is the only reason to do military medicine. Patriotism was the four years I spent in the infantry, two of which were in the desert. I'm not asking for anything from current or prior AF or Navy docs. I don't care about the AF or Navy. Seriously. Please, someone just give me some info on the ARMY to help my decision making, and take the ridiculous amount of whining and "i'm-just-trying-to-help-you-out-by-b*tching-about-how-bad-it-was-for-me" somewhere the f*** else. Thanks to those adults who still take part in this forum.
If you are so excited about Army EM why are you seeking information? Why not just take a leap of faith and sign up for the first available position?
Yeah...Shame on you for not answering his question...after all, this poster has such a nice tone, especially for somebody new to this forum looking for answers
Wow, with such a great post asking for information, I can't imagine why people aren't rushing to answer it.
well i apologize for letting my frustration show. i had spent about 2 hours reading nothing but people bickering back and forth and complaining. all i want is some info. if you guys rather point out the flaws in my approach instead of helping out, that's cool. it's close to what i expected, even with the original post blatantly asking that no one post anything but information. seriously though, i'm well aware of the flaw in my approach, however i felt that unless i tried to nip it in the bud, the thread would get derailed like every single other thread on this forum. obviously, although there hasn't been anybody just telling me how much their life sucked while they were in, i get a whole new set of responses that have nothing to do with my question. thanks for the help. and although i may have few posts, i'm not exactly new to the site. i've been trolling this place for information for a while now, and i got frustrated with all the threads getting off track for like 6 pages until an administrator tries to get it back together and on topic, and then it turns to people talking trash about the people that were bickering. so, if you wanna help and can understand where i'm coming from, please respond or PM me. thanks to those that already have. as for the rest, if you wanna tell me that i shouldn't have asked in the manner that i did, the best way would be to not respond, instead of repeating the 5 people above you by saying that i should have gone about things differently. i am well aware of the disapprovals and distaste that some of you have for me now. no need to waste time by reminding me. thanks again professionals and upstanding students alike.
Here's why you haven't gotten a response: There are no army EM docs on here (at least based on past threads on the subject.) However, the army and AF EDs are not significantly different and aside from longer deployments, the jobs are nearly exactly the same. On my recent deployment I treated army and AF folks alike. But you specifically said you didn't want to hear from disgruntled AF EPs, of which I am one, so until you change your mind, I won't bother telling you what I know of the Army EM residency programs nor give you contacts for some of my friends in Army EM. Have a nice day, use a reasonable tone when asking questions, and learn what a capital letter is before writing your personal statement and you should be just fine. Good luck.
What is it you would like to know? We are more than willing to help you out. Just don't poke us in the eye during the process.
good thing this is an internet forum and not a personal statement then. wow. thanks so much for that advice. what is a capital letter anyhow? as for IgD, just looking for an honest to god assessment of a couple of things: how is the experience in contrast to a civilian residency? do you get just as much experience, just as broad of a caseload? are army ED's busy, slow, or busy with minor cases? (the one trip i made to the ED at Bragg was an early saturday morning and it was pretty much full of sniffles and upset stomachs) what are your colleagues like? is it easy to get along with everyone, and do a good job with team effort, or is it every man for himself? we were all about teamwork when i was enlisted, but the officers, at least on our side of the fence, were very wrapped up in politics, as in, who cares if the job gets done efficiently or if my troops suffer uselessly to get it done, so long as i look good and get a good bullet on my OER. have you found yourself in a situation in which you wished you had done a civilian residency? see, just some general info. thanks so much for the help.
That's pretty much been my experience of ED's in several civillian hospitals (not level 1 trauma centers, of course), as well. I think EM is quickly becoming the primary care of the underinsured or urgent care for those with adequate insurance. I am under the impression that Womack is more of a community medical center (at least that's sort of the impression I got when I was there), if I am not mistaken, so you are going to see more of the run of the mill kind of ED stuff there.
Hopefully this helps some. Honest answer from a non EM Army doc but who works very closely with them. 1. Army EM can be very challenging and frustrating for several reasons, first and foremost because as you correctly identified, many Army ER's are actually urgent care clinics (not real professionally stimulating). Secondly there are not enough Army ER docs in the inventory so many of your colleagues will be civilians, sometimes not EM trained. Because of this limited pool of active Army EM physicians, you will likely work more hours/wk than a civilian coworker or civilian counterpart not associated with military medicine and will face more frequent deployments than some other specialities (good news is that EM deployments are now 6 months rather than a year to 15 months if you are at a CSH). In theater you will see trauma (obviously) as well as the occassional contractor with an MI, or DKA plus the usual ortho injuries, diarrhea etc. 2. I don't have first hand experience with EM teamwork, politics or dynamics. 3. I can't not speak to the residency training, so I'll leave that to others. But I can say that the Army EM graduates I have worked with appear well trained, and are collegial.
Womack is a pretty nice hospital with lots of services...but you are right it does seem more community oriented these days. All of the times that I shadowed in the ER things were pretty laid back. I think most of the serious training injuries are actually flown out to the regional medical center now anyway. About 6 months ago, the ER only had like 1 "ER" doc actually working there. The rest were deployed. Womack has a very solid FM residency, great OB/GYN services, and I heard their orthopedics are great as well (so many broken bones from the jumps).
My friend was an army ER doc for 3 years, he recently separated and here is what he told me about it. I spent some time with him down range and would consider him anything but a "hardcore" fan of military medicine and I was actually surprised that retrospectively he is as positive about his experience as he wrote me. I asked him specifically about what he thought about the quality of army residencies were and if he felt like he his time was wasted while on active duty. "The military ED residencies are highly respected. Military ED docs continue to figure prominently in national ED circles. I can't speak for all the residencies, but all three ED residencies at Madigan, Ft. Sam, and Ft. Hood are above average in the education you get. Ft. Hood actually has led nationally in board score for years running, Ft. Sam was in the top 5-10% nationally as well. I've heard similar things of the other residencies, radiology, anesthesia, ophthalmology, etc. from my colleagues. No one seems to have difficulty going what they where they want to go after they get out. As to wasted time, if you plan you're career a little in the military, you won't waste any time. I believe there are probably jobs where you could waste your skills in the military. I was deployed about 1/2 my time, but they were good experiences, though hard on the family. I was stationed at a Podunk ED, low acuity, and skills did diminish there. But I always had the option of moonlighting to keep my skills up. Deployments helped though, as you get to do things there you cannot do anywhere else. But I volunteered for that Podunk ED so I could be the top guy administratively, as I didn't want to just do shifts all my life. I was able to get some valuable administrative experience being the chief there, and made an easier transition to a directorship on the civilian side where I'm working less shifts than my counterparts, the administrative duties, and walked in getting paid better than guys there for many years." He finishes up with saying that you have to keep in mind that while on active duty the military owns you and will get all they can out of you, but it is a mutual relationship...since you are using them for all you can as well (paying for school, getting experience, etc). Take it for what you will.
amazing responses! please keep them coming....invaluable. not too close to an army installation so i can't just go up there and ask. thank you so much gentlemen, and please, keep them coming. i'll take everything i can get. thanks again.
The hospital associated with my medical school had a level 1 trauma center and trauma surgery residency. The military doesn't have anything like that. I agree with the other posters that there is a lot of urgent care in the ER. The hospital near me has a senior PA who focuses on this. The perception is when appointments aren't available clinics re-direct patients to the ER. I've heard through the grapevine that MTFs are paying civilian contractors double or triple what uniformed providers make which is demoralizing.
This is true. However...most people that are physicians in the military took their extra pay up front in the form of HPSP or FAP...so there really isn't anything to complain about. Here is one for you, they deployed a plastic surgeon from my last assignement to Iraq to be a general surgeon, then hired a civilian to replace him stateside and paid the civilian something like 300k for a 6 month contract. On a side note, ERs in the states seem to be the answer for the uninsured or unbooked...but in Canada where I am working now, ERs are just as busy with the same type of pts because it is free...same problem, different cause.
The more I see what ER docs really do, the less interesting it is becoming. The surgical teams handle all the big stuff...the ER docs are great at handling a multitude of problems at the same time, and shuffeling patients here and there, but they don't seem to be anything more than specially trained medics/EMTs...especially in a level I trauma center where all of the other staff is on call to get involved immediately. The variety is nice though...as are the hours.
I did my internship several years ago at BAMC. It is a level 1 trauma center and does get quite busy at times. The other poster was correct in stating the education value at BAMC is pretty top notch. From what I saw as an intern, the residents were very well read and up to date on all areas of emergency medicine. Each and everyone one of them did very well on their annual in-service examinations. The staff also seemed to take pride in this. As a result, they were all extremely motivated to make sure that the residents were well trained. I think during my year, a resident from the Ft Hood program received the #1 score inthe nation on the annual in-service exam. The resident-resident and resident-attending relationships seemed to work out well without too many heart aches. Overall, I think the quality of the EM residency programs are very high. Take this as you will from a non-em former army doc. Nonetheless, good luck and thanks for being a grunt for 4 years
I for one am NOT an EM guy, but here is what I can tell you. Every EM program is at a med cen (yes somebody is going to actaully waste time typing a correction and point out that Darnall is not a med cen but the place is getting big and will be at med cen status soon) and there is only three. Of the three, BAMC has the level I trauma center (as already pointed out by another). The other programs see a good mix and do guest rotations at nearby affiliated institutions to fill in any gaps. Overall, the programs are solid.(in my opinion). Here is the gossip that I hear from rotating medical students and interns who have applied for EM and rotated at all three places. For some reason, many do not like BAMC. Why, I really never asked?? Those at Darnall really like the program because the only other residency there is FM so they get to do lots in the ED. MAMC, many like the location or just don't want to go to BAMC (again, no really sure what people have against BAMC EM). I honestly feel that the programs are solid and do a good job of filling in the gaps at nearby institutions. The problem is that I have known a few who were unsatisfied with what happened to them after graduation. For example, I knew of one guy that was upset because he spent all of those years training in EM to get slotted as a brigade surgeon. He is angry about this and clearly states that he didn't train to do EM so that he could practice essentially family medicine for a brigade of soliders. But while he was upset, some like this set up. There are also a few prior service guys who don't mind being slotted as brigade surgeons to special forces or becoming flight surgeons. Some EM docs that do not get the ideal slot after graduation feel that they have to moonlight occasionally a shift at a civilian hospital to maintain skills. Overall, this should not discourage you because this just does not apply to EM, MANY specialist get deployed as brigade surgeons or slotted for things not relevant to their training. Many pediatric residents I knew became bridgade or flight surgeons. I've heard of a pediatric neurologist getting deployed as a brigade surgeon going to a mass casualty where he has some help from another physician which happened to be a psychiatrist. I AM NOT stating all of this to complain, but pointing it out because this IS NOT something a recruiter for HPSP would EVER tell you. In fact, I'd bet that they deny it is asked. I just would not want you to get caught off guard or end up bitter like some of the posters on this forum that you have pointed out.
