Navy Staff locations for EM

[Cooperd0g]

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What are the CONUS and OCONUS locations for Navy EM staff?

 

[d2305]

Portsmouth, Bethesda, San Diego, Pendleton, Lejeune, Great Lakes, Jacksonville, Naples, Sigonella, Rota, Yokosuka, and Okinawa. The smaller hospitals have closed their ERs.

 

[Cooperd0g]

Yeah, I knew the smaller ones were closing so I just wanted to get a handle on what was left. Thank you.

Nothing in Guam I guess?

 

[Gastrapathy]

Yes, no, yes, yes, no, maybe, no, no, yes, yes, yes, no.

Binary reviews of the listed sites.

 

[d2305]

Forgot about Guam.

 

[d2305]

Bethasda doesn't have an ER? How does Okinawa not have an ER?

 

[DrMetal]

Bethasda doesn't have an ER?

It does, but there's no EM training program there. It's a very low acuity ER, you'd want nothing to do with it as a trainee.

 

[Cooperd0g]

No one asked about residencies. He is asking if there are staff billets for the Navy there since Gas said there aren't billets there. Which would surprise me since there are army staff and civilian contractors at a minimum.

 

[DrMetal]

No one asked about residencies.

I thought to mention it, since you seem to be a medical student interested in EM, and by the letter of the law you have to do an EM residency before you become staff.

Since you are interested in what it's like being staff--a good interest to have, good to think a couple steps ahead--I'll provide my opinion and what I think is close to the opinions of others. If you're actually interested in being a good EM staff physician, and you genuinely care about emergency medicine, you're going to be frustrated as staff. You can only work at MTFs that have EDs, and they're all very low acuity. During my rotation in the ED, I saw about 125 patients (amongst my cohort of interns, >500 patients during said block). Not one intubation (not even BiPAP), not one STEMI, not one DKA. (By contrast, saw that every day at a civilian trauma rotation). The military EDs are equivalent to an urgent care . . and hell some urgent cares by the border might have higher acuity. And so as staff--again if you truly care about being a good EM--you'll be bored as hell. You could of course augment your skills by moonlighting, but your future son's little league might preclude that.

 

[Cooperd0g]

I appreciate the feedback and am aware of what you describe as well as understanding that one needs to complete residency before being anything but a GMO. But as you said I like to look ahead and that means I like to know as much as I can. Which is why I was asking about staff locations. I know FM can be just about anywhere, but with the recent changes happening I wasn't confident in where the EM locations are.

 

[DrMetal]

I appreciate the feedback and am aware of what you describe as well as understanding that one needs to complete residency before being anything but a GMO. But as you said I like to look ahead and that means I like to know as much as I can. Which is why I was asking about staff locations. I know FM can be just about anywhere, but with the recent changes happening I wasn't confident in where the EM locations are.

It's all good...tread cautiously with respect to EM, its not quite the glamorous specialty that everyone paints it to be in the mil. If you really wanna do it and you have a short commitment (ie hpsp), might be best to gmo your way out and pursue it in the civilian world.

 

[jabreal00]

It's all good...tread cautiously with respect to EM, its not quite the glamorous specialty that everyone paints it to be in the mil. If you really wanna do it and you have a short commitment (ie hpsp), might be best to gmo your way out and pursue it in the civilian world.

It's not very glamorous on the civilian side as well. Lots of social visits (intoxication) and primary care stuff (UTI, abdominal pain, headaches, rash) with intermittent bursts of real emergencies. But I guess it is "shift work" as they claim?

 

[DrMetal]

It's not very glamorous on the civilian side as well.

A valid point .... But you can choose where to work (more readily) as a civilian

 

[pgg]

It's not very glamorous on the civilian side as well. Lots of social visits (intoxication) and primary care stuff (UTI, abdominal pain, headaches, rash) with intermittent bursts of real emergencies. But I guess it is "shift work" as they claim?

That's the plight of the ER doc ... saving the world from having to see its primary care physician. 🙂

Military ERs are a few notches lower on the acuity scale though. It's the nature of the beast. There could be a 40 car pileup within sight of the front gate, and the ambulances aren't going to be able to go on base in most cases. For the most part the only patients that arrive at military ERs are the ones who get driven there by a family member, which cuts down the trauma and codes to almost nothing.

 

[d2305]

Navy ER is after hours sick call.

 

[jabreal00]

That's the plight of the ER doc ... saving the world from having to see its primary care physician. 🙂

Military ERs are a few notches lower on the acuity scale though. It's the nature of the beast. There could be a 40 car pileup within sight of the front gate, and the ambulances aren't going to be able to go on base in most cases. For the most part the only patients that arrive at military ERs are the ones who get driven there by a family member, which cuts down the trauma and codes to almost nothing.

I could only imagine that any ER staff has to moonlight to maintain their sanity. The last MTF I was stationed was a notch below urgent care. The only ER in the military that may see some decent trauma is SAMMC. They are level 1 and have an agreement with the city of San Antonio to see adult civilian emergencies where the university program sees pediatric emergencies (at least that is how it was when I did my residency there).

 

[alpinism]

That's the plight of the ER doc ... saving the world from having to see its primary care physician. 🙂

Military ERs are a few notches lower on the acuity scale though. It's the nature of the beast. There could be a 40 car pileup within sight of the front gate, and the ambulances aren't going to be able to go on base in most cases. For the most part the only patients that arrive at military ERs are the ones who get driven there by a family member, which cuts down the trauma and codes to almost nothing.

This actually happened multiple times at my base (multi car MVA with serious injuries right in front of the front gate). Not only did the civilian ambulances not go to the base hospital (1 mile away) but we also weren't allowed to go off base with the ambulance and rescue truck (1/2 mile away).
Instead we "waited" at the front gate for the civilian ambulances to get there (10 miles away) to transport the patients to the next closest hospital
(14 miles away). And by "waited" I mean we left the trucks and walked 50 yards to the crash site to stabilize the patients.

 

[FermiParadox42]

It's all good...tread cautiously with respect to EM, its not quite the glamorous specialty that everyone paints it to be in the mil. If you really wanna do it and you have a short commitment (ie hpsp), might be best to gmo your way out and pursue it in the civilian world.

This has always been my plan. I love the Navy, but love EM more.