Looking for some advice/experiences from those that have made similar decisions in the past.
Reasons why I left after 15 years toward retirement in 2005...in retrospect.
This year marks 21 years since I decided to leave the USAF after 15 years toward retirement (as y'all know, the 4 years I spent in uniform on active duty under the UCMJ at USU did not count thanks to DOPMA, which was designed to coerce military physicians to stay in an extra four years to catch the brass ring of retirement at 20 years total AD, not including USU).
Looking back, here are the main reasons that stick out for why I decided to resign my regular commission as a LtCol and walk away without any retirement benefits at all.
1) It was not about the money for me.
--I had a very nice house, three vehicles, and all the amenities of modern living I needed on my military salary. Financial issues did not enter into my decision to walk away.
2) I could not stand being commanded by idiots who thought they could tell me how to do my job.
--As I have said, having an RN commander order me to assume the front leaning rest position at 0300 in front of her office as punishment would not have bothered me. Endangering the lives of patients for political reasons did bother me.
3) I could not stand being commanded by non-physicians who merely had date of rank on me.
--I offered to stay in if the USAF would PCA me to USU from Andrews in a teaching position (which I already had as a voluntary extra duty for years by that time), which would have cost the government zero dollars. In response, they said: "No, we are PCSing you to [the worst possible Air Force medical center] to be commanded by a LtCol CRNA with date of rank on you." The lack of actual choice you have in assignments, given that the "needs of the service" always outweigh your and your family's needs, can be devastating to your quality of life.
4) I had a very bad feeling about the place they were planning to send me.
--I had taken leave months in advance before every single hurricane and major tropical storm that hit Maryland during my time on active duty (and for years thereafter). Something about being at that place in the summer of 2005 gave me very bad vibes that I couldn't rationally explain. In retrospect, I would have lost all of my earthly belongings, and possibly the lives of my family and myself, if I had ignored my nightmarish misgivings. See:
Katrina.
5) I refused to lose my marriage (at the time) by being transferred to the most racist state in the USA (still true in 2026), because my (then) wife would be forced to close her solo medical practice we had spent years investing in if she packed up the kids and followed me to that hellhole.
--I knew my (then) wife would initiate divorce and keep her practice, the house, and our Chinese-Welsh-German-Italian kids in our far-more-integrated U.S. state the moment I got orders to go there. The only way you can have a hope of a chance at stability in where you live is to leave the military.
6) I objected on moral grounds to the war of choice in Iraq that was based on false claims of non-existent WMDs that my flight commander's famous husband spent years not finding despite thorough attempts, and that was in fact used to enrich private companies connected to the administration at the expense of American and Iraqi lives, the health of our soon-to-be vets, and trillions of taxpayer dollars.
--Now replace "Iraq" with Iran, Cuba, Greenland, Canada, Mexico, or who knows where else, and you have the situation in 2026 and beyond. I joined the military in 1981 to support and defend the Constitution against dire external threats like the communist dictatorships in the USSR and PRC...not some random goatherders 6,000 miles away who posed zero threat to our homeland, but who had the misfortune of living on ancestral land that harbored natural resources that could be exploited for money by multinational corporations. Now replace "goatherders" with "aboriginal subsistance fishermen"...
7) As I was looking for civilian jobs before the end of my terminal leave, one of the first questions they all asked me was "How likely is it that you will be recalled to active duty and leave our practice at unpredictable intervals for unknown periods of time?"
--I knew that retired military officers can be recalled to active duty involuntarily for the rest of their natural lives, as an 86-year-old psychologist found out during Operation Iraqi Liberation (sic). I didn't want to be that guy in the year 2049.
8) Military interns and residents have work hour restrictions. Attendings don't.
--When, due to sheer poor planning, destruction of anesthesiology residency slots at WHMC, and lack of retention, we went from 11 anesthesiologists at Andrews to 2 (plus a useless Colonel who only did pain management a few days per year, when she wasn't at home watching her children during supposed duty hours on the taxpayer dime), I was forced to take every other night call for three months in a row to maintain the same surgical and OB ops tempo with two anesthesiologists that we had needed ten (useful) ones to accomplish over many years prior, including during my internship there in 1990-1991. I don't think I ever recovered from this, mainly due to the unfairness of it all, in addition to the toxic effects of sleep deprivation. If I had been civilian, I could have quit. As active duty, one cannot quit, no matter how soul-crushing the job becomes (this is not even counting working during a deployment, which usually [historically] risks death through boredom and erosion of clinical skills, rather than overwork per se).
9) I was told independently by both my (nice) Squadron Commander (who replaced the evil one in my final months on active duty) and my (useless) Flight Commander that AFPC did not believe that I would walk away after 15 years. They both told me that the Air Force thought that I was lying about my intentions, possibly to get a better assignment than they planned for me, because almost no one left with so few years until retirement.
--You can question my intelligence, competence, judgment, clothes, and smell all day long. "Yeah, well, you know, that's just, like, your opinion, man", to quote the sage. The moment the U.S. military questioned my honor after all those years in uniform since age 17: that was it.
See this page for a curated collection of SDN posts on this subject from me and others over many years:
Reasons not to join or stay in military medicine
Best of luck as you make your decision.
