Straight through fellowship

[IgD]

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It's interesting that Hasan apparently did a straight through fellowship without a utilization tour. It looked like he graduated psych residency from WRAMC then went straight into a 2 year fellowship. The Navy physicians I worked with were always really frustrated about this because they were required to do a utilization tour before they were given a look at the GME selection board. At the same time, Navy psychiatrists were being pulled to go on Army deployments...

 

[sethco]

It was my impression that utilization tours (in between residency and fellowship) are less common in the Army than they are in the AF and Navy.

Am I wrong?

 

[IgD]

It was my impression that utilization tours (in between residency and fellowship) are less common in the Army than they are in the AF and Navy.

That's the point I was trying to make. It's not really fair for Navy and AF physicians to be pulled to deploy in Army billets when Army physicians are going straight from residencies into fellowships without a utilization tour.

 

[colbgw02]

Who has the authority to deploy a Navy doc to an Army slot? Do the specialty consultants get together and arm wrestle?

 

[IgD]

I heard it was done before at the Joint Chiefs of Staff level. A tasker gets generated and it rolls down hill. I saw a stat once that there were more Navy psychiatrists deployed than Army psychiatrists at one particular time. I think for interservice taskers, the specialty leaders have little or no influence over the process.

 

[NavyFP]

I heard it was done before at the Joint Chiefs of Staff level. A tasker gets generated and it rolls down hill. I saw a stat once that there were more Navy psychiatrists deployed than Army psychiatrists at one particular time. I think for interservice taskers, the specialty leaders have little or no influence over the process.

This is where the SG and CNO need to pitch a fit. Part of this started under Admiral Arthur who never saw a tasker he didn't like. The amount of staffing provided by the Navy caused huge expectations and we have yet to dig out from under them. Our mission in Kuwait is a good example of an Army mission entirely sourced by Navy Medicine.

 

[orbitsurgMD]

This is where the SG and CNO need to pitch a fit. Part of this started under Admiral Arthur who never saw a tasker he didn't like. The amount of staffing provided by the Navy caused huge expectations and we have yet to dig out from under them. Our mission in Kuwait is a good example of an Army mission entirely sourced by Navy Medicine.

Admiral Arthur, go figure. There is a real BUMED inspiration. Doctor, lawyer, indian chief, who bought at least one "professional degree" from a diploma mill and yes, did in fact use that so-called credential in his submitted promotion package, a fact that has now been proven with written evidence, despite both his and the Navy's lame and false after-the-fact denials that he didn't.

What a black eye. What an embarrassment. What a complete failure of leadership.

 

[NavyFP]

Admiral Arthur, go figure. There is a real BUMED inspiration. Doctor, lawyer, indian chief, who bought at least one "professional degree" from a diploma mill and yes, did in fact use that so-called credential in his submitted promotion package, a fact that has now been proven with written evidence, despite both his and the Navy's lame and false after-the-fact denials that he didn't.

What a black eye. What an embarrassment. What a complete failure of leadership.

I think that is putting it mildly. I have a few other choice adjectives, but will refrain.

 

[IgD]

The thing all about the Army mental health taskers was the Marine Corps needed the mental health officers way more than the Army. It seemed like we had 1/10th of the mental health assets that the Army had. At the same time the Navy leadership supported pulling what little mental health assets we had to support the Army compounding the problem. For example, one of the social workers who got murdered in Iraq was pulled from Camp Lejeune according to the information I have.

Very frustrating not to feel supported by leadership.

 

[pgg]

That's the point I was trying to make. It's not really fair for Navy and AF physicians to be pulled to deploy in Army billets when Army physicians are going straight from residencies into fellowships without a utilization tour.

In the words of one of my favorite Corpsmen from my GMO days ...

"I hate the Army more than I hate the enemy, sir."

 

[AF M4]

I think that is putting it mildly. I have a few other choice adjectives, but will refrain.

http://www.military.com/news/article/exadmiral-claimed-dubious-degrees.html

Wow. I actually had never heard of this before this thread. That is classic. Damn, you can get as far as you want in milmed so long as you don't give a damn about maintaining your integrity. Wow.

 

[Gastrapathy]

I hate the Army too but it is possible that they kept Hasan in fellowship to avoid having him practice unsupervised. His fellowship was a non-patient care type job.

 

[BigNavyPedsGuy]

I hate the Army too but it is possible that they kept Hasan in fellowship to avoid having him practice unsupervised. His fellowship was a non-patient care type job.

So, I should suck at my job to get the fellowship I want? 🙁

 

[colbgw02]

I hate the Army too but it is possible that they kept Hasan in fellowship to avoid having him practice unsupervised. His fellowship was a non-patient care type job.

I'm not following your logic. The total amount of time he would have practiced unsupervised at best stayed the same after his fellowship. In all likelihood, doing a fellowship lengthened his ADO. Why delay and even prolong the inevitable?

It's possible that Hasan had a genuine interest in his subspecialty, but when I heard that he did a fellowship my first thought was that he was trying to lengthen the amount of time he remained in a non-deployable status. Back in 2006 or so - when he was applying for fellowship - he may very well have believed that his likelihood of deploying would be significantly decreased by the time he exited fellowship (July 2009).

Perhaps some psychiatrists, particular Army ones, can speak to the popularity and competition of Hasan's fellowship. If it's an uncommonly selected one, then that would speak for my theory.

 

[NavyFP]

I'm not following your logic. The total amount of time he would have practiced unsupervised at best stayed the same after his fellowship. In all likelihood, doing a fellowship lengthened his ADO. Why delay and even prolong the inevitable?

It's possible that Hasan had a genuine interest in his subspecialty, but when I heard that he did a fellowship my first thought was that he was trying to lengthen the amount of time he remained in a non-deployable status. Back in 2006 or so - when he was applying for fellowship - he may very well have believed that his likelihood of deploying would be significantly decreased by the time he exited fellowship (July 2009).

Perhaps some psychiatrists, particular Army ones, can speak to the popularity and competition of Hasan's fellowship. If it's an uncommonly selected one, then that would speak for my theory.

With ROTC and USUHS obligations, adding a fellowship will not increase his overall ADO. Staying in a non-deployable status may have been an incentive, but I can see also keeping him in a position where he could be supervised. I would hate for him to go off and have been a division psychiatrist.

 

[colbgw02]

With ROTC and USUHS obligations, adding a fellowship will not increase his overall ADO. Staying in a non-deployable status may have been an incentive, but I can see also keeping him in a position where he could be supervised. I would hate for him to go off and have been a division psychiatrist.

A sponsored fellowship at a civilian program would have increased his ADO irrespective of how much time he already owed. I'm guessing you already know that he did his fellowship at an MTF, because I honestly don't know where he did it??

 

[dwb8p]

A sponsored fellowship at a civilian program would have increased his ADO irrespective of how much time he already owed. I'm guessing you already know that he did his fellowship at an MTF, because I honestly don't know where he did it??

Fellowship was at USUHS.

 

[pgg]

With ROTC and USUHS obligations, adding a fellowship will not increase his overall ADO.

The fellowship still increases his time on active duty, if for no other reason than his payback clock stopped for the two years he was a fellow.


I too suspect his motivation for fellowship was at least partly due to a desire to stay nondeployable for another two years ... during which time op tempo might have decreased and a new president who wasn't GWB might have scaled back troop deployments.

And perhaps he was also trying to move to a less clinical future though the fellowship in emergency & disaster psychiatry, with its concurrent MPH program. (There's plenty of cynical discussion on this forum regarding less capable clinicians taking the admin track by piling on degrees and other quals.)

 

[Gastrapathy]

Surgeons will sometimes encourage less than slick senior residents to do a fellowship. A little more supervised time benefits the trainee and the system.

Perhaps Hasan figured that this would make him less deployable. When you have a 9 year committment (7 years for USUHS plus 2 bonus years for taking 6 years to graduate), that probably already seemed like forever to him.

 

[BlackFrancis33]

This kind of makes me laugh. Most Army GME graduates do a utilization tour before getting fellowship due to the 'points' system. I assure you that the main reason AF and Navy are filling Army billets is not because all of the Army GME grads are out doing fellowships. This is a rare exception rather than a rule. I wish it were true since I am being utilized while awaiting (hoping) to do a fellowship.

 

[GeoLeoX]

The Army puts more people straight through residency to fellowship because there are on the average more opportunities to do so than the Navy or Air Force. The Army has the largest GME program in the DOD. There are point-based "merit" systems for all branches. In addition the Army has made a commitment to having board-certified physicians treating their service members and dependents and for that reason have phased out most GMO positions. These decisions were made in peacetime and are having repercussions now on the medical mission. The Navy has a different mission and a greater number of billets for GMOs. As a result more Navy GMOs deploy than Army GMOs. Then there's the aforementioned ADM Arthur's vision of single-handedly destroying Navy GME...