talked to a milmed in his intern year (hpsp)

[theonlytycrane]

He said that matching into his preferred specialty (radiology) ultimately was determined by his performance on audition rotations during early 4th year and making connections with residency program directors. He said he is safe from GMO/deployment until the completion of residency training and seemed positive about his experiences. He said doing BOLC after ms1 decreased his time for research, but that he got posters and a pub in by managing time well in years 3/4. Just wanted to share info that I got from him, though n=1.

---

Members don't see this ad.

 

[Homunculus]

He said that matching into his preferred specialty (radiology) ultimately was determined by his performance on audition rotations during early 4th year and making connections with residency program directors. He said he is safe from GMO/deployment until the completion of residency training and seemed positive about his experiences. He said doing BOLC after ms1 decreased his time for research, but that he got posters and a pub in by managing time well in years 3/4. Just wanted to share info that I got from him, though n=1.

sounds pretty par for the course. the death by a thousand cuts starts later in residency and as staff. most military residents have it pretty good, to be honest.

--your friendly neighborhood soon the veil will be pierced caveman

 

[Gastrapathy]

He doesn't know why he was selected or who was left on the cutting room floor. We all want to think we are chosen on our merits but these processes are highly subjective (even when they are sincerely trying to be objective).

That said, he is one of the fortunate group who will train due course. There are folks who roll through their time unscathed and he's made it through the first round. May the odds be forever in his favor.

 

[pgg]

sounds pretty par for the course. the death by a thousand cuts starts later in residency and as staff. most military residents have it pretty good, to be honest.

--your friendly neighborhood soon the veil will be pierced caveman

The tender womb of med school and residency ...

 

[theonlytycrane]

sounds pretty par for the course. the death by a thousand cuts starts later in residency and as staff. most military residents have it pretty good, to be honest.

--your friendly neighborhood soon the veil will be pierced caveman

What types of things specifically? Admin stuff, deployment, or something else?




Sent from my iPhone using SDN mobile app

 

[Homunculus]

What types of things specifically? Admin stuff, deployment, or something else?

Sent from my iPhone using SDN mobile app

all of the above? the forum is full of reasons. you can take your pick of a litany.

endless mandatory training without time given to complete it, no control over schedules, no time given for research, lack of nursing support, lack of resources to properly do our jobs, poor IT support, arbitrary nature of promotions with moving goalposts of standards for promotion, lack of consistency in application of military rules and regulations, 2 year admin tours as BDE/WTU surgeons, 9 month deployments as subspecialists as GMOs, GMO tours in general, disconnect of upper leadership from those in the trenches, lack of loyalty/integrity in commands who expect it of their subordinates, constantly justifying your time, pay disparity with civilian counterparts, treated like a necessary evil instead of the reason people come to the hospital to begin with, lazy unfire-able GS employees, non-deployable colleagues who don't pull their own weight, random UAs run without regard to clinical duties, constantly changing hospital commanders with each wanting to put their own spin on things and change things for the sake of change (and an OER bullet)... the list goes on.

and that's just what I can rattle off sitting here posting between sick call patients. there are countless more. I didn't even get into duty locations, assignments, selection for GME jobs, etc. do these same headaches exist in the civilian world? probably. but there you can walk, or fire people, or actually have the ability to change where you work.

as a resident most of the above things don't apply. once you are birthed into the .mil attending world where you aren't protected by work hour restrictions and a program director, this board will make more sense.

--your friendly neighborhood remembers his blissful days caveman

 

[theonlytycrane]

Is it off-base to say that doing well in med school, boards, and audition rotations should secure a matching spot (safe-guarding from GMO until after residency) for most areas other than the uber competitive fields?

Sometimes I get the feeling that matching in .mil is a dice roll.

 

[Homunculus]

Is it off-base to say that doing well in med school, boards, and audition rotations should secure a matching spot (safe-guarding from GMO until after residency) for most areas other than the uber competitive fields?

Sometimes I get the feeling that matching in .mil is a dice roll.

allow me to add-- fellowship you may be interested in may not be allowed the years you are interested in it, or you may have a year where your residency is hyper-competitive compared to previous years.

in general if you do well in school, score well on boards, and impress the right people on rotations in the "normal" specialties you *should* secure a spot. but it's never 100%. lets say peds has a glut of applicants one year. or they cut a program and some slots go away. in general you will most likely be fine- playing the odds you will be-- but there's always a chance your dice roll may be bad. frankly I wouldn't worry as much about residency as fellowships-- those are much more haphazard and are highly variable depending on demand (people in front of you waiting to start), need (some specialties stay in the army forever like peds ID) and utilization (don't need that many of certain subspecialties).

if you wanna do primary care and stick w/ primary care (kudos to you, i'd poke my own eyeballs out first) you're probably fine.

--your friendly neighborhood deployed soldier PCM is the worst of both caveman

 

[WernickeDO]

Let me add to Homunculus' post: it's not off base to make the assumptions that you are making, but you need to understand that you can do all those things and still end up as a TY bound for GMO time. It is very subjective who goes where. If you rotate at a site and they all like you, then you are in a good spot to match. If they like you but you are #4 on a list of 3, then you're in trouble. Compare that to the civilian match, where you can rank 50+ programs if you want. In the mil it will be more like 5 depending on specialty, and you are part of a hypothetical applicant pool of say 30 people, 7 of whom are going to be disappointed. If the idea of a GMO tour is not appealing to you, then perhaps re-consider joining.

 

[SurgDoc95]

allow me to add-- fellowship you may be interested in may not be allowed the years you are interested in it, or you may have a year where your residency is hyper-competitive compared to previous years.

in general if you do well in school, score well on boards, and impress the right people on rotations in the "normal" specialties you *should* secure a spot. but it's never 100%. lets say peds has a glut of applicants one year. or they cut a program and some slots go away. in general you will most likely be fine- playing the odds you will be-- but there's always a chance your dice roll may be bad. frankly I wouldn't worry as much about residency as fellowships-- those are much more haphazard and are highly variable depending on demand (people in front of you waiting to start), need (some specialties stay in the army forever like peds ID) and utilization (don't need that many of certain subspecialties).

if you wanna do primary care and stick w/ primary care (kudos to you, i'd poke my own eyeballs out first) you're probably fine.

--your friendly neighborhood deployed soldier PCM is the worst of both caveman

If you get unlucky enough to be assigned to a BRigade surgeon tour, are you over seas for two full years or are you stationed stateside? Let's say we're married with kids, are we expected to never see our family for two years?

 

[theonlytycrane]

allow me to add-- fellowship you may be interested in may not be allowed the years you are interested in it, or you may have a year where your residency is hyper-competitive compared to previous years.

in general if you do well in school, score well on boards, and impress the right people on rotations in the "normal" specialties you *should* secure a spot. but it's never 100%. lets say peds has a glut of applicants one year. or they cut a program and some slots go away. in general you will most likely be fine- playing the odds you will be-- but there's always a chance your dice roll may be bad. frankly I wouldn't worry as much about residency as fellowships-- those are much more haphazard and are highly variable depending on demand (people in front of you waiting to start), need (some specialties stay in the army forever like peds ID) and utilization (don't need that many of certain subspecialties).

if you wanna do primary care and stick w/ primary care (kudos to you, i'd poke my own eyeballs out first) you're probably fine.

--your friendly neighborhood deployed soldier PCM is the worst of both caveman

Thanks for the insight. I'm interested in anesthesia, radiology, or maybe something else non-primary care. So I guess the chances would be even lower for residency.


Sent from my iPhone using SDN mobile app

 

[psychbender]

Thanks for the insight. I'm interested in anesthesia, radiology, or maybe something else non-primary care. So I guess the chances would be even lower for residency.

Sent from my iPhone using SDN mobile app

The two Army anesthesiology residency programs are not that competitive, compared to the surgical fields or EM. If your academics are solid and you show that you are attentive and knowledgeable when you do your audition rotation, you'll likely get in (unless your year happens to get 47 applicants for the 20-something spots, which would be unusual).

 

[pgg]

Is it off-base to say that doing well in med school, boards, and audition rotations should secure a matching spot (safe-guarding from GMO until after residency) for most areas other than the uber competitive fields?

Sometimes I get the feeling that matching in .mil is a dice roll.

Oh, the civilian world is a dice roll too, the difference is that there are a whole lot more dice and the middle of the curve is a lot fatter, so the odds of a 1 coming up on every die are a lot lower.


There's another elephant in the room that no one likes to talk about, but he shows up every time a pre-med looking at HPSP starts a post with the assumption of doing well in med school, and puts the cart in front of the horse.

And that is simply this: even though you plan and expect to do well in med school, maybe you won't.

1/4 of every med school class finishes in the bottom 1/4 (go ahead, check my math!) and exactly NONE of those bottom 1/4 MS4s applying for residency thought they'd be there when they were riding high, on top of the world, holding a big fat med school acceptance letter.

In this scenario, being in the military can be bad or good. Bad, because you've got good odds of going to GMO-land, even if you're in a GMO-light service like the Army or AF. Good, because you're going to GMO-land ... and can sort of redeem yourself before taking another stab at the residency you want.

 

[theonlytycrane]

The two Army anesthesiology residency programs are not that competitive, compared to the surgical fields or EM. If your academics are solid and you show that you are attentive and knowledgeable when you do your audition rotation, you'll likely get in (unless your year happens to get 47 applicants for the 20-something spots, which would be unusual).

Doing some cursory research I see that you were an anesthesia intern in 2009! Can I PM you?

Oh, the civilian world is a dice roll too, the difference is that there are a whole lot more dice and the middle of the curve is a lot fatter, so the odds of a 1 coming up on every die are a lot lower.


There's another elephant in the room that no one likes to talk about, but he shows up every time a pre-med looking at HPSP starts a post with the assumption of doing well in med school, and puts the cart in front of the horse.

And that is simply this: even though you plan and expect to do well in med school, maybe you won't.

1/4 of every med school class finishes in the bottom 1/4 (go ahead, check my math!) and exactly NONE of those bottom 1/4 MS4s applying for residency thought they'd be there when they were riding high, on top of the world, holding a big fat med school acceptance letter.

In this scenario, being in the military can be bad or good. Bad, because you've got good odds of going to GMO-land, even if you're in a GMO-light service like the Army or AF. Good, because you're going to GMO-land ... and can sort of redeem yourself before taking another stab at the residency you want.

I also appreciate your insight. I wasn't trying to come off cocky or riding high.

Edit: I think pgg is an anesthesiologist too! I would love to gain more insight from you both

 

[narcusprince]

Doing some cursory research I see that you were an anesthesia intern in 2009! Can I PM you?



I also appreciate your insight. I wasn't trying to come off cocky or riding high.

Edit: I think pgg is an anesthesiologist too! I would love to gain more insight from you both

The military was great when I was in residency. Im also an anesthesiologist. If you want to stack your odds go to the best medical school you can. Bottom 1/4 at hopkins looks better then top 1/4 at someneocom.

 

[theonlytycrane]

The military was great when I was in residency. Im also an anesthesiologist. If you want to stack your odds go to the best medical school you can. Bottom 1/4 at hopkins looks better then top 1/4 at someneocom.

Were you also HPSP and are you still serving in the military? I'll be at a mid-tier MD school so my future is open to my own hard work!

 

[psychbender]

The military was great when I was in residency. Im also an anesthesiologist. If you want to stack your odds go to the best medical school you can. Bottom 1/4 at hopkins looks better then top 1/4 at someneocom.

Of course the military was great when you were a resident. It was all but nonexistent to you. You trained at an excellent civilian program, while being paid by the Navy as active duty (you were FTOS, right?). What's not to love about that? Us poor saps that had to do inservice GME still had it good, as we were paid better than civilian residents, but had crappier cases, worse hours, and had to put up with military BS like random urine drug screens while you're post-call from the ICU, mandatory quarterly sexual assault training, cyber awareness challenges, etc.

Overall, I'm somewhat glad I did HPSP, as I still got my specialty of choice straight out of med school, made the most of my training, went to an assignment where I sometimes got to hone my skills with sick as **** patients, bolstered my CV with leadership experiences, am debt free, and now heading to greener pastures. However, I probably could have done all of that without HPSP, completed fellowship already, and had three years out in practice to eliminate that debt, so I guess it's kind of a wash.

 

[narcusprince]

Of course the military was great when you were a resident. It was all but nonexistent to you. You trained at an excellent civilian program, while being paid by the Navy as active duty (you were FTOS, right?). What's not to love about that? Us poor saps that had to do inservice GME still had it good, as we were paid better than civilian residents, but had crappier cases, worse hours, and had to put up with military BS like random urine drug screens while you're post-call from the ICU, mandatory quarterly sexual assault training, cyber awareness challenges, etc.

Overall, I'm somewhat glad I did HPSP, as I still got my specialty of choice straight out of med school, made the most of my training, went to an assignment where I sometimes got to hone my skills with sick as **** patients, bolstered my CV with leadership experiences, am debt free, and now heading to greener pastures. However, I probably could have done all of that without HPSP, completed fellowship already, and had three years out in practice to eliminate that debt, so I guess it's kind of a wash.

Sails and winds! Enjoy private practice! Psych is exactly right trained on the outside and cannot wait to get out. Once I learned how to work the navy things are better. Also realizing I dont need the navy yet the navy NEEDS me. Life got better.

 

[theonlytycrane]

For the anesthesiologists above, how much more do you expect to earn in the civilian world per year? 1.5x, 2x?

 

[psychbender]

For the anesthesiologists above, how much more do you expect to earn in the civilian world per year? 1.5x, 2x?

At least 3x. I'm doing locums at the moment, and I made as much in one week (M-F, no nights, <50hr week) as the military paid me in a month. As an active duty anesthesiologist during your payback period, you'll make less than a civilian CRNA. If you stay in longer, you can sign up for multi-year bonuses that'll take you up to the low end of the civilian market (mid to high 200k), but unless you're chasing 20 years, I just don't see that it's worth it in the current market.

Money aside, my job satisfaction is much higher right now then when I was in the Army. As locums, I'm doing all of my own cases, and I'm only looking at physician-only practices to join after I complete fellowship. I'm taking care of tons of sick patients right now. A third of my patients these past few weeks have been ASA4s. Most of the remaining have been sick ASA3s. Granted, I think they've been scheduling me this way on purpose as a way to entice me to join here full time, but it's still doing what I love. I don't have to submit crap loads of paperwork to go anywhere on my time off. I had minimal mandatory online training for my fellowship to complete, and that should be it.

Life is good right now.

Sent from my SM-G930V using SDN mobile

 

[theonlytycrane]

At least 3x. I'm doing locums at the moment, and I made as much in one week (M-F, no nights, <50hr week) as the military paid me in a month. As an active duty anesthesiologist during your payback period, you'll make less than a civilian CRNA. If you stay in longer, you can sign up for multi-year bonuses that'll take you up to the low end of the civilian market (mid to high 200k), but unless you're chasing 20 years, I just don't see that it's worth it in the current market.

Money aside, my job satisfaction is much higher right now then when I was in the Army. As locums, I'm doing all of my own cases, and I'm only looking at physician-only practices to join after I complete fellowship. I'm taking care of tons of sick patients right now. A third of my patients these past few weeks have been ASA4s. Most of the remaining have been sick ASA3s. Granted, I think they've been scheduling me this way on purpose as a way to entice me to join here full time, but it's still doing what I love. I don't have to submit crap loads of paperwork to go anywhere on my time off. I had minimal mandatory online training for my fellowship to complete, and that should be it.

Life is good right now.

Sent from my SM-G930V using SDN mobile

Oh wow. Glad to hear that you're doing well. This is an eye-opener. Are your cases in the military often with more healthy patients? Also, are your hours longer?


Sent from my iPhone using SDN mobile app

 

[theonlytycrane]

Also, another question for the anesthesiologists. Are the two army residency programs equally competitive?

 

[psychbender]

I'll respond in detail by PM in another day or two. The movers are here, so I'm a bit preoccupied.

Sent from my SM-G930V using SDN mobile