The Hidden Catches of HPSP/USUHS

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've enjoyed your posts in the past and hope I am just reading too much into your last sentence.
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Sorry about that... my bad. As I re-read that now, I realize that it makes me sound like I'm accusing everyone else of having no integrity.

I really could have said that better... Please don't take it as any sort of implied accusation.
 
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Ex-44E3A said:
Sorry about that... my bad. As I re-read that now, I realize that it makes me sound like I'm accusing everyone else of having no integrity.

I really could have said that better... Please don't take it as any sort of implied accusation.
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No problem. It seemed harsh to me yet from your prior posts I never saw that from you, so I figured I was probably just reading something into it.
 
Edited. Thanks for bringing that to my attention.

Threadjack over... back to the topic at hand.
 
chopperdoc said:
Also, you anti-Christian sentiments were appalling, ignorant, and downright disrespectful to the many amazing Christians soldiers that fight in out great military.
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I receive command wide e-mails on the daily basis containing words like “Godspeed” or biblical passages on the signature section. Sadly, most of this e-mails come from my leadership. This is simply unacceptable. BTW, I grew up in a catholic family…

PS:

This is one of the most fanatical posts I have seen on SDN so far.
 
Dive MD,
The term Godspeed is not Christian in nature, Wikipedia defines it as...

Godspeed, as a word, is a wish for a prosperous journey, success, and good fortune. For example, it was said by Scott Carpenter to John Glenn before Glenn's first trip to space in Friendship 7.

The Bible happens to be the most quoted book in history, and often times it's quoted by non-Christians. I'm sorry if you were offended by Commanders who use Bible verses in their signature lines. Are you honestly telling us that you were offended and concerned by these things? I've seen alot of quotes / references attached to people's signature lines (some of them very crude) and I've never been too concerned about them. Do you think you might be a little too on the sensitive side?
 
Tired said:
At the risk of being grossly obvious . . .

I assume then, that you would be comfortable receiving an email from your CO that ended with, "There is only one God, and Allah is his prophet"?

Or "May the great God Vishnu guide our hands this day"?

Or perhaps, "Praise be lord Satan"?

I mean really. This kind of overt religious material is no longer acceptable in any civilian business setting or government office. Why in the military, where personnel cohesion is so much more important, should it be accepted?
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this is a great discussion topic. I have some agreements on both sides. I will say that I would be "comfortable" if someone sent me an email that said "God Bless" or some other Christian "comment", and at the same time I would be "unconfortable" if the comment were "Praise be Satan" or something "nonChristian" but still "religious". Why is that. Because when someone claims (and hopefully attemps to live their life accordingly) it gives you alot of insight as to "who they are". And in general, somebody should be confortable with a "true Christian" because in general, that person is somebody who will treat everyone (Christian and non Christian alike) with respect, love etc. That is a "comforting" thing to know, and is certainly better than how many people treat others.

Now the "Praise Vishnu" or other things similar may alos be "reashuring" but I would be uncomfortable, just because of my lack of knowledge on what some thing like that means. In general I have found "people of faith", any faith, including Muslim, Christian, Jewish etc to be the most wonderful people. Now there are always the EXTREMIST in any religion, and that can get scary (ie terrorist etc) but they are the minority (although in the Muslim case, even a minority of a billion can cause alot of problems/terrorism).

So back to the original question. I do not put "God Bless" in my emails, but with my friends, co-workers, and even patients; when appropriate I completely share my faith. To NOT do so shows how little/weak my faith/beliefs are.
 
Tired said:
At the risk of being grossly obvious . . .

I assume then, that you would be comfortable receiving an email from your CO that ended with, "There is only one God, and Allah is his prophet"?

Or "May the great God Vishnu guide our hands this day"?

Or perhaps, "Praise be lord Satan"?

I mean really. This kind of overt religious material is no longer acceptable in any civilian business setting or government office. Why in the military, where personnel cohesion is so much more important, should it be accepted?
Click to expand...

this is a great discussion topic. I have some agreements on both sides. I will say that I would be "comfortable" if someone sent me an email that said "God Bless" or some other Christian "comment", and at the same time I would be "unconfortable" if the comment were "Praise be Satan" or something "nonChristian" but still "religious". Why is that. Because when someone claims (and hopefully attemps to live their life accordingly) it gives you alot of insight as to "who they are". And in general, somebody should be confortable with a "true Christian" because in general, that person is somebody who will treat everyone (Christian and non Christian alike) with respect, love etc. That is a "comforting" thing to know, and is certainly better than how many people treat others.

Now the "Praise Vishnu" or other things similar may also be "reassuring" but I would be uncomfortable, just because of my lack of knowledge on what some thing like that means. In general I have found "people of faith", any faith, including Muslim, Christian, Jewish etc to be the most wonderful people. Now there are always the EXTREMIST in any religion, and that can get scary (ie terrorist etc) but they are the minority (although in the Muslim case, even a minority of a billion can cause alot of problems/terrorism).

So back to the original question. I do not put "God Bless" in my emails, but with my friends, co-workers, and even patients; when appropriate I completely share my faith. To NOT do so shows how little/weak my faith/beliefs are.
 
Tired said:
At the risk of being grossly obvious . . .

I assume then, that you would be comfortable receiving an email from your CO that ended with, "There is only one God, and Allah is his prophet"?

Or "May the great God Vishnu guide our hands this day"?

Or perhaps, "Praise be lord Satan"?

I mean really. This kind of overt religious material is no longer acceptable in any civilian business setting or government office. Why in the military, where personnel cohesion is so much more important, should it be accepted?
Click to expand...

this is a great discussion topic. I have some agreements on both sides. I will say that I would be "comfortable" if someone sent me an email that said "God Bless" or some other Christian "comment", and at the same time I would be "uncomfortable" if the comment were "Praise be Satan" or something "nonChristian" but still "religious". Why is that. Because when someone claims (and hopefully attemps to live their life accordingly) as a Christian, hopefiully it gives you alot of insight as to "who they are". And in general, somebody should be confortable with a "true Christian" because in general, that person is somebody who will treat everyone (Christian and non Christian alike) with respect, love etc. That is a "comforting" thing to know, and is certainly better than how many people treat others.

Now the "Praise Vishnu" or other things similar may also be "reassuring" but I would be uncomfortable, just because of my lack of knowledge on what some thing like that means. In general I have found "people of faith", any faith, including Muslim, Christian, Jewish etc to be the most wonderful people. Now there are always the EXTREMIST in any religion, and that can get scary (ie terrorist etc) but they are the minority (although in the Muslim case, even a minority of a billion can cause alot of problems/terrorism).

So back to the original question. I do not put "God Bless" in my emails, but with my friends, co-workers, and even patients; when appropriate I completely share my faith. To NOT do so shows how little/weak my faith/beliefs are.
 
62Alpha said:
I'm an Army Emergency Physician currently on my ninth month in Iraq. I thought of a few more "hidden catches" you could add to your list MC:
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Welcome! It's great to hear the perspective of another specialty trained military physician. I echo the sentiment above: regardless of our feelings with regard to the ongoing fiasco in Iraq, we truly appreciate your service to our nation, and to its brave sons and daughters serving in harm's way.

Oh, and I really like the moniker "MC"...now, who borrowed my hammer?

--There is a war on and as a military doctor you may have to actually come over here and take care of young Soldiers, Sailors, Airmen and Marines who make much less money than you but are actually putting their lives on the line.
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During my brief time deployed in support of OEF to Incirlik AB, Turkey, I found that, other than the pangs of missing my family (especially my 2 year old ex-preemie), life while deployed is filled with 99.9% less of the soul-sucking bullSurgeonGeneral one suffers while being micromanaged by microcephalic *****s at one's CONUS base/post. Sadly, I have since heard that the Nurse Corps empowerment CA has metastasized to our deployed MTFs:
http://www.medicalcorpse.com/doctorssuggestions.html

--While deployed you will likely deal with primadona physicians who cannot seem to understand why they personally have been so inconvenienced. While you will at times want to kill them yourself, all of the primadonas will make it home safely at the end of their tours, unlike the soldiers you'll be asked to treat.
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Do you think that the profession of medicine self-selects "primadonna" personalities who are driven and arrogant enough to put knives and tubes into people's bodies to cure them? Just asking.

--Because there are fewer and fewer medical students willing to suffer the inconveniences of military service you will have to bear a greater share of the burden.
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Alternatively, from a business perspective, the U.S. military has done nothing to make service as a physician more attractive to potential "buyers", even though the risk of deployment, death and dismemberment has increased 643% since when I joined in 1981. Back then, unless the Warsaw Pact rolled across the Fulda Gap to start WWIII, we were pretty secure in the knowledge that we could spend our military careers deterring wars, rather than (political viewpoint alert) prosecuting ones we start voluntarily based on false information without any viable exit strategy. Imagine if the risk of owning, say, a Lexus came with a 1% chance it might explode, leading to death or permanent disability. If fewer people choose to buy Lexus vehicles, should Lexus A) blame the buyers for lack of brand loyalty, B) whine about how difficult this situation makes the lives of hard-working Lexus dealers, C) provide massive incentives which motivate people to buy cars fully loaded with C4 despite all risks, or D) fix the problem with exploding cars? You're basically saying that medical students should be encouraged to choose a life contrary to their individual long-term self-interests. This is a recipe for recruiting *****s.

--Every time some congressperson demands an investigation into something that happened on some base somewhere it will translate into an additional hour of annual mandatory training for the million plus people in the Military, and no the people who make this crap up don't let you off the hook because you are a really smart doctor. I personally have had two hours of training in the last year to prevent me from raping people.
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Don't forget not to off yourself (Wingman Day) or engage in human trafficking (http://www.defenselink.mil/news/Sep2004/n09212004_2004092109.html)

--A plurality of people in the military are overworked, underpaid and undervalued. Since most of them cannot double, triple, quadruple or better their salary the moment they get out it is hard to find non-doctors in uniform who understand what a hardship that low six-figure salary is for you.
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Conversely, people who choose not to double, triple, or quadruple their salaries the moment their ADSCs expire must be motivated by:
1) Stupidity
2) Lack of sufficient clinical skills to make it on the outside, due to years of mistaking Outlook operations and Powerpoint Pap smears for actual medical care.
3) Overweening lust for power over the lives of others via the UCMJ authority given to non-clinical *****s with shiny shoulders (e.g., my Colonel "Rusty")
4) Pathological patriotism...the kind which makes you act against the financial and familial interests of yourself, your children, your spouse, and your descendants.
5) Sheer sloth: It's so much easier to continue in the well-worn, regimented military rut to which you have become accustomed over more than a decade than to join the scary "outside" world.
6) Did I mention stupidity yet?

--Once you graduate from medical school without owing a penny and earn 10K more a year as a resident than your civilian counterparts, the fact that a lot of money has been spent on your sorry butt will fade from your mind as you compare and despair with your civilian buddies who are making a mint while you are in the damn Military and actually have to do what you said you would do (what were you thinking?!)
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Oooh, 10K more a year. Wow. That's a lot of money in 2007, isn't it?

I spent 15 years in the damned Military as a physician doing what I said I would do. To review for those who care: 4 years for ROTC to Harvard, 7 years for USUHS, and 4 years as a resident (didn't count toward payback) = 15 years total service toward retirement. As a matter of honor, I consider the 4 years in uniform, under the UCMJ, on active duty at USUHS as active duty time, which is why I repeatedly say: 19 years total active duty, of which 15 years counted toward retirement (yes, the 4 years I spent at USU would have been given back had I survived to 20 years [e.g., 24 years TAFMS at the 20 year point], but who cares?).

The point is this: If I, who grew up in the military since age 17, and who owed a good chunk of my life to the Air Force, could become so terminally embittered at the mistreatment I suffered, the malpractice committed on our troops and their families, and the utter disintegration of what USED to be a proud institution-- U.S. military medicine-- how much more could a 4 year HPSP Ranger, subject to far less indoctrination than I received, expect to be totally miserable being micromanaged by non-physicians in the desert? That's the key: I should have been a poster child for U.S. military medicine as an O-6 by this year...instead, I am just another bitter ex-military physician casualty of the obscenely dysfunctional and moribund Military Medical Corpse.

I enjoyed our little chat. Let's do this more often.

Rob
Ex-LtCol, etc.
http://www.medicalcorpse.com

(note: my .sig doesn't always show up on my posts. Consider this yet another example of the military Dept. of Redundancy Department you will know and loathe on active duty)
 
USAFdoc said:
this is a great discussion topic. I have some agreements on both sides. I will say that I would be "comfortable" if someone sent me an email that said "God Bless" or some other Christian "comment", and at the same time I would be "uncomfortable" if the comment were "Praise be Satan" or something "nonChristian" but still "religious". Why is that. Because when someone claims (and hopefully attemps to live their life accordingly) as a Christian, hopefiully it gives you alot of insight as to "who they are".
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I could not agree more.

http://www.google.com/search?hl=en&lr=&q=%22priest+molestation"
http://www.denverpost.com/ci_4817067
http://www.msnbc.msn.com/id/16281616/
http://www.msnbc.msn.com/id/7769149/
http://www.bpnews.net/bpnews.asp?ID=22401
http://www.plamerican.com/node/311
http://www.wdtn.com/dsp_story.cfm?storyid=64042
http://en.wikipedia.org/wiki/Jimmy_Swaggart
http://en.wikipedia.org/wiki/Inquisition
http://www.jewishvirtuallibrary.org/jsource/anti-semitism/pius.html
http://en.wikipedia.org/wiki/Crusades
http://www.amazon.com/Dark-Side-Christian-History/dp/0964487349
(update) http://www.cnn.com/2007/WORLD/europe/01/07/poland.bishop.reut/index.html

A lot of insight indeed.

--
R
Your resident born-again Pagan since ca. 1985
 
chopperdoc said:
The Bible happens to be the most quoted book in history, and often times it's quoted by non-Christians. I'm sorry if you were offended by Commanders who use Bible verses in their signature lines. Are you honestly telling us that you were offended and concerned by these things? I've seen alot of quotes / references attached to people's signature lines (some of them very crude) and I've never been too concerned about them. Do you think you might be a little too on the sensitive side?
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So, if I had made it to O-6, I would have been within my rights to put Pagan/Wiccan quotes/prayers/verbiage into my official e-mails using official U.S. government computer systems?

Once again it's time for the (cue theme music) Alternate Reality Thought Experiment Game:

Date: 21 June 2009
To: Members of MedicalCorpse's Command
From: Col. (Dr.) MedicalCorpse
Subject: Summer Solstice Greetings

I wish to greet all of my hard-working medics at this apogee of Light. I know it's hard to stand the brutal glare of Father Sol here in this dry and dusty land, but know that all the blessings of the Mother Goddess be upon you for your courageous support of Our Nation's goal to bring the joys of Paganism to this benighted, Islamic country. Thus, I have composed the following, original poem for your enjoyment.

As always,

Blessed Be!

Frater Dreamquencher, a.k.a. Col. (Dr.) MedicalCorpse

A Celebration of the Summer Solstice (Litha)

Croeso, Alban Heruin!
(Welcome, Light of the Shore!)

Now is the mighty Sun, life-bringer, at his apex
Bel, Sky-Father, glowing comforter of trees, we greet thee!
Now is Danu, Mother Earth, prepared for you
Deep in darkest mystery of once-dead forests
Spiralling wildly amidst the triumphant green
Hidden within the eternal, Sea-cooled wood.
In the mystic light of that blue-green shore,
Join now in joyous Oneness!
That our celebration of life be ecstatic:
Join now!
That our hearts be merry at Midsummer:
Join now!
To banish fear of the coming darkness:
Join now!
To crown the Oak King upon that swirling Throne
Filled to the golden brim with ivy life
Hurtling insatiably ever starward,
Join and drink
Of life and love,
To the emerald keening of
A distant dove

So mote it be!

an original poem by F.D.
Rob Jones, M.D.
Col, USAF, MC
Commander, 675th Imperial CSH, Tehran, Iran Protectorate, Objective United States of America

----

That would go over well, right? You wouldn't mind seeing that in your inbox, would you?

P.S. Pagans never proselytize...which is why this is an Alternate Reality Thought Experiment, get it?
 
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USAFdoc said:
So back to the original question. I do not put "God Bless" in my emails, but with my friends, co-workers, and even patients; when appropriate I completely share my faith. To NOT do so shows how little/weak my faith/beliefs are.
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I would argue that the "when appropriate" time is limited to when you are out of uniform and not on U.S. federal military property.

Otherwise, there will always be those who feel, as I do, that attempted proselytization of ANY religion while using the power and perks of military rank violates the First Amendment to the Constitution of the United States of America...which we raised our right hands to support and defend.

Unless, like Major General Jack Catton, you put your God in front of your Constitution while at work: http://forums.studentdoctor.net/showpost.php?p=4562588&postcount=22

Perhaps all those who feel so strongly that their God should be first in their lives, above our Constitution, should seriously consider resigning their military commissions and joining the ministry of their respective religions.

You would not tolerate the anesthesiologist at your military hospital sharing his Wiccan/Pagan beliefs with your patients in the spirit of "witnessing"; why should I tolerate the proselytization of the captive audience of your co-workers, subordinates, and patients to Christianity?

From when I joined the military in 1981 until ca. 2000, it was clear that the military stood both for freedom OF personal religion, and freedom FROM inappropriate expressions of religion while on duty. The fact that this paradigm has changed 180 degrees in the last 7 years did, in fact, contribute to my decision to leave the Air Force after putting in 1.5 decades toward retirement.

Blessed be!

--
R
 
Nota bene: initial post in this thread has been modified based on y'all's kind feedback.

Thank you, thank you very much.

--
R

MedicalCorpse said:
The "Hidden Catches" of HPSP/USUHS
Catch 1-8 of 100​

Hidden catch #1: (Updated) If you choose to join the Air Force or the Navy, you will most likely NOT get the residency of your choice right out of internship. The USAF and Navy force interns to do General Medical Officer/Flight Surgeon tours of 2-3 years after internship, where you will be treating the runny noses and jock itch of soldiers/sailors/airmen/marines with no opportunity for further education during that time. I have been informed (see below) that the U.S. Army is currently (late 2006) treating its interns better; there appear to be more opportunities for residency right out of internship in the Army. However...

Hidden catch #2: In all branches of service, even after your GMO tour, you will not be guaranteed the residency of your choice. The number of slots available in each service varies from year to year; often, between 50-100% of people who want training in a specific specialty fail to match. Even after you are residency trained, there is no guarantee you won't get deployed to fill a GMO slot anyway (imagine being a pediatrician, urologist or radiologist and being sent to see sick call in a busy ER in the desert-- this happens [see our honorable moderator's post on this topic below]).
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-I am a little disappointed that the AF decided to bring back the obligated GMO tours for transitional years. Minimal possiblity of doing a GMO tours was the main reason I joined the AF.😡

-When I signed up, I didn't know that there was a specific formula that gave a overwhelming advantage to returning GMOs when it came to matching into residencies. I knew they had an advantage, but not to the extent the formula provides them.🙁

I'm sure these will not be the end of my disappointments while I'm on HPSP. Then again, what part of my life do I NOT have any complaints? As long as the good outweighs the bad, I'll be cool with it. Sounds like the future is looking a little gloomy for me, but I'm hoping I'll be the lucky few who will have at least a decent experience with all this.

Thanks again to all who post valuable information. One request I have is that when people post statistics, such as the percentage of people who didnt get the residency of their choice, I would like to see some official data to validate the numbers. If the poster cannot provide one, please put a disclaimer like "I believe.." or "from my experience.." Most people have these disclaimers, but some people tend to state stats as if they are the true representation of the entire military medicine community.

One question I had about getting into the residency of your choice:
Do the stats(and/or personal experience) mentioned apply equally to D.O. students as they do to M.D. students? Most D.O.s do primary care, and I have heard that one reason why this is true is that it is harder for a D.O. to find a non-primary care residency compared to their M.D. counterparts.

My current impression of military medicine is that they tend to be more friendly to D.O. than the civilian sector. For example, I know that some civilian residencies still do not accept the COMLEX scores, whereas ALL military residencies accept it. I'm hoping this is not another common myth among the inexperienced and naive medical student community😛
 
chopperdoc said:
Dive MD,
The term Godspeed is not Christian in nature, Wikipedia defines it as...

Godspeed, as a word, is a wish for a prosperous journey, success, and good fortune. For example, it was said by Scott Carpenter to John Glenn before Glenn's first trip to space in Friendship 7.
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REALLY? Why don't you go ahead and search the same term on Wiktionary:

http://en.wiktionary.org/wiki/godspeed

Godspeed:

1) An expression of respect and good will when addressing someone, typically someone about to go on a journey or a daring endeavor.
2) A Christian substitute to the otherwise sacrilegious "good luck", which implies that anything can be random and out of the hands of God. Used to express concern and prayer for someone.


BTW, while you are in uniform...keep it secular.
 
MC:

You must have some serious free time to be able to make such lengthy contributions to this forum. I must say, though, that I am impressed by your prose and creativity! Keep it coming!
 
chopperdoc said:
The Bible happens to be the most quoted book in history, and often times it's quoted by non-Christians. I'm sorry if you were offended by Commanders who use Bible verses in their signature lines. Are you honestly telling us that you were offended and concerned by these things? I've seen alot of quotes / references attached to people's signature lines (some of them very crude) and I've never been too concerned about them. Do you think you might be a little too on the sensitive side?
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Of course I am concerned. Military rules are there to be followed. Religious propaganda should never be part of official military communications. As a Christian, I am objective enough to know that not all my fellow sailors want to read biblical passages every time they get an e-mail about GMT’s, PT sessions or award ceremonies. You apparently can’t understand that not everybody in the military is a Christian. In which planet do you live?
 
While may sole exposure to military medicine was a three-week course at AFIP, which was awsome, but also happened a loooong time ago, I do agree that there seems to be serious and increasing problems, at many levels. I

can imagine, that the horrible situation in Iraq must put a serious strain on the already stretched medical system. I can fully understand, that it must be incredibly problematic, if medical decisions are being second-guessed by non-physician superiors. I agree, that while personal religious freedom is a given, it is inappropriate for people in leadership to openly and sometimes brazenly refer to their religious beliefs when communicating with subordinates.

I am also remined of an excellent story I read a while back about two neurosurgeons in Iraq, telling about the challenges they face. I was, however, especially struck by their mentioning that they should be armed AT ALL TIMES, even in the OR. In fact, there was a picture of them in a hallway, with rifles (not pistols, mind you) slung across their back. Imagine trying to save a 19-year old from gunshot wounds to the head, while you're trying to keep your firearm from interfering with your work. Absurd...

While I obviously respect the physicians, nurses and other healthcare workers who care for soldiers and their dependents, and note that the military medical service to my knowledge is the only truly comprehensive free medical system in the US, I would have to agree that it seems that serious action must be taken, unless the system will completely fall apart.

This of course would invariably require more money. But it seems that other steps could be taken, such as separating administrative and medical command chains (as in the civilian world, where a nurse must follow instructions from a Resident, who must follow an Attending, who may has to follow a Chairman, but certainly not the hospital CEO, Chief Administrator or Financial Controller).
Also, creating attractive residency options would be a helpful step forward. Imagine, if federal funds could create special HSPS residencies at UCSF, Hopkins, MGH, etc., where military residents would even receive higher pay... That could be a pretty powerful recuiting tool.

As of now, I am frankly chocked by the bitterness of most of the posters in this forum. Obviously, there'll always be miscontends in any system, but I think there's way to many different posters, that obviously know the system intimately, and essentially are in agreement that it's broken down. Very sad.
 
here's an interesting quote from this weeks navytimes. It's in the article about degrading support for the war within the military:

"One contentious area of military life in the past year has been the role religion should play. Some troops have complained that they feel pressure to attend religious services. Others have complained that chaplains and superior officers have tried to convert them. Half of the poll respondents said that at least once a month, they attend official military gatherings, other than meals and chapel services, that began with a prayer. But 80 percent said they feel free to practice and express their religion within the military"
 
danjo said:
MC:

You must have some serious free time to be able to make such lengthy contributions to this forum. I must say, though, that I am impressed by your prose and creativity! Keep it coming!
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Thanks. I work 50-80 hours/week in the O.R. at my civilian institution. I worked about the same (or more) at Andrews...much, much more between Sep-Dec 01. Luckily, unlike at Andrews, Travis, and WHMC, there is no OB at my facilty 😛 . Oh, and the E.D. docs are sufficiently intelligent to transfer major trauma patients out, rather than trying, as the Andrews E.D. docs did, to play as if MGMC were something other than a level 328 trauma center.

I am required to attend exactly 2 (two) mandatory meetings per year. At these meetings, a free, catered dinner is served, to include prime rib cut to order, tender lamb, crabcakes, and abundant wine, which I am encouraged to partake of by my group president (to make the 1 hour meeting go quicker).

Oh, and at the last meeting, $100.00 American Express gift cards were handed out as door prizes, in order to motivate the important and valued physicians who support my community hospital to attend the mandatory meetings.

Things to look forward to when you (inevitably) make the correct decision to punch out when your ADSC concludes...

--
R
 
PathOne said:
(slightly redacted for readability) As of now, I am frankly shocked by the bitterness of most of the posters in this forum. Obviously, there'll always be miscontents in any system. However, I think there are way too many different posters who obviously know the system intimately; they essentially are in agreement that it's broken down. Very sad.
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(bowing) Grasshopper, truly you have learned the ways of Wushu. I can teach you no more.

--
R
 
HumptyDumptyMil said:
My current impression of military medicine is that they tend to be more friendly to D.O. than the civilian sector. For example, I know that some civilian residencies still do not accept the COMLEX scores, whereas ALL military residencies accept it. I'm hoping this is not another common myth among the inexperienced and naive medical student community😛
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I beg to differ. One of my best friends in this world, and my colleague in my private practice, is a D.O. anesthesiologist. He is respected throughout my hospital as an extremely talented and personable physician. I have helped him with three emergency AAAs over the past 1.5 years (the last time when I wasn't even on call): no one could have managed patients better.

D.O.s should absolutely not worry that the letters after their names will reflect ill on their futures in civilian medicine. In the end, competence and caring trump papers on the wall.

--
R
 
backrow said:
here's an interesting quote from this weeks navytimes. It's in the article about degrading support for the war within the military:

"One contentious area of military life in the past year has been the role religion should play. Some troops have complained that they feel pressure to attend religious services. Others have complained that chaplains and superior officers have tried to convert them. Half of the poll respondents said that at least once a month, they attend official military gatherings, other than meals and chapel services, that began with a prayer. But 80 percent said they feel free to practice and express their religion within the military"
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Here's a link to the entire article (the quotation above is from the very end of said article): http://www.militarycity.com/polls/2006_main.php

--
R
 
Tired said:
The military, I've been told by assorted HPSP DO students, does not really have this bias. Thus many DOs who would have a very very difficult time getting competitive allopathic spots in the civilian world may find it much easier in the military match, especially in surgical subspecialties.
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I am not an expert on this matter, nor have I researched this area as thoroughly as Tired. Feel free to ignore my anecdotal post above. Logically, it's about as meaningful as the opinions of those folks who savage me because their idiosyncratic experiences during their prior, non-medical service do not mesh with the harsh reality I experienced as a military attending physician.

"Never mind."
--Rosanne Rosannadanna

--
R, M.D.
 
Tired said:
While the DO is certainly no barrier to the career of an attending, it is probably worth pointing out that DOs face a substantial uphill battle in obtaining an allopathic residency in the civilian world. In addition to the burden of taking both COMLEX and USMLE, many of the DO students I have met describe an inherrent bias against them in the actual selection process. A brief survey of the Pre-Allopathic and Allopathic forums (foramina?) here will reveal a lot of stories about this.

The military, I've been told by assorted HPSP DO students, does not really have this bias. Thus many DOs who would have a very very difficult time getting competitive allopathic spots in the civilian world may find it much easier in the military match, especially in surgical subspecialties.
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Thanks for the info. It always good to hear some positives in a place filled with negatives. I'm currently interested in some sort of surgical specialty, so the military match may work out to my advantage.

MC- Thanks for you anecdotal story as well. It will be another thing I can look forward to after I'm done with my military career. I'm sure that at a individual level, D.O.s are very well respected. I was more concerned with the residency matching process, because I heard that is where D.O.s have the most issues compared to their M.D. counterparts.
 
Quote:
Originally Posted by mitchconnie
Any comparinson to Johns Hopkins or the Duke is simply ludicrous. Walter Reed has about 16 SICU beds. The civilian institution where I trained had over 50. Walter Reed has about 200 staffed beds. Major civilian teaching institutions have 900+.


Apollyon said:
As a few military guys here know, I support everything you guys do and have put up with. As such, I'm just funnin' here.

Duke has 16 SICU beds, and is licensed by the state for 811 beds total.
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duke has 16 general sicu beds, 16 cardiac surgery ICU beds, 16 neuro ICU beds, plus all the ICU's on medicine and peds.
 
Desperado said:
If that were readily available there would be no need to have this forum. The "official data" of which you speak simply isn't published in the military medical system. The only way to get the info is to talk to one of the 3-5 people who actually sat around the table and made the decisions.
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yeah, i was afraid of that. Thought it will be worth it to at least ask🙄
 
encourageable said:
duke has 16 general sicu beds, 16 cardiac surgery ICU beds, 16 neuro ICU beds, plus all the ICU's on medicine and peds.
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"All the ICUs" on medicine and peds equals 12 in the CCU, 16 in the MICU, and 16 in the PICU, both of which have about 4 each of 'garden variety' critical care players. The MICU is half trached rocks, about 4 pulmonary pre/post transplant failures, and the 4 'just sick as hell' patients. The PICU has about half of the cardiothoracic/"one day old Jim Jaggers (who is a GREAT guy and surgeon, by the way)" kids/Blalock-Taussig, Norwood, whatever else kids that are managed by peds cards and peds CTSx, one quarter bone marrow failures, and about 4 at any time generally sick kids (the other kids are totally sick, but specialized).

The cardiac surg ICU beds (isn't that the "ACU"?) don't "count", since, rarely, post-op general surg patients go there, and overflow MICU NEVER go there, and they're not included in the counts for critical care beds when the administrators are trying to juggle which beds are open. It is deceptive to include those numbers.

If the surgical patients go to the NeuroICU, CCU, or MICU, those are all closed units (the team in the unit manages), so they do their damndest not to. Sometimes the patients go to the MICU or NeuroICU, but are moved as soon as they can. So, MOSTLY, it's the 16 SICU beds. It's NOT a "50 bed" SICU. That is the point.
 
OK- so it seems that there's alot mroe complaints about AF HPSP than the other branches... what about Army HPSP? Is it nearly as bad as AF HPSP seems to be (judging from this thread), or are these points applicable to all branches of military medicine?

If so, would all of you recommend FAP instead of HPSP for a medical student set on Trauma Surgery?
 
ummm... I'd pretty much recommend FAP over HPSP whatever your circumstance.

It puts off the decision to join the military until much later in the process, when you're more sure of your specialty, geography, personal situation, etc. That allows you to make a better and more-informed decision without the "needs of the service" screwing you up if you have a mid-course change-of-plan.
 
Ex-44E3A said:
ummm... I'd pretty much recommend FAP over HPSP whatever your circumstance.

It puts off the decision to join the military until much later in the process, when you're more sure of your specialty, geography, personal situation, etc. That allows you to make a better and more-informed decision without the "needs of the service" screwing you up if you have a mid-course change-of-plan.
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I agree, I think FAP is the way to go for most people who are looking to be a military physician. It allows you to put off making the decision for several years, and will most likely give one a better chance at matching in their specialty of choice.
 
Hello! I'd like to thank you all for providing info on the three military medicine feeder programs. At first I was planning on applying to USUHS for med school, primarily because of feelings of duty, "adventure", and the attractive financing (plus I like that whole uniform, orienteering around in the woods with a pack thing). However, my mom became much too worried about my prospects of going to Iraq so, for her sake, I let that go.

I then considered the HSPS program, which I thought would be a good deal if I were accepted to a private medical school costing ~65k/yr + interest.

However, I realized that the FAP would be a much better option for me over HSPS. Even if there is a slight to moderate possibility that I would be forced into a residency I dislike, or forced to be an independent provider (GMO?) without sufficient training, then that is a bit of a deal breaker.

Then, lastly, after reading all these posts, I have to say that I don't think I want to get involved with military medicine at all. I am really sorry that so many of you have had mixed to bad experiences. It is a real shame that the uniformed medical services have deteriorated as you have described.

I'd like to especially applaud MedicalCorpse. While I don't agree with all of your views it takes a lot of bravery to bring these issues out into the open (and put your own name down as well). I wish you the best of luck in publicizing these deficiencies so that (hopefully) they can be remedied.
 
Bottom line:

The posts on this thread are:

30% true
30% well meaning exageration/hype/axe grinding/lacking in perspective
30% anecdote (hard to argue with anecdote)
10% obsolete (e.g. GMOs are largely a thing of the past in the Army--I did one by the way, it's not as bad as you might think)

I don't have the time or energy to go head to head with the points made by MC et al (I redeploy in two weeks!!!), but I'd be happy to pick up the conversation privately with anyone interested in military medicine with questions/concerns they'd like to discuss with an Army physician currently on active duty. Drop me a line.

Cheers.
 
[
QUOTE=62Alpha;4993791]Bottom line:

The posts on this thread are:

30% true
30% well meaning exageration/hype/axe grinding/lacking in perspective
30% anecdote (hard to argue with anecdote)
10% obsolete (e.g. GMOs are largely a thing of the past in the Army--I did one by the way, it's not as bad as you might think)

I don't have the time or energy to go head to head with the points made by MC et al (I redeploy in two weeks!!!), but I'd be happy to pick up the conversation privately with anyone interested in military medicine with questions/concerns they'd like to discuss with an Army physician currently on active duty. Drop me a line.

Cheers.
Click to expand...
[/QUOTE]

1) glad to hear somebody out there is part of an area of milmed that is functioning well.

2) by the way, you must know some milmed FP docs doing 100% clinic work (not admin). Have them say something about how FP is going in the Army.

3) No disrespect, but neither you nor I can make a statement like you just did (30% of posts are true, etc). I have no credibility to critique USArmy Emergency med because I have never been there/done that. I DO have credibility to critique USAF Primary care for the same reason, and I have extensive direct and indirect contacts with many other USAF FP sites.

One of the major reasons for "conflict" on this site are when people start making claims against, or in defense, of things that they have no expertise in. That creates conflict when a med student starts defending milmed, and when a ARMY ER doc starts "claiming" that the majority of threads on this site are "innaccurate".
I would love to hear how well ER Army Med is going and could never dispute what you say about it, and have no reason to doubt you. I would expect the same back on your part.



thanks (and cheers)
 
62Alpha said:
Bottom line:

The posts on this thread are:

30% true
30% well meaning exageration/hype/axe grinding/lacking in perspective
30% anecdote (hard to argue with anecdote)
10% obsolete (e.g. GMOs are largely a thing of the past in the Army--I did one by the way, it's not as bad as you might think)

I don't have the time or energy to go head to head with the points made by MC et al (I redeploy in two weeks!!!), but I'd be happy to pick up the conversation privately with anyone interested in military medicine with questions/concerns they'd like to discuss with an Army physician currently on active duty. Drop me a line.

Cheers.
Click to expand...

And oh by the way building 18 doesn't exist. It was all part of a media conspiracy! I agree there are some good points about military medicine but we need to be honest about the parts that need fixed too.
 
I can't say it any clearer. The points made by current and former military docs like MC, are right on, and most active duty docs at my facility would agree. The frustrating thing is that no one in the upper levels of military medicine is clued in to what is really going on. Military GME needs to close for the good of the soldiers/airmen that we are caring for and for the good of the military medical corps.

I am glad to see that there is a forum for this kind of dialogue so that inherently naive pre-medical students have access to additional insights about real-world military med (ie that which the recruiters are clueless about).

Oh how do I wish I could go back to that fateful day in 1997 when, as a pre-med student sufferin from both a lack of experience and poverty-induced psychoiss, I literally signed my life away.

Now back to the countdown until 2014............
 
Rudy said:
I can't say it any clearer. The points made by current and former military docs like MC, are right on, and most active duty docs at my facility would agree. The frustrating thing is that no one in the upper levels of military medicine is clued in to what is really going on. Military GME needs to close for the good of the soldiers/airmen that we are caring for and for the good of the military medical corps.

I am glad to see that there is a forum for this kind of dialogue so that inherently naive pre-medical students have access to additional insights about real-world military med (ie that which the recruiters are clueless about).

Oh how do I wish I could go back to that fateful day in 1997 when, as a pre-med student sufferin from both a lack of experience and poverty-induced psychoiss, I literally signed my life away.

Now back to the countdown until 2014............
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I feel for you bro. Keep your head high and your integrity intact. Knowing alot of the problems that exists makes your expectations different than what we had. You know the system is broken, and hopefully you can navigate in your immediate surroundings better than we did, and help the deserving people you serve. Thanks for being there, as you will only hear that in times of extreme circumstances, or never at all.

Good luck and keep us informed, and teach others just like we will continue till this crap is shut down or drastically changed.
 
Can anyone comment on their experiences with these points by the OP?

How often do MD's/DO's have to sign off on mid-level providers' charts in garrison or on deployment? I'm an FP thinking of joining Army. Are Np's/PA's having free reign seeing patients without every running the cases by their supervising doctor, then having you sign off on every chart? Should I be worried my license is gonna be on the line every day b/c of the midlevels?

Hidden catch #8: You will be ordered to allow non-physicians to practice essentially independently under the fig leaf of your medical license. In violation of civilian Federal and State law, the military has actively encouraged the independent (mal)practice of CRNAs, NPs, and PAs with inadequate or absent physician supervision. This has been seen as necessary because the current retention rate of M.D.s hovers around the 8% range...while advanced practice nurses, PAs, and other non-M.D. "providers" get a good deal in the military: pay commensurate or better than the outside world, PLUS the ego-boosting chance to gain life or death, UCMJ Command authority over the cowering, low-ranking physicians under them (a situation which essentially never occurs in the outside world). Remember: if a patient dies because of malpractice committed by a PA/CRNA/NP working independently, but your name is on the chart, guess who is going to be reported to the National Practitioner Databank? And do you think that your appeal to the Chain of Command that you never saw the patient, because the system is set up to encourage the independent practice of non-physicians by forcing you to sign charts of patients you were never consulted about, will be grounds for your exoneration, or used as a club to destroy your military career, life, and family in retribution for your "unbecoming conduct" of speaking out in violation of the military medical omerta (code of silence)?
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If I'm reading correctly -- an officer who's completed 20 yrs of service can be recalled at any time after life?

Hidden catch #4: If you do HPSP and fulfill your 4 year payback, you will still owe Uncle Sam 4 more years of IRR (Individual Ready Reserve) service...and many, many docs are being recalled involuntarily from their cushy civilian lives back to active duty right now, even BEFORE we invade (Iran, Syria, Somalia, North Korea, fill in the blank). The military has done a tragically atrocious job of retaining active duty docs; the regular reserves of all services are tapped out...thus, they are right now drawing on troops with IRR commitments and 86 year old retirees (remember, if you retire from the military as an officer, you are subject to involuntary recall to active duty FOR LIFE [yes, I know of an 86 year old psychologist who was given a flak jacket and sent to the desert at a remote location, only to be air evaced back to the U.S. when he *surprisingly* developed a medical problem]).
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Thx folks.
 
Ascultator said:
(remember, if you retire from the military as an officer, you are subject to involuntary recall to active duty FOR LIFE [yes, I know of an 86 year old psychologist who was given a flak jacket and sent to the desert at a remote location, only to be air evaced back to the U.S. when he *surprisingly* developed a medical problem])

If I'm reading correctly -- an officer who's completed 20 yrs of service can be recalled at any time after life?

Thx folks.
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I find it VERY hard to believe they would recall someone that is 86...and send them to a remote desert location...seriously what would you need a psychologist for in a remote location for? Psychologists dont go to med school...unless the OP meant Psychiatrist (which do go to medical school)...anyway a psychologist couldnt fill a GMO spot (again the whole med school thing)...so again...what the heck would u need a psychologist for in a remote desert location...let alone an 86 year old...HAHAHAHA

Remember every contract that is drawn up with the military is an 8 year contract...so say you are already a doc and want to join up...you say I want to serve active duty for 4 years...great you go and serve your 4 years...then back to civi-land...but remember every contract is 8 years so technically after your 4 years of active duty are done...there are 4 years you can be called back up...BUT my understand is once that 8 years is done you are officially released from service including being called back up
 
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If you have a Regular, not Reserve commission, then technically you can be called back in an emergency- even if you've served your obligated years in IRR.

I think this is why the .Mil started giving all Doc's Regular commissions a few years back....

-61N
 
61November said:
If you have a Regular, not Reserve commission, then technically you can be called back in an emergency- even if you've served your obligated years in IRR.

I think this is why the .Mil started giving all Doc's Regular commissions a few years back....

-61N
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Interesting...well done 61N...guess I learned something new today...but still we are probably talking like WW3 for something like that...
 
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61November said:
If you have a Regular, not Reserve commission, then technically you can be called back in an emergency- even if you've served your obligated years in IRR.

I think this is why the .Mil started giving all Doc's Regular commissions a few years back....

-61N
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I wasn't able to find the regulations on this but I was under the impression that you could only be called back if you retired with your commission. If we could be called back at any time, then why put people in the IRR at all?
 
I like how we keep resurrecting these old threads...

Four years later, the original Catches are as true as they've ever been.
 
Superman1978 said:
I wasn't able to find the regulations on this but I was under the impression that you could only be called back if you retired with your commission. If we could be called back at any time, then why put people in the IRR at all?
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The point is that our military has a pecking order for personnel, there are different pools of people. Whenever a job--medical, combat, or otherwise--needs to get done, the military draws from these pools, using the following priority:

Active Duty > Selective Drilling Reservist OR Civilian Contractor > IRR > National Draft.

The military has to keep all of these pools populated, to some extent (the Draft of course, encompassing all registered able body adults). So that's why they place people into the IRR.

We haven't had a draft in almost 40 years, and we hardly recall from the IRR. Between those first 3 pools (AD, SELRES, Contractors), we get the job done 95% of the time. For the remaining 5%, the jobs are usually canceled, or a way is found to do it, without recalling from the IRR (b/c it's a pain to do so).

If you're thinking about joining the mil, base your decision on what/when/how your active duty time will be spent, don't worry so much about the IRR.
 
DrMetal said:
If you're thinking about joining the mil, base your decision on what/when/how your active duty time will be spent, don't worry so much about the IRR.
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Easy for you to say. What would happen to your private practice that you spent years building and invested your life into . . . when you get called up via IRR?
 
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