The Insanity of It All

[island doc]

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I don't think I have told you all about the peds interns we had at my last base. Their stories go to show how crazy things were:

The first poor guy was a peds intern from Indiana. He was in his first year of peds when the AF told him that he wasn't going to finish the civ program. Off to be a GMO in the Adult Medicine Clinic. The poor guy arrived almost clueless. I was working the grave yard shift in the ER and can remember him coming in at like 5:00 in the morning every morning to study, so he could re-learn adult medicine. I came from a TY so had one clue when I got there.

Another was from an active duty peds program. For whatever reason, she too was not allowed to finish either. Guess where they sent her? To work with me in the ER taking care of adults. Is this crazy or what? She did eventually go on to an excellent "named" Civ EM program, after separating.

I guess to have assigned these people to the peds clinic would have made too much sense.

Can anyone explain all this to me???

 

[Croooz]

"Your a doctor dammit!"
That's basically how the brass views it. In the end you all learned the same in medical school so should be able to be put anywhere in military medicine and contribute. 🙄

 

[island doc]

"Your a doctor dammit!"
That's basically how the brass views it. In the end you all learned the same in medical school so should be able to be put anywhere in military medicine and contribute. 🙄

Ah Shucks, I didn't know "a doctor is a doctor is a doctor", if I'd known that I would uh been a brain surgeon GMO 😛 Gee, I could've done some brain transplants on them "brass". 😱

 

[GMO2003]

I don't think I have told you all about the peds interns we had at my last base. Their stories go to show how crazy things were:

The first poor guy was a peds intern from Indiana. He was in his first year of peds when the AF told him that he wasn't going to finish the civ program. Off to be a GMO in the Adult Medicine Clinic. The poor guy arrived almost clueless. I was working the grave yard shift in the ER and can remember him coming in at like 5:00 in the morning every morning to study, so he could re-learn adult medicine. I came from a TY so had one clue when I got there.

Another was from an active duty peds program. For whatever reason, she too was not allowed to finish either. Guess where they sent her? To work with me in the ER taking care of adults. Is this crazy or what? She did eventually go on to an excellent "named" Civ EM program, after separating.

I guess to have assigned these people to the peds clinic would have made too much sense.

Can anyone explain all this to me???

I can definitely relate to what you are saying islandoc. I am currently "doing time" in a GMO billet after completing only a TY. I do feel that my knowledge gaps become apparent at times. This is especially the case when I interact with the other staff who are all board certified in their respective specialties. It makes me look forward to separating so that I can get on with my life and complete my training. 👍

 

[Homunculus]

they essentially do this with all of peds deployments. we're sent into GMO slots.

the kicker is the Peds higher ups actually use this as a selling point to keep us around-- our "deployability" as GMO's allows our training programs to continue.

one would think humanitarian missions would make more sense for pediatricians-- but i'm not sure how many of those we have operating right now. i doubt very many, if any at all. we go, and do an excellent job, but i can't help but think maybe that neonatologist could be better used treating infants that 32 year olds with chest pain. 🙂

--your friendly neighborhood 1.5 years or so away from the desert caveman

 

[island doc]

they essentially do this with all of peds deployments. we're sent into GMO slots.

the kicker is the Peds higher ups actually use this as a selling point to keep us around-- our "deployability" as GMO's allows our training programs to continue.

one would think humanitarian missions would make more sense for pediatricians-- but i'm not sure how many of those we have operating right now. i doubt very many, if any at all. we go, and do an excellent job, but i can't help but think maybe that neonatologist could be better used treating infants that 32 year olds with chest pain. 🙂

--your friendly neighborhood 1.5 years or so away from the desert caveman

There certainly were humanitarian missions to Soto Cano Honduras 5 years ago, I went TDY on one for three weeks. There was a tremendous need for the expertise of peds there. It was one of the best experiences I have ever had in medicine, and was the best experience of my four years in the AFMS. I think there still are MedRetes (Medical Readiness Training Exercises) to Soto Cano. I thought it was a very interesting place. There was a small Army medical unit there that was doing alot of amazing stuff functioning as a surgical "trauma center" for the local Hondurans. They actually did alot of trauma surgery there in this tiny facility with one OR. Any of you been there?

 

[island doc]

I can definitely relate to what you are saying islandoc. I am currently "doing time" in a GMO billet after completing only a TY. I do feel that my knowledge gaps become apparent at times. This is especially the case when I interact with the other staff who are all board certified in their respective specialties. It makes me look forward to separating so that I can get on with my life and complete my training. 👍

Hang in there. Life will get much, much better 👍, trust me. The freedom that awaits you is orgasmic!!

 

[GMO2003]

Hang in there. Life will get much, much better 👍, trust me. The freedom that awaits you is orgasmic!!

thanks for the words of encouragement...I am trying to keep things in perspective...It actually wouldn't be that bad if I had my wife and family with me...the boredom and lonliness can be overwhelming at times.

 

[island doc]

thanks for the words of encouragement...I am trying to keep things in perspective...It actually wouldn't be that bad if I had my wife and family with me...the boredom and lonliness can be overwhelming at times.

I know it really sucks. I narrowly escaped spending my last year on a remote unaccompanied tour. Can you imagine how difficult it would have been to line up a civilian residency, from some isolated overseas hell hole? I can't imagine how a person would line up a civilian residency while they are floating or submerged in the middle of the ocean or hiding in a desert. The civilian program directors wouldn't know you from Adam, and it would be virtually impossible to go spend time working with them so they could, so any very competitive residency slot would be extremely difficult to get. I am in FP now, although that was never a thought as a medical student. Had I not had a military obligation and been forced into becoming a GMO, I would be a neurological surgeon right now. I am serious, I had worked with the NS PD as a student and he was my faculty mentor as a student. I have performed burr holes and put my finger inside the cavity of brain tumors. 😱 By the time the military was over, I was just to old and with too many other obligations to go back to such a long residency, not to mention the fact that other students had taken my "place" in line for the residency spots by then.

Civilian residency directors tend to accept applications from students who they have worked with and know, or at least have strong LOR's from their faculty colleagues in the same specialty, and to get those LOR's you still have to spend time working with someone of similar caliber in the specialty. Thus, GMO's and FS's are at a distinct disadvantage in the civilian world.

Hang in there, your assimiliation into the Borg Collective will eventually come to an end.

 

[Mirror Form]

Had I not had a military obligation and been forced into becoming a GMO, I would be a neurological surgeon right now.

So let me get this straight. Thanks to the military, you're now living a great life with good hours on a tropical island. Whereas, if it hadn't been for the military you'd probably be a miserable neurosurgeon who had all of their soul sucked out during residency and now works 24/7.

Sounds to me like you should be thankful you got stuck on a gmo tour!

 

[USAFGMODOC]

So let me get this straight. Thanks to the military, you're now living a great life with good hours on a tropical island. Whereas, if it hadn't been for the military you'd probably be a miserable neurosurgeon who had all of their soul sucked out during residency and now works 24/7.

Sounds to me like you should be thankful you got stuck on a gmo tour!

Nicely put! 👍

 

[island doc]

So let me get this straight. Thanks to the military, you're now living a great life with good hours on a tropical island. Whereas, if it hadn't been for the military you'd probably be a miserable neurosurgeon who had all of their soul sucked out during residency and now works 24/7.

Sounds to me like you should be thankful you got stuck on a gmo tour!

That may be, but I wouldn't have to drive to the beach. Could just walk out my back door onto it, because I would be living in one of the many multi-million dollar beachfront estates here, and relaxing by the pool over looking the water at sunset would bring back my soul. 😛

 

[GMO2003]

That may be, but I wouldn't have to drive to the beach. Could just walk out my back door onto it, because I would be living in one of the many multi-million dollar beachfront estates here, and relaxing by the pool over looking the water at sunset would bring back my soul. 😛

I know this is off topic...but how can docs afford multimillion dollar homes...I've never taken out a mortgage and don't know the parameters that are involved when figuring out how much you can borrow and so forth...nonetheless, I know plenty of docs that are in 1mil+ homes with apparent incomes that I can't figure out how they can afford it...so if you make the average annual income of around 200k/yr...how is it possible to take out a mortgage for a 1mil+ pad? 😕

 

[militarymd]

I know this is off topic...but how can docs afford multimillion dollar homes...I've never taken out a mortgage and don't know the parameters that are involved when figuring out how much you can borrow and so forth...nonetheless, I know plenty of docs that are in 1mil+ homes with apparent incomes that I can't figure out how they can afford it...so if you make the average annual income of around 200k/yr...how is it possible to take out a mortgage for a 1mil+ pad? 😕

trust me, it is not hard....in the civilian world...MDs are treated with respect. You are actually considered respected members of society...Sort of like an O-6 on a ship.

You will be surprised when you get out how many people will kiss your ass like you do to O-6 right now in the military.

Complete reversal of the military, and they wonder why no one is flocking in.

 

[USAFdoc]

So let me get this straight. Thanks to the military, you're now living a great life with good hours on a tropical island. Whereas, if it hadn't been for the military you'd probably be a miserable neurosurgeon who had all of their soul sucked out during residency and now works 24/7.

Sounds to me like you should be thankful you got stuck on a gmo tour!

Sledge...nice try, but you do not thank someone for the wrong things they do if it ends up working out in the end. I would certainly thank God that things work out, but not the offender.

For example, if I rob your house of everything, and because of that, you spend the night at the home of a friend, and that very night a tornado completely destroys your house (you would have died if you would have slept there)....now do you thank me and give me some reward because I robbed you????? From your take on Island docs quote, it sounds like you would. No, you thank God you are alive, and as for the robber, toss em in jail.

In the Bible, Joseph's brothers sold him into slavery. In the end Joseph stated that what his brothers intended for harm, God used for good. Same situation going on in the USAF. I do not have any thanks to give the USAF on how misserable they run a primary care organization, but I am forever grateful to God for the wonderful life I have now.

 

[IgD]

Had I not had a military obligation and been forced into becoming a GMO, I would be a neurological surgeon right now.

I keep reading this claim over and over. Do you take any accountability for not getting selected for the position twice? It doesn't make sense. I've made some mistakes. I could have blamed other people but instead I got feedback figured out what happened and grew as a professional.

I have some knowledge of the GMESB and it's pretty much impossible for a GMO not to get a position because of the number of points they get. Is it possible you gave one of the members of the GMESB a bad impression? Were your board scores competitive? Did you have any publications? How competitive was the specialty you chose at the time your applied?

 

[bobbyseal]

My house is roughly 5x my annual salary which isn't that much on what an intern makes. If I was a ct surgeon making 400K + per year, it wouldn't be a big deal to buy a 1-2 million dollar home.

I know this is off topic...but how can docs afford multimillion dollar homes...I've never taken out a mortgage and don't know the parameters that are involved when figuring out how much you can borrow and so forth...nonetheless, I know plenty of docs that are in 1mil+ homes with apparent incomes that I can't figure out how they can afford it...so if you make the average annual income of around 200k/yr...how is it possible to take out a mortgage for a 1mil+ pad? 😕

 

[omnipotentx]

Can you imagine how difficult it would have been to line up a civilian residency, from some isolated overseas hell hole?

They can force you to go overseas for civilian residency?!!!!!

-Jeff

 

[Pendraegon]

I'm currently applying for a 3 year HSPS for the Air Force. From what I had heard GMOs were much more common in the Navy then in the AF.... How common is getting pulled out of residency? From what I had heard it wasn't very common at all in the AF because, again I had heard, that the AF would prefer to have a board certified physician. Also do they treat 3 year HSPS people different then the 4 years? Thanks

 

[IgD]

I'm currently applying for a 3 year HSPS for the Air Force. From what I had heard GMOs were much more common in the Navy then in the AF.... How common is getting pulled out of residency? From what I had heard it wasn't very common at all in the AF because, again I had heard, that the AF would prefer to have a board certified physician. Also do they treat 3 year HSPS people different then the 4 years? Thanks

You can't get pulled out of a military residency. That's misinformation. What happens is that a MS4 applies for an internship position. He is granted a deferrment. At the end of PGY1 he has to either do a GMO tour or apply for a military residency position. Sometimes the PGY1 is misinformed and thinks he was granted a full outservice residency when really he was just granted a 1 year deferral.

 

[island doc]

I keep reading this claim over and over. Do you take any accountability for not getting selected for the position twice? It doesn't make sense. I've made some mistakes. I could have blamed other people but instead I got feedback figured out what happened and grew as a professional.

I have some knowledge of the GMESB and it's pretty much impossible for a GMO not to get a position because of the number of points they get. Is it possible you gave one of the members of the GMESB a bad impression? Were your board scores competitive? Did you have any publications? How competitive was the specialty you chose at the time your applied?

I think I have said before that I have no idea why I was not selected by the JSGME board. I was never told. Bad Impression?, Maybe I did piss somebody off, having had a chip on my shoulder as a GMO, it's quite possible. Board Scores were above average, but it has been so long ago I don't remember what they were. Pubs: None., Competitiveness: Very.

 

[island doc]

They can force you to go overseas for civilian residency?!!!!!

-Jeff

Sorry you misunderstood. I was emphasizing how difficult it can be to make application for a civilian residency position in the U.S., while stationed in a remote overseas location, especially if the residency program does not have recent knowledge of you.

 

[island doc]

I'm currently applying for a 3 year HSPS for the Air Force. From what I had heard GMOs were much more common in the Navy then in the AF.... How common is getting pulled out of residency? From what I had heard it wasn't very common at all in the AF because, again I had heard, that the AF would prefer to have a board certified physician. Also do they treat 3 year HSPS people different then the 4 years? Thanks

Where are you getting your information? From recruiters whose career/promotions depend upon convincing you to sign your future life away?

If you think that the AF entirely prefers BC/BE's, then you need to read the online MedLink publication for deferred physicians on the AFPC website concerning those who choose to withdraw from their specialty and pursue another, current policy is that they become GMO's/FS's. If the AF were so committed to having all BC/BE physicians they would reverse that policy. That policy has been on the books for years.

How common is it to be pulled out of residency? Just look at how many "one year wonder" GMO's/flight surgeons there are and that should answer that question. Given the fact that today's modern medical education model is for the seamless completion of residency after medical school, there should not be any GMO's/FS's with only one year of GME under their belt as staff physicians.

Three year HPSP are treated better than the four year-their "assimilation" period is shorter.

 

[MoosePilot]

island doc - man isn't there some beach to hang out at? It's always overcast here in WA, but I remember my short visits to HI fondly... I'm jealous.

 

[island doc]

island doc - man isn't there some beach to hang out at? It's always overcast here in WA, but I remember my short visits to HI fondly... I'm jealous.

".....some beach, some where....." 😎