Well...now what?!

[Heeed!]

Now that the IFB results have been posted, I'm considering the very real possiblity I won't match. My worse case scenario would be to only get my intern year worth of training and then go be a flight doc.

My questions are surrounding options afterward. I wouldn't want to do a residency after the flight surgery tour, for a varitey of reasons. So, what options are available if you only get your intern year worth of training and then have (in my case) 5 years worth of experience? Can I work in an ER somewhere? Can I hang out my shingle and open a practice? Are reimbursements the same for a board certified FP vs. someone w/ just internship? Can you take/pass a board certification exam and then be considered board certified, even though you haven't completed a residency?

Here is the link to where the AF IFB results can be found. Any thoughts would be appreciated!

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[militarymd]

Without Board Certification, it will be difficult for you to get privileges at hospitals.....unless it is a very rural place where they are desparate for docs.

Check the ABMS website, there maybe a way for non-residency trained folks to become BC in FP, but it may take you a few years of OJT.

This option may have been phased out, but when I was AD in the 90's , I remember running into more than a few FPs who never did residencies but became BC.

 

[orbitsurgMD]

Now that the IFB results have been posted, I'm considering the very real possiblity I won't match. My worse case scenario would be to only get my intern year worth of training and then go be a flight doc.

My questions are surrounding options afterward. I wouldn't want to do a residency after the flight surgery tour, for a varitey of reasons. So, what options are available if you only get your intern year worth of training and then have (in my case) 5 years worth of experience? Can I work in an ER somewhere? Can I hang out my shingle and open a practice? Are reimbursements the same for a board certified FP vs. someone w/ just internship? Can you take/pass a board certification exam and then be considered board certified, even though you haven't completed a residency?

Here is the link to where the AF IFB results can be found. Any thoughts would be appreciated!

This is where you see the greatest divergence between the military perspective on training and everyplace else. Without being board-eligible at a minimum, you will have great difficulty(read: not) being able to be accepted to hospital staffs or by insurance plans and by managed-care entities. You can be licensed, and you could set up a GP practice that accepted cash and maybe Medicare and Medicaid, but you wouldn't be able to work at a hospital or have privileges there or be able to accept your Medicare patients' secondary plan payments. You may have difficulty getting malpractice coverage. I really doubt you could make your bills on those terms even in the most desparate places. The problem is that in those kinds of places, people living there are often unable to pay you for care, and you will not be able to survive like that. Worse, you will not enjoy professional respect in your community. These days, if you aren't board-certified, people think there is something not right about you.

The military pretends that with an internship you are good to go. Outside, with an internship you are good to go right back to residency.

 

[pgg]

I wouldn't want to do a residency after the flight surgery tour

Why not?

If you don't want to do a military residency after the FS tour because of the longer AD service obligation, get out and do a civilian residency. Many people do. (Be sure to max out your GI bill contributions so you can collect as a resident.)

Not doing a residency, ever, is a poor plan unless you quit seeing patients altogether and go the admin/business route. You don't want to be the medical equivalent of a GMO the rest of your life.

The military gets a lot of criticism for its relatively limited use of non-board-cert physicians in operational settings, some of which I think is not deserved. But deliberately ending your training halfway through and continuing to see patients as a civilian - assuming you can find a decent job doing so - is unwise, IMHO.

 

[Mirror Form]

Why not?

If you don't want to do a military residency after the FS tour because of the longer AD service obligation, get out and do a civilian residency. Many people do. (Be sure to max out your GI bill contributions so you can collect as a resident.)

Not doing a residency, ever, is a poor plan unless you quit seeing patients altogether and go the admin/business route. You don't want to be the medical equivalent of a GMO the rest of your life.

Agreed, you should definitely do a civilian residency after your gmo tour unless you have a really really good reason for not doing so.

 

[Heeed!]

Why not?

Well...I'll share a couple of my reasons. I'm old, I'm married, I have kids, and I've been in school my whole life. At this point, I would be reluctant to go from making major's pay + whatever bonus I'll get and drop back down to a civilian resident's salary. I'm thinking out loud here, but I guess I would consider a civilian sponsored residency...or a military residency. I'm not ruling anything out, and hopefully I'll match into gas this first go-round. But I am just curious about my own, personal "worst case scenario" and what options are available.

Also, I'm not eligible for GI benefits since I graduated from that bastion of higher learning in Colorado Springs.

 

[militarymd]

The potential gain (good job) is worth the 2 years...just my 0.02 cents

 

[towellman]

What field were you planning on applying for before the IFB came out?

 

[Heeed!]

What field were you planning on applying for before the IFB came out?

I'm going for anesthesiology. I have a friend who is in the same position as I am...he's hoping to get radiology. But with only 4 spots for rads..????

We were discussing our future possibilities in the AF and neither one of us knew about life after intern year + flight surgery.

 

[deuist]

I'm looking at the IFB results. What does "(AU)" stand for? Also, I agree that M4's are getting screwed this year. 14 spots for EM?? What the hell?!

 

[island doc]

Well...I'll share a couple of my reasons. I'm old, I'm married, I have kids, and I've been in school my whole life. At this point, I would be reluctant to go from making major's pay + whatever bonus I'll get and drop back down to a civilian resident's salary. I'm thinking out loud here, but I guess I would consider a civilian sponsored residency...or a military residency. I'm not ruling anything out, and hopefully I'll match into gas this first go-round. But I am just curious about my own, personal "worst case scenario" and what options are available.

Also, I'm not eligible for GI benefits since I graduated from that bastion of higher learning in Colorado Springs.

No chance whatsoever of becoming board certified in family medicine without completing an accredited residency in family medicine. Little if any chance of making it in civilian clinical practice without completion of some type of accredited residency.

You could complete a civilian family medicine residency in only two more years of GME, thus limiting the amount of time spent as a low wage earner. And don't forget about moonlighting during residency, many civilian residents do it which would increase your income.

Having taken a military medical service obligation upon yourself sucks doesn't it...

 

[Heeed!]

Having taken a military medical service obligation upon yourself sucks doesn't it...

I found out as I came to the end of my flying commitment, I was in the driver's seat. But I used my leverage to go to med school. Now I'm strapped with that 5 year obligation. The price of changing careers, I guess.

I just hope I and my bro match this first time around so neither of us has to call the number for that truck driving school...truckmaster, I think it is.

 

[Monty Python]

Also, I'm not eligible for GI benefits since I graduated from that bastion of higher learning in Colorado Springs.

When were you a doolie, or were you cadre in Jack's Valley? I did stand-by first aid on the assault course in 92 and 94. A Marine O-4 Harrier pilot (on cross-assignment duty to USAFA) was the OIC of the cadre in 92 - interesting guy.

 

[Heeed!]

When were you a doolie, or were you cadre in Jack's Valley? I did stand-by first aid on the assault course in 92 and 94. A Marine O-4 Harrier pilot (on cross-assignment duty to USAFA) was the OIC of the cadre in 92 - interesting guy.

Doolie in '90. I worked 2nd beast in '95 as my squad's training officer. The basics were glad to go to the A-course for a little respite from the yelling act I put on

 

[Heeed!]

Is there a restriction on the intern year as far as completing a FP residency goes? Can you do any intern year (transitional, surgery, IM) and still get credit for the 1st year of a FP residency?

 

[NavyFP]

Is there a restriction on the intern year as far as completing a FP residency goes? Can you do any intern year (transitional, surgery, IM) and still get credit for the 1st year of a FP residency?

You will get some credit, but may not get full credit. You may have to take some additional Peds and OB.

 

[island doc]

Is there a restriction on the intern year as far as completing a FP residency goes? Can you do any intern year (transitional, surgery, IM) and still get credit for the 1st year of a FP residency?

Of the three, best to select a transitional year if you think you may be going into FP later as this would fulfill the most requirements. Surgery would not be a good choice and would most likely result in the need to repeat the first year if you wanted FP.

 

[Xclone]

I am thinking about signing the army hpsp this next week. I am 50/50 on this decision. My main concern is getting my residency I want. If they do not have enough spots and I do not get my residency with the Army, can I do a civilian residency if I am matched? Also, what if I only want to do a civilian residency? I know that you must apply for a military residency and accept if matched? This means if I don't match in the military with my residency, I can do civilian right? Thx guys

 

[deuist]

I am thinking about signing the army hpsp this next week. I am 50/50 on this decision. My main concern is getting my residency I want. If they do not have enough spots and I do not get my residency with the Army, can I do a civilian residency if I am matched? Also, what if I only want to do a civilian residency? I know that you must apply for a military residency and accept if matched? This means if I don't match in the military with my residency, I can do civilian right? Thx guys

I am not in the army, but I'll try to answer these questions specific to your branch. When the military is in short supply of specialists, yet does not have enough residency spots to fulfill those specialties, it will grant deferments to the civilian sector. Unfortunately, I've heard that the army rarely grants deferments, meaning that you'll probably have to do an army residency. The silver lining is that so few people are in the Army that there are more spots than applicants for some specialties. I heard that a few years ago the Army did not fill all of its radiology spots.

If you only want to do a civilian residency: too bad. The Army owns you and dictates where you go. Don't think that screwing up your third and fourth year rotations will make the program directors want to get rid of you by sending you to the civilian sector. If they rank you low enough, you'll be sent to a one-year internship and then off to a GMO position.

If you don't match through the military route, you will become a GMO. To do a civilian residency, you must get selected (kind of "matched" through the Army), meaning that getting a civilian deferment is more competitive than matching into a military spot.

You should ask your recruiter all of these questions before signing anything. There is a link at the top of this thread which goes into more detail about HPSP. It was written by someone in the Air Force, but the information is applicable to all branches.

 

[i want out]

Now that the IFB results have been posted, I'm considering the very real possiblity I won't match. My worse case scenario would be to only get my intern year worth of training and then go be a flight doc.

My questions are surrounding options afterward. I wouldn't want to do a residency after the flight surgery tour, for a varitey of reasons. So, what options are available if you only get your intern year worth of training and then have (in my case) 5 years worth of experience? Can I work in an ER somewhere? Can I hang out my shingle and open a practice? Are reimbursements the same for a board certified FP vs. someone w/ just internship? Can you take/pass a board certification exam and then be considered board certified, even though you haven't completed a residency?

Here is the link to where the AF IFB results can be found. Any thoughts would be appreciated!

There are some things that you can do with only an internship, but none of them will pay as well as getting a residency out of the way, and being board eligible.

You can work in urgent care centers, as long as you have a license. And all it takes most places to get a license is an internship.

i want out

 

[sethco]

I realize that you really want Anesthesiology. Chances are, because of your prior military service, you have more than enough points to be in the running for a spot. However, since you are considering FP or life after the military as a GP, why not put FP as a second choice residency on the application. At worst, you WILL get an FP spot and get training. After your done your residency and 5 years of practice in the military, you can either get out of the military or choose to go back into GME and apply for Anesthesia. You may have more options than you percieve right now, especially since FP might now be that bad for you.