What are the opportunities for doctors with surgical and emergency training forward operating in the field, including SOST, OGA, and general special operations?
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What are the opportunities for doctors "outside the wire" and in the field?
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US Military or another country? With or without a medical license from a US state?
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and here we go
Short version - if you weren't part of those communities before you became a doctor, there aren't many paths to get to to them as a doctor fresh off the onion cart.
Short version - if you weren't part of those communities before you became a doctor, there aren't many paths to get to to them as a doctor fresh off the onion cart.
US MIL, American citizen.
Because those groups are super insular and very selective in trust. And you don't real have opportunity for face time in most specialties, particular hospital based ones.
Sure it's possible, but extremely rare. IMHO, the odds are better that they have a need and you fall into their lap than you expressing interest. Outside of rare FORSCOM billets.
Sure it's possible, but extremely rare. IMHO, the odds are better that they have a need and you fall into their lap than you expressing interest. Outside of rare FORSCOM billets.
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It's been asked many times. People have an abstract idea about being a doctor and a door kicker, but, when actual mil docs say that it's unlikely, if at all, the person with the idea pushes back against that, and the wheel goes round and round.
Not a door kicker, more where they keep you in the trunk of the car in the event they need you, Mexican doctor back-of-the-van stuff.
From what a guy who trains these guys told me--"there aren't enough of them."
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Again - with or without a medical license from a US state? Will you have completed a residency in the US? The answer does matter. Without an independent license in the US and BE/BC, it's unlikely you can join the US military as a physician currently.
With residency in the US.
I spoke with a couple current SOST team members, reached out to the SOST training contact, and they all confirmed that they take plenty of EM docs straight out of residency with no prior experience.
SOST is AF. I'm answering more about OGA and other general special forces from an Army perspective in my specialty. Other than when I heard them come talk to the AF residents about the process to join them, I dont have much/any interaction with SOST in the Army.
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To add to what has been said, Special Operations Forces (SOF) work in small teams, often far outside the wire. They need everyone on the team to be able to take care of themselves and others in a firefight. Sure they'll take non-shooters for select missions but it's hard to be organic to the team unless you can operate at the same level and they trust you. You can't have the mentality of just sitting in the vehicle like a trunk monkey. If the convoy encounters an ambush and fit hits the shan, they'll lose a gun in the fight if you go fetal and someone has to babysit you to extract.
All SOF teams have one or two special operations medics that are trained to provide trauma care in the middle of a firefight, stabilize them, and even maintain them for a couple days. They also learn clinical medicine, certain surgical procedures such as amputations, and even veterinary. They are the ones that usually do the "Mexican back of the van stuff" for the team in particularly austere environments. They are at the level of PAs and know how to move, shoot, and communicate as well as everyone else in the team (they have to go through the same pipeline as the other operators). Sure there are certain missions that its great to have an MD/DO for a local clinic or something, but these are occasional events in more controlled situations.
There are teams, such as SOST, that will take doctors without SOF training to provide surgical care far forward but these are not on the "X". And you are not part of the SOF team, you're part of the surgical team. Don't get me wrong, this is good work and a great asset but you are not part of the SOF team on missions. This is most likely the closest you'll get to the "action" without previous SOF experience.
As was said, it IS possible to actually be part of a SOF team but its extremely rare. And you have to build your reputation within the community to get a shot. Understand we're not trying to discourage, but just setting expectations.
All SOF teams have one or two special operations medics that are trained to provide trauma care in the middle of a firefight, stabilize them, and even maintain them for a couple days. They also learn clinical medicine, certain surgical procedures such as amputations, and even veterinary. They are the ones that usually do the "Mexican back of the van stuff" for the team in particularly austere environments. They are at the level of PAs and know how to move, shoot, and communicate as well as everyone else in the team (they have to go through the same pipeline as the other operators). Sure there are certain missions that its great to have an MD/DO for a local clinic or something, but these are occasional events in more controlled situations.
There are teams, such as SOST, that will take doctors without SOF training to provide surgical care far forward but these are not on the "X". And you are not part of the SOF team, you're part of the surgical team. Don't get me wrong, this is good work and a great asset but you are not part of the SOF team on missions. This is most likely the closest you'll get to the "action" without previous SOF experience.
As was said, it IS possible to actually be part of a SOF team but its extremely rare. And you have to build your reputation within the community to get a shot. Understand we're not trying to discourage, but just setting expectations.
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On the Army side, these Golden Hour Offset Surgical Team (GHOST) teams are probably the furthest outside the wire with SOF for non-SOF MDs:
http:// medium.com/experientia-et-progressus/reducing-risk-training-surgical-teams-to-survive-3447731834da
Again, not on the "X" with the team but relatively close. These surgical teams provide pretty close support on missions. This may be what you're thinking about.
http:// medium.com/experientia-et-progressus/reducing-risk-training-surgical-teams-to-survive-3447731834da
Again, not on the "X" with the team but relatively close. These surgical teams provide pretty close support on missions. This may be what you're thinking about.
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It comes up a lot. I call it "adventure summer camp syndrome" ... which I'll confess is a little dismissive, but it's usually an apt description.
Fundamental misconception #1 is the notion that surgeons or EM docs or other physicians can provide field care that is SO dramatically better than what a medic can do, that it justifies the cost and risk of placing a very scarce and valuable resource in that position. No. (Unfortunately there is a small cohort of adrenaline-junkie EM docs who should know better but think otherwise. They sit around with fellow good idea fairies coming up with idiotic ideas like pushing REBOA to the point of injury in the field. They are a problem.) The truth is there isn't much a doctor can do in such austere environments that a medic of spec-ops quality can't do, and the cost/risk of putting a doctor there is enormous.
Fundamental misconception #2, which was alluded to in a post above, is the idea that a physician would be a greater team asset than a warfighter who fills the medic role as a secondary responsibility. The presence of a physician means the loss of an actually qualified person on a small team far outside the wire. You've got to understand that everyone on these teams has multiple responsibilities and there isn't room for a one-dimensional team member. Such a person is an intolerable compromise for the team, which is why the occasional physician serving in that capacity is invariably a prior service person who qualified for that job and can do the other stuff (move, shoot, infiltrate, communicate, observe, call for fire, etc etc etc) as well as the other team members.
Fundamental misconception #3 is that there's a pipeline for physicians without prior service in those communities as non-medical operators to join them. There really isn't.
All that said, "special ops" is a vague term that can mean a lot of different things on a spectrum ranging from the bearded 6-man team whose very existence is denied, to a Role 2 surgical team that sits on a flat deck ship "supporting" sneaky operations ashore. And there's certainly room for ordinary physicians to dip their toes in some parts of that world. Just not in the role typically envisioned by these SDN queries.
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I’ve said this before on one of these threads: I only know of two docs in the Army who I know for sure (not just water cooler talk) ended up spending time with SF.
One was an ER guy who was in one of these supporting roles mentioned above.
One was a guy who had SF tabs before he even went to med school, and he went back to a unit after residency. I haven’t talked to him in a minute, but last I did he wasn’t able to tell me much about what he was actually doing. Something in Africa. But again, he went back to doing it. It wasn’t a new hat.
There’s a deluge every year of med students, residents, or (more commonly) high school kids who want to be a pediatric oncologic-trauma neurosurgeon who is dual certified in emergency medicine and HALO jumps in to a black ops firefight. That’s just not a thing. As illustrated above, modern medicine is exceptionally reliant upon access to modern technology. The more tech you strip away, the more rapidly what we all do approaches being a GP in the Wild West - mostly laudanum and tourniquets. And that’s only a slight exaggeration. Certainly our knowledge base is better and we have -some- better tools. But not a ton. So sending a guy who trained for 15 years and who knows how to crack a chest isn’t really a good ROI.
No one would ever need an ENT in an SF scenario anyway, but in the hypothetical situation where they did: I could diagnose a lot without access to a hospital, but I couldn’t do much about any of it. The stuff that I could treat in a field, a PA could probably treat.
One was an ER guy who was in one of these supporting roles mentioned above.
One was a guy who had SF tabs before he even went to med school, and he went back to a unit after residency. I haven’t talked to him in a minute, but last I did he wasn’t able to tell me much about what he was actually doing. Something in Africa. But again, he went back to doing it. It wasn’t a new hat.
There’s a deluge every year of med students, residents, or (more commonly) high school kids who want to be a pediatric oncologic-trauma neurosurgeon who is dual certified in emergency medicine and HALO jumps in to a black ops firefight. That’s just not a thing. As illustrated above, modern medicine is exceptionally reliant upon access to modern technology. The more tech you strip away, the more rapidly what we all do approaches being a GP in the Wild West - mostly laudanum and tourniquets. And that’s only a slight exaggeration. Certainly our knowledge base is better and we have -some- better tools. But not a ton. So sending a guy who trained for 15 years and who knows how to crack a chest isn’t really a good ROI.
No one would ever need an ENT in an SF scenario anyway, but in the hypothetical situation where they did: I could diagnose a lot without access to a hospital, but I couldn’t do much about any of it. The stuff that I could treat in a field, a PA could probably treat.
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It may just be speculation, and certainly doesn’t apply to all cases even if it is not, but it seems to me that most of the SF guys I have met could have done almost anything they wanted out of high school, but knew they wanted to be a high speed SF guy and just did that out of the gate. It takes an extremely skilled and dedicated person to do that job. And then, if they want, they go into another (usually competitive) career field afterwards. Most of the docs or potential docs I’ve known who want to do SF came to that idea because it sounds cool and they’re hoping that being a doctor will give them an edge when it comes to getting in to an SF opportunity. But that isn’t how it works. You have to be good enough for SF first, medical degree or not. And in most cases, if you were good enough and you wanted to do SF, you would already be SF. If for no other reason than that you’re now at least 10 years older than you were when you could have done it initially.
obviously there are exceptions to every rule.
obviously there are exceptions to every rule.
I know. Without getting into a lot of detail in a forum where it doesn't belong, I know a thing or two about handling myself, survival, and small-team tactics. I'm not so much interested in being on "the team," so much as pushing myself to the limits of my skills and knowledge with limited resources, so to speak.
I honestly had no interest until recently, but that's not say I'm not a capable individual or in my athletic prime and peak--but point taken.
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And they surely had prior service as pilots.
The path to doing neat stuff like that is "do neat stuff before you become a doctor so you can go back to it, maybe" ...
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Again though, these were people who were military pilots before they became doctors. They cut flight training for GMO flight surgeons years ago to a bare minimum; last I looked they don't even get solo time any more ... and even the pretty substantial pre-9/11 flight training they used to get was WORLDS away from dual designation.
There is no way, just no way, a guy is going to START flying jets off a carrier[1] after medical school. Full stop.
When these threads come up, it's never people with relevant prior service and a plausible path asking the question. It's always people who hope they can parley being a doctor into some kind of "in" to do highspeed lowdrag things. And they can't. When you say "an ER doc ... flew jets off a carrier" without any kind of context, it's misleading. There isn't an ER doc in the Navy who can do that, short of quitting medicine and starting at the beginning of the "fly jets off a carrier" training pipeline.
OP's been a little vague about his background and what he actually wants. It could be that his goal is congruent with what ordinary greenside GMOs do - the "back of the van" comment is clearly television/movie inspired, but it isn't all that far off what a Marine GMO might do in a forward BAS, or what a Role 2 surgical team does in a deployed setting. Those things are definitely attainable and might scratch his itch. On the other hand, the comment about "survival and small team tactics" just screams "I have no idea what I'm really asking for or how grossly unqualified I am to do that stuff for real" ...
[1] as pilot in command, any yokel GMO flight surgeon can get backseat rides
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I would say that in the current atmosphere this is correct; however, maybe 10-15 years ago there was a path to do just this. There’s a Navy radiologist that went medical school—>internship—>GMO/Primary flight—>dual designator S3 pilot —>radiology residency. (No prior Navy/aviation service)
I have not heard of a single person successfully navigating that path in more recent history.
"Back of the van" isn't meant literally. I could get very specific, but this isn't the place for talking about that stuff. Obviously, as a civilian, its highly unlikely I will have any experience with military logistics, all the technical manuals, and things like air assault or HALO jumps.
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I'm just trying to find work 'inside the wire'. You'd be surprised how difficult that is to do these days.
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Focus on graduating medical school and getting a US residency - that alone is going to be difficult. You've got four more years of medical school right? Looking for military opportunities that are seven plus years out is a time dilation exercise. You will be eligible to join the US military as a US IMG physician once you have an unrestricted state medical license and are BE/BC.
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That's pretty cool. Things were definitely different in those days. He probably had time to do that because JKO and NKO didn't exist yet.
I'm just dipping my toe in the water. There is very little easily found information available online about this. I googled GHOST, and all I got was some obscure documentation on it.
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Let me guess.. airsoft?
I understand where you're going with this question, which is honestly a little insulting, but I also understand. Airsoft is more accessible than simunition.
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I think a lot of us joined to do cool stuff that we couldn't do as civilian docs. But as others have stated, the odds of a physician joining operators on a real kinetic mission is slim to none - and even if they did for a very specific mission, odds are you would be told to keep your head down, do exactly what you're told, and keep your weapon on safe unless things really go bad.
As much as we want to fantasize about doing cool stuff, we are technical experts in medicine. In order to get tactical proficiency at the level of a true operator, you would likely sacrifice clinical competence, and thus your purpose. If you have the skills needed for a mission, the military will pull you and figure out how to get you in and out without you needing to know how to be a trigger puller.
That being said, it never hurts to learn more about the communities to which you are assigned. Knowing what they go through, knowing their lingo, knowing their missions, helps you better take care of them and advise them and keep them in the fight. As much as they appreciate a doc that takes interest in them, I'm sure they'd prefer a clinically competent doctor a lot more.
As much as we want to fantasize about doing cool stuff, we are technical experts in medicine. In order to get tactical proficiency at the level of a true operator, you would likely sacrifice clinical competence, and thus your purpose. If you have the skills needed for a mission, the military will pull you and figure out how to get you in and out without you needing to know how to be a trigger puller.
That being said, it never hurts to learn more about the communities to which you are assigned. Knowing what they go through, knowing their lingo, knowing their missions, helps you better take care of them and advise them and keep them in the fight. As much as they appreciate a doc that takes interest in them, I'm sure they'd prefer a clinically competent doctor a lot more.
I think you misunderstand. I don't want to be a trigger puller by default. I like my knees and my back, and I especially like my nervous system, soft tissue, and muscles intact.
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Well, when you drop vague tidbits about tactical survival skillz and your ability to handle yourself, but then refuse to elaborate on information that's directly relevant to the question you're asking a pool of experts about, you don't get to be offended when people roll their eyes a little.
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See, this is part of the issue that people are explaining above.
You ever play any video games? Not even regularly, but at all? You know that mission where you can’t just go out guns akimbo because you have to protect some NPC target? Those missions suck, right? Like carrying dead weight the whole time and the little guy keeps wandering out into crossfire or getting stuck in an area off screen?
That’s you. If you are afraid to shoot or get shot at with an SF unit, you’re the NPC they have to protect on this $#!tty mission.
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Unless you were combat arms, I sincerely doubt your ability to 'handle yourself," and before you ask, I wore a blue cord on my shoulder so yes, I can.
I don't mind getting shot at, it's been run into the ground to the point your knee has to be replaced.
That's...actually reasonable.Well, when you drop vague tidbits about tactical survival skillz and your ability to handle yourself, but then refuse to elaborate on information that's directly relevant to the question you're asking a pool of experts about, you don't get to be offended when people roll their eyes a little.
generally speaking--Gun handling and gunfighting, transitions, more so CQB, combatives, MMA, weapons-based martial arts, tradecraft, bushcraft....
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So, are you alluding to the CIA, or some other 3-letter agency?
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In general, the answer to your initial question has been covered (TLDR; there may be opportunities with a far-forward surgical team such as SOST or GHOST teams but being attached to a SOF team is rare).
Since you keep mentioning your tactical skillz, though, it seems that you feel that these will allow you to more easily gain access to these special units. Given that you're apparently a 24 or 25 years old civilian, you're unlikely to have gained the experience you listed at a proven military school and instead did some civilian course, akin to the "adventure summer camps" mentioned above, or possibly was given some lessons by a family member or family friend with some relevant background. None of these will provide you any leverage with these communities and if you mention them as assets you'll most likely be laughed at or just ignored. What they need is someone they can trust to not quit when things are hard or go bad. Every one of those operators have passed a proving school that would weed out 99.9% of the population. They have sacrificed their knees and back to do so. Every SEAL or SF candidate says they won't quit. The vast majority of them do. If you're more concerned about keeping your own nervous system, soft tissue, and muscles intact instead of putting them at risk to support your teammates, then that would be a problem. And you haven't proven yourself not to bail in those situations. No one truly knows if they mind getting shot at until they get shot at. If you really are good with weapons, it'll definitely help on the off chance you get attached to a team, but they won't help you get on one.
So unless there is something about your background that we're missing, your most likely opportunities to be far out in the field would be one of these surgical teams (and I imagine these are not that easy to get into either). I think they would be a great experience though and something worthwhile to shoot for, but would advise not to have any expectations of being directly attached to a SOF team.
You tell me. They said it was relevant to the question.
That's true. I thought I was supposed to mention my "skillz" 🤷♂. Respectfully, I undertstand what "forward" and "outside the wire" entails, increasing your chances of getting shot, and obviously I'd prefer not to be shot at, and obviously things go bad, and you do what you have to do. I'm more referring to constant training injuries, and the things veterans have told me, developing chronic joint problems that military docs weren't all that interested in.
But understand the bottom-line. I'd be an outsider without a track record.
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Hate to tell you, but that is the price of admission and plenty are happy to pay it.
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I, too, want to have a great job but not sacrifice that much for it.
I won’t pay a lot for that muffler!
I won’t pay a lot for that muffler!
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I feel like something doesn't add up here. Less than a year ago you are 24 years old living in Poland, with a subpar GPA that probably doesn't even qualify you to attend a US medical school and now you're in here talking about having operator-level skills, implying you've been trained by a three letter agency of the US government and you're asking about being a doctor in the military?
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So you just want the aura of being cool and none of the actual risk? I'm sorry but if you're seeking out these opportunities you need to recognize and accept the possibility of injury and be ok with that. I did environmental health in the Army for 5 1/2 years and deployed to Iraq in 2009. I had to go outside the wire a lot for my job including times where I was on Iraqi Army or Police bases or had to walk in the streets. In my job I was definitely not a trigger puller but I respected the soldiers who were and listened to exactly what they told me to do. I took the risks because that was the job and I felt I was providing a service to the soldiers who were actually doing the important stuff.
While I was deployed our brigade PA was a former service guy from way back (he rejoined as a PA in his 50s). He got the idea that he wanted some of that hooah crap and instead of doing his job he took a medic's job and went on the convoys. The command loved it because of the optics (they were *****s, but another story). In the meantime, who did his job as the brigade PA? Nobody. Being a military doctor is an important job and soldiers rely on you to do it and do it well. What they don't need is a doc who wants to be Rambo. Can you do the cool sh$t as a military doc? Sure. But as has been enumerated above, if you don't have prior experience it's unlikely and most of the time you provide more value to the soldiers by just being a good doctor as opposed to a bad@ss one.
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I can’t believe this thread is still going.
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