What differentiates people who love military medicine and people who don't

[llamasarefuzzy]

Hello everyone! I've recently been accepted to USUHS ( AF)! I am tremendously excited. After the interview day, I realized that it is absolutely feels like the right path for me for a variety of reasons.
However, I want to be sure I'm making an informed decision. I've talked to several former military docs who all loved their services and their time in the military. I've also heard stories ( mostly online and the nyt articles, etc) of people who had a miserable time.


What do you guys think differentiates these people? What are the important questions I should be asking myself to make sure military is the right fit for me? What questions should I be asking my contacts?

Thank you very much in advance for helping me out!

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[BigNavyPedsGuy]

1) What's more important to you: being able to choose where you live and work (or at least avoid a job you'd hate) or being an officer?
2) Will your career always be more important to you than your spouse's?
3) Are you willing to make your children move schools every 3 years?


OK, that's enough. Just read the threads. The military sucks and I'm REALLY happy to be a civilian. One of the best decisions I ever made was turning down my USUHS interview.

 

[llamasarefuzzy]

Thanks! I've been doing A LOT of reading lately. It is certainly going to be a very tough choice!

 

[DrMetal]

What do you guys think differentiates these people?

Your choice of specialty matters a lot, I think. If you do things that are primary-care-ish (IM, FM, Peds, OB), you stand to be happier (workload, academics, pay are somewhat commensurate to the civilian world). Other specialties (particularly the surgical and procedural ones): people are not so happy. The problem is, as a medical student, you might not know exactly what specialty you'll like and want to go into. To that end, if you're really unsure what you want to do when you grow up, might be best to defer joining the military.

1) What's more important to you: being able to choose where you live and work (or at least avoid a job you'd hate) or being an officer?
2) Will your career always be more important to you than your spouse's?
3) Are you willing to make your children move schools every 3 years?


OK, that's enough. Just read the threads. The military sucks .

No, it doesn't always suck, some of us are quite happy with our decisions. I'm sorry it didn't work out for you (and the majority of posters on this forum) . . . but that doesn't mean it's bad for everybody. There are plenty of happy people in the milmed, particularly in the Navy, perhaps evidenced by the fact that the O-5/O-6 levels are very top heavy (fewer getting out, less promotion rate ~50%).

Try not to be so bitter. The other points you made are very valid (one has to be flexible with their career path, geography, needs to have a supportive family).

 

[deleted444089]

In my opinion, those who love military medicine tend to fall more on the side of the view that they are officers first and physician second and have a little less of an entitled attitude. (ie. 'I'm a doctor so some of these stupid policies don't apply to me') They also don't mind packing up and moving every 2-3 years as much as someone who hates mildmed, and if they have a family, a spouse that doesn't mind staying at home with any children they may have.

HOWEVER probably the biggest factor is that those who love military medicine are the ones fortunate to have had a string of great assignments or opportunities and not relegated to some ridiculously remote hospital/clinic with a skeleton crew for staffing and ancillary services and realize how bad it can be.

Someone who gets selected straight through for internship, residency, and a fellowship while being stationed in Southern California then sent to Boston for a second fellowship, putting on O-4 before ever having a real assignment (it's happened), then having the possibility of being assigned to only a select few, non-overseas and remote places for their first tour before being sent right back to a major MTF is likely to be more enthusiastic about their military career as a physician than an attending sent overseas to an undermanned clinic and forced to undertake duties and responsibilities that are beyond their training and/or support staff situation.

 

[DrMetal]

In my opinion, those who love military medicine .

It's quite true . . . if you get what you want, you tend to be more happy.

"Love" is a strong word . . .I love my wife, my kids, my guitars, my whiskey . . . I don't like the people who claim to "love" the mil med unconditionally, they're pretentious, they have unrealistic expectations and delusions. "Like" is a better word. On the spectrum of happiness, 0 being the grumpy bitter F, 10 being the douchey happy guy, you should strive be a 6 or 7.

 

[llamasarefuzzy]

It's quite true . . . if you get what you want, you tend to be more happy.

"Love" is a strong word . . .I love my wife, my kids, my guitars, my whiskey . . . I don't like the people who claim to "love" the mil med unconditionally, they're pretentious, they have unrealistic expectations and delusions. "Like" is a better word. On the spectrum of happiness, 0 being the grumpy bitter F, 10 being the douchey happy guy, you should strive be a 6 or 7.

Good point. It just seemed like (in my limited observations) people either really liked their military career or really didn't, and that it was a bimodal distribution with very few people in the "hmmm, yeah, it was fine while I was there but I didn't think it was a great experience" sort of pool.

It seems like some of the gripes that people have with milmed is the lesser pay compared to civilian counterparts in the procedure based specialties. I am currently not in a position to judge this particular complaint, because right now (as a lowly accepted pre-med I'm in the school of thought that as long as I make enough to get by comfortably, I'm good). This could change in the next 7-10 years of my life. Certainly a good point to keep in mind for now, though.

I also see myself more in primary care as of now, although, again, may or may not change....

I think that the travelling/relocating is one of the exciting advantages of milmed for me. I was always sort of bummed by the fact that docs couldn't just up and move to a different country to practice, and milmed would allow me the opportunity to still explore different parts of the US and abroad while doing medicine. I'm single now, though, so I'll keep in mind that future spouse/children may not feel the same way (although I cant see myself marrying someone without this perspective!)

 

[j4pac]

I love the military. I love the people of the military and their families. I am significantly indebted to the military for allowing my ancestors to build better lives for themselves.

The military has awarded me excellent work experience and relationships that I will never forget.

The military match/training experience is a frustrating one. You are incredibly limited and often military is more competitive than civilian. There is also an incredible level of malignancy when it comes to many military hospitals. Lots of commanding officers willing to step on everyone in their way (including line officers) to get a star. The malignancy from the top often leads to poor moral. Life is much better in the fleet (believe it or not)...but the hospital even tries to control you in the fleet.

I will miss many things about the military and don't regret my decision to serve...but there is no question that life will get easier in many ways.

 

[jabreal00]

In my opinion, those who love military medicine tend to fall more on the side of the view that they are officers first and physician second and have a little less of an entitled attitude. (ie. 'I'm a doctor so some of these stupid policies don't apply to me') They also don't mind packing up and moving every 2-3 years as much as someone who hates mildmed, and if they have a family, a spouse that doesn't mind staying at home with any children they may have.

HOWEVER probably the biggest factor is that those who love military medicine are the ones fortunate to have had a string of great assignments or opportunities and not relegated to some ridiculously remote hospital/clinic with a skeleton crew for staffing and ancillary services and realize how bad it can be.

Someone who gets selected straight through for internship, residency, and a fellowship while being stationed in Southern California then sent to Boston for a second fellowship, putting on O-4 before ever having a real assignment (it's happened), then having the possibility of being assigned to only a select few, non-overseas and remote places for their first tour before being sent right back to a major MTF is likely to be more enthusiastic about their military career as a physician than an attending sent overseas to an undermanned clinic and forced to undertake duties and responsibilities that are beyond their training and/or support staff situation.

I agree with the gist of this post. Before the wars in the middle east, I could see how some people loved milmed. Prior to early 2000s, one could homestead at a certain location. There were no deployments. Promotion was pretty automatic up to LTC/05. Many moonlighted to supplement their income. AMEDD and the Army in general were flushed with cash for people to go on conferences, TDYs and other military related assignments.

That has since changed. People are deploying multiple times. No more homesteading. Expect to move every 3-4 years (if one has a long obligations). Promotion is no longer a foregone conclusion. There is no funding for conferences or continuing medical education opportunities. There's more of an emphasis on operational medicine/billets. People are being tasked straight out of training or their second duty assignment to a mostly administrative 2 year tour. Budgets for training facilities are getting slashed. Many hospitals are contracting or closing. Primary care in Milmed is brutal. It's mostly all clinic and high volume, low acuity stuff. You will be squeezed to see more and more patients and potentially do things outside your scope of practice. The direction of Mildmed is not pretty.

I came in when things were relatively good and am currently witnessing the slow gutting of military medicine. It's not so apparent while one is in training (residency/fellowship). However once one finishes it is a gut check. I don't have regrets about my time (1.5 years and counting until I get out). I thought my training (residency/fellowship) were great and comparable to any well-regarded university based program. However, I see the writing on the wall. My first 2.5 years as a staff have been an exercising in endurance in taking repeated kicks to the teeth but grinning and bearing the blows. I keep my head down. I wisely pick and choose my battles. Systemic problems are above my pay-grade and not worth my effort to try to change. Local stuff to my clinic/department I can affect I try to make more efficient or better.

In the end it's all a matter of perspective and expectations. For me, I like the academic environment. I relish in those who push themselves to be great clinicians. Outside of the biggest MEDCENs that is just not possible. If one like or is good at administrative tasks or likes the operational aspect of military medicine, then it's not so bad.

Once I get out I'll have no hard feelings. I felt like I got good training. I've been able to keep my skills up to a standard level (due to being aggressive retaining patients or just working harder than most). I will look at this as an experience and I am proud that I've been able to serve my country (deployment). However, I won't miss the crappy locations, dysfunctional system, emphasis on being an officer over being a physician, emphasis on useless metrics to help for promotion.

 

[deuist]

I've talked to several former military docs who all loved their services and their time in the military.

Why are you talking to only former military physicians and not current ones? Also, how long ago did these doctors practice? If it was during the 1990s, then yeah, they probably did enjoy their time in the service. But as you have witnessed on this board, lots of physicians have had poor experiences over the past few years.

 

[llamasarefuzzy]

Why are you talking to only former military physicians and not current ones? Also, how long ago did these doctors practice? If it was during the 1990s, then yeah, they probably did enjoy their time in the service. But as you have witnessed on this board, lots of physicians have had poor experiences over the past few years.

I live in a part of the country with 0 active duty people, but tons of docs, so it's just who is available. I figure I would come on here to get a more diverse perspective

 

[Homunculus]

I live in a part of the country with 0 active duty people, but tons of docs, so it's just who is available. I figure I would come on here to get a more diverse perspective

deuist beat me to it. you need to talk to currently active duty docs to get a good idea of the environment. people who have retired or are even current O-5's and O-6's have had a dramatically different career than anyone starting out now will experience. i know O-6's nearing retirement that haven't moved in over 10 years and have never done an operational assignment and didn't complete advanced officer training like ILE. some haven't deployed. staff that were O-6's and retired that you spoke with haven't experienced the current .mil like you will.

i get asked by interns and rotating students frequently about this. most people are probably lukewarm about the military, with the outliers being vehemently against it and the "kool aid" drinkers who are advancing up the ladder. the vast majority of us are doing what we can to survive, and trying to look into the crystal ball to predict the future. the pendulum swings both ways, and some of us, like it or not, will be watching/waiting for it to swing back as we near the end of our ADSOs.

in general, the people i find who "enjoy" their military experience are non-deployable for some reason (eliminating a huge source of stress for many), religious conservative, and are in a specialty generally on par salary wise with their civilian counterparts or are ok with administrative work and don't mind a paltry volume of patients. prior service helps, as does being an academy grad. the "ring knocker" phenomenon is real. ROTC may pump out the officers, but it seems the academy folks are the ones gravitating toward admin--- which they probably should be. but this does instill some institutionalization to the command since they've likely been academy/USUHS and don't know anything other than the military way. stability in a duty station near extended family also predicts happiness. there is also this rare breed of "super soldier" that just for some reason has the military thing in their DNA. not sure how to explain those other than being patton incarnate or something.

in general, the most disgruntled people are ones isolated from their family-- i.e., stationed on the west coast with all their family in the east (or at a craphole MTF in BFE), more liberal, less openly "religious", in a specialty with dramatic salary difference, have been deployed for an extended period and potentially up for another, or assigned a 2 year brigade or flight surgeon slot or forced to PCS due to "being in one place too long." there are also the same genetic people who just hate every damn thing about everything and let you know it-- to the point you wonder how the hell they ever signed up to begin with. some of the worst complainers actually have characteristics (non deployable, homesteaded, etc) of the group that would make you think they should be happy but aren't. just to prove the exception i suppose.

those are both gross generalization of my 10+ years of military exposure. most people are going to fall somewhere in th middle. i think you find the polarization on this site since most people aren't going to be moved to post and say "yeah, i kinda feel both." people are moved to post things they are passionate about, which is there many of the opinion pieces come from. factual stuff you will find this forum is also very useful for.

good luck with your decision. at a minimum you don't have the same excuse all of us pre-SDN people do.

--your friendly neighborhood where's gallo or medicalcorpse caveman

 

[llamasarefuzzy]

Thank you guys so much for taking the time to help inform a lowly premed I very much appreciate it, and can't imagine trying to inform myself in pre-sdn days! Right now I'm still "floating" from the acceptance, but I do want to make sure that I go into the decision with my eyes wide open!

 

[orbitsurgMD]

What do you guys think differentiates these people? What are the important questions I should be asking myself to make sure military is the right fit for me? What questions should I be asking my contacts?

Thank you very much in advance for helping me out!

In a sentence: the happiest people in milmed are those who had their expectations met and thought on balance they got a good deal, or at least a good enough deal.

I know that isn't too specific, but your particular expectations will have everything to do with how satisfied you will be with your military experience.

If you expect the military to train you in something you want to be trained in, and they deliver, you might be quite happy. If they do not, you might not be so happy. If you expect professional-quality support where you practice and you get that, then you might not mind the military. If you don't, you might be unhappy. If you expect to be treated as a team member and are willing to make sacrifices for the "team" and in turn expect the team to look out for you, and if that is what you experience, you could be happy. If that is not what you experience, you might feel deceived and alienated by the military.

Certainly a resilient and positive attitude can help you, but other conditions have to obtain to bring you satisfaction in or out of the military, enjoying the variety of your work, believing yourself to be a valuable member of the enterprise and being treated by the enterprise as such, having colleagues you hold in esteem. A lot of those things do not necessarily require much money, or as much money as you might make elsewhere, but having them can make the financial differences seem not as great. Not having them can do the reverse and throw the financial differences in stark relief.

If you have your heart set on training as soon as possible, especially in a surgical or other focused specialty, you should carefully think how happy you would be if you knew you would have to wait four years after internship to begin your residency training, starting as a resident when your medical school classmates are finishing residency and moving on with their lives.

 

[DeadCactus]

Only in the Guard but personally I think more than anything it's luck. There's a certain amount of flexibility you need, more generalist sort of specialties do better, and you have to take some pleasure in non-clinical aspects of the career.

But the guy who lands straight through training and then spends 4 years under a good command in a good location is going to have loved the military. The guy who had to do a GMO tour and landed crappy commands in crappy locations for his entire career will hate it. There are AD folks I've met who I would trade places for in a heartbeat and people I've met who make me so thankful I went the Guard route...

 

[deuist]

the people i find who "enjoy" their military experience are... religious conservative

I have been shocked just how religiously fundamentalist so many people in the military are. Chaplains routinely show up to public events such as fun runs and squadron meetings to lead us all in prayer. I've even heard colleagues spout believes that homosexuality is unnatural and a sin – and that was from the doctor!

In my case, I was not allowed to go into the residency I wanted coming out of medical school. I was not allowed to go into the fellowship I wanted. I was sent to an MTF location I did not want to go to, forcing my wife to give up her career in the process. I was selected for deployment within three months of coming on active duty – yet have multiple colleagues who've been in the military for longer and have never deployed. And every medical commander I've met along the way has ranged from mediocre to dreadful. I can't name a single one that I would want for a boss.

 

[BigNavyPedsGuy]

If you have your heart set on training as soon as possible, especially in a surgical or other focused specialty, you should carefully think how happy you would be if you knew you would have to wait four years after internship to begin your residency training, starting as a resident when your medical school classmates are finishing residency and moving on with their lives.

The OP is talking about attending USUHS. They'd be on the hook for up to 7 years if they couldn't land the specialty they want or the AF doesn't have it.

 

[WernickeDO]

GMO doc here, currently deployed in a not-so-awesome place. I'm about as active duty as they come. The day may come when I look back on my military career and get the warm and fuzzies, but it is not this day. The day may come when I feel like this was all worth it some how, but it is not this day. Why? I'm one of the cautionary stories you hear of...getting sent to GMO land rather than continuing my medical training. When not deployed, my patient load is very light and there low acuity, but there is plenty of time dedicated to paperwork, APEQS, SHARP training, etc. Fortunately, I am in a good battalion so I don't catch too much grief from the top.

Look, I signed up for this and I am now paying the piper, but this is not how I wanted my career to go. I can swallow all this, but I have had to ask my spouse to sacrifice aspects of her career to accommodate my military career. If I had known I was going to meet my spouse in medical school, I would have never signed up. This is another fact to consider: You cannot predict where you will be at personally or professionally in 4 years. The military may fit your plans, but it may not. Bear in mind that if you go to USUHS, you will owe 7 years AFTER residency.

GME may or may not be conducive to your training desires. For example, EM is competitive in the military, and I watched many excellent applicants get rejected, while mediocre civilian applicants had no problem with the civilian match. Frankly, GME is ripe for the trimming every year. Academic conferences are now a thing of the past.

So, this is coming from someone who did NOT get what they wanted, which as noted above, is a very different voice than someone who went straight through their training and got a nice assignment after residency. Some pros: There have been some unique experiences, I do enjoy taking care of soldiers, and I truly desire to serve my country. Also, if you go to USHUS they basically pay you 50 grand a year to go to medical school, which is nice. Just remember that there are other ways to go that will give you more freedom and control over your career, like FAP.

 

[pgg]

In a sentence: the happiest people in milmed are those who had their expectations met and thought on balance they got a good deal, or at least a good enough deal.

I agree with that.


I'm probably the happiest person in milmed who posts on SDN. I've gotten everything I wanted, with three significant caveats. One, I did GMO time. But it was a good tour for non-medical reasons. I look back on it with mostly good memories and satisfaction. Even though I still sometimes cringe at the things GMO-me did and got away with. Two, it's proving harder than expected to get a FTOS fellowship slot. It seems pretty likely that at some point before my time is up, I'll be able to go. But I like being a generalist in my field. It's not like I'm a miserable internist looking to escape to a GI fellowship the Navy won't let me have. Three, I was passed over for O5 my first time up, which made me angry beyond words, but I made it the 2nd time and the net result is I'll put on O5 a few months later than I would have, had I been picked up on the first look.

I went to USUHS, got paid to go to medical school. Comfortable standard of living and had 3 kids while I was there. Internship at Bethesda (one more year I didn't have to move). GMO tour for 3 years, see above. Residency in 1st choice field at a solid program. First staff tour I stayed put for 5 years ... close to extended family. Worked with some great people in and out of my department, including a really wonderful CO and XO for the last year. Moonlit my ass off and more than closed the civilian pay gap. Good hours, good case mix. One deployment during that time to the Kandahar Role 3 ... a great location with great cases with great people. On my 2nd staff tour now at my 1st choice next duty station, another good group of people. It's likely I'll be able to stay here a while.

I've got some time to go on active duty, so there's still room for me to get hosed by the Navy. On balance I got a good deal. Some of the above was luck. Some of that luck I made via good working relationships with the people who had power over me. Happy and successful people make most of their own happiness and success. But some was just luck.

 

[HighPriest]

Echoing the above, primarily chance: what specialty you choose, whether you match, whether you get your fellowship, where you're stationed, whether you're promoted (bigger deal beyond O4), deployments... It's hard to picture as an incoming med student, but its complettely unpredictable as to whether you're going to be in a good place, or miserable. To an extent that' true of most things, but not to the same extent as it is in the military, from my exprience (having had a career before medicine). I agree that to some extent things are what you make them, and you can adjust your expectations to make yourself happy - to a point. But if you've been hit repeatedly with disappointment, that's a hard target.

That being said, I know plenty of people who are O-5/O-6, work at a MEDCEN, got the fellowship they wanted, and still hate the military. In a grass-is-always-greener kind of sense I have trouble relating, but I'm not waking in their shoes either. My outside assessment would make me thing their lives are pretty great, at least relatively speaking. Most of their gripes have to do with pay issues (these are subspecialty surgeons), a lack of case complexity, and the day-to-day Army tasking that irritates everyone but in-and-of-itself is just jock itch at the prom (troublesome but not devestating). There is also a prevailing sense of enttlement that is never fullfilled in the military - some people feel like they need to be treated "like a doctor." I have never cared about that point specifically, and when I work on the outside I find it somewhat embarassing in many cases. I do take issue with being an officer before a doctor, which I've mentioned before, but that is not the same thing. I think the biggest -real- issue that they have is the unavailability of a kill switch. Even if they'd never pull it, people like the illusion of being able to jump ship at any time.

 

[BigNavyPedsGuy]

I think the biggest -real- issue that they have is the unavailability of a kill switch. Even if they'd never pull it, people like the illusion of being able to jump ship at any time.

Exactly! It's not always getting what you want. It's having absolutely no way to say no to the horrible situation or get out of a clinically dangerous one.

 

[bustbones26]

Hello everyone! I've recently been accepted to USUHS ( AF)! I am tremendously excited. After the interview day, I realized that it is absolutely feels like the right path for me for a variety of reasons.
However, I want to be sure I'm making an informed decision. I've talked to several former military docs who all loved their services and their time in the military. I've also heard stories ( mostly online and the nyt articles, etc) of people who had a miserable time.


What do you guys think differentiates these people? What are the important questions I should be asking myself to make sure military is the right fit for me? What questions should I be asking my contacts?

Thank you very much in advance for helping me out!

I for one am proud of my past military career. I think that overall, I had fairly good experience. That being stated, I also feel that I got out before there was an opportunity for things to turn sour and I do not regret that decision.

There are some people that love military medicine, and this is just my two cents toward those that absolutely love it:
--Spend their entire careers at the large MTFs
--Get fellowships whenever they apply
--Rarely, if ever deploy, and when deployed, never tasked out as a GMO but rather to a CSH
--Get high awards (e.g. bronze star, legion of merit, etc) just for essentially "being a good doc".

Nothing against these types, good for them! But the horror stories you hear are from the MEDDACS and smaller MTFs. The one example that I will share is at my former hospital where and orthopedic surgeon was reamed out by his DCCS for not knowing how to do ventilator management on a post-op patient that went into respiratory distress. Knowing this ortho well, he shared with me that he did seek assistance from the medicine attending on call who essentially abandoned him and the patient. Those stories that you read in the NYT expose these types of situations.

So, in short, some are rarely if ever exposed to those horrors and thus love military medicine and wonder why we all are not staying in for a 20 year career? While others are subjected to those horrors and run away screaming. I was somewhere in between, but again, I saw bad things coming down the pike and realized it was time to go.

 

[colbgw02]

So, in short, some are rarely if ever exposed to those horrors and thus love military medicine and wonder why we all are not staying in for a 20 year career? While others are subjected to those horrors and run away screaming. I was somewhere in between, but again, I saw bad things coming down the pike and realized it was time to go.

Good post and well stated. The quoted part is how I feel. I've been relatively fortunate in my career with the Army, but I see bad things down the road for milmed, at least for my specialty. I'm happy to be separating before those things impact me, especially because I don't feel too bad about walking away from my years and because I'm still an attractive applicant for private practices.

 

[llamasarefuzzy]

Good post and well stated. The quoted part is how I feel. I've been relatively fortunate in my career with the Army, but I see bad things down the road for milmed, at least for my specialty. I'm happy to be separating before those things impact me, especially because I don't feel too bad about walking away from my years and because I'm still an attractive applicant for private practices.

Not to pry, but do you care to share what these bad things might be? At least in general terms?

 

[colbgw02]

Not to pry, but do you care to share what these bad things might be? At least in general terms?

well, it's a little hard to articulate, but some things include:

-brigade surgeon tours and generally increasing emphasis on operational assignments.
-an abysmal promotion rate to O5 in the zone, to include people who have checked all of the boxes (deployment, CCC, administrative leadership roles) getting passed over.
-retention issues. i see people leaving at 14-17 years, good people. that leaves only the dregs behind to fill leadership positions, and i don't want to work for those people.

i also think there are huge structural issues with military medicine, starting with the promotion system. the whole system is designed to focus on metrics, most of which are meaningless, so that some admin guru can pin on the next rank. using the same selection system that works for the line to promote physicians just doesn't work, imo.

but if i had to sum it all up in a phrase, it would be "don't just be a doctor", which is a common utterance at CCC, designed to motivate physicians to do something other than take care of patients. the army sees my medical degree and training as a means to be an officer, which entails a lot of things other than the delivery of medical care. i don't share that vision. it took a decade of training in order for me to practice medicine independently, and i'm okay with that being the end goal for my career.

i don't want to sound preachy, meaning i don't think there's anything wrong with people who are okay with jumping through the extra hoops that the military requires. it's just not for me.

 

[Chonal Atresia]

Many great points articulated above.

I just left this past summer after 12 years in as an otolaryngologist. I was actually "tagged" as a brigade surgeon in the spring of 2011 but evaded it at the last second. One of my urologist friends just got tagged last week. She just recently had her 2nd child. It will devastate her surgical career. Her ADSO is up at the end of her 2-year tour but no civilian hospital will credential her. The army has effectively extended her obligation in the best case scenario and ended her surgical career worst case.

Ask yourself: Is this an organization that I want to work for? As described above, THEY DO NOT VALUE PHYSICIANS. Your skills as a doctor (i.e. patient volume, complication rates, satisfaction scores, etc) are not even on the army OER. Personally, it was the best professional decision I have ever made by leaving the military. I absolutely loathe the leadership in army medicine.

 

[haujun]

Instead of asking posters here I think the best way to get this answer to ask O5P or O6 why they decide to stay in the military. From my observation I see the following trends:

1. In addition to getting a medical degree obtain MPH and study occupational, aerospace medicine, preventive medicine OR other primary care non-procedure based specialty such as pediatrics, family medicine or psychiatry and occupy non-clinical administrative positions or perform series of operational tours and complete or study other residency or fellowship during O-6 to get him or herself more marketable during retirement...

2. After fellowship stay in the MEDCENS and complete all the obligations incurred from ROTC, Academy, USUHS etc and become program director, chief etc...and transition to work at VA or contractor in the military hospital......

 

[llamasarefuzzy]

Instead of asking posters here I think the best way to get this answer to ask O5P or O6 why they decide to stay in the military. From my observation I see the following trends:

1. In addition to getting a medical degree obtain MPH and study occupational, aerospace medicine, preventive medicine OR other primary care non-procedure based specialty such as pediatrics, family medicine or psychiatry and occupy non-clinical administrative positions or perform series of operational tours and complete or study other residency or fellowship during O-6 to get him or herself more marketable during retirement...

2. After fellowship stay in the MEDCENS and complete all the obligations incurred from ROTC, Academy, USUHS etc and become program director, chief etc...and transition to work at VA or contractor in the military hospital......

Thanks for the idea. I've contacted a local doc who did 20+ years in army before retiring, so I'll be sure to ask that question

 

[bustbones26]

Not to pry, but do you care to share what these bad things might be? At least in general terms?

There are so many things that cannot be said. Frankly, if I share some personal experiences with you, it might be obvious who I am and in this profession, documentation of potentially negative statements can STILL haunt your career. If you think that sounds like paranoia, well, that is the type of passive-agressive BS I had seen at my last duty station. I seen some have their careers ruined over this type of thing.

First and foremost, we all face skill atrophy:
--Imagine being a cardiologist at a hospital that does not admits MIs?
--Imagine being a neurologist at a hospital that does not admit strokes?
--Imagine being an oncologist at a hospital that does not have an infusion ward?

Again, skill atrophy is less at the major MTFs, but we all can't be on staff there. Now, bear in mind that even in civilian medicine, some enjoy the business and administrative aspects of medicine. So, that being stated, in the military, some do not mind the skill atrophy in trade for "business and administrative" positions, which you are eligible by the time you make O5, e.g. deputy commander, hospital commander, department chief, division surgeon, OTSG jobs, etc. That being stated, the majority of us want to be clinical and realize that the further out from residency we are, the higher risk of completing losing our skill sets, hence, we run!

As a last comment, and food for thought, all hospitals, even civilian, have their problems. The military however, must always have a "sacrificial lamb" and place the blame onto somebody. Thus, somebody always has their career raped. I've seen it happen to others, it never happened to me, but boy, I sure got out before it could!