Why USUHS and thoughts about eventual civilian life?

[hamiltong]

Hey all,

I initally posted this on a different thread, but got directed here not realizing there was a dedicated military med forum. Thanks all! Here is the post:

While this question is posed mostly to those attending USUHS, I suppose others might be able to provide some insight as well. I'm interested and intruiged by the school, but would like to learn more about the committment and life afterwards. Do most of the students plan on becoming career officers or look forward to getting out and working in civilian practices as soon as their commitments are over? What are some of the defining medical differences between Army, AF, and USN when selecting a branch? I realize that they are probably questions which have answers on the USUHS website, but in the hour I've spent downloading PDF and perusing the pages, I haven't found what I'm looking for. Any comments are greatly appreciated, even if they don't pertain to the topic.

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[Heeed!]

Hey all,

I initally posted this on a different thread, but got directed here not realizing there was a dedicated military med forum. Thanks all! Here is the post:

While this question is posed mostly to those attending USUHS, I suppose others might be able to provide some insight as well. I'm interested and intruiged by the school, but would like to learn more about the committment and life afterwards. Do most of the students plan on becoming career officers or look forward to getting out and working in civilian practices as soon as their commitments are over? What are some of the defining medical differences between Army, AF, and USN when selecting a branch? I realize that they are probably questions which have answers on the USUHS website, but in the hour I've spent downloading PDF and perusing the pages, I haven't found what I'm looking for. Any comments are greatly appreciated, even if they don't pertain to the topic.

Peruse past threads and you'll find answers to all these questions. Most people do not stay around to become career officers. Those of us with prior service do it because we're 1/2 way there anyway. The military is not for everyone so it's good you're doing research before you sign up. The best advice I've heard is to join the military after residency. Search for MilMD/X-MilMD posts and you'll read about the darker side of military medicine. Not necessarily USUHS specific but it will be a experience.

 

[militarymd]

Search for MilMD/X-MilMD posts and you'll read about the darker side of military medicine. Not necessarily USUHS specific but it will be a experience.

Dude,
I was actually going to not respond to this thread, but now that you brought me up.... 🙂

Check my threads.

 

[BOHICA-FIGMO]

As someone who has now seen both sides of the fence, all I have to say is, BEING A CIVILIAN FRACKING ROCKS!!! Not that the military is all bad, but I LOVE civilian life. Being a service academy grad, I had never really had a chance to experience civilian life as an adult. Boy, was I missing out!

 

[MoosePilot]

Ok, big disclaimer. I really want to attend USUHS, so I am not a disinterested party this year. I'm a pilot right now, not a doc. I've done extensive research on USUHS and have been hanging in this forum for a year and a half now.

I wouldn't advise a civilian to go to USUHS unless they were hair on fire, determined to go career military no matter what. The commitment is an awkward length if you have no prior service time. Long enough to make it painful to separate at the end and give up what is probably 3/4 progress towards retirement, but short enough that you'll probably want to anyway.

My advice would be to actually run the numbers. Think of what specialty you want to pursue. Compare the higher pay and no debt of USUHS combined with a long commitment vs. the minimal pay and no debt of HPSP with a moderate commitment vs. the higher earning potential of a civilian doc (depending on residency). Think about your family life, your desire to move often and at someone else's direction, and your desire to be deployed to a hot sandy combat zone.

Then make your own choice.

 

[IgD]

The problem with USUHS is the 7 year commitment you owe after you graduate. IMHO, USUHS is designed for someone with prior military service who wants to stay in for 20 years. For example, a line officer (former pilot, submariner) who wants to become a doctor. Another example of this would be an enlisted medical corpsman who wants to become a physician officer.

7 years is a long time if you aren't happy...

 

[UncleRico]

I am a USUHS grad and had no prior service before joining the military to go to USUHS. I agree with the above statements that USUHS is best for those with prior service who will a) make more money during school and payback, and b) be very close to retirement upon finishing active duty residency and the 7 year payback.

Being in the military has been pretty miserable for me and my family. We really didn't know what we were getting ourselves into and there is no way out. I think military GME is generally subpar, and if you go to USUHS you are basically required to do a military residency. After residency, most of the military clinics are poorly run and have little case diversity to help maintain one's skills (big problem for subspecialists). Many of the senior docs (Lt Cols and Cols) that stay in the military are not competent to practice standard of care medicine on the outside, yet these are the people in leadership positions and they can make life difficult for you as you try to practice the quality of medical care that you learned in residency.

Also, while in the military, you have limited say in where you live. While I suppose I knew this before I signed up, I did not realize how painful this would be until I had young children who miss their grandparents and cousins and are not able to see them because we cannot afford the plane tickets to fly out very often. Also, it has been extremely hard on my wife to be so far from family support while I am working long hours in residency training.

Another painful part of being in the military is the government bureaucracy. Never having worked for the government before, I never imagined how much waste and inefficency there could be.

Finally, in my field, financially it was a very poor decision to go to USUHS. I probably will be out about $750K when my 7 years is up.

So it has been a poor decision for me and my family personally, professionally, and financially. Yes I will get out when my time is up, even though I will have 12 years toward retirement. There are about 10 other USUHS grads in my residency program, and we talk about getting out every day. None of them plan on staying in. In fact, we are all currently turning down fellowships because they are all civilian sponsored and would require us to take on an extra 2 years of commitment for every 1 year of training.

So my recommendation is that unless you have lots of prior service or some other pressing reason why you legitimately want to be in the military, do not join USUHS or HPSP.

 

[MoosePilot]

I'm glad UncleRico posted that, because that's how bad it could be.

Now imagine the difference if your military obligation took you right up to retirement, you were in family practice where military docs are on par for pay, and you weren't too attached to one location. Then it could be a good deal. You've got to look at what you want and your situation.

 

[hamiltong]

All of these opinions are quite valuable to me and my future decisions. On the USUHS site one gets a bit of a biased, one-sided view of the coin. While I do see the necessity of military medicine pertaining to our future in international affairs, this route seems like a bumb deal. Maybe student committees should organize medical school websites in order to get a more realistic view and addresses prospective students' questions.

Thanks all

 

[DrYo12]

I actually posted a response to this in the allo thread you started.

 

[hamiltong]

Mad props to you too! Thanks for eveything!

 

[indigoblue]

i agree with one of the above posts that usu is only for those die-hard military. i am one of those people. i would really like to attend usuhs, especially because of it's unique ties to the nih, at which i worked for this last year.

my ultimate goal is to work in the surgeon general's office as a commissioned corps officer (USPHS).

thank you

 

[GMO_52]

i agree with one of the above posts that usu is only for those die-hard military. i am one of those people. i would really like to attend usuhs, especially because of it's unique ties to the nih, at which i worked for this last year.

my ultimate goal is to work in the surgeon general's office as a commissioned corps officer (USPHS).

thank you

Sorry, I'm about as pro-USUHS as anyone here (more about that in a sec), but the only special relationship with NIH is proximity.

Now, in talking about the 7 year committment, it IS long. However, if (like me) you want 6 years of GME, its basically a wash compared to an HPSP committment, since you'll owe that much out the other side regardless.

Oh yeah, I'm back in GME land, and the ol' 52 has a new GMO, so I'm 'bout done here.

 

[indigoblue]

wouldn't you say that as a commissioned officer, you have a "key in" to the inner circle of nih... what i mean is that those who are active duty personnel are tied to the usphs... which is where the surgeon general is at.

i'm not active duty now, so i can't say much for myself... but it just seems that way. at the risk of sounding ignorant, i would say that commissioned officers do have a unique link to the department of health and human services.

 

[DrYo12]

i agree with one of the above posts that usu is only for those die-hard military. i am one of those people. i would really like to attend usuhs, especially because of it's unique ties to the nih, at which i worked for this last year.

my ultimate goal is to work in the surgeon general's office as a commissioned corps officer (USPHS).

thank you

you should get some info about this before you decide what you're going to do. At USUHS, there are 169 students in the entering class and only 2 of them are USPHS folks. You can be commissioned into the USPHS without going through USUHS.

For what its worth.

 

[indigoblue]

while we are talking about usuhs, is there a preference for clinical m.d.'s over research m.d.'s? i read from the interview invitation that those serving in usphs in usuhs are required to practice general family practice and serve on an indian reservation for the residency, but what if i wanted to serve in the army and work in research later someplace (such as the nih) as a clinical researcher? maybe someone here can shed some light on this for me.

thanks.

 

[MoosePilot]

while we are talking about usuhs, is there a preference for clinical m.d.'s over research m.d.'s? i read from the interview invitation that those serving in usphs in usuhs are required to practice general family practice and serve on an indian reservation for the residency, but what if i wanted to serve in the army and work in research later someplace (such as the nih) as a clinical researcher? maybe someone here can shed some light on this for me.

thanks.

My impression from my studies as a hopeful applicant is that the military emphasizes clinical medicine over research medicine in general. I don't know that you couldn't get into research, but I doubt it's very common. Chances would be against you.

 

[deegs]

My impression from my studies as a hopeful applicant is that the military emphasizes clinical medicine over research medicine in general. I don't know that you couldn't get into research, but I doubt it's very common. Chances would be against you.

The powers that be have advised us that there are 4 career tracks a medical officer can take: Operational/command, clinical, academic, and research.

 

[militarymd]

The powers that be have advised us that there are 4 career tracks a medical officer can take: Operational/command, clinical, academic, and research.

B u l l S h i t ....as with just about everything that the "powers that be" says.

There is only one career track....the-incompetent-physician-becoming-an-adminstrator-telling-competent-physicians-what-to-do-track....with very few exceptions.

 

[militarymd]

The powers that be have advised us that there are 4 career tracks a medical officer can take: Operational/command, clinical, academic, and research.

B u l l S h i t ....as with just about everything that the "powers that be" says.

There is only one career track....the-incompetent-physician-becoming-an-adminstrator-telling-competent-physicians-what-to-do-track....with very few exceptions.

 

[DCM]

I am an MS1 at USU and have already begun research. They really encourage it if you are interested. There is a lot going on at the school. Basic science, clinical...

After med school I have no idea about "tracks" etc...

My mentor said that research opportunities as a doctor are best in the army, followed by air force and worst in the navy.

 

[mitchconnie]

B u l l S h i t ....as with just about everything that the "powers that be" says.

There is only one career track....the-incompetent-physician-becoming-an-adminstrator-telling-competent-physicians-what-to-do-track....with very few exceptions

.

I agree with military MD that it is totally unrealistic to expect a basic or even clinical science research career in the military. You can probably count on one hand the number of active duty MD’s who manage a real basic science program. I was assigned to USUHS and can tell you first hand that the basic science people are largely civilian PhD’s. Sure, you can do a project as a resident or student, or play in the lab one day a week if you happen to be an attending in the National Capital Area, but to run a lab, compete for NIH funding, and publish in "Science" or "Nature"—no way. What gets published out of military institutions are small case series and retrospective reviews, there is even very little in the way of participation in major clinical trials. Publishing a small case series is great, but it's far different from a real academic "career."


There is simply no support AT ALL for hard core academics at 99% of military institutions. I can only speak first-hand about surgery, but I know of no active-duty surgeons who are nationally prominent in research of any kind(Dr. Rich at USUHS does not count—he’s essentially retired). While there may be a couple of isolated comprehensive research programs (maybe at AFIP or the Comprehensive Breast Center at Walter Reed) a research career in the active-duty military is likely a fantasy. The VA has FAR more nationally respected clinical research programs then the DoD.

 

[Croooz]

.

I agree with military MD that it is totally unrealistic to expect a basic or even clinical science research career in the military. You can probably count on one hand the number of active duty MD’s who manage a real basic science program. I was assigned to USUHS and can tell you first hand that the basic science people are largely civilian PhD’s. Sure, you can do a project as a resident or student, or play in the lab one day a week if you happen to be an attending in the National Capital Area, but to run a lab, compete for NIH funding, and publish in "Science" or "Nature"—no way. What gets published out of military institutions are small case series and retrospective reviews, there is even very little in the way of participation in major clinical trials. Publishing a small case series is great, but it's far different from a real academic "career."


There is simply no support AT ALL for hard core academics at 99% of military institutions. I can only speak first-hand about surgery, but I know of no active-duty surgeons who are nationally prominent in research of any kind(Dr. Rich at USUHS does not count—he’s essentially retired). While there may be a couple of isolated comprehensive research programs (maybe at AFIP or the Comprehensive Breast Center at Walter Reed) a research career in the active-duty military is likely a fantasy. The VA has FAR more nationally respected clinical research programs then the DoD.

I worked with the Navy's transplant surgeon at NMRI now NMRC. I always asked him why he would stay in when the money and research oppurtunities were so much better on the outside. He said from the beginning that once his research was hampered by the Navy he would get.....he did. Now at the NIH.

For those who think going to USUHS will give you connections into NIH, the only reason this happens is because of proximity but nothing more. I still work at NMRC and we have collaborations with USUHS and the NIH and military "physician/scientists" are not in abundance. There are the ones who come in for a tour and off they go. Military research is run by PhD's and mostly civilian.

The problems in the military that you have read about here are the same in research. If your goal is to become a scientist then follow the previous advice about which service to go into....Army. Be prepared to be pulled for a tour in the sand because we've had them come and go......MD's and PhD's playing soldier. As always a soldier, sailor, airman is what you signed up to be.....practising medicine is secondary. Understand that and you are good to go in your military career.

If you want to get into research then stay out of the military. I was stationed at NMRC and now still work here as a civilian and can say without question that military research is NOT a priority in the military. The powers that be who control the purse strings are realizing they can get the research done by collaborating with civilian companies. It's cheaper and places the people in uniform where they need them....Piss clinics.

Please do yourself a favor and do not get into the military for research. I'm not a naysayer......I'm in military research and you don't want this.....if you think you do embrace this term, SOFT MONEY. If you want the NIH then so be it. For those who want USPHS you have a better chance at doing research at the NIH....heck this counts for your payback.