Army Army Medicine- Anything Positive to Say?

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SequesterGrundleplithMD

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Does anyone have anything positive to say about army medicine? I'm contemplating an acceptance at USUHS. My dad went to West Point, then USUHS, did his residency at Walter Reed, and then worked there till retirement except for a 3 year stint at Landstuhl from when I was 4 until 7. He only has positive things to say about army medicine; he loved his time at Walter Reed and retired as an O-6 only at my mom's insistence after earning the pension. He says his time both as a resident and attending was intense and busy and he doesn't understand when I tell him that the people who post on these forums complain of skill rot. I showed him this forum and he thinks that a lot of the information is harmful and inaccurate. He's really enthusiastic about me attending USUHS; we've already looked at condos in the Bethesda area (he thinks renting is silly) and he's put me into contact with current and former deans and department heads who were his classmates.

The army has afforded me and my family a great life (grew up in a big suburban D.C. house, prep school, an elite university, country clubs, fancy cars, etc) and I feel like I owe the army for this. I, too, would want this life for my wife and kids.

Is military medicine really as broken as this forum makes it out to be? Should I seriously consider my acceptances to other civilian schools? I don't currently owe any time nor am I in any debt.

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So your dad got to stay at one location his entire career except for three years at (arguably) the Army's most desirable hospital? No wonder he thought it was great. I probably would have too when I was getting dragged all around the country every 1-3 years as a kid. I'm sure he wouldn't have had to worry about skill rot, considering it sounds like he never had to work outside of a tertiary referral center.

It sounds like he had a great experience. It was also atypical. It could work out that way for you and your family too, but it probably won't. I've been in and around the Army for 33+ years, and you're the only Army brat I've ever heard have that sort of upbringing, much less attribute it to the Army.

When did he retire? If you're a college senior, then there's a good chance your dad was out of uniform well before things like furloughs and the sequester hit military medicine. I bet he had CME funding falling out the sky, but that's now nonexistent. There's also a good possibility that he trained before CHAMPUS/Tricare came along and vastly changed the landscape of military GME.

If you feel like you owe this country and want to serve, then by all means, sign up. If you expect to recreate your father's experience, then brace yourself for disappointment.

Oh, and kudos on being able to afford at least a second property in the ridiculously expensive city of Bethesda. #notsosubtlehumblebrag
 
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That is a very atypical experience with the military in general....
 
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That is a very atypical experience with the military in general....
It's actually not terribly atypical in military medicine: it's the career path of the medical subspecialist. You do your residency, then do either a chief year or a utilization tour, then fellowship, and then 10 more years at a tertiary care center. There is no posting in Guam for (for example) a Pediatric Nephrologist. More than half of the O-5/O-6 faculty at my residency only spent 3 years outside the command. A few didn't even do the utilization tour.
 
You don't owe the gov anything. Any perks you got for growing up Army were earned by your dad's service to the nation. He was insulated from the bad, probably an IM sub specialist or similar and is telling you the truth about his career. But...the world is changing. Ask him about going to conferences, then find out how it is now (one small example).

We need the children of military to join, it's what got me into the service too. But don't join for him.


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Yes, I realize this isn't a typical route for an army physician. And yes, he got out before the NNMC/WRAMC merge, furloughs, sequestration, etc. And yes he had to do a fair bit of moonlighting to keep up with the Jones'. But with all the overwhelmingly negative experiences shared on this forum, I wanted to provide something positive!
 
Does anyone have anything positive to say about army medicine? I'm contemplating an acceptance at USUHS. My dad went to West Point, then USUHS, did his residency at Walter Reed, and then worked there till retirement except for a 3 year stint at Landstuhl from when I was 4 until 7. He only has positive things to say about army medicine; he loved his time at Walter Reed and retired as an O-6 only at my mom's insistence after earning the pension. He says his time both as a resident and attending was intense and busy and he doesn't understand when I tell him that the people who post on these forums complain of skill rot. I showed him this forum and he thinks that a lot of the information is harmful and inaccurate. He's really enthusiastic about me attending USUHS; we've already looked at condos in the Bethesda area (he thinks renting is silly) and he's put me into contact with current and former deans and department heads who were his classmates.

The army has afforded me and my family a great life (grew up in a big suburban D.C. house, prep school, an elite university, country clubs, fancy cars, etc) and I feel like I owe the army for this. I, too, would want this life for my wife and kids.

Is military medicine really as broken as this forum makes it out to be? Should I seriously consider my acceptances to other civilian schools? I don't currently owe any time nor am I in any debt.

Why not HPSP instead or USUHS? There are lots of pros and cons to the military, but the single biggest con (other than deployment) is that when you join the military you are stuck matching at military hospitals for your training. This isn't necessarily bad (most people agree the training is good) but it means your match will have different odds than the civilian match, and for a few unlucky specialties that means the odds of getting in with a given GPA is way worse inside of the military than outside of it.

Your defense against a bad result in the military match is that they can't, legally, force you into a residency training program. So if you want something thats more competitive inside the military than outside, for example EM, and they say the average step 1 score this year for EM is 285, they can't actually make you train for 3 years as an internal medicine resident instead. Every year many doctors who can't match into their chosen professions in the military do an Intern year, serve out their time, and then become a civilian residents afterwards. Ditto if you decide you hate the military after your first year of serving: you can stop after a year of residency and serve out your time. If, however, you go to USUHS and incur a 7 year obligation you effectively lose those options. Civilian programs don't want physicians that are 7 years out of medical school, and no sane physician wants to be in residency in his mid 30s anyway. So if you decide that military medicine IS as broken as many posters here say, but you went to USUHS, you'd be effectively stuck with both military residency training and 7 subsequent years of military practice anyway. Especially considering that the financial benefits of HPSP and USUHS are now equivalent, there is no reason not to keep your options open by choosing HPSP.

BTW, if you are going to join, I wouldn't fixate on the Army because that's the service you grew up in. There are some pros to joining the Navy/AF.
 
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I really do appreciate everyone's responses. I fortunately have just about four more months to figure out where I'll be attending medical school next year.
 
It's actually not terribly atypical in military medicine: it's the career path of the medical subspecialist. You do your residency, then do either a chief year or a utilization tour, then fellowship, and then 10 more years at a tertiary care center. There is no posting in Guam for (for example) a Pediatric Nephrologist. More than half of the O-5/O-6 faculty at my residency only spent 3 years outside the command. A few didn't even do the utilization tour.

You should ask all of those Army pediatric subspecialists who are currently doing brigade surgery tours about their career paths. Oh, and LOL at Landstuhl as a "utilization tour". A lot of people would step over their own mother to get an assignment there. That arc may not have been atypical at the time of the OP's dad, or even just 10 years ago, but it is now.

Times have changed, at least in the Army. The career path in question used to be roughly the same for my specialty - not so much anymore. And it's not all about the brigade surgery thing. The Army is re-emphasizing non-medical training and assignments, trying to provide rank appropriate "leadership opportunities". I know one doc who was moved, against his will, 2 years into a 3 year assignment (and less than 2 years from his ETS date) from a MEDCEN to a podunk MTF because they needed someone with "experience". Nevermind that this blackhole of an assignment had been considered a utilization tour, manned by freshly-minted graduates, since time immemorial. Or how they tried to reassign a subspecialists at a MEDCEN to a hole-in-the-wall MTF a year away from ETS because it was a good "leadership opportunity".

Again, I'm not saying that the OP's father's experience is not reproducible, just that it's unlikely. And to give the expectation that it's "not terribly atypical" for someone specifically inquiring about the Army is a black pearl.

OP - you mentioned your dad's moonlighting. One thing you may not have considered is the non-monetary opportunity costs of that moonlighting, particularly if a civilian salary for his specialty would have provided the same or greater salary for fewer hours worked. For example, I'm very content with how much money I make, and - for the record - my post-moonlighting income doesn't even sniff what the civilian contractors at my MTF make (nevermind private practice). What I'm not content with is the extra week's worth of work I do every month to make it. I'd rather spend those nights and weekends with my family. Even a ridiculously low paying civilian job will pay me more than what I make now, but more importantly, I can make that money working "normal" hours. I understand that, as a college student, this sort of thing is about as far away in your mind as possible, but that just highlights another issue with military medicine. To wit, it locks you into an obligation so far into the future that you can't envision how your life will change. Assuming you'll be 22 at the start of medical school, you'll be 36 at the youngest before you can separate from the military if you were to go to USUHS. Take HPSP and that age drops to 33.
 
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My training for residency and fellowship were great experiences in the Army. Both were in large metropolitan cities and the training itself was very good. However my time for payback not so much. I know people in my cohort who eased into a nice cushy assignment in a large metropolitan area and can moonlight to keep up with the Jones. When these people look back, they will have nothing but positive experiences. However, I also know many others including myself who are stuck in middle of nowhere America with a well meaning but incompetent hospital ancillary staff and command. Plus with furloughs, budget and staff cuts, it means more work or in Army parlance, "do more with less." Oh, and I am a medical sub-specialist. There are plenty of large MTFs that are in horrible locations (Fayetteville Nc, Killeen Tx, or El Paso Tx, Augusta Ga) that need medical sub-specialists. Oh and don't let me forget about me telling you the new edict from the top stating that all medical specialists are now on the hook to do operational (Brigade Surgeon) assignments for two years. The list of horrible places just goes up exponentially and to make matters worse one is not even practicing medicine for those two years because it's a mostly administrative assignment. Now if you are a generalist in medicine, general surgery, pediatrics, ENT, ortho, urology the list of horrible places to get stationed are bountiful. Only the surgical sub-specialists are assigned to larger medical centers.

They heyday of military medicine has passed. It's a brave new world. However, you may be one of the lucky ones. Your father is a retired O6. He must have a lot of contacts. In the military, from what I am learning (painfully), contacts matter.
 
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You should ask all of those Army pediatric subspecialists who are currently doing brigade surgery tours about their career paths. Oh, and LOL at Landstuhl as a "utilization tour". A lot of people would step over their own mother to get an assignment there.
.


Oh, and I am a medical sub-specialist. There are plenty of large MTFs that are in horrible locations (Fayetteville Nc, Killeen Tx, or El Paso Tx, Augusta Ga) that need medical sub-specialists. .

Maybe the Navy is a better option right now? I know things can turn on a dime with military medicine but at least at the moment there is no equivalent of the brigade surgeon edict in the Navy, the subspecialist path I mentioned still seems to be intact, and the large MTFs are all in desirable locations (Bethesda, Virginia Beach, and San Diego).

Of course, there is a much better chance you will have to deal with a 2 year GMO tour after intern year in addition to a utilization tour after residency, but that still sounds better than what the Army is offering right now.
 
Maybe the Navy is a better option right now? I know things can turn on a dime with military medicine but at least at the moment there is no equivalent of the brigade surgeon edict in the Navy, the subspecialist path I mentioned still seems to be intact, and the large MTFs are all in desirable locations (Bethesda, Virginia Beach, and San Diego).

Of course, there is a much better chance you will have to deal with a 2 year GMO tour after intern year in addition to a utilization tour after residency, but that still sounds better than what the Army is offering right now.

It very well could be, but your statement about things turning on a dime is apropos. No one can predict what military medicine will look like by the time the OP finishes residency, which will be no earlier than the summer of 2021. I've learned some hard lessons about expectations with military medicine, and one of them is that you're setting yourself up for disappointment if you expect past or current trends to hold. Besides, the OP can't reasonably know what specialty, much less subspecialty, he'll end up in. The Navy might work out well for a medical or pediatric subspecialist, but what if he opts for a more competitive residency? He could be kicking himself for not choosing the Army with its relative preponderance of continuous contracts. This is what they should have made Sophie's Choice about (kidding).
 
It's "Brigade Surgeon", not "brigade surgery"...the difference being that you don't practice surgery, or much clinical medicine at all while serving in this capacity. You are a consultant for the line unit, advising on medical readiness. You'll be lucky to touch a patient, certainly not one in your subspecialty. I'm 1/2 in the the entire DoD who has my specialty (the other guy is non-clinical at USUHS, so really I'm 1/1), and I'm going as a brigade surgeon this year. This is after an 8 month deployment as a GMO in 2012.

I'm guessing OP's dad served before the advent of AHLTA, as well. Perhaps, also, before the Army became a daycare for malingering idiots?
 
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Malingering idiots have been around since the 70s.
 
I thought about since the revolution. Washington hanged a few of them.
 
My experience has been similar to your father's (without the job satisfaction, love of service, the country club, elite schools, moonlighting, tour in Europe) and I am a USUHS grad. That being said,
USUHS is really at least a 14 year commitment so you had better think of it that way. In that time you might get married and the future spouse might not appreciate living
in Ft Polk La while their law degree whithers on the vine. As was mentioned consider HPSP. Since you or your family seem flush with cash, you could even consider civ med school, civ residency and the FAP (or Army equivalent) then you could give back while still getting the training you want and avoiding the GMO tour.

I think what a lot of us feel is that times are changing - for completely random examples: we need commander's approval to moonlight (easily denied); no more money for CME trips AND no money for CME while sitting in your office - not even money for CME for the job you have that is required to pass the next civilian inspection; a tremendously laborious task to go present research if you are dedicated enough to do research; no paper (seriously) or no printer or no printer cartridges (seriously x 3); an atmosphere that rewards physical fitness prowess more than good physician-ship; a joint atmosphere that is poisoned by us all sharing the worst of each service instead of the best; and now force reduction ironically applied so that if you stayed on through all this suck you may be asked to leave even if you want to stay.

The country club military is long gone. You will not be getting a driver and a vehicle with flags on the hood whisked away from the Paris Airport, unless maybe you are in the procurement branch.
 
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Does anyone have anything positive to say about army medicine? I'm contemplating an acceptance at USUHS. My dad went to West Point, then USUHS, did his residency at Walter Reed, and then worked there till retirement except for a 3 year stint at Landstuhl from when I was 4 until 7. He only has positive things to say about army medicine; he loved his time at Walter Reed and retired as an O-6 only at my mom's insistence after earning the pension. He says his time both as a resident and attending was intense and busy and he doesn't understand when I tell him that the people who post on these forums complain of skill rot. I showed him this forum and he thinks that a lot of the information is harmful and inaccurate. He's really enthusiastic about me attending USUHS; we've already looked at condos in the Bethesda area (he thinks renting is silly) and he's put me into contact with current and former deans and department heads who were his classmates.

The army has afforded me and my family a great life (grew up in a big suburban D.C. house, prep school, an elite university, country clubs, fancy cars, etc) and I feel like I owe the army for this. I, too, would want this life for my wife and kids.

Is military medicine really as broken as this forum makes it out to be? Should I seriously consider my acceptances to other civilian schools? I don't currently owe any time nor am I in any debt.

What you're talking about is noblesse oblige. That, in itself, is an honorable impulse. As others have stated, you do not owe the Army for this. You owe your father, and perhaps the nation that allowed him to accumulate enough wealth to afford you so many privileges while working as a military physician (family money? excessive moonlighting? wife's dowry?).

So you were given much, and therefore much is expected. That is the essence of noblesse oblige. It is an antiquated term, that used to apply to the European aristocracy. In the olden times, aristocracy was associated with service, whether that was to the nation (the Officer Corps) to the Church (priesthood) or to the Polis (public servants).

If you want to join the Army based on this impulse, then I commend you, although you will quickly discover that the vast majority of people you meet could care less about it, if they even know what the term means. If you want to join the Army to have the same things that you grew up with, you are hopelessly naïve. Also, noblesse oblige entails sacrifice. True aristocrats did not join the military to enjoy the comforts and privileges it afforded them. They became Officers to lead less fortunate and privileged men by their own example, and often demonstrated great bravery and selflessness, a fact borne out by the casualty rosters from any WWI trench battle or encounter of bygone eras.

The military as a whole, and the Army in particular, will trample out quickly any aristocratic trappings you affect. Your wife will not be hosting luncheons with bluebloods from the upper echelons. She will be hosting FRG meetings at the Ft. Leonard Wood PX officiating between women with BMI's from 35-65 who greatly resent her fancy jewelry and lack of a muffin top. If she is a professional, she will either hector you into quitting the Service or divorce you (possibly both).

The Army I knew, as a recently discharged flight surgeon now IRR resident, involved 12 month deployments every other year and 2-3 months of out of state training when in garrison. As a flight doc, I spent more than 1/2 of my 4 year commitment either in Afghanistan or training to deploy. Had I been married, I would surely have gotten divorced. I was stationed at a typical backwoods post and commuted 1 hour each way, every day, in order to live in a nearby city. That's a lot of mileage on the car your father bought you.

In other words, your father's army is long-dead. His career path (never deployed, choice postings) is unlikely to resemble yours in any way, shape, or form. The post-Vietnam generation experienced the halcyon days of military service; of course they look back fondly on those times and disparage those of us who led a different life. Your experience as a military Physician is FAR more likely to resemble mine (or PGG's, or any of the repeat OEF/OIF vets) on this forum.

Do not join the military on your father's endorsement, or because you think it will give you life stability or prestige, because it will not. What I got out of military service in general, and combat in particular, was an extraordinary sense of comradeship that I have not found since leaving the Service, and that sustained me in the worst times.

Make sure you join for the right reasons. And do not go to USUHS unless you want to be a career military Physician. You sign one piece of paper and owe 14 years. I think it's a terrible and nonsensical decision for non-prior service folks, unless you're married and have a number of dependents.


- ex 61N
 
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I would say attend USUHS and let us know how it went 15 years from now.

Maybe the 7+ people who are/were active duty physicians are at the far left of the military experience bell curve.
 
Do not join the military on your father's endorsement, or because you think it will give you life stability or prestige, because it will not. What I got out of military service in general, and combat in particular, was an extraordinary sense of comradeship that I have not found since leaving the Service, and that sustained me in the worst times.

I am only in residency, but I have this to be true for all of medical school (at USUHS) and so far into residency. It is by far my favorite part of serving.
 
So you were given much, and therefore much is expected. That is the essence of noblesse oblige. It is an antiquated term, that used to apply to the European aristocracy. In the olden times, aristocracy was associated with service, whether that was to the nation (the Officer Corps) to the Church (priesthood) or to the Polis (public servants). - ex 61N

It goes back even further, with more general application:

"For unto whomever much is given, of him shall be much required." Luke 12:48, King James Bible
 
At your prep school or elite university did you read Kipling?

If any question why we died,
Tell them, because our fathers lied.


Or Heraclitus?

No one steps into the same river twice, for always different waters flow.

Heed the words of those above. Serve only if you believe in the cause. The cause is noble, but the military bureaucracy will devour your soul. The cause will be your only solace when the things forewarned of above have come to pass. And finally, while I have followed a career arc similar to your father (thus far), I would never describe my military career as la dolce vita.
 
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Great Heraclitus quote; I have dabbled in the classics in the past. I'll admit I wasn't familiar with the Kipling one, but I did look it up and it's quite appropriate for this situation.

I get the point guys. I've begun drafting update letters for the civilian schools I interviewed at. With my medical interests leaning towards either surgery or radiology, I'd likely be in the military for at least 16 years once arriving at Army BOLC this summer, and who knows what the military medical landscape looks like when I emerge from residency. It could be better, but it could just as easily be worse. But then again with the implementation of the Affordable Care Act, who knows what civilian medicine looks like in 10 years.

My one disagreement with some comments on this thread:

I don't think going to USUHS commits you to a career in military medicine. Assuming you enter USUHS as a 23 year old, depending on your residency you'd be eligible to leave around the age of 37-40. That leaves at least another solid 25 years of doctoring. My grandfather practiced medicine into his seventies. And my dad made plenty of friends at USUHS with no prior military experience, did their time in the military, got out and currently work at fantastic academic institutions (Rochester, Johns Hopkins, and Mayo to name a few).

I really do believe in the cause, and the reimbursement isn't a dealbreaker for me, but the potentially toxic/hostile/incompetent work environment is.

I'm leaning towards the civilian side of medicine. Thanks for everyone's input.
 
SequesterGrundle, please tell us when your father retired from the military. I would be very interested to know. My guess is that it was at least before OIF. Military medicine used to be great in the 90's, but those days are long gone! Even if your father was still in the military when things started going downhill, he had probably already made a nice place for himself as an 0-6 at a tertiary care center, and was relatively protected from all the crap.

I used to see a lot of retired 06 physicians, and they'd always tell me how wonderful military medicine is and then give some completely out-dated career advice. Looking back I'm not sure how I managed to keep my mouth shut. If you are set on military medicine, at least don't sign yourself up for that long USUHS commitment! You'd be practically locking yourself into a career in the military (and definitely doing so if you complete a fellowship). That would be a very unwise decision for someone in their early 20's.
 
My one disagreement with some comments on this thread:

I don't think going to USUHS commits you to a career in military medicine. Assuming you enter USUHS as a 23 year old, depending on your residency you'd be eligible to leave around the age of 37-40. That leaves at least another solid 25 years of doctoring.

When people say "career" they mean finishing up at least 20 years of service. If you already have 12 or more years in by the time your obligation is up, then it's pretty tough to just walk away with absolutely nothing and leave all that retirement pay. So in reality you'll probably stay in until you're well into your 40's.

Some specialties can retire and do great at that point, but others have a tougher time so they just end up staying in. For example, do you really want to be a junior associate who has to take all the holiday calls and work their butt off when you're in your mid 40's just so you can then start to buy in over 5-7 years in your late 40s/early 50's
 
He retired in 2005. He became chief of his department in '02 and I guess that protected him from being shipped to the sandbox.

And you raise a good point about a military career and transitioning to the civilian world. I had not really considered that aspect.
 
AHLTA was barely getting rolled out at my MEDCEN in 2006, so it's safe to say your dad might have missed it altogether, particularly if he had been in a largely admin job since 2002. OP, keep in mind that this is an EMR that was so bad that it was cited as the #2 reason why physicians separated from the military back when OIF and OEF were in full swing. Pay was #3.
 
AHLTA was barely getting rolled out at my MEDCEN in 2006, so it's safe to say your dad might have missed it altogether, particularly if he had been in a largely admin job since 2002. OP, keep in mind that this is an EMR that was so bad that it was cited as the #2 reason why physicians separated from the military back when OIF and OEF were in full swing. Pay was #3.
And the number one reason was ??
 
AHLTA was barely getting rolled out at my MEDCEN in 2006, so it's safe to say your dad might have missed it altogether, particularly if he had been in a largely admin job since 2002. OP, keep in mind that this is an EMR that was so bad that it was cited as the #2 reason why physicians separated from the military back when OIF and OEF were in full swing. Pay was #3.
Maybe it is better now than the original version but it is still horrible. It is the rate limiting step in productivity for me.
 
Maybe it is better now than the original version but it is still horrible. It is the rate limiting step in productivity for me.

Most people I know seem to think it has improved, but you're right, that still doesn't mean it's any good. Luckily, I don't have to use it with any regularity. My wife, on the other hand, is a civilian doc for the DoD, and she uses it daily. Before our last PCS, she had a remarkably similar job, but working for a large, multi-state, multi-specialty civilian healthcare system. She sees 4-5 fewer patients each day in her current job largely because AHLTA prevents her from being more efficient.
 
Why is pay such a big issue for military physicians? Is it just because military docs make less than their civilian counterparts or because they are poorly paid in general? I'm applying for the HPSP right now, so I'm trying to get as much info as possible. I'm not going into medicine for the money at all. I think I'd actually do it for free if all of my needs were provided for, but I'd definitely like to know that I'll be able to support myself and my family when the time comes.
 
Why is pay such a big issue for military physicians? Is it just because military docs make less than their civilian counterparts or because they are poorly paid in general? I'm applying for the HPSP right now, so I'm trying to get as much info as possible. I'm not going into medicine for the money at all. I think I'd actually do it for free if all of my needs were provided for, but I'd definitely like to know that I'll be able to support myself and my family when the time comes.

Pay is a big issue for all types of physicians. Believe me, military physicians aren't unique in this sense. I know docs who make my net worth in 6 months who perseverate over reimbursement.

To answer your question, it's definitely the former for me. I'm happy with how much money I make, but it's still frustrating to work along side civilians who make over twice as much as I do for the same job, especially when I frequently outperform them. And, oh yeah, they don't have to worry about things like deployments or annoying administrative positions. Sure, they may have to do APEQS too, but no one will disapprove their leave or cancel their moonlighting if they're not in compliance.

DoD civilian physicians still get to treat servicemembers (the best part of our job, IMO), but they do it with fewer hassles and substantially better pay (at least for my specialty). I could never justify staying in uniform when I could get such a job, treat the same patients, work the same hours, get the same job satisfaction, more than double my pay, and decrease my frustration level.
 
Pay is a big issue for all types of physicians. Believe me, military physicians aren't unique in this sense. I know docs who make my net worth in 6 months who perseverate over reimbursement.

To answer your question, it's definitely the former for me. I'm happy with how much money I make, but it's still frustrating to work along side civilians who make over twice as much as I do for the same job, especially when I frequently outperform them. And, oh yeah, they don't have to worry about things like deployments or annoying administrative positions. Sure, they may have to do APEQS too, but no one will disapprove their leave or cancel their moonlighting if they're not in compliance.

DoD civilian physicians still get to treat servicemembers (the best part of our job, IMO), but they do it with fewer hassles and substantially better pay (at least for my specialty). I could never justify staying in uniform when I could get such a job, treat the same patients, work the same hours, get the same job satisfaction, more than double my pay, and decrease my frustration level.

This.

I felt it was almost criminally insensitive/disrespectful when I was assigned to meet-n-greet, interview, and give tours to candidates for a contract physician position for the same clinical job as mine, that would report to me, but pay 2.25x my total gross pay.

In addition, as the uniformed physician, your off-time/leave is afforded the lowest priority because you aren't limited to 80 hours in a pay period or 1920 hours in a contract-year, and, despite statements to the contrary, no one else is really held accountable if you lose leave at the end of the year.
 
Why is pay such a big issue for military physicians? Is it just because military docs make less than their civilian counterparts or because they are poorly paid in general? I'm applying for the HPSP right now, so I'm trying to get as much info as possible. I'm not going into medicine for the money at all. I think I'd actually do it for free if all of my needs were provided for, but I'd definitely like to know that I'll be able to support myself and my family when the time comes.
The great philosopher Patrick Ewing once said, "Sure I make a lot of money, but I spend a lot of money too". Military docs make more than most (all) other officers but we compare that to what we could be making on the outside. You are probably single and in your early 20's and fine dining consists of pop tarts in the morning and Chipotle on the way home at night - you are not all that concerned about the pay. But when faced with all the other costs of raising a family, mortgage, college etc the money flies out the door. Then your spouse looks at you and says "Remind me, why are you still in the military?".
 
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I'm not going into medicine for the money at all.

The great thing about the internet is that 15 years from now, you'll be able to retrieve this post from the depths of the SDN archives and marvel at the things your younger self said.


Always amazing that so many premeds are so willing to trade away a paycheck they haven't earned yet.
 
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The only thing positive about military medicine is showing it the old brown eye on your way out the door at the end of your adso. Good rid dens government.
 
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I'm not going into medicine for the money at all. I think I'd actually do it for free if all of my needs were provided for, but I'd definitely like to know that I'll be able to support myself and my family when the time comes.

Ah the old pre-med "I'd do this for free" gambit. We're not a medical school admissions committee: the shibboleths need not be uttered and no "party line" need be toed.

I'll take a page from history and graciously accept your salary while in return making sure that you and your family's "needs" are taken care of. Pretty soon you'll be saying things like "Napoleon is always right", and "I'll just work harder."

#Benjaminthedonkey
 
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The only thing positive about military medicine is showing it the old brown eye on your way out the door at the end of your adso. Good rid dens government.

There's nothing wrong with a good ol' fashioned mooning. Actually showing the hole is over the line.
 
I think that was the horse. The donkey knew what was up, he just didn't care.

I consider us (the board's resident cynics) to be akin to Benjamin. It's our jobs to get the Boxers of the world to see the system as it truly is. If they still decide to give themselves to the cause and end up at the glue factory, they cannot say they weren't warned.
 
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Thank you to colbgw02 and denali for the insight. That's what I figured but I just wanted to make sure. I was just curious about the monetary thing because even though I've researched it I can't find how much military physicians typically make and if there is a difference between specialties. I know it's based on rank, but I've found and been told conflicting information about what rank physicians start at and how much that actually pays. If you don't mind sharing, how long were you/have you been in the military and how long did you/are you planning on staying in the military as a physician? Are you just fulfilling obligations or are you staying for the duration of your career?

Ah the old pre-med "I'd do this for free" gambit. We're not a medical school admissions committee: the shibboleths need not be uttered and no "party line" need be toed.

Well obviously money is a motivator, but I consider anything over 50k a year to be more than sufficient for me. So in terms of that aspect job security is much more important to me than the actual pay. Anyone would take 300k/yr over 100k/yr if that was the only factor, but we all know that it's not. Saying I'd do it for free was only meant to illustrate that being rich isn't important to me and that as long as I'm independent and able to support myself and my family, the excess isn't a priority. I didn't come here to get a bunch of BS about how naive you perceive me to be. I came here to get legitimate perspectives about the HPSP and life as a military physician, not a misguided and misquoted analogy from an middle school level book. That being said, I'd greatly appreciate any actual insight into life as a military med student/resident/physician that you or any other military member has to give.

I am in a situation where I can either pay for one year of living expenses or half a year's tuition meaning I'll need to take out around $200,000 in loans to pay for tuition and another 70k for living/travel expenses. That doesn't include testing/book/lab fees or interest, which will probably bring that up to at least 400k. If I took the HPSP, tuition would be paid for, plus I would get another 108k in stipend, active duty pay, and the sign-on bonus. So that would take care of living expenses and then give me around an extra 25k left over after that. Follow that up with the facts that (from what I've been told from several sources) military residents typically make more than civilian residents and that I wouldn't have to pay for malpractice or health insurance, and the HPSP seems very attractive from a purely financial aspect. Doing the math in terms of service time, if I chose a specialty with a 5 year residency or less I would easily finish my required service time by the time I'm 40.

The general consensus I've been seeing here is to run as far away from the military as possible, I'll ask the question differently. If I'm interested in providing medical care to members of the military but still want to maximize my financial gains (which is apparently inevitable from what everyone has written or implied), would people recommend taking the HPSP, staying debt-free, and then moving into civilian medicine after fulfilling the obligation if I no longer wanted to , or would you recommend taking the normal med school route and trying to get a contract with the DOD or at a VA hospital after racking up a massive amount of debt that I probably wouldn't be able to pay off until I'm well over 40?
 
I didn't come here to get a bunch of BS about how naive you perceive me to be. I came here to get legitimate perspectives about the HPSP and life as a military physician, not a misguided and misquoted analogy from an middle school level book. That being said, I'd greatly appreciate any actual insight into life as a military med student/resident/physician that you or any other military member has to give.
A piece of advice:

When you post a question on a forum like this, you are asking docs to take time from their busy schedules to give you information to help you make a big life decision. There is nothing in it for them. Even if you don't like their advice or the tone in which it's given, insulting very busy people from whom you're essentially asking the favor of time is bad juju. I guarantee that there are people that might have weighed in to give you their thoughts that read the bolded and just said, "forget it."
 
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even though I've researched it I can't find how much military physicians typically make

It is complex and confusing.

The official military pay calculators on the web all suck, because they weren't written with doctor pay, or doctor training, or doctor obligations, or doctor pay-after-getting-out in mind. They're a useless as recruiters. So I wrote a web app to
  • estimate active duty pay until retirement eligibility based on specialty, rank, and other factors
  • estimate the value of a military retirement, not counting health or other benefits
  • compare lifetime earnings of a milmed career vs departure immediately after ADSO fulfillment
  • attempt to determine a rough "break even" point, after which it makes financial sense to stay in until retirement
In the next week or so, when I'm done debugging it, I'll post it here. And then you'll be able to see exactly how much military physicians make.


Well obviously money is a motivator, but I consider anything over 50k a year to be more than sufficient for me.

You realize median income in parts of the US is well in excess of $50K/year, right? You really think you'd be cool with 4 years of top performance at a not-free university, during which time you get 4 years older, then 4 years of really really hard work at a not-free medical school, during which time you get another 4 years older, then 3-5+ years of internship and really really hard life-dominating residency, during which time you get another 3-5+ years older (meanwhile your college pals are pushing 10 years in a JOB and CAREER with substantial paychecks and 401(k)s and career advancement and weekends off, just in time to emerge to practice a very demanding, high risk profession for LESS than median wage?


as long as I'm independent and able to support myself and my family, the excess isn't a priority.

Here's the thing, though. You can "support" yourself and your family on $50K/year, so long as "support" means a roof, a couple thousand calories per day per person, a car that's mostly reliable. You won't be "supporting" your son with music lessons or your daughter with gymnastics meets on a traveling team. And if you choose to live in a "desirable" city you'll be "supporting" that roof via rent, not a mortgage.


With rising loan balances, rising interest rates, and declining reimbursement, HPSP/USUHS are financially more attractive than ever. This would be a good thread for you to read:

http://forums.studentdoctor.net/threads/the-skyrocketing-value-of-the-hpsp-scholarship.1003915/

But don't join the military unless you want to be in the military.
 
I apologize if I offended anyone with that post, that wasn't my goal. I was simply trying to point out that posting stuff saying how naive I am is a waste of time, especially for people as busy as the doctors you are talking about. I admitted that I don't know all the details about the financial aspects of of military medicine and am trying to learn. So when someone makes a post that has the tone of "looks at the foolish little pre-med, let's point out how childish they are" it's a waste of everyone's time. I wrote the "I'd work for free" part because I legitimately meant that money isn't a major motivator for me. Maybe someday that perspective will change, but I was trying to express my current situation.

As I stated before, I greatly appreciate all those who who have taken time out of their day to come and share their knowledge with all of us young and inexperienced kids. It's just frustrating when I ask a legitimate question with minimal background and I get condescending responses. So once again, I'm sorry if I offended anyone, but I generally show people the same amount of respect they give me.
 
One other thing -

I didn't come here to get a bunch of BS about how naive you perceive me to be.

One of the things teachers and mentors do is tell us things that we don't want to hear or don't want to believe.


I remember taking a mock oral board with a pair of my attendings, just a few months into residency. They told me (paraphrased) that my answers were below standards, even for a new resident, and I'd better get my **** together and rearrange my life around residency, or else. I didn't like hearing it, but they were right. They weren't friendly about it, they didn't coddle me or worry about my feelings, they told me something I needed to know, and I'm glad they didn't just blow some smoke up my ass and watch me sink.

Now, obviously we're just a bunch of random people on the internet, not your teachers ... but we do try to offer information, advice, and mentorship to anyone who comes here looking for help. If it's smoke you're after, leave this forum and go talk to a recruiter, 'cause it's a sure thing he'll tell you the only thing that matters is the honor and privilege of serving, Semper Fi, sign right here.
 
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