Army Ortho Programs

[HPSPosteopathic]

So as you can tell by my account name I'm an(*aspiring*) D.O. going through the Army HPSP program. I recently got back board scores for step 1 (yay!) and was looking for a little advice regarding Army Ortho programs. I only have so many electives and have to narrow down which Army hospitals to perform ADT's (and maybe some non-ADT's if i can).

(1) Would someone with experience be able to shine some light on what Army Ortho programs offer something unique that gives that program an advantage over others? I know Walter Reed has the Ortho oncology docs, which is really impressive to me. However, if there is such low volume at Walter Reed, the Ortho oncology wouldn't have as much of a draw.

(2) I just discovered my USMLE score will not even be shown on my application through MODS. Was that a waste of time to take step 1? (My score was over 255) Not sure if they will only look at my comlex score.

Thank you for your time!

---

Members don't see this ad.

 

[YayPudding]

Eyeballing this thread...

 

[Ziehl-Neelsen]

(2) I just discovered my USMLE score will not even be shown on my application through MODS. Was that a waste of time to take step 1? (My score was over 255) Not sure if they will only look at my comlex score.

Not a waste. You will interview with the program director when you rotate on your ADT. Ask frankly about your competitiveness. The PD will ask about your stats. If the PD is a DO, give your COMLEX (which is hopefully similarly high). If the PD is an MD (which is the more likely scenario), that's when you get to drop your USMLE score on him or her. The USMLE's value is that MDs know the SDs of the USMLE score but have far less familiarity with the COMLEX. When we ranked applicants for my old program, we used to have to call in one of the DO residents to walk us through COMLEX scores.

(1) Would someone with experience be able to shine some light on what Army Ortho programs offer something unique that gives that program an advantage over others? I know Walter Reed has the Ortho oncology docs, which is really impressive to me. However, if there is such low volume at Walter Reed, the Ortho oncology wouldn't have as much of a draw.

WRNMMC and SAMMC both have ortho onc specialists. They also do most of crazy ortho reconstruction cases because they receive the vast majority of the horrendous battlefield trauma when it gets evac'd stateside. In general, they will have the widest variety of subspecialist staff to learn from and you'll have the ability to scrub in/manage many different types of pathology. That said, the programs there are larger and the operative volume (per surgeon) is smaller.

Talked to an ortho staff buddy a few months ago and he told me the highest operative volume for staff (and thus residents) was currently at WBAMC (which makes sense--the only larger FORSCOM bases than Bliss are Hood and Bragg, neither of which have ortho residencies; WBAMC also has joint [no pun intended] status with the VA so all the El Paso VA ortho is performed by WBAMC surgeons). The caveat is that the volume is almost exclusively sport (active duty population) and joint (VA and retired population). The program is combined with Texas Tech's civilian program to get a wider exposure from my understanding.

I don't know anything specific about the other 3 ortho programs. I know the general reputation for surgery at Tripler is malignant and at EAMC is low volume (though you should see for yourself in both instances). I've not heard any specific negative reputations about Madigan.

If you're interested, this paper may serve as a resource:
Military Medicine - International Journal of AMSUS

 

[HPSPosteopathic]

Thank you so much for the info! Comlex was relatively strong as well (over 700) I just wasn't sure if the USMLE would actually serve me well. Like you said, I guess ill have to play it by ear based on the program director.

I may be naive, but could you elaborate on how a program can have high complexity cases but low volume? I'd assume they come hand in hand. Then again, maybe it's because Walter Reed is in a saturated area (meaning many hospitals). *shrug*

Yeah, I just checked into some things you said. Apparently William Beaumont orthopods spend "3 months a year" at the local Trauma 1 Texas Tech hospital. That sounds pretty awesome, even if it is mainly sports-related. That civilian/military combined program sounds like it could be a really good experience to train in both healthcare systems. Especially when it's not just an away rotation but rather an integral, significant time spent in civilian.

Thank you for your help.

Hopefully we will get lucky and have a current/former ortho resident chyme in and let us know about their personal experience.

Not a waste. You will interview with the program director when you rotate on your ADT. Ask frankly about your competitiveness. The PD will ask about your stats. If the PD is a DO, give your COMLEX (which is hopefully similarly high). If the PD is an MD (which is the more likely scenario), that's when you get to drop your USMLE score on him or her. The USMLE's value is that MDs know the SDs of the USMLE score but have far less familiarity with the COMLEX. When we ranked applicants for my old program, we used to have to call in one of the DO residents to walk us through COMLEX scores.


WRNMMC and SAMMC both have ortho onc specialists. They also do most of crazy ortho reconstruction cases because they receive the vast majority of the horrendous battlefield trauma when it gets evac'd stateside. In general, they will have the widest variety of subspecialist staff to learn from and you'll have the ability to scrub in/manage many different types of pathology. That said, the programs there are larger and the volume is smaller.

Talked to an ortho staff buddy a few months ago and he told me the highest operative volume for staff (and thus residents) was currently at WBAMC (which makes sense--the only larger FORSCOM bases than Bliss are Hood and Bragg, neither of which have ortho residencies; WBAMC also has joint [no pun intended] status with the VA so all the El Paso VA ortho is performed by WBAMC surgeons). The caveat is that the volume is almost exclusively sport (active duty population) and joint (VA and retired population). The program is combined with Texas Tech's civilian program to get a wider exposure from my understanding.

I don't know anything specific about the other 3 ortho programs. I know the general reputation for surgery at Tripler is malignant and at EAMC is low volume (though you should see for yourself in both instances). I've not heard any specific negative reputations about Madigan.

If you're interested, this paper may serve as a resource:
Military Medicine - International Journal of AMSUS

you

 

[Ziehl-Neelsen]

I may be naive, but could you elaborate on how a program can have high complexity cases but low volume? I'd assume they come hand in hand. Then again, maybe it's because Walter Reed is in a saturated area (meaning many hospitals). *shrug*

Numerators and denominators (these numbers are fabricated but they should get the point across).

You're a resident at SAMMC on the adult reconstructive service. There are 2 attendings who have divided 30 referrals for joint replacement that month between them. At most you'll get to operate on 15 patients because you can't be scrubbed in on 2 cases at the same time.

You're a resident at WBAMC on the adult reconstructive service. There is one attending who receives a smaller volume of referrals (let's say 17) than the department at SAMMC that month, but because there is only one attending, that attending performs all 17 cases and you get to scrub on all of them.

The trade-off is the complexity. The 25 year old whose coccyx and pelvis were destroyed in an MRAP roll-over is getting evac'd to SAMMC, not WBAMC, for his orthopedic reconstruction. Will the fact that you get to operate on that patient as a resident at SAMMC make up for the fact that you'll have done less ACL repairs than a graduating resident at WBAMC? I dunno. That's for you to decide.