BUMED GME note 2021

[SirGecko]

BUMED note 1524 is out.

Happy to see radiology increased to 7 from the untenable position of only four residents for the last two years.

Looking at training goals by site and I was wondering if anyone in the ortho community knew why they are only taking one intern at San Diego this year. Is ortho overmanned or something? Maybe it’s a typo? It previously took the most navy interns at 5. Is the Air Force taking up these spots or something? Also total number of ortho interns down from 12 to 6?

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[Matthew9Thirtyfive]

Also interesting to see a rad onc and a pmr spot. Urology also increased to 4 spots.

 

[MCCareer.org]

BUMED note 1524 is out.

Happy to see radiology increased to 7 from the untenable position of only four residents for the last two years.

Looking at training goals by site and I was wondering if anyone in the ortho community knew why they are only taking one intern at San Diego this year. Is ortho overmanned or something? Maybe it’s a typo? It previously took the most navy interns at 5. Is the Air Force taking up these spots or something? Also total number of ortho interns down from 12 to 6?

It is part of the transition plan for straight-through GME. While the exact number of interns we ultimately take will not be determined until November, temporarily reducing interns makes room for returning GMOs.

 

[Gastrapathy]

30 interns to 10 R2s for general surgery. Considering that the surgical subs have their own interns now, that seems like a lot of interns bound for the fleet.

Overall, the fact that they are still trying to train in this diverse a list of specialties and subspecialties is good news for the folks in the pipeline. Hopefully there's someone on the west coast who wants that Advanced Endoscopy slot because I don't think theres anyone out here who will.

 

[Gastrapathy]

It is part of the transition plan for straight-through GME. While the exact number of interns we ultimately take will not be determined until November, temporarily reducing interns makes room for returning GMOs.

There will inevitably be folks who get lost in the shuffle in the highly competitive residencies with this transition. There is no way for them to avoid having interns and GMOs collide. But...this is a really good step for Navy Medicine. I'm happy to see that the 20+ years of talk about getting rid of GMOs has finally led to some action and, despite the problems it creates, this needed to happen.

 

[cgk]

Also interesting to see a rad onc and a pmr spot. Urology also increased to 4 spots.

I thought that the military closed( stopped expansion) the Rad/Onc residency program.

 

[Matthew9Thirtyfive]

I thought that the military closed( stopped expansion) the Rad/Onc residency program.

So did I, but WR has one spot.

 

[pawprint]

Weird to see that peds interns spots increased by 2, and that there are 3 peds fellowship opportunities + 2 surgical (urology and anesthesia) peds fellowships….seems like a lot if they are planning on gutting pediatrics

 

[Brouillet2017]

Weird to see that peds interns spots increased by 2, and that there are 3 peds fellowship opportunities + 2 surgical (urology and anesthesia) peds fellowships….seems like a lot if they are planning on gutting pediatrics

My understanding is that general Peds grads will be highly utilized as OMOs. Not sure what the subspecialists will do, though

 

[pawprint]

My understanding is that general Peds grads will be highly utilized as OMOs. Not sure what the subspecialists will do, though

Which makes no sense....lets take a doctor who specializes in treating children, and have them see adult patients as an OMO for 2-3 years, and then send them back to pediatrics. They will make bad OMO's and bad pediatricians with that model.

It doesnt make sense to me that the argument keeps being made that pediatricians make good operational officers. We learned how to take care of babies, and my residency had 1 month of adolescent medicine. Sure, 20 year old Marines/Sailors are similar to 16 year olds in some ways. But in many ways they arent, and pediatricians just dont spend enough time in adolescent medicine for that to translate. Im a good flight surgeon because I'm quick on my feet to learn new things, not because my pediatric training prepared me for treating adults.

The real pull for pediatricians in the Navy is our ability to deliver unexpected NICU-style babies in overseas locations like guam and stabilize them until we can get them transported back to the US. Navy pediatric training is heavily focused on nursery/NICU (and rightfully so). Take us from getting to practice that kind of medicine in hospitals to be OMO's for 2/3 year tours, and we will just have bad medicine all around.

 

[MCCareer.org]

Weird to see that peds interns spots increased by 2, and that there are 3 peds fellowship opportunities + 2 surgical (urology and anesthesia) peds fellowships….seems like a lot if they are planning on gutting pediatrics

My understanding is that general Peds grads will be highly utilized as OMOs. Not sure what the subspecialists will do, though

The Peds numbers have absolutely nothing to do with OMOs. They are the numbers we need. Rumors we are "gutting" Pediatrics are not true.

 

[militaryPHYS]

Unfortunately this stuff is such a moving target and there is often bad gouge being thrown around (even from leaders in each of our communities).

@MCCareer.org any thoughts from Chief's office of starting an annual "status of the forces" release which would highlight key things in each specialty community, goals for force shaping and commander's intent as it relates to a 1, 5 and 10 year plan? It would likely help dispel rumors and provide facts for us to apply to the way we all mentor and lead our people. I know the SG office has their release but that doesn't provide high yield facts most medical professionals in MilMed are interested in. The 1524 is great but all it does is cause people to question why the changes are there and create speculation on where we are headed because no context is given to the numbers presented.

As always we appreciate the transparency and all of the work that you do. The information and context you provide has been excellent and a welcomed new thing for the community but I know that your ability for public release of information can be limited.

 

[Gastrapathy]

The message keeps changing so it’s not hard to understand why people don’t have the latest take exactly right. Just look at the Peds thread from a few months ago where @MCCareer.org agreed that the “trend” was to train fewer pediatricians. Absent any further information, it’s easy for people to interpret that accordingly (particularly ones who remember when peds was eliminated and then restored in a 72 hour period way back when).

 

[MCCareer.org]

Unfortunately this stuff is such a moving target and there is often bad gouge being thrown around (even from leaders in each of our communities).

@MCCareer.org any thoughts from Chief's office of starting an annual "status of the forces" release which would highlight key things in each specialty community, goals for force shaping and commander's intent as it relates to a 1, 5 and 10 year plan? It would likely help dispel rumors and provide facts for us to apply to the way we all mentor and lead our people. I know the SG office has their release but that doesn't provide high yield facts most medical professionals in MilMed are interested in. The 1524 is great but all it does is cause people to question why the changes are there and create speculation on where we are headed because no context is given to the numbers presented.

As always we appreciate the transparency and all of the work that you do. The information and context you provide has been excellent and a welcomed new thing for the community but I know that your ability for public release of information can be limited.

Honestly, this would be really tough to do. When people call me and ask questions about the future of specialties, I give them my best answer but caveat it with the reality, which is that the answer to most questions right now is..."I don't know." Things are so up in the air and constantly changing. For example, we started to develop the GME goals in March. In the interim, the divestitures have been pushed to the right again, moving to FY24-FY26. Will they ever actually happen? "I don't know." We just take all the info we have and do the best we can with it, and that's all people can do.