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SurfingDoctor

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I realize this is probably a semi-unusual topic... but what are the disadvantages to joining AMEDD as a reservist mid-career? Like, I'm going up for a tenure position (which I'll get), which in my field (pediatric intensive care) is quite rare, but it is kinda unsatisfying. For those who don't know, tenure is mostly a BS position that doesn't really mean anything except they can't fire you for reason "X" and if you get an endowed chair... you get a pot of money to do whatever (I'm not that far along though)... I just get the "you've made it... whoop" back pat and stroke. I've thought about AMEDD as a reservist, realizing that its without any financial commitment (my loans are more or less paid off) and could theoretically continue in a tenure position which I only mildly care about, but really am interested in hearing the pros and cons.

I get the whole subordination thing (you're a soldier first and a physician second), but the reality is academics isn't much different. Maybe less in schedule flexibility, but I don't see that as much different (though maybe I'm wrong... speak up please). Anyway, I feel like I need some honest, outside assessment of something which I have little experience of and want further input.

Only honest input is appreciated... Thanks (you can tell me I'm an idiot if its appropriate). Mostly, my wife will be pissed if I join, but I don't see that as a major hurdle since her father was MACV-SOG... I just need some positives to coax her... or not if they don't exist.

I've already emailed a recruiter and I'm gonna talk to one in person... but I'm not convinced that I'll get a honest answer... so lay it on me. Any lack of response I'll take as affirmation.

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What are you looking to get out of it? What branch are you exploring and are you thinking Guard, Reserve, or both? It sounds like Army as a Reservist but I just want to confirm. How much time and effort do you want to invest in this? Is the goal being a part-time physician in uniform and occasionally doing interesting things or are you looking for something more intensive and "military"? Pros and cons would be easier to discuss from that perspective.

Disadvantages on the military side of joining later in life are hitting your 20 years in service later in life and the relatively long timeframe of getting up and running and in a position to do the more interesting things the military has to offer. Disadvantages on the civilian side are introducing a whole new set up time commitments on top of established obligations and having to sort out the balancing act with an already full plate rather than developing it from the ground up as a trainee or junior faculty member.

You can still be an academic while serving in the reserve component but it does make it more difficult. Between family, hobbies, the military, and an academic career you'll have to prioritize which ones you want to be great at and which ones you're happy to be adequate at. Different departments will be varying levels of supportive regarding military service. Shift-based specialties like PICU, EM, MICU, anesthesia, etc. are easier to make work. Realistically, you are asking your family, co-workers, and employers to work with you as you pick up a 0.2 to 0.5 FTE job on the side. The 1 weekend a month and 2 weeks a year is the recruiting line but it can be significantly more demanding depending on your specific goals, branch, and unit. In the first few years you'll have to find several extra weeks of time to go to the initial officer training and then any entry training for the more specialized positions. Reserve tends to be less intense than the Guard and Air Force tends to be less intense than the Army.

There are generally signing bonuses available so you could get some extra cash in your pocket for signing up even if your loans are paid off. You would probably make more cash moonlighting as a civilian for 38 days each year.
 
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I realize this is probably a semi-unusual topic... but what are the disadvantages to joining AMEDD as a reservist mid-career? Like, I'm going up for a tenure position (which I'll get), which in my field (pediatric intensive care) is quite rare, but it is kinda unsatisfying. For those who don't know, tenure is mostly a BS position that doesn't really mean anything except they can't fire you for reason "X" and if you get an endowed chair... you get a pot of money to do whatever (I'm not that far along though)... I just get the "you've made it... whoop" back pat and stroke. I've thought about AMEDD as a reservist, realizing that its without any financial commitment (my loans are more or less paid off) and could theoretically continue in a tenure position which I only mildly care about, but really am interested in hearing the pros and cons.

I get the whole subordination thing (you're a soldier first and a physician second), but the reality is academics isn't much different. Maybe less in schedule flexibility, but I don't see that as much different (though maybe I'm wrong... speak up please). Anyway, I feel like I need some honest, outside assessment of something which I have little experience of and want further input.

Only honest input is appreciated... Thanks (you can tell me I'm an idiot if its appropriate). Mostly, my wife will be pissed if I join, but I don't see that as a major hurdle since her father was MACV-SOG... I just need some positives to coax her... or not if they don't exist.

I've already emailed a recruiter and I'm gonna talk to one in person... but I'm not convinced that I'll get a honest answer... so lay it on me. Any lack of response I'll take as affirmation.
How do you think the military could/would utilize your extremely important yet niche skill set?

Are you willing to operate outside your traditional scope of practice?

What experiences are you looking towards in the military?
 
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How do you think the military could/would utilize your extremely important yet niche skill set?

Are you willing to operate outside your traditional scope of practice?

What experiences are you looking towards in the military?
To the first question, I have no idea. If they have no need, then I guess that would be that.

As to outside my scope of practice, I guess it depends. Pediatrics, in least one my area, treats up to mid-20 year olds so the age wouldn’t be problematic… unless it was like 60 year olds. If they wanted to do some far outside my scope, like psych evaluations or something, that would be problematic.

As to last question, it’s the one I struggle with most. If I had to distill it down, probably just a change of pace and something different than just day to day pediatric ICU care intermixed with papers and grant writing. After all these years, that’s gotten quite monotonous.
 
What are you looking to get out of it? What branch are you exploring and are you thinking Guard, Reserve, or both? It sounds like Army as a Reservist but I just want to confirm. How much time and effort do you want to invest in this? Is the goal being a part-time physician in uniform and occasionally doing interesting things or are you looking for something more intensive and "military"? Pros and cons would be easier to discuss from that perspective.

Disadvantages on the military side of joining later in life are hitting your 20 years in service later in life and the relatively long timeframe of getting up and running and in a position to do the more interesting things the military has to offer. Disadvantages on the civilian side are introducing a whole new set up time commitments on top of established obligations and having to sort out the balancing act with an already full plate rather than developing it from the ground up as a trainee or junior faculty member.

You can still be an academic while serving in the reserve component but it does make it more difficult. Between family, hobbies, the military, and an academic career you'll have to prioritize which ones you want to be great at and which ones you're happy to be adequate at. Different departments will be varying levels of supportive regarding military service. Shift-based specialties like PICU, EM, MICU, anesthesia, etc. are easier to make work. Realistically, you are asking your family, co-workers, and employers to work with you as you pick up a 0.2 to 0.5 FTE job on the side. The 1 weekend a month and 2 weeks a year is the recruiting line but it can be significantly more demanding depending on your specific goals, branch, and unit. In the first few years you'll have to find several extra weeks of time to go to the initial officer training and then any entry training for the more specialized positions. Reserve tends to be less intense than the Guard and Air Force tends to be less intense than the Army.

There are generally signing bonuses available so you could get some extra cash in your pocket for signing up even if your loans are paid off. You would probably make more cash moonlighting as a civilian for 38 days each year.
Yeah, Army Reserve. More the former of parttime and doing something different to break up the current routine, I’m not ready nor really interested in a complete career change.

All good points. I’m kinda getting to the age of get up or shut up as far as enlisting and while my plate is full, I don’t always find it the most satisfying anymore… though there’s probably a fair share of mid-career people that feel that way. That being said, while I’m not terribly concerned about my personal time, I don’t want it to negatively impact others substantially. My current federal grant allows for some deferment for military commitment, though I’d probably have to go back and read the fine lines.

I’ve read other people of this forum say the 2 weeks + 1 weekend/month despite being what is told, is typically underestimated. Can you give me insight into want those other commitments are?

As for the bonuses, at this juncture, money isn’t really a concern and would forgo any bonuses or incentives they offered if they are optional.
 
Army reservist here.
Biggest negative is that with your specialty you likely won't do much over drill weekends. You will not see patients. Maybe some training... Usually consisting of briefings. Maybe some range and field but that would be rare for your specialty.

Maybe your skills could be used if activated but that's usually 90 day deployments with another 30 days for spin-up and wind-down. A lot of time away from family. But I highly doubt there are many billets for your specialty. You could opt to be a field surgeon but thats a long story...

Also, about two months of training for DCC and BOLC.

There are some positives... A sense of service really and financial incentives especially for those of us trying to get to 20.

Downsides are big. I wouldn't recommend it for a "change of pace"
 
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Army reservist here.
Biggest negative is that with your specialty you likely won't do much over drill weekends. You will not see patients. Maybe some training... Usually consisting of briefings. Maybe some range and field but that would be rare for your specialty.

Maybe your skills could be used if activated but that's usually 90 day deployments with another 30 days for spin-up and wind-down. A lot of time away from family. But I highly doubt there are many billets for your specialty. You could opt to be a field surgeon but thats a long story...

Also, about two months of training for DCC and BOLC.

There are some positives... A sense of service really and financial incentives especially for those of us trying to get to 20.

Downsides are big. I wouldn't recommend it for a "change of pace"
2 months of training? That is meant over what period of time?

Away from the family would probably be a blessing in disguise, but it would only work if it didn’t piss off my wife enough that I had to sleep on the couch.

I definitely won’t be going for the 20. I’d be too old then.
 
Yeah, Army Reserve. More the former of parttime and doing something different to break up the current routine, I’m not ready nor really interested in a complete career change.

All good points. I’m kinda getting to the age of get up or shut up as far as enlisting and while my plate is full, I don’t always find it the most satisfying anymore… though there’s probably a fair share of mid-career people that feel that way. That being said, while I’m not terribly concerned about my personal time, I don’t want it to negatively impact others substantially. My current federal grant allows for some deferment for military commitment, though I’d probably have to go back and read the fine lines.

I’ve read other people of this forum say the 2 weeks + 1 weekend/month despite being what is told, is typically underestimated. Can you give me insight into want those other commitments are?

As for the bonuses, at this juncture, money isn’t really a concern and would forgo any bonuses or incentives they offered if they are optional.

Is there a reason behind your choice of Army or Reserve?

In terms of time commitment, it's a little complicated. It varies a lot between units, branch, and Reserve vs Guard. The expectation for the reserve components (RC), has increased over the past 2 decades and many units spend significantly more time at drill and at training events. Any schools you need or want to go to will also add time. Then there are deployments (and state activations for the Guard) that can mean months in uniform. How much of a unit's drill and training schedule they will let you out of for civilian obligations is variable. Physicians tend to get more slack but it's not guaranteed. The Army will generally be a bigger commitment than the Air Force and the National Guard will generally be a bigger commitment than the Reserve.

The other thing that makes it challenging to talk about time commitment is a lot of it comes down to what you want to get out of the military. The truth is that drill is pretty boring. It's mostly administrative work and health screens with maybe some time to provide low level medical training. The more unique opportunities generally mean spending extra days in uniform to go to schools, training events, deployments, etc.

Bottom line, you have some control over the commitment, but it can be significantly more than the one weekend a month and two weeks a year. I estimate 12 drill weekends and then 3-4 weeks of training per year (sometimes split up over various training events, sometimes clumped together for a school) plus a few deployments over the course of a career would be a reasonable estimate for someone relatively engaged in the military side of their career. You can definitely spend significantly more time in uniform but that would take some exceedingly bad luck or active effort to do so on your part.

It's a 0.2 to 0.5 FTE job and, if something dramatic happens globally, it can become a full-time job. People were deploying for 9, 12, and 15 months in the past 2 decades. It's more typical now for Guard and Reserve deployments to take you out for 3 or 4 months but you have to accept the risk. You really need your family on board and an employer who will be at least be grudgingly supportive.

Most of the incentives at the attending level come with pretty reasonable commitments especially given the fact that the second you sign any contract you've committed to allowing them to call you back into service anytime for the next 8 years. I would look into what is available before deciding not to take anything.
 
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Is there a reason behind your choice of Army or Reserve?

In terms of time commitment, it's a little complicated. It varies a lot between units, branch, and Reserve vs Guard. The expectation for the reserve components (RC), has increased over the past 2 decades and many units spend significantly more time at drill and at training events. Any schools you need or want to go to will also add time. Then there are deployments (and state activations for the Guard) that can mean months in uniform. How much of a unit's drill and training schedule they will let you out of for civilian obligations is variable. Physicians tend to get more slack but it's not guaranteed. The Army will generally be a bigger commitment than the Air Force and the National Guard will generally be a bigger commitment than the Reserve.

The other thing that makes it challenging to talk about time commitment is a lot of it comes down to what you want to get out of the military. The truth is that drill is pretty boring. It's mostly administrative work and health screens with maybe some time to provide low level medical training. The more unique opportunities generally mean spending extra days in uniform to go to schools, training events, deployments, etc.

Bottom line, you have some control over the commitment, but it can be significantly more than the one weekend a month and two weeks a year. I estimate 12 drill weekends and then 3-4 weeks of training per year (sometimes split up over various training events, sometimes clumped together for a school) plus a few deployments over the course of a career would be a reasonable estimate for someone relatively engaged in the military side of their career. You can definitely spend significantly more time in uniform but that would take some exceedingly bad luck or active effort to do so on your part.

It's a 0.2 to 0.5 FTE job and, if something dramatic happens globally, it can become a full-time job. People were deploying for 9, 12, and 15 months in the past 2 decades. It's more typical now for Guard and Reserve deployments to take you out for 3 or 4 months but you have to accept the risk. You really need your family on board and an employer who will be at least be grudgingly supportive.

Most of the incentives at the attending level come with pretty reasonable commitments especially given the fact that the second you sign any contract you've committed to allowing them to call you back into service anytime for the next 8 years. I would look into what is available before deciding not to take anything.
What specific training and school? Is that an obligation or more like something else someone can do if interested? Like I’m already ATLS, PALS and ABLS credentialed as part of my job anyway, so I don’t need that training. But is it like courses that people just want to take to get something more, besides some mandated courses on the military structure and function?

And yeah, if I can’t get my family on board, it’s obviously a no go. That’s probably the biggest hurdle. I know there are reservists on faculty where I’m at so I doubt the employer would be an issue. Also with tenure, I technically can’t be let go.

As to why Army versus Guard, well from this forum, it made it seem like Guard was a bigger commitment. As to why not Air Force, I don’t think there is anything around me,
 
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What specific training and school? Is that an obligation or more like something else someone can do if interested? Like I’m already ATLS, PALS and ABLS credentialed as part of my job anyway, so I don’t need that training. But is it like courses that people just want to take to get something more, besides some mandated courses on the military structure and function?

And yeah, if I can’t get my family on board, it’s obviously a no go. That’s probably the biggest hurdle. I know there are reservists on faculty where I’m at so I doubt the employer would be an issue. Also with tenure, I technically can’t be let go.

As to why Army versus Guard, well from this forum, it made it seem like Guard was a bigger commitment. As to why not Air Force, I don’t think there is anything around me,

Your basic obligation is going to be the initial officer training which is relatively lengthy but a one time thing. After that it depends on your goals in terms of military career progression and what opportunities you want. The other lengthier schools are mostly optional. Things like becoming an aviation physician, critical care transport physician (Air Force specific), dive medicine physician (Navy specific), various global health type trainings, etc. Things that open up new opportunities. Or simply wanting to serve with units that are busier in terms of training and deployment. Ultimately, it really comes back to what you want out of the military. Plenty of physicians have a rewarding careers drilling with medical based units, going to annual training, and deploying on a rare occasion. You get what you put into it, you just have to make sure you'll get what you want in exchange for the time you're willing and able to put in.
 
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Your basic obligation is going to be the initial officer training which is relatively lengthy but a one time thing. After that it depends on your goals in terms of military career progression and what opportunities you want. The other lengthier schools are mostly optional. Things like becoming an aviation physician, critical care transport physician (Air Force specific), dive medicine physician (Navy specific), various global health type trainings, etc. Things that open up new opportunities. Or simply wanting to serve with units that are busier in terms of training and deployment. Ultimately, it really comes back to what you want out of the military. Plenty of physicians have a rewarding careers drilling with medical based units, going to annual training, and deploying on a rare occasion. You get what you put into it, you just have to make sure you'll get what you want in exchange for the time you're willing and able to put in.
Helpful to know. Thanks.
 
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2 months of training? That is meant over what period of time?

Away from the family would probably be a blessing in disguise, but it would only work if it didn’t piss off my wife enough that I had to sleep on the couch.

I definitely won’t be going for the 20. I’d be too old then.
Initial training is Direct commission course aka DCC Basic officer leadership course aka BOLC, each about a month. There are options to taken them together or separately I believe. Requirements change and it's been a few years for me so YMMV.
 
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Ever slept in the woods in the cold or searing heat? The Army can arrange a campout for you. Our former moderator was a pediatric sub specialist, and they put him in the sand box treating adults.
 
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How old are you and how is your health and physical fitness?

If you want to get outside your comfort level and treat adults, you can still do a lot of 'fun' stuff that is a world away from peds. I have a peds attending friend that is overseas now as a battalion surgeon with a NG unit.
 
How old are you and how is your health and physical fitness?

If you want to get outside your comfort level and treat adults, you can still do a lot of 'fun' stuff that is a world away from peds. I have a peds attending friend that is overseas now as a battalion surgeon with a NG unit.
40, almost 41. I don't know how to describe my physical fitness, but I run intermittently (I don't know distance in minutes exactly, would guess 8-10 minutes/mile) and have a BMI of like 23. I have familial hypertension though.
 
Well you asked for an honest assessment and, to use a colloquial cliche, it sounds like you're having a bit of a "mid life crisis." Which, in more psychological terms, is that you're mid-life, early/mid-career, and had the somewhat recent milestone birthday. It's normal in this life stage to take stock of what you've done, where you are, and what you want to do in the future. If you were open to it, this is the exact situation that can benefit from finding a good therapist for some time limited treatment. And that is not me pathologizing what's going on here. You're normal and healthy. It can just help to have a neutral, psychologically minded person to help you figure out the underlying drives/interests/values that are being expressed as "want to join the reserves." There might be even better ways of meeting those needs, once you have a bit more clarity.

I also associated to something my cousin (does change mgt and workforce development) was trying to get my brother to do. Think about this as if you're targeting a company/market that you want to work in. You need to be able to explicitly delineate what you offer to that company as well as what you want to learn/gain from employment there and how that will serve next steps in your career/personal path.
 
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If you want to serve in the reserves, the Air Force Reserve or the Air Guard are less likely to put you in the field. The Coast Guard Reserve would be fine too,
 
Your specific skills will be wasted in the .mil.
Are you ok with that?
What do you want to get out of the .mil and the reserves?
I was AD for 7 years and I got out what I wanted and more, nothing would have made me stay in the reserves, especially so as it was still active war time. At that point, nothing to gain and everything to lose, for me.
Also, my skills were highly desirable and useful at the time. (Anesthesia)
I’m not sure how I would feel if they said, we have enough anesthesiologists so you can run a clinic at the airport in Baghdad for 6 months.
 
Well you asked for an honest assessment and, to use a colloquial cliche, it sounds like you're having a bit of a "mid life crisis." Which, in more psychological terms, is that you're mid-life, early/mid-career, and had the somewhat recent milestone birthday. It's normal in this life stage to take stock of what you've done, where you are, and what you want to do in the future. If you were open to it, this is the exact situation that can benefit from finding a good therapist for some time limited treatment. And that is not me pathologizing what's going on here. You're normal and healthy. It can just help to have a neutral, psychologically minded person to help you figure out the underlying drives/interests/values that are being expressed as "want to join the reserves." There might be even better ways of meeting those needs, once you have a bit more clarity.

I also associated to something my cousin (does change mgt and workforce development) was trying to get my brother to do. Think about this as if you're targeting a company/market that you want to work in. You need to be able to explicitly delineate what you offer to that company as well as what you want to learn/gain from employment there and how that will serve next steps in your career/personal path.
Fair enough. I can guarantee talking to a random person and paying them tell me that my career has become more monotonous overtime is probably a waste of money and better served in a variety of venues that involve booze.

I guess it would be fair to call it a mid-life crisis in that I've been doing the same thing for a decade and its getting less fun overtime. That being said, I have thought about the Reserves for a long time, stretching back before becoming an attending. However, for a variety of reasons, the timing has been off and probably more importantly, I still had the belief a decade ago that NIH-funded research was going to lead to a fulfilling career. I mean, its been okay and I've been successful for the most part, but it wasn't all I envisioned it to be. A vast majority of NIH-funded research is a waste and the paylines are so low that all you do is constantly write to possibly get that pot of money for 5 years, half of which goes to the university so they can keep the lights on and having flushing toilets. Then rinse and repeat. Don't get me wrong, I enjoy parts of my job, but I feel like a change up would be good. I think the lack of a path/goal beyond "do something medicine related that isn't academics" is a fair point though. I've kept my general peds boards (even though I haven't practiced in that area in over a decade) for a just in case, but could bail and just do that if things really came to a grind. Fortunately, they aren't really there yet. Anyway, honest feedback is good too... so thanks.
 
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Your specific skills will be wasted in the .mil.
Are you ok with that?
What do you want to get out of the .mil and the reserves?
I was AD for 7 years and I got out what I wanted and more, nothing would have made me stay in the reserves, especially so as it was still active war time. At that point, nothing to gain and everything to lose, for me.
Also, my skills were highly desirable and useful at the time. (Anesthesia)
I’m not sure how I would feel if they said, we have enough anesthesiologists so you can run a clinic at the airport in Baghdad for 6 months.
I mean, I hear what you are saying. I don't mind not doing critical care. That's part of the reason I went into research, its not really fun watching kids waste away on ventilators on a regular basis. That I know from personal experience leads to burnout. I always figured my "skill" was diagnosis and management of physiology, the rest was superfluous. I had an attending tell me early on that was the point of the career I picked, and that the procedural aspects could be taught to a trained monkey. Of course, they burned out eventually too (lordy... I do know a lot of people who go smoldering down in flames), but I think they were kinda right and I think the skill of diagnosis and management is broadly applicable.

But I get that people all have different paths and things they find fulfilling and chances are over time, those things may change. Specific to your question though, would I care if they made my staff some adult clinic? I mean, that probably wouldn't be wise since my only experience with adults are ICU trauma patients, but I don't think I would mind either. Actually, at this juncture, the person who needs convincing the most probably isn't me.
 
I think the Coast Guard has commissioned USPHS officers.
 
I read the military forum from time to time because I find its lingo super weird and interesting but rarely have something useful to add. That said in this case, have you considered medical missions as an option? Establishing yourself with a regular group and doing yearly trips rather than just a one and done sort of thing? I had a PP attending in residency who set his own up with a partner hospital in the DR and he has run it every year and its really grown and he gets immense enjoyment and satisfaction out of it. It would honestly check a lot of your boxes with the exception specifically of service to country (if that's even a box) but would still be an incredible service and duty to... well, humanity I guess. And your skill set could be highly useful. If you go with the goal of teaching other doctors rather than just touching a few patients and walking away that can be a really wild and rewarding thing that can make a massive difference.

Two cents. Good luck friend.
 
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I agree it could be a midlife crisis, but whatever.

Join the NG, go to flight surgeon course, do a bunch of medical paperwork for your guys one weekend a month, due a bunch of military paperwork too, fly around on helicopters and do something few other physicians can or are willing to do. Enjoy some $200/mo, $150 deductible Tricare Reserve Select, get your 10% off a Lowes and Home Depot and a free meal at some chain restaurant every Nov 11, and look forward to wearing a black trucker hat that says 'Veteran" one day. :rofl:

For every doc that tells you it was a great experience, there are two to tell you how much it sucks and was a fool's errand. And everyone is right from their experience, but for you it is a roll of the dice because you are just an anonymous doc on the internet to all of us.

Hey, there are worse mid life crises than this.....I think.

Good luck whatever you decide.
 
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Your specific skills will be wasted in the .mil.
Are you ok with that?
What do you want to get out of the .mil and the reserves?
I was AD for 7 years and I got out what I wanted and more, nothing would have made me stay in the reserves, especially so as it was still active war time. At that point, nothing to gain and everything to lose, for me.
Also, my skills were highly desirable and useful at the time. (Anesthesia)
I’m not sure how I would feel if they said, we have enough anesthesiologists so you can run a clinic at the airport in Baghdad for 6 months.
Ha ha. Ask me how I know they try to deploy anesthesiologist as flight surgeons "to protect" their overburdened primary care physicians (many of who were slick sleeves e.g. without deployments). Technically, they can't do it per regs (until they change the regs, it defines who is substitutable for 62B and 60N in the Army and anesthesiologists arent), but they've show a proclivity to ignore the rules until they get pushback.
 
The longer you're out of the military, the more favorably you remember it.
 
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I think unless you are deployed you are unlikely to feel you contributed meaningfully as a reservist. Not to say if you are deployed you will feel you contributed meaningfully.

If you are ok with being a cog in a wheel, and know in your heart that on the army team the s#it shoveler is just as important as the doctor and green beret then you will be fine.

I would guess you'll never use your skills. And if you do it will be at a dumpy 4 bed post-op/IMC at an army hospital even though they dont need your help.
 
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