How often do military doctors move

[Septimusseverus]

I know the stereotype of servicemembers is that you'll be PCS'd every 2 to 3 years. Is this true of military physicians as well, or is there the chance of being allowed to put down roots for longer in order to preserve some level of continuity of care? Would it be unheard of for a military physician to be posted at one base for all 5 years of commitment time?

For reference, I'll be in a small non-surgical specialty (ie not FM, IM, gen surg, etc). If that matters.

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[DrMetal]

I know the stereotype of servicemembers is that you'll be PCS'd every 2 to 3 years. Is this true of military physicians as well, or is there the chance of being allowed to put down roots for longer in order to preserve some level of continuity of care? Would it be unheard of for a military physician to be posted at one base for all 5 years of commitment time?

For reference, I'll be in a small non-surgical specialty (ie not FM, IM, gen surg, etc). If that matters.

No. There's no such thing as continuity of care in the military. All of my patients have had 6 to 8 different Pcms over the last 10 years. I'm their favorite.

 

[SirGecko]

3-4 years happens pretty often depending on circumstances, 5 or more is becoming more rare. Continuity of care definitely wouldn’t be a reason they would let you stay in one place though.

 

[Caverject]

I know the stereotype of servicemembers is that you'll be PCS'd every 2 to 3 years. Is this true of military physicians as well, or is there the chance of being allowed to put down roots for longer in order to preserve some level of continuity of care? Would it be unheard of for a military physician to be posted at one base for all 5 years of commitment time?

For reference, I'll be in a small non-surgical specialty (ie not FM, IM, gen surg, etc). If that matters.

Standard military answer: It all depends. Don't plan on homesteading unless you're in a large DHA market like National Capital Region, and even that can be risky. But if you need an estimate that will cover you 85% of the time, you'll probably move every 3 to 4 years depending on operational circumstances.

Do yourself a favor and get rid of the phrase "continuity of care" from your lexicon for any type of personnel action reasoning in the military. Everybody and everything is replaceable and interchangeable and you'll be laughed at.

 

[DOswag]

Yeah there's no continuity of care. Myself being a patient as well as physician. I've seen a different PCM nearly everytime I've gone and that counts my 4 years of residency and now going into 3rd year of active pay back time. My orders are for 3 years, I know some who are on 4 years so 3-4 is pretty typical. More than that is going to be hard to pull but I can't say it's impossible.

 

[GreenHousePub]

If you want to promote it's best to go to a variety of duty stations.

 

[TheEarDoc]

Standard military answer: It all depends. Don't plan on homesteading unless you're in a large DHA market like National Capital Region, and even that can be risky. But if you need an estimate that will cover you 85% of the time, you'll probably move every 3 to 4 years depending on operational circumstances.

Do yourself a favor and get rid of the phrase "continuity of care" from your lexicon for any type of personnel action reasoning in the military. Everybody and everything is replaceable and interchangeable and you'll be laughed at.

Aye just another cog in the murder machine.

 

[deuist]

Maybe. For people with 4-year commitments, staying put is easy. Since you're a sub-specialist, there aren't going to be a lot of places where big military can send you, anyway.

 

[sarturo]

Maybe. For people with 4-year commitments, staying put is easy. Since you're a sub-specialist, there aren't going to be a lot of places where big military can send you, anyway.

Is there any possibility of serving your 4-year commitment at the same hospital you did your military residency at? Or are you forced to PCS to a different location? If you have a family in that location where you did your residency, would that be taken into account at all?

 

[SirGecko]

Is there any possibility of serving your 4-year commitment at the same hospital you did your military residency at? Or are you forced to PCS to a different location? If you have a family in that location where you did your residency, would that be taken into account at all?

Possible? Yes. Likely? No. They typically want you to clear out to make way for other people to return to the big hospitals. In order to stay there is usually some kind of extenuating circumstance. (That said this will vary depending on specialty and people do sometimes wind up staying put, very few absolute answers when it comes to military detailing)

Just having family in the area wouldn’t be enough to keep you tied to a location.

 

[sarturo]

Possible? Yes. Likely? No. They typically want you to clear out to make way for other people to return to the big hospitals. In order to stay there is usually some kind of extenuating circumstance. (That said this will vary depending on specialty and people do sometimes wind up staying put, very few absolute answers when it comes to military detailing)

Just having family in the area wouldn’t be enough to keep you tied to a location.

That makes sense, thanks for clarifying. To be more specific, would a civilian spouse who is still doing their residency in that area (and therefore unable to move with you if you had to PCS somewhere else post-residency) be considered an extenuating circumstance?

 

[usma05]

That makes sense, thanks for clarifying. To be more specific, would a civilian spouse who is still doing their residency in that area (and therefore unable to move with you if you had to PCS somewhere else post-residency) be considered an extenuating circumstance?

It could be but I wouldn't bank on it. I was originally supposed to stay where I trained and a last minute need came up for another institution about a month prior to me going from resident to staff. I was the easiest widget to move, therefore I was the one to PCS. Your consultant, even in the time of AIM, still has some level of control and if you can convince him/her that the best fit for #1 the military and #2 you is to he colocated w/ spouse it's possible. Would also depend on slots being open at that location. Your consultant will likely be empathetic, but have limited control as at the end of the day he has to match people/places for entire system. Sure in the last couple years AIM has given the perception this has changed...and maybe for some specialities it has, but if you find yourself in a speciality with limited personnel and limited spots you better believe there's review at the consultant level to make sure of good matches and not just the free hand of the AIM marketplace.

My civilian spouse did fellowship in another city which would've been closer if I hadn't PCSed. When she finished, the market where I was wasn't good and we tried to coordinate a move to a base closer to a job offer for her but met inertia. She took a job where I was that wasn't what she was looking for and to her credit built off of it (but still not ideal). The following year (and the year after too), the system required me to compete for jobs across the MEDCOM/FORSCOM/DHA even though my preference was to stay so I didn't have to cause her to job hunt so quickly again. Luckily, I made myself valuable at the institution I was at so I matched there two years in a row....but that took effort and sacrifices (trading off clinical care time for admin responsibilities).

 

[TheEarDoc]

That makes sense, thanks for clarifying. To be more specific, would a civilian spouse who is still doing their residency in that area (and therefore unable to move with you if you had to PCS somewhere else post-residency) be considered an extenuating circumstance?

Most likely no unless your wife is in the service as well. If she is a civilian they won't care and you will go where the military needs you first. If it matches up with your wants/needs awesome, but that doesn't happen often.

 

[pgg]

That makes sense, thanks for clarifying. To be more specific, would a civilian spouse who is still doing their residency in that area (and therefore unable to move with you if you had to PCS somewhere else post-residency) be considered an extenuating circumstance?

Not a bit.

 

[pgg]

Is there any possibility of serving your 4-year commitment at the same hospital you did your military residency at? Or are you forced to PCS to a different location? If you have a family in that location where you did your residency, would that be taken into account at all?

It's possible. We usually keep one or a couple of our residents each year. Sometimes none. Sometimes three. It's hard to predict and they don't find out for sure until about 6 months prior to graduation.

Subspecialists have a better chance of re-touring at a large medical center. It also helps if the place you want to homestead is less popular. E.g. in the Navy it's easy to stay at Portsmouth than it is to stay at San Diego.

 

[Baron Samedi]

Maybe. For people with 4-year commitments, staying put is easy. Since you're a sub-specialist, there aren't going to be a lot of places where big military can send you, anyway.

As a sub-specialist I can say with 100% confidence that the military can and will ignore your subspecialty training and place you in a primary specialty billet.

 

[Volatile]

I’m Air Force. While it is sometimes challenging to get your first choice of base after residency, it is generally pretty easy to stay at that base moving forward. Our consultant rarely moves people if they’re happy at their current assignment. Overseas locations are probably the one exception.

 

[eagledriver]

I’m Air Force. While it is sometimes challenging to get your first choice of base after residency, it is generally pretty easy to stay at that base moving forward. Our consultant rarely moves people if they’re happy at their current assignment. Overseas locations are probably the one exception.

This is highly dependent on specialty. In many specialties you cannot expect to stay put unless you’re at a highly undesirable location and express a strong desire to stay.

 

[DOswag]

I am Air Force. It seems the ones who say absolutely no to extenuating circumstances are other branches. Had a guy in my class that stayed on staff at the program we did residency at because his wife was a civilian surgical resident nearby. They definitely took that into consideration. Our consultant works with us pretty well to help place us where we want to go. May not get #1 on the list but they try to work with you. Just having family nearby probably won't be a big deciding factor. Ultimately though it is true the military can send you wherever they want to so I wouldn't count on a certain circumstance to be the major deciding factor. You know where you're going when you arrive there and in-process. Otherwise you're fair game to go anywhere.

 

[Rector]

Recently retired O-6 physician here. So this kind of continuity can happen, but it is unusual. I did my Navy internship in San Diego, then fleet time as a flight surgeon, then back to SD for residency and fellowship. I left San Diego after fellowship for a 3-year OCONUS tour, returned to San Diego, and then basically didn't leave until retirement (other than deployments and a lot of last-minute TAD). Like, clearing out my office at my retirement was basically archaeology. I am in a relatively small subspecialty community and did a lot of direct operational support stuff when based at the MTF, plus did time as a program director, so there are reasons I never wound up moving. I was also not alone; some of the same people were there with me for the bulk of my tenure. CAPT Schofer mentioned on another thread that there is an intent to preserve a degree of continuity in academic faculty at the larger MTFs, so that affected me as well.

Don't get me wrong, this was unusual, although I know plenty of folks in Bethesda who have done basically the same thing, rotating between different Beltway billets. I also didn't pull any crazy strings to stay in San Diego; when I was up for orders, I submitted my request for extension or re-touring via normal channels and got was I was given. If I had been told to move, I would have done what I did when I was told to be an IA in Afghanistan: saluted and executed the orders. I also don't think the way I did my military career is the best way I could have done it. It worked out well for me and my family, but I regret not doing another OCONUS tour (because that was a highlight of my career) and I think I would have enjoyed another operational tour...a number of my friends served or currently serve as CATF surgeons, and it has been a good experience for them, for example.

The biggest thing I can say is that a lot of my expectations for a "good career" starting out as a new intern turned out to be a bit wrong. I think straight-through training for Navy GME is the right decision and the move away from GMOs is better for care in the fleet, for example, but I also wouldn't have personally traded my time as a flight surgeon for anything. Continuity and homesteading are nice (believe me), but the OCONUS and operational stuff can be the parts of the military that make it worthwhile.

Listen, military medicine goes off its meds every 15 years and attempts suicide.

BTW, for people commenting about lack of continuity of care in the DoD...the outside world will be a little disappointing for you. With the rise of group practices and employed clinicians, I have been a bit disappointed in attitudes about continuity out here. It feels sometimes like surgeons and ID doctors may be the only ones left who care about it. My clinic patients at NMCSD had better continuity than my current practice, even with staff rotating every 3 years or so.