Army List of GMO's in CONUS + states with to obtain easy licenses + civilian intern spouse? Need advice

[frugopl]

Hey guys,

Got a bit of a dilemma. I'm a TY intern in the Army with a civilian spouse who's also an intern. If I get into residency at where I'm at right now, then awesome, both of us get to finish our residencies in the same geographical location. If I fail to match, well, that's when the butt-hurting begins I guess in an effort to try to stay together.

Our plan/options:

1. I match into residency at this hospital I'm at. Best case scenario.
2. I fail to match, need to start looking for a GMO. I'm trying to figure out where the GMO's are ahead of time, so we can start cross-matching available civilian residencies with available spots for her so she can try to transfer into residency.
3. If #2 fails, we'd both try to get medical licenses in a state that's easy to do it in. I rank all my GMO spots in that state at the top, we both move to the state (assuming I get in) and she tries to find part-time work at an urgent care/clinic/some hospital.

So, to accomplish this, I'd like to know a.) if there is a list of all GMO spots (not just the one's available this year), and b.) which states have the easiest/fastest licensure process.

I heard VA is pretty quick and easy. Any others? And, any other advice on the situation?

Thanks in advance!

EDIT: Yes, we have a 3 month baby, which is the primary driving force behind this.

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[SeminoleFan3]

Your civilian spouse should try to finish residency regardless (unless you guys have kids and absolutely need to be geographically near each other).

 

[backrow]

Your civilian spouse should try to finish residency regardless (unless you guys have kids and absolutely need to be geographically near each other).

This 100%. Do not recommend pulling your spouse out of residency except in the extremist of situations.


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[j4pac]

You're in a tough spot and I empathize, being in the same situation a handful of years ago.

If you don't match through, you will likely have to spend time apart. I don't think that having your spouse transfer is realistic. What's much more realistic is doing a 1-year stint in a place nobody wants to go, and reapply at the same program more competitive.

My advice sucks...but it kind of is what it is.


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[frugopl]

Your civilian spouse should try to finish residency regardless (unless you guys have kids and absolutely need to be geographically near each other).

Yup, got a 3 month baby, so being apart is absolutely not the way to go. Yes, the baby will be a year old by the time I start GMO, but it's still not realistic (or fair) to have my wife raise our child for a year or two while she's going thru residency.

We thought about the possibility of me doing GMO somewhere else while she finishes her current residency, but honestly, it would just be ****ty time for both of us. Neither of us is really in a hurry to finish residency if it comes at the cost of living in different states.

 

[frugopl]

This 100%. Do not recommend pulling your spouse out of residency except in the extremist of situations.

While I understand that it's better to finish and get your boards done, it's not uncommon to have people leave after intern year, get licensed, work, then come back to finish residency. We (the military docs) do it all the time if we choose to do TY + 4 GMO and then get out. Are there any specific issues that this may cause for my wife?

 

[Gastrapathy]

While it is normal in the .mil, a gap in training is not typical on the civilian side. There are no guarantees. Furthermore, when will she train? It will be just as hard/harder when you are in Korea or Killeen.

If she is in a remotely competitive specialty or has any blemishes in her academic record, this is a high risk strategy.

As for it not being "fair", you'll probably deploy right after graduation, so there's lots more where that came from.

Move a grandmother out. Hire a nanny and an au pair. Fly back every chance you can. Have her and the baby fly out every chance they can. Unless she wants to give up medicine until you are done in the .mil and then try to get back in (not easy), it won't get easier. She could see if she can be a part time resident. There are job shares.

 

[frugopl]

While it is normal in the .mil, a gap in training is not typical on the civilian side. There are no guarantees. Furthermore, when will she train? It will be just as hard/harder when you are in Korea or Killeen.

If she is in a remotely competitive specialty or has any blemishes in her academic record, this is a high risk strategy.

As for it not being "fair", you'll probably deploy right after graduation, so there's lots more where that came from.

Move a grandmother out. Hire a nanny and an au pair. Fly back every chance you can. Have her and the baby fly out every chance they can. Unless she wants to give up medicine until you are done in the .mil and then try to get back in (not easy), it won't get easier. She could see if she can be a part time resident. There are job shares.

Well, she's family med, so I figure that makes things easier. Her residency does not have spot sharing. I will have her talk to her PD, perhaps she can defer for a year or two. I'm fine with switching to FM myself just to make matching easier and coming back to my current location if need be.

 

[SeminoleFan3]

I agree with Gastrapathy. Get some help for her and fly back when you can. This, unfortunately, would put her on the path to never finishing residency. It's hard enough as it is, to then have to stop and try to restart would be grueling. And by then she possibly won't want to because she's been out of residency for awhile and no one wants to go back to working 80+ hours a week. And it's really not fair to her to move her somewhere else only for you to likely deploy.

I would not count on her doing a medical job after internship. Not widely available with just a internship under your belt. So basically probably not practicing medicine for two years and then trying to get back into residency, not going to be looked on favorably.

We get jaded as to what's "normal" in the military. This leaving residency after a year to return a few years later is absolutely not normal, and while it wouldn't be a big deal for you trying to get into a civilian program given that you're military, she is not and I can't imagine it will be looked on favorably or even as a neutral thing.

I feel for you. My husband and I had a similar discussion during medical school about what ifs, time separated, etc. We made family planning decisions based on possibly being separated (ie chose not to have kids until I knew I'd go straight through), and I actually decided between a couple of specialities and picked the one where I would have more of a chance of going straight through.

 

[WernickeDO]

Nebraska is easy to get licensed in, since you asked.

 

[j4pac]

The baby makes things more complicated. Do what you've got to do to get the PGY-2 slot. If you don't get it...there will be very tough decisions ahead. Your wife could leave...sure. There are many places throughout the country, especially in underserved areas that you can work in urgent care without a residency (I did...and many of my friends did). Depending on her level of competitiveness going into residency...she may be able to get a residency a few years down the line. It is a gamble...but yeah...you've gotta do what you've gotta do. I think that your wife being by herself going through residency with a baby could be a recipe for disaster. It's doable but she would need quite a bit of reliable 24-7 support. Ideally it would come in the form of family helping her. If you don't have family support...it's going to cost you $$$ to have a nanny arrangement that is conducive to your wife making it through residency. Obviously...you taking the child is NOT a good idea because of deployment potential.

Something that I would do if I were you...

I'd consider having your wife talk to her PD about the situation. If her PD is a reasonable human being...it would be unlikely to turn out negative for you. There is always the chance that your wife can RE-MATCH at the same program that she left. If she is a good resident...accommodations could be made. Then if you have to go GMO...she goes with you with the baby. She finds work if she can to keep up her skills. Then you match back into your prior program...then she could match back into her prior program. She may have to repeat an internship depending on the specialty...but whatever.

 

[notdeadyet]

Don't let the military fool you into thinking that dropping out of residency after intern year is common anywhere in this country for the past, what, 30 years? Other than milmed.

And because it's so uncommon, finding a PGY-2 year is hard to do. Definitely possible, but uncommon and will make her very geographically restricted, often to potentially malignant programs.

Having her drop out of residency is really bad juju and should be avoided at all costs.


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[Gastrapathy]

Don't talk to her PD until you know there is s problem. They might start looking for her replacement and consider not renewing her.

 

[j4pac]

Don't talk to her PD until you know there is s problem. They might start looking for her replacement and consider not renewing her.

I didn't make that clear in my origin post...but this is true.


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[j4pac]

Don't let the military fool you into thinking that dropping out of residency after intern year is common anywhere in this country for the past, what, 30 years? Other than milmed.

And because it's so uncommon, finding a PGY-2 year is hard to do. Definitely possible, but uncommon and will make her very geographically restricted, often to potentially malignant programs.

Having her drop out of residency is really bad juju and should be avoided at all costs.


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There are jobs out there for PGY-1 trained docs (assuming they are US grads). They aren't great jobs...but they are jobs. And I wouldn't consider then reliable, permanent jobs. I had businesses begging for me to moonlight with them as a PGY-1 trained FS.

Nobody is suggesting that the wife drops out of residency permanently...I'm just presenting leaving temporarily as a bad option (but perhaps less bad than the wife being on her own going through residency with a baby).

There aren't many PGY-2 spots out there...but there are PGY-1 spots. The wife would have to repeat an internship, which would suck...but again, we are talking about multiple bad options here. Much would depend on her competitiveness.

I feel for the guy...and perhaps this should serve as a cold reminder to those wanting to do HPSP. Life changes quickly, and it's nice to be able to adapt.


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[Homunculus]

Yup, got a 3 month baby, so being apart is absolutely not the way to go. Yes, the baby will be a year old by the time I start GMO, but it's still not realistic (or fair) to have my wife raise our child for a year or two while she's going thru residency.

We thought about the possibility of me doing GMO somewhere else while she finishes her current residency, but honestly, it would just be ****ty time for both of us. Neither of us is really in a hurry to finish residency if it comes at the cost of living in different states.

a lot of good advice on this thread. I'd echo to try to not interrupt her training and try to find her some support via family/au pair/nanny. things as an attending won't get easier-- people deploy with pregnant wives/recent newborns all the time. the more complicated the plan and the more subjective decisions by other people are involved, the more likely things can get screwed up-- especially when the military is involved.

if i recall correctly most (but obviously not all) TYs in the army tend to be in larger cities-- so you have that going for you in regards to flights and finding potential childcare.

good luck and keep us posted

--your friendly neighborhood facetiming caveman