MS3 or MS4 military rotation/clerkship as civilian?

[oldjeeps]

After having spent a couple of years looking at the HPSP option, I have decided to put off any decision for a bit - partly due to a feeling that my recruiters (from all branches) weren?t really taking me or my interest seriously (even though they ALL said that I would have a competitive application). That being said, I am starting to look at the FAP option (currently an MS1) ? should I still feel a desire to go into military medicine.
One of the points of disappointment is that they would never arrange for a base tour (a prime opportunity to speak with folks currently dealing with practicing military med.). Have I just not played the correct cards to get a tour, or is there something more to it?

Anyway, I was thinking that if I could do an MS3 or MS4 rotation/clerkship with the HPSPers it would give me a chance to speak with attendings and get my feet wet in military medicine, WITHOUT making a multi-year commitment. Does anyone out there know if a civilian has ever done a military rotation/clerkship? How many headaches should I anticipate in trying to set up such a thing? And finally, who would I have to co-ordinate (on the military side) to pull it off?

Thanks

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[kedhegard]

I think you can do them at Eisenhower Hospital in Augusta GA (Army). You could try there to start anyhow...supposedly students from UGACOM do rotations there, and they are definitely not all military.

 

[cdreed]

I think you can do them at Eisenhower Hospital in Augusta GA (Army). You could try there to start anyhow...supposedly students from UGACOM do rotations there, and they are definitely not all military.

Most Army and some AF hospitals are open to letting civilians rotate through. When I was stationed at Wilford Hall, the AF hospital in San Antonio, a lot of UT students would rotate through. My best guess would be to call the GME offices at the prospective facilities you're interested in seeing to try to set up a clerkship. It's probable that each facility has different policies regarding availability and paperwork. Even now, my preceptor is a flight doc at Luke AFB. I see lots of civilians in the clinics doing rotations there.

Hope this is useful. And by the way, what recruiters would not set up a tour for you of the local installations? That is unheard of. At the very least, they should be willing to introduce you to local physicians so that you can talk to someone about military medicine.

 

[oldjeeps]

Hope this is useful. And by the way, what recruiters would not set up a tour for you of the local installations? That is unheard of. At the very least, they should be willing to introduce you to local physicians so that you can talk to someone about military medicine.

Army: wanted more of a commitment (like the application filled out and ready to be submitted, if not already submitted) out of me than I was/am ready to give in exchange for a tour ? something about there not being any medical bases near Mich. Basically they wanted to feel fairly confident that they had me before spending the bucks to get me to and show me any of their medical facilities.

Air Force: Had a tour of Wright Patterson scheduled which was cancelled due to bad weather; when it was rescheduled it was cancelled due to lack of participation (must have conflicted with the undergrads schedules). Claimed that Selfridge wasn?t a ?real? Air Force base.

Navy: Has been dragging their feet every time that I try to convince them that they want to take me over to Great Lakes. Choose the excuse for why it wouldn?t work to take a day or weekend trip over to Chicago; I think that I have heard them all.

As for introducing me to some local physicians, I haven?t asked about that and none of them have volunteered to do so.
Along those lines, I know a few military (and former military ? both recently out and out for a decade plus) physicians and have been getting differing and sometimes conflicting insight from them.

 

[cdreed]

Along those lines, I know a few military (and former military ? both recently out and out for a decade plus) physicians and have been getting differing and sometimes conflicting insight from them.


Sounds about right. Military medicine is not right for everyone. So depending on the assignment, specialty and individual predilection for the military, you will probably hear responses and experiences that vary greatly. But you need to be as well informed about mil medicine before you join. Talk to as many people as you can. Make an informed decision. I love the AF. No better place to be, IMO. I suggest that you be as proactive as possible while making this decision. And if you decide to take the plunge, being proactive will benefit you, as well.

 

[oldjeeps]

Along those lines, I know a few military (and former military ? both recently out and out for a decade plus) physicians and have been getting differing and sometimes conflicting insight from them.


Sounds about right. Military medicine is not right for everyone. So depending on the assignment, specialty and individual predilection for the military, you will probably hear responses and experiences that vary greatly. But you need to be as well informed about mil medicine before you join. Talk to as many people as you can. Make an informed decision. I love the AF. No better place to be, IMO. I suggest that you be as proactive as possible while making this decision. And if you decide to take the plunge, being proactive will benefit you, as well.

cdreed,
That sounds very similar to what I have been told by one of the Navy docs that I know and is part of why I finally decided it was time to post a question to this forum.
My desire to make as fully informed of a decision, as possible, is what is at the root of my interest in doing a rotation/fellowship at one of the military hospitals. Talking to people is good (and this forum lets me increase the number of opinions I get to hear) and if I can supplement that with some firsthand observations, so much the better (plus it takes the recruiters and their version of the ?facts? out of the equation).
Would you suggest that I delve into the ?assignment, specialty and individual predilection for the military? question when I am speaking with folks about mil med?

 

[militarymd]

cdreed,
That sounds very similar to what I have been told by one of the Navy docs that I know and is part of why I finally decided it was time to post a question to this forum.
My desire to make as fully informed of a decision, as possible, is what is at the root of my interest in doing a rotation/fellowship at one of the military hospitals. Talking to people is good (and this forum lets me increase the number of opinions I get to hear) and if I can supplement that with some firsthand observations, so much the better (plus it takes the recruiters and their version of the ?facts? out of the equation).
Would you suggest that I delve into the ?assignment, specialty and individual predilection for the military? question when I am speaking with folks about mil med?

Search and read all of my posts.

 

[dtn3t]

When I was doing Peds in Hawaii, there was a civilian PA student rotating through. Her school let her do her rotation there, Tripler accepted her, and she had good friends who let her stay for free. Needless to say, she had a great time doing peds.
So if a civilian PA student can rotate through, why couldn't you? Just be aware, dealing with the clinical clerkship coordinators at these hospitals is like dealing with no one at all - they don't do crap. If you want to do a certain rotation, I suggest calling up a that dept directly. Those people are generally much better. Hawaii wasn't too bad, but the guy at Walter Reed takes the term useless to a whole new level.

 

[oldjeeps]

Search and read all of my posts.

x-mmd,

As a result of having been lurking on this forum for a while I have read some of your posts and have reviewed some of them over the past couple of days (as time permitted, have an anatomy final coming up later this week).

In reviewing some of your posts it appears that you feel that military medicine has really gone downhill in the past 5 ? 6 years. What are your thoughts on why that is the case? Does it have to do with the politicians or is it more of an issue with mil med as an institution?

If mil med has changed that much in the past few years, do you think there is any chance that it might recover in the next 5 ? 6? Like I said in my original post, I am looking into the idea of going FAP or perhaps joining outright after completing my residency. So we are essentially talking about where mil med will be in 4+ years (currently an MS1).
I know that it is always said not to do mil med for financial reasons, but if I do decide to go in would it make more sense financially to go FAP (instead of joining post-residency)?

Final question (which borders on some that have previously been asked), is mil med any better for some specialties than others (FP or ER vs surgical specialties) or does the hierarchy make it equally cruddy for everyone?

Thanks everyone for your thoughts
oldjeeps

 

[oldjeeps]

When I was doing Peds in Hawaii, there was a civilian PA student rotating through. Her school let her do her rotation there, Tripler accepted her, and she had good friends who let her stay for free. Needless to say, she had a great time doing peds.
So if a civilian PA student can rotate through, why couldn't you? Just be aware, dealing with the clinical clerkship coordinators at these hospitals is like dealing with no one at all - they don't do crap. If you want to do a certain rotation, I suggest calling up a that dept directly. Those people are generally much better. Hawaii wasn't too bad, but the guy at Walter Reed takes the term useless to a whole new level.

On that note, any suggestions for what rotation I should attempt to pull at a military facility?
Unlike that PA student I don?t think I would be able to crash with a friend, so what facilities would y?all suggest?

Is it realistic for me to think that I would be able to get an adequate feel for what mil med is like in the course of a single clerkship/rotation? Or would all the ?smoke and mirrors? get in the way?

 

[militarymd]

x-mmd,

As a result of having been lurking on this forum for a while I have read some of your posts and have reviewed some of them over the past couple of days (as time permitted, have an anatomy final coming up later this week).

In reviewing some of your posts it appears that you feel that military medicine has really gone downhill in the past 5 ? 6 years. What are your thoughts on why that is the case? Does it have to do with the politicians or is it more of an issue with mil med as an institution?

If mil med has changed that much in the past few years, do you think there is any chance that it might recover in the next 5 ? 6? Like I said in my original post, I am looking into the idea of going FAP or perhaps joining outright after completing my residency. So we are essentially talking about where mil med will be in 4+ years (currently an MS1).
I know that it is always said not to do mil med for financial reasons, but if I do decide to go in would it make more sense financially to go FAP (instead of joining post-residency)?

Final question (which borders on some that have previously been asked), is mil med any better for some specialties than others (FP or ER vs surgical specialties) or does the hierarchy make it equally cruddy for everyone?

Thanks everyone for your thoughts
oldjeeps

Certain specialties certainly do better in the military. Advanced practitioners do the best (CRNP, CRNA, etc....) Generalists do well.....Specialists (surgery, anesthesia, cardiology, etc...) are treated very poorly.

One of the problems with military medicine is that they don't know what they want, and as long as you don't know what you are shopping for, you're not going to get it.

In the mean time, the losers in medicine (meaning those who would not succeed in private practice) take advantage of the system for their own benefit.

Will it change? I can't predict that for you....maybe, but I doubt it.

 

[Soccer Doc]

It is unfortunate for you that you are trying to get information and we can't provide you with enough to know what you are getting into. FAP is a good thing only if you do a specialty that we are interested in (Surgery, Ortho, etc.) but not if you are interested in some of the primary care specialties. What XMMD said is right about losers taking advantage of the system, but as a general rule, we sit on a board in Bethesda, and we do screen out the real losers - not license, unsuccessful in private practice, convicted felons, pedophiles, medicare insurance fraud, etc. We are a little better on that. We have also tightened down on foreign medical grads, now requiring board certification and licensure before accepting them. So, that is the good news!
It does cost a lot of money to arrange tours if you are not somewhere bear a base. Plus, Great Lakes, for example is a nice mid-sized hospital, but is not that typical. I have been in the Navy for 21 years, and I stay in because of the intangibles. I can work, see patients, operate, do administrative work, teach med students, interns, and residents, and have an excellent range of family activities including sports, church, and okay, well mostly sports.
With regard to civlian rotations, you can rotate anywhere that there is a MEMORANDUM OF UNDERSTANDING between your institution and the program. For a rotation to count, you must have some relationship between the school and the hospital, and it is preferred that it is a training hospital, and not a community hospital or clinic. If you are on active duty for a clerkship, obviously, you can go wherever they will take you. But if you want to do a civilian rotation for credit, you must have an MOU in place. Students can initiate them, but there must be an agreement between the military installation and your med school. This is to protect us and our patients from you and you from us. Insurance coverage must be provided by your school and it must be in writing. This is also true for any students on scholarships that do rotations at military hospitals when not on active duty. I believe there are several D.O. schools that have MOUs with ourmilitary FP programs. - all initiated by the students or their schools. It could be worth the time! Let us know how it goes. Good luck!

After having spent a couple of years looking at the HPSP option, I have decided to put off any decision for a bit - partly due to a feeling that my recruiters (from all branches) weren?t really taking me or my interest seriously (even though they ALL said that I would have a competitive application). That being said, I am starting to look at the FAP option (currently an MS1) ? should I still feel a desire to go into military medicine.
One of the points of disappointment is that they would never arrange for a base tour (a prime opportunity to speak with folks currently dealing with practicing military med.). Have I just not played the correct cards to get a tour, or is there something more to it?

Anyway, I was thinking that if I could do an MS3 or MS4 rotation/clerkship with the HPSPers it would give me a chance to speak with attendings and get my feet wet in military medicine, WITHOUT making a multi-year commitment. Does anyone out there know if a civilian has ever done a military rotation/clerkship? How many headaches should I anticipate in trying to set up such a thing? And finally, who would I have to co-ordinate (on the military side) to pull it off?

Thanks

 

[oldjeeps]

It is unfortunate for you that you are trying to get information and we can't provide you with enough to know what you are getting into. FAP is a good thing only if you do a specialty that we are interested in (Surgery, Ortho, etc.) but not if you are interested in some of the primary care specialties. What XMMD said is right about losers taking advantage of the system, but as a general rule, we sit on a board in Bethesda, and we do screen out the real losers - not license, unsuccessful in private practice, convicted felons, pedophiles, medicare insurance fraud, etc. We are a little better on that. We have also tightened down on foreign medical grads, now requiring board certification and licensure before accepting them. So, that is the good news!
It does cost a lot of money to arrange tours if you are not somewhere bear a base. Plus, Great Lakes, for example is a nice mid-sized hospital, but is not that typical. I have been in the Navy for 21 years, and I stay in because of the intangibles. I can work, see patients, operate, do administrative work, teach med students, interns, and residents, and have an excellent range of family activities including sports, church, and okay, well mostly sports.
With regard to civlian rotations, you can rotate anywhere that there is a MEMORANDUM OF UNDERSTANDING between your institution and the program. For a rotation to count, you must have some relationship between the school and the hospital, and it is preferred that it is a training hospital, and not a community hospital or clinic. If you are on active duty for a clerkship, obviously, you can go wherever they will take you. But if you want to do a civilian rotation for credit, you must have an MOU in place. Students can initiate them, but there must be an agreement between the military installation and your med school. This is to protect us and our patients from you and you from us. Insurance coverage must be provided by your school and it must be in writing. This is also true for any students on scholarships that do rotations at military hospitals when not on active duty. I believe there are several D.O. schools that have MOUs with ourmilitary FP programs. - all initiated by the students or their schools. It could be worth the time! Let us know how it goes. Good luck!

Soccer Doc,
Why is FAP a bad idea for the primary care specialties? My Navy recruiter told me that the vast majority (>50%) of Navy FAPers are in the surgical specialties; I took that to mean it was just a bit more difficult to go FAP in the non-surgical specialties, was I mistaken?
Of course since I am currently an MS1, I have NO idea what I am going to end up doing in a couple of years ? MS3 and MS4 are for figuring that out, so the FAP-primary care issue may not matter.

Thanks for the wonderful information on away rotations ? I had no idea that MOUs even existed, I?ll have to check with the powers-that-be at school and see who would know with which institutions we have MOUs.

Thanks again
oldjeeps

 

[oldjeeps]

It seems like most of the questions and discussions around here are about HPSP; does anyone else out there have any knowledge on the topic of FAP (for any of the branches)?

 

[oldjeeps]

What does it take to have a MOU generated? Or is that something that varies by school and branch/hospital?

I am looking a year plus down the line and was thinking that it would be an educational experience to do one of my MS3 or MS4 electives – as a civilian - at a military hospital (should be a good way to decide if mil med might be for me, right?) and after a bit of work it looks like I managed to find a loophole in their argument and convince the Navy that it might be possible. Only thing is that they seem to think that there would have to be a ‘memorandum of understanding’ between them and my school.
Now the question is how much bureaucratic red tape am I going to run into if I attempt to have a new MOU generated?

 

[island doc]

What does it take to have a MOU generated? Or is that something that varies by school and branch/hospital?

I am looking a year plus down the line and was thinking that it would be an educational experience to do one of my MS3 or MS4 electives – as a civilian - at a military hospital (should be a good way to decide if mil med might be for me, right?) and after a bit of work it looks like I managed to find a loophole in their argument and convince the Navy that it might be possible. Only thing is that they seem to think that there would have to be a ‘memorandum of understanding’ between them and my school.
Now the question is how much bureaucratic red tape am I going to run into if I attempt to have a new MOU generated?

If you are giving any though whatsoever to Air Force medicine, please stop now before you do something that you will definitely regret later on. I speak as one who has ten years active duty experience in the USAF both as a line officer and as a physician. I could go into all the reasons why you should not join the Air Force, but neither you nor I have the time for me to go through them all on this forum. All I can say is take it from those of us who have made that mistake already, and don't do it. (See my postings in this forum). Best thing for you to do is to go through medical school without a military obligation, then complete the residency program of your choice, then consider all your employment options at that point. If at that time, you still wish to join the military, they would love to have you, and would help you pay off your loans in order to "access" you. Now is the time for you to preserve your freedom of choice. The only way in which you can do that at this point in time, is for you to remain a civilian.