physicians in combat

[Masonator]

The Geneva Accords allow medical personnel to carry weapons for their personal defense and protection, and that of the wounded in their care. That generally means no "crew served" weapons, but they certainly can carry a rifle.

Are physicians allowed to bring personal weapons? Examples: Shotguns, submachineguns, .44s, .45s, etc.

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[flighterdoc]

Are physicians allowed to bring personal weapons? Examples: Shotguns, submachineguns, .44s, .45s, etc.

Generally no, it's against the service's rules. One reason is that you have to use "Geneva Accord" acceptable ammo - FMJ's usually, nothing with any expansion. But in a war, lots of strange things happen. Bringing it back home with you will be pretty much impossible though.

You can get shotguns and subs, they're in the inventory. If you're in SpecOps they'll have them available. Most of the SpecOps operators are carrying some version of a .45 these days, the SOCOM 45 is pretty good (but not as good as my Mk IV/Srs 70). Why would you want a wheel gun?

 

[PACtoDOC]

I have to mostly agree and slightly disagree with MilitaryMD. A physician really has no business being in an area where they can become a casualty, but that said, even the most skilled 18D medics and recon/grunt corspmen are not usually confident enough or trained at a level high enough to intervene in certain critical situations. From serving in a combat zone, I know pretty standard what types of interventions are necessary. Some of the more common procedures at a first echelon care level are cutdowns, arterial cross clamping, surgical airways, hemorrhage control with surgical ties, pericardiocentesis, etc... Even with all the training I had I simply had not had exposure to these types of basic procedures that anyone should have learned during medical school and residency. The Army caught on to this and started using PA's as the primary means of first echelon care, and this seems to have worked quite well. But it would make no sense to send a physician into harms way just to get his rocks off, which is basically what that would be equivilant to.

 

[Biodude]

Good points all around. I'll keep those in mind.

 

[Navy Dive Doc]

Poor eyesight is (or has been) a disqualifier for most SpecOps assignments - you can't wear glasses and be jump qualified, or dive qualified, for example, you have to be able to see without aids. The Army is getting into various corrective vision surgeries (LASIK, PRK, whatever) for the troops because it's cheaper than buying them glasses (and the standard US government frame is SO ugly they're called BCG's - birth control glasses). The AF still is down on such surgeries last I checked for all flight (class I and II) catagories.

I don't know about the Navy (and Marines).

From the Navy standpoint, eyesight is not a disqualifier for diving or jump duties, provided it is correctable to 20/20 and does not exceed certain limits. For DMO candidacy, the eyesight limits are extremely generous, and almost anything is waiverable. I wear glasses (20/60-20/70) and had no problem, one of my classmates was 20/600 or something equally obscene, and he made it through. Prescription masks work fine. Even the SEALS are allowed moderate vision defects (20/70) without a waiver for duty. Also, any Diver in the Navy (including DMOs) are eligible for free PRK after initial dive training to fix the defect. LASIK is still considered disqualifying for DIve duty, though is often waived and would almost certainly be waived for a DMO (we're short staffed in the community)

As for combat, I have to agree with militaryMD that MDs are not best suited for front line combat. Yes, we can stabilize with some advanced techniques, maybe, but truthfully the grab and go by a medic and evac to definitive care is what is really needed. The units appreciate a motivated physician, but they really want you back behind the lines waiting for them, not acting as a shooter by their shoulder.

Whoever said "my main concern is not getting enough action" should probably postpone med school in favor of a try at BUD/S or Ranger school. That said, I think the Navy offers the most chance for "action", as we cover for the Marines, DMOs cover Marine Recon, EOD and SEAL Teams. The DMO billets are tough to get, but the USMC spots are there for the asking.

 

[Masonator]

Generally no, it's against the service's rules. One reason is that you have to use "Geneva Accord" acceptable ammo - FMJ's usually, nothing with any expansion. But in a war, lots of strange things happen. Bringing it back home with you will be pretty much impossible though.

You can get shotguns and subs, they're in the inventory. If you're in SpecOps they'll have them available. Most of the SpecOps operators are carrying some version of a .45 these days, the SOCOM 45 is pretty good (but not as good as my Mk IV/Srs 70). Why would you want a wheel gun?

I think an SMG would be better for a physician. It is less bulky can be stowed on a combat harness and is accurate. I am not a fan of the M-16 at all(sorry guys). Combat shotguns would be great in an urban setting, especially if your medical station was getting overrun.

 

[Navy Dive Doc]

My Internship/Dive School buddy was issued a shotgun for OIF, as well as a 9mm sidearm. He's with Recon out of Camp Pendleton, and spent 7.5 months on the ground in Iraq.

 

[DD214_DOC]

Dive Doc, I PM'ed you but I can just repost it here.

Is there any way for someone to serve in the Navy and not be put into almost direct combat situations? As I said elsewhere, a couple years ago it wouldn't have mattered, but I'm getting married in May and will more than likely have children by the time I graduate from med school.

I also don't think being in a combat situation with a huge lack of combat training would be a good idea either.

 

[mitchconnie]

I think some of the above enthusiasm for "getting enough action" and carrying weapons is probably a bit misplaced. At deployed locations I have been to and heard about, a physician would look like an idiot carrying around a sidearm let alone an M16. I'm sure such places exist, but it would be a very rare situation.

For someone who is an "adrenaline junky" and is interested in treating shock-trauma on a regular basis, the military is a poor career choice. Major conflicts with a significant flow of casualties are typically years apart and you could easily spend your entire career in the military and never see a gun shot wound. Even in the current Afghanistan/Iraq situation, the casualty flow is really only a trickle and can be handled by a relative few surgeons.

The most experienced trauma docs are now in the civilian urban level I trauma centers. Last weekend I was working at our local county hospital and we took care of five thoracic/abdominal gunshot wounds in 30 minutes (drug war), followed by bilateral popliteal artery transections (MVA), followed by a blunt aortic transection (MVA). This is just an average Saturday night at a urban trauma center, but is more trauma than 99.9% of military docs see in their careers.

If you are really interested in doing trauma--as opposed to "treating" a lot of mock casulaties in a medical-readiness excercise, civilian general surgery or ER residency and a staff position at LA County might be a more satisfying career than any position in the military.

 

[Cerberus]

I need to clarify that when I said i was afraid of not getting enough action in the military, I wasnt refering specifically to combat. Rather, I was refering to whether I would be twitteling my thumbs in the middle of BF or getting patients (specifically trauma since that is what interests me). Thanks for the info so far guys, keep it coming

BTW-Navy Dive Doc, reading some of your posts on DMO makes Navy sound really appealing. It sounds like a blast!

 

[Navy Dive Doc]

JKDMed and others,
I didn't mean to give the impression that many Docs get anywhere close to the frontlines of combat. Shipboard GMOs will deploy, but who has a modern Navy to engage us in combat anymore? True, my buddy at Recon was literally on the front lines, and some of my fellow interns with the USMC were quite close. But the vast majority are behind the seens or CONUS. My first job was with a submarine squadron, 100% away from Combat (though being on board during a collision was probably more dangerous.) With EOD, I've played with some good toys, but the units are too small to justify sending a physician with them, so I'm home based and non-deploying. The flight surgeons tend to be homeported with their squadron and deploy on the carriers, that's safe. If you stay away from the USMC billets, you can certainly stay out of combat. People were fighting for the recon job, so don't feel like you'd be stuck with it as a DMO...no one fought over the sub or clinic DMO jobs.

I have to agree with Mitchconnie, military hospitals do not see trauma (most anyway, I know about the two trauma centers). Our surgeons moonlight at the local Level I to keep their skills up...the Navy did send them to fellowship training at some great places, though.

Cerberus, it's a good time.

 

[Cerberus]

NDD, heres a hypothetical. Let's say you really like your DMO tour. What are your options after it is finished? I assume you go ahead and finish your residency but what about after that? If there an option to do DMO tours later on?

 

[PACtoDOC]

Navy medicine in the field is simply not as cohesive and organized as Army medicine. You have these Navy docs who can't even figure out how to wear their uniform, much less the "system" of Marine warfare. Army physicians are soldiers first and at least go through adequate field and combat training. Navy medicine has schools you can attend to improve these things like C4, but most are Army run anyway. Battalion surgeons in the Army are way more likely to see action that the Marine docs because the Marines are so small. They have about 80 thousand combat troops while the Army has hundreds of thousands. Yes Marines usually go in first, but rarely alone. Army medicine is more equiped to handle casualties and the system just works better. Navy docs in the field at times look like a fish out of water. They are some of the goofiest people you will ever seein uniform if they are not motivated about being there. The Navy should have put PA's into operational billets years ago like the Army did, because these guys are historically prior enlisted and understand how the system works.

 

[r90t]

My specialty leader is flight surgeon/DMO/radiation oncologist, who is currently doing a diving medicine exchange tour with the British Royal Navy. It is his last operational tour, before heading back to the hospital on a twilight tour. It is possible to go back out, but after you are board certified in your specialty.

I have to agree that physicians on the front line isn't a great idea. It takes 6 months to turn an 18 y/o into a rifleman. It takes 9 years to take an 18 y/o to a minimum physician, i.e. GMO. It is a waste of resources to have a physician pulling a trigger in the field, unless something really, really bad has happened.

Experienced corpsman/medics should be with the combatants with the intended purpose as stated by MilMD. My corpsman, when they were with the marines, were riflemen. One even had to sign a waiver to carry a SAW, since he was giving up his Geneva Convention status if captured.

Oh, quite picking on the Navy guys! We may look funny in the field, but we sure look at home on the ocean. Khakis with grease, paint and oil smudged on them (from bumping into things) make us look like surface warfare officers.

 

[Navy Dive Doc]

I won't get into a match over Marines vs. Army, and I'll agree that probably a majority of Docs aren't up to the challenge for a USMC tour. The Navy's biggest mistake is putting interns into USMC GMO billets that don't want to be there. The Marines will crush them, and next to a squared away Marine, they look like idiots. Unfortunately, there are just too many USMC billets to find enough people who want to go green. I think that's a shame. In a perfect world, I agree that former independent duty corpsmen (IDCs) trained as PA's make the perfect front line asset. There just aren't enough to go around. The SEALs are already moving to that system, and I think the days of the IDC are numbered. There is also a lot of talk about using PAs in GMO positions, but again, it's a numbers issue. Plus, a GMO, O-3 with 2 years of service is significantly cheaper than an O-3 PA with 15 years in.

As for DMO career paths, they are not as straight forward as they used to be. There are a few CAPTs that have been DMOs their entire careers, but this is not a viable option anymore. You will not make O-5 without a residency. There used to be a residency in Undersea Medicine, which was realy just an OCCMed residency with some hyperbarics, but this is essentially gone as well.

Generally, people do the 6 months of training after internship, then do one or two tours in the fleet as a DMO. Anymore than that is just too much time out from residency. Residency in whatever you want to do. Then, you do a payback tour as a specialist. After that is complete, you'll generally be on O-5, and in line for senior level DMO jobs. These are positions like the FOrce Medical Officer for Submarines/EOD/Specwar. Also, there are billets at the Experimental Dive Unit, the Dive School, Naval Undersea Medical Institute. The exchange billet the r90t talked about is actually an O-3 billet that has been filled by twilighting O-6's for years, I don't expect that to change. Generally, the SUBFOR/SUBPAC jobs make people O-6's. There is the head honcho job at BUMED for a DMO, that's an O-6 looking for a star.

You need to plan on jumping in and out of your specialty in order to make O-6. One tour as payback is not really enough. Usually, people alternate one tour as a DMO/one tour in their specialty.

You can also come to DMO or FS later. My roomate through NUMI was a board certified ER doc, who had done regular shipboard GMO tours prior to residency, then residency, dept. head tour at NH GUam, then came in as a DMO. SO you can come in after your intial payback if you're picked up for straight through training.

 

[mumiitroll]

There are also opportunities for operational medicine in the AF, most notably as a special operations flight surgeon. While at the intro course to USAFSAM for HPSP (http://wwwsam.brooks.af.mil/web/af/courses/hpsp/hpsp01.htm) I met a former chief flight surgeon of AFSOC (Col. B. Hadley Reed, who runs the above course) and another Spec Ops FS (Col. Allen). As it was explained by Col. Reed, selection is pretty competetive, basically hand-picking by whoever is Chief FS of AFSOC. After selection there is another year of training before getting out in the field ie. wherever AFSOC units might go and with whomever they might go with (sister services' SOC forces). Col. Allen worked most frequently with special tactics teams (PJ's and Combat Controllers. Note: check out specialtactics.com, and read Black Hawk Down and The Perfect Storm for a little insight into these guys who are probably the least known bad-a**es of the spec-ops community), but he also worked occasionally with TAC-P's (which would entail working with the army). Along with other training, he was sent to both the NOAA and navy Dive Medical Officer (DMO) courses, making him one of the few DMO's in the AF. He said that when he deployed he often did so just as the other ground-pounders. While his experience might not be reflective of every Spec Ops FS, it does give an indication to the opportunities available.

I read those books. What is NOAA? So what exactly did he do when deployed? I know that navy flight surgeons get to hold the stick of a plane at the discretion of the pilot. I still don't know what DMO or specwar doctors do outside of medicine??

 

[USAF_Dentman]

I was wondering if there are any opportunities like this for Dentists in the Navy and possibly the Army?


For example, shipped out with a USMC billet?


Thanks

 

[former military]

So docs in the military can be sent near or even to the front lines, but aren't issued weapons to protect themselves?

Out of curiosity, any idea how many physicians are KIA in recent wars?

In the AF physicians depolyed to the sand carry an M-9 9 mm Beretta...you also get some often poor fitting body armour... many would feel a .40 cal or 45 ACP would have more take down power... the ultimate weapon may be a democratic vote although my wallet cringes against that thought. With our extended occupation of nations the medical student can almost assure him or herself the opportunity to serve in the sandbox.

 

[AF M4]

Interesting - would they give us some sort of training with those weapons first? I've shot off a rifle or a shotgun on maybe 10 occasions in my (and no one at COT received weapons training)...I think I'd be more of threat to myself and anyone in the billet if they told me I had to carry one.

"The pointy end goes at the thing I want to shoot, right?"

 

[i want out]

Interesting - would they give us some sort of training with those weapons first? I've shot off a rifle or a shotgun on maybe 10 occasions in my (and no one at COT received weapons training)...I think I'd be more of threat to myself and anyone in the billet if they told me I had to carry one.

"The pointy end goes at the thing I want to shoot, right?"

They will give you some training with the M16 and M9 if you look for it.

The training is usually fairly minimal, Usually a class done by an MA then the you go out and shoot with a line coach. At least thats about all there is to it on the Blue side if your assigned to a ship.

The down side, is that its up to your chain of command whether they issue you a weapon.
And yes, I have been sent into harms way without a side arm, or even body armour. I was lucky, and wasn't hurt any of the times that this happened.
And yes, I did specifically request the above gear, and was denied each time.

As far as using your own personal weapon, it is expressly forbidden, in general order #1, in the middle east AOR.

i want out

 

[pmoney]

I was wondering if there are any opportunities like this for Dentists in the Navy and possibly the Army?


For example, shipped out with a USMC billet?


Thanks

I am interested in this answer as well, more on the Army side.

I know that Dentists (especially those with their 1 year AEGD) can easily get jump and/or air assualt qualifed and get assigned to a TOE unit such as the 82nd, 101st, or 10th Mountain. Additionally, there are a variety of medical companies (Dental Services) that are available. In fact, the one fully Airborne/AA capable company is at Ft. Bragg. The disadvantage here is that in one of the Med companies (DS) you may get as little as 2 days clinic a week. This is not a problem for a dentist who has been practicing awhile, but for a noobie you need more clinic time than that.

Ranger school seems a near impossibility because the unit that you are assigned to will almost cerntainly not pay for it. Besides, Ranger School billets are very scarce, considering that the Army basically wants most 2LTs in an INfantry/Forward Artillery Observer/Cav Scout, etc to go through it. Just recently RS was opened up to Combat support and CSS folks. In order for a dentist or a doc to go through RS, he would either need to be assigned to the 75th Ranger Regiment (which I have never heard happening for any doc) or very very lucky. If he got in, he would have to work his ass off at PRC + extra training, since docs and dentists know nothing about even the most basic infantry tactics. In 1989, when the Rangers were jumping into Panama they took along a 'hotshot' (or maybe more) doc on his GMO tour (or he might have been a surgeon) with them.

SF seems impossible as well unless you were SF tabbed before becoming a dentist. I believe that SERE is an option but there is no point unless you plan on going through Q course and/or plan on getting captured.

Anybody have any more info, please add on to this thread.

 

[DD214_DOC]

If you want action or trigger time why didn't you just enlist?

 

[militarymd]

here's one for you tired

 

[apoptosisisfun]

Good read; thanks.

 

[SF49ers Fan]

It was good to read some of Navy Dive Doc's stuff again. He was quite the champion of Navy GMO tours, if I remember correctly.