How many "tours" would I need to do to fulfill my 4 year service obligation? I read somewhere about it being a little different for anyone with a family but it was vague.
You need 4 years worth orders to pay down your 4 year obligation. In the Navy the length of the orders depends on the order. Unattached orders (overseas, can't bring your family) are usually a year. Operational orders (attached to Marines/a wing/a ship) are usually 2 years. Hospital orders might be anywhere from 1-3 years, depending on the job and the hospital.
It was my understanding that for flight surgeon you would complete some kind of primary care residency (internal medicine, etc.), THEN go to a relatively quick training specific for flight surgeon. Navy looks to be substantially more intense than AF for some reason. But you're saying you do a 1 year internist, then flight surgeon training, serve, then finish residency?
In both the AF and the Navy you do a 1 year Internship before flight surgery. In the Navy it can be an Internship in anything from psych to ortho, while I believe AF pulls mostly from transitional years. Navy flight surgery training is longer than Army/AF because it involves more actual flight training. In both cases you are allowed to reapply to residency after 2 years with the wing. The Navy takes a larger percentage of their GMOs back
would that GMO tour fulfill my service requirement? Also, would the specific path you're mentioning only apply if I did a military residency as opposed to a civilian residency? I've read quite a few negative things about being a flight surgeon on SDN with the recurring theme that they're simply not prepared, which makes sense if you just do one internist year and then start treating people
This is complicated: a GMO tour DOES pay back your obligation. However, if you return to a military residency, at the end of the residency you owe what you owed going in OR the length of the residency, whichever is more. So two scenarios:
1) you owe 4 years, you do a 2 year GMO and now owe 2 years. You do 2 more years of IM residency. Now you owe 2 more years
2) You owe 4 years, you do a 2 year GMO and now owe 2 years. You do 4 more years of ortho residency. Now you owe 4 years
Whether or not a GMO is adequately prepared is questionable. The argument for GMOs is that, as we are providing primary care to a population carefully screened to be extremely healthy we can get away with less preparation. The argument against is that just an Intern year is no longer the standard of care for anyone
Getting back to aerospace, you seem to be saying do a "normal" residency (internal medicine, family practice, etc.), THEN go back and do a second residency for aerospace? That seem like a LOT of time and I don't really see the benefit of it.
Three reasons I think this is the better path:
1) Preparation: If you do one of the (two?) civilian residencies in Aerospace medicine you will spend a career doing nothing but aerospace med: Occ med and flight physicals. Unfortunately, however, in the Military you will likely be the senior physician with a wing/on a carrier, meaning that in addition to the aerospace side of things you will be providing primary care, and supervising people providing primary care, for a carrier/wing. I think its best to actually have done a full residency in primary care if that's the path you are going to go down
2) Employability: Civilian aerospace medicine is a small field with questionable employment prospects. I don't think anyone should decide to bet their entire medical career on it. FM/IM is much more employable.
2) Personal cost: Because Aerospace medicine isn't a huge field in the civilian world, most people who decide to do the RAM are basically declaring that they want a 20-30 year military career. If that's you, then why NOT do a second residency? It counts towards retirement and it pays the same as actually work. There is a reason that so many career military docs have a fellowship, MPH, MBA, and/or degree from the war college. Every year you spend getting a degree is another year towards retirement.
My SO would be fine as a normal pharmacist, that wouldn't be an issue. I've also read sometimes civilians work for consulates and the like (i.e. they can serve as a civilian overseas but not necessarily DoD).
Again, there needs to be a job for her to take, and a lot of times there just isn't one. Embassies do not operate hospitals, so if she's a pharmacist her one and only option for a job with the government will likely be the DoD hospital that, again, probably won't need a contract pharmacist. That is especially a problem for overseas commands because US medical licenses do not transfer to foreign countries, so its the base hospital or bust. There are a LOT of Navy docs who ended up requesting Lemoore, twentynine palms, and Yuma (really crappy rural US bases) because their spouses couldn't possibly work in the much nicer Japanese commands.
If I went Navy, how likely do you think it would be that I'd wind up on a ship? ... Hard as base living might be, I don't think it would be much compared to living in the f***ing ocean. Not really sure how Navy operations work, I mean I'm normally at a base and they need me on the water for a few weeks or something that's fine, but I don't have any interest on being on an aircraft carrier (or god forbid a sub) for any extended length of time.
A navy ship is usually a lot of GMOs/flight surgeons (2 year operational orders in between Intern year and the rest of residency), and an SMO (a residency complete, higher ranking physician who runs the GMOs). I'm sure our docs who have actually worked on a ship would have a better perspective here. If the make you take operational orders and you don't like ships you will usually have the alternative to be a GMO/SMO with the Marines ashore instead. If you do a military residency in Aerospace medicine and don't want to be on a carrier you are making a huge mistake, because that is what you will be doing for the rest of your career.
