The decline of military medicine

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Galo,

You should be able to sticky this thread by sending homonculus ( the forum moderator) a PM or something.

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Galo said:
I think this post, and the "AVOID MILITARY MEDICINE" posts should be STICKIED. How do we go about this. They clearly represent the majority of negatives with well documented paperwork besides our personal rantings, and should be available to all who consider a military career.

read the "viewpoint" sticky. feel free to attach your paperwork there.

Galo said:
Hell, I may even start another post about what I felt was OK. I may digress into hell, but I can at least try.

someone attempted a positives thread, but it didn't get bumped repeatedly like some of the other ones. you'll notice the majority of the responses on some threads (AVOID MILITARY . . . being the main one) are from a only few people.

--your friendly neighborhood moderating caveman
 
Homunculus said:
..... are from a only few people.

--your friendly neighborhood moderating caveman

mitchconnie
xmmd
usafdoc
flightsurg
galo

and several others...who don't come very frequently

All with years of actual experience.

just a few
 
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militarymd said:
mitchconnie
xmmd
usafdoc
flightsurg
galo

and several others...who don't come very frequently

All with years of actual experience.

just a few

top 3 posters in that thread:

USAFdoc- 86 (33%)
milMD- 22 (8%)
islanddoc- 13 (5%)

most other people only have 1 or 2 posts. if it weren't for repeated bumping by USAFdoc, the thread would have dropped into oblivion with the rest of the old threads. that thing is like his baby-- if it gets too far down the list he bumps it to keep it alive that much longer, lol.

--your friendly neighborhood been around a while caveman
 
Homunculus:

I'm not sure I understand where you sit on this issue. Clearly there is an overabundance of negative sentiment from what seems like a few experienced people. However, I have yet to see much of anything positive being said from any physicians that have left the service. You even mentioned the last positive post sort of died out. What exactly is the harm in stickying the 2 posts we've been talking about.

Sure I can link them on the viewpoint post, but I just don't understand the need.

Where as moderator do you sit on these issues? Do you have military experience?? Are you pro or con military medicine, or are you trying to stay neutral?? Please understand these are merely inquiries and I am not implying you are either way. I would just like a better explanation of why these should not be stickied??

Thank you

Galo
 
Galo said:
Homunculus:

I'm not sure I understand where you sit on this issue. Clearly there is an overabundance of negative sentiment from what seems like a few experienced people. However, I have yet to see much of anything positive being said from any physicians that have left the service. You even mentioned the last positive post sort of died out. What exactly is the harm in stickying the 2 posts we've been talking about.

Sure I can link them on the viewpoint post, but I just don't understand the need.

Where as moderator do you sit on these issues? Do you have military experience?? Are you pro or con military medicine, or are you trying to stay neutral?? Please understand these are merely inquiries and I am not implying you are either way. I would just like a better explanation of why these should not be stickied??

Thank you

Galo

Homunculus is a pediatric resident in a military facility.
 
Homunculus is a pediatric resident in a military facility.


Wow?! So how about it Homunculus, my questions still stand.

Galo
 
Galo said:
I'm not sure I understand where you sit on this issue.

that's good. :cool:

Galo said:
What exactly is the harm in stickying the 2 posts we've been talking about.

i can't sticky a post-- i can sticky a thread. honestly it would be easier for you to copy and paste your posts to the "viewpoint" thread instead of stickying this whole thing. besides, we have plenty o' stickies the way it is. i could sticky both "pro" and "con" threads but they would both probably devolve into the same argument. if enough people like the idea, and people agree not to hijack, we can look into it though.

Galo said:
Where as moderator do you sit on these issues? Do you have military experience?? Are you pro or con military medicine, or are you trying to stay neutral??

fair enough. as an admin/moderator i try to be an unbiased as possible. i hope people in the forum can attest to that. i've been on SDN over 6 years now, 5.5 on this screenname. i remember when SDN had something like 4 forums and *maybe* 15-20 people on at once max to what it is now.

personally? i'm a second year resident at WRAMC/NNMC. i have an 8 year obligation (i paid for undergrad with an Army ROTC scholarship and did Army HPSP for medical school).

i'm not necessarily "pro" or "con". if you had to pigeon-hole me, i'm probably more on the "pro" side. that being said-- i think everyone in the forum is on the same side. everyone wants the system fixed, and even those most vehement of detractors are serving the common good by informing those people what may happen in military medicine. personally i haven't seen a lot of the horror stories-- in fact my time so far has been a very pleasant surprise, and i wouldn't trade it for anything. the military medical system is so broad that many times people are comparing apples to oranges-- the current state of affairs of the navy GMO program has nothing to do with what life is like as an army pediatric subspecialist. which is probably where my main point of contention is with some of the "con" members. air force family practice may be going down the crapper, but to warn people about the ills of all of military medicine from that is iffy at best. believe it or not, some people like the GMO model, and some great physicians *choose* to stay in-- i've seen it first hand. do i espouse this every opportunity i get? no, mainly becasue my "n" isn't that big. i will comment on what i've seen but no more. it not fair for me to discourage someone being a navy dive medical officer because last week i had a hard time getting durable medical goods ordered for one of my patients.

as i think r90t put it-- the signal/noise ratio amongst the "con" folks is often tilted toward "noise". one or two well thought out posts work much better than a hundred "bumps", "military medicine is teh suxx0r", or "i got screwed worse than anyone" posts.

so basically i am moderating as unbiased, personally more toward favorable, but do not view those critical of the military as antichrists. they're just trying to help, in their own way. i just wish sometimes they'd be more civil about it.

--your friendly neighborhood gotta hit the sack caveman
 
Homonculus,
Check out this thread:
http://forums.studentdoctor.net/showthread.php?t=239423

In this thread some users are banned for posting trolls about a Duke residency program. Lee Burnett states that the forums are not to be used for revenge posting. Several of the key stone throwers listed in this forum have described similar motivations for posting and they account for almost 50% of the total posts as you pointed out. I am also to curious as to whether or not people are posting under different nicks from the same IP address. Can you verify that this is not the case?

Are you going to enforce the ToS here or just let everything slide?

Comments are owned by their posters. However you are the moderator and ultimately you have accountability for the comments made.
 
IgD said:
Homonculus,
In this thread some users are banned for posting trolls about a Duke residency program. Lee Burnett states that the forums are not to be used for revenge posting. Several of the key stone throwers listed in this forum have described similar motivations for posting and they account for almost 50% of the total posts as you pointed out. I am also to curious as to whether or not people are posting under different nicks from the same IP address. Can you verify that this is not the case?

Are you going to enforce the ToS here or just let everything slide?

Comments are owned by their posters. However you are the moderator and ultimately you have accountability for the comments made.

It is hard not to feel somewhat offended when I read the above statement. Being called a "stone thrower" a "troll" and other things, seems to be about the same type of things this person has said in the past.

Still, I care more about the truth being told, than some "word insults" tossed out there by a few towards the physicians. I also hope that military medicine improves where it needs to. This is bigger than us students and docs; healthcare affects people lives; quality and length. While things may not 100% terrible across the board, there are serious significant issues going on that no recruiter, and probably no Commander is going to tell prospective students about.

IgD has done this in previous threads and now again; asking to censor the voice of those that have actually been "on the front line". Why is he doing this? I'll lay my money on pride. Too proud to believe that he is a part of something (as we all are/were) that might not be living up to the high standards it claims to stand for.His answer appears to be to look the other way himself and qwell the information so that others don't even see.
 
USAFdoc said:
...IgD has done this in previous threads and now again; asking to censor the voice of those that have actually been "on the front line"...

Usually when someone says "on the front line" they are talking about being in a combat situation outside the continental United Stated. Have you ever been OCONUS?

Here is how Wikipedia defines troll and trolling:
"...a troll is a person who posts rude or offensive messages on the Internet, such as on online discussion forums, to disrupt discussion or to upset its participants. "Troll" can also mean the message itself or be a verb meaning to post such messages. "Trolling" is also commonly used to describe the activity."

USAFDoc, you've got 33% of the posts as described above and most of them are negative. Regardless of what I say, others have complained that these posts are disruptive to discussion. Your posts are rude and offensive. Let me give you an example: Someone comes on here and says "I've decided to take a HPSP scholarship..." Then you guys hijack the thread and criticize the person for taking the scholarship.

Here is something we almost agree on. I don't think you should be censored I think you should be banned.
 
IgD said:
Here is something we almost agree on. I don't think you should be censored I think you should be banned.

Usually when someone says "on the front line" they are talking about being in a combat situation outside the continental United Stated. Have you ever been OCONUS?

The readers here can come to their own conclusions about your other comments.

I have been OCONUS...I've been in a war zone. I throw stones just like usafdoc, but at different things.

I/we have been criticizing the SYSTEM.

You and others talk about how each of you have great INDIVIDUAL EXPERIENCES....

These are 2 different things.

This messed up system doles out uneven experiences based essentially on luck....and the recipient has no say in it....
 
IgD said:
Here is something we almost agree on. I don't think you should be censored I think you should be banned.

Usually when someone says "on the front line" they are talking about being in a combat situation outside the continental United Stated. Have you ever been OCONUS?

The readers here can come to their own conclusions about your other comments.

again, personal attacks from IgD, as if my experience and take on the state of military medicne should revolve around my OCONUS status. Actually IgD, I have probably been to about as many countries as you hav teeth (Africa, much of Asia, Australia etc), not that that should ever have much to do about this site. You are way outta line. You are entitled to your opinion to "ban" everything you don't agree with. If you stay with the military, I am sure there will be somebodys shoes you can fill, and with that attitude, nobody will notice the change.

Having said that, there are good leaders and Commanders out there.
 
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I found a lot of your stuff on here hard to believe. When I asked about being in a combat setting, I was attempting to validate your claim of being "on the front line".

I've said before there are good points and bad points about military medicine. I don't agree that everyone that disagrees with me should be banned. On the contrary, I think it's good to have diverse opinions. I think there are only 3 people (You, MilMD and Island Doc) who account for the majority of the posts as described above and should be banned.

USAFdoc said:
again, personal attacks from IgD, as if my experience and take on the state of military medicne should revolve around my OCONUS status. Actually IgD, I have probably been to about as many countries as you hav teeth (Africa, much of Asia, Australia etc), not that that should ever have much to do about this site. You are way outta line. You are entitled to your opinion to "ban" everything you don't agree with. If you stay with the military, I am sure there will be somebodys shoes you can fill, and with that attitude, nobody will notice the change.

Having said that, there are good leaders and Commanders out there.
 
IgD said:
Here is how Wikipedia defines troll and trolling:
"...a troll is a person who posts rude or offensive messages on the Internet, such as on online discussion forums, to disrupt discussion or to upset its participants. "Troll" can also mean the message itself or be a verb meaning to post such messages. "Trolling" is also commonly used to describe the activity."

.


if I am to believe the above; then YOU IgD are the troll. You are the one placing rude remarks and causing people to be upset as well. Isn't hat is how you got placed on probation for awhile?

I have placed positives and negatives about military med on this site, it just so happens that the my overall assessment of military medicine as we speak is much more negative than positive. Just about anyone currently serving as a physician seeing patients would say the same. Again, this does not mean that every single doc seeing patients is counting down the days till they separate, but I will tell you, that the vast majority proabably are. And not because we don't love our country, or because there is more $$$ on the outside. It is because we demand excellence from ourselves and will not tolerate an organization that is committed to mediocrity, places patients unneccessarily in harms way, and then has the gall to say all is wonderful.

I have nothing negative to say about anyones experience with military medicine. If someone likes it, great, there are good positions still out there, although rare. I am here to let those know about my experience and what I saw first hand duringn my career. As time goes by, more and more info has been coming out that supports my experience in USAF primary care as being the norm, not the exception. My travels and contacts around the USAF and my referring to sites such as the USAFP also support my claims.
 
By "probation" I'm assuming you are referring to a period of time that I didn't post anything here. I basically lost interest and just stopped. It gets to the point where trying to post here is like paddling up a waterfall.

I made my points very clear. We can leave it to the powers that be and other posters to decide what direction they want this forum to go in. I'm going to stand down.

USAFdoc said:
if I am to believe the above; then YOU IgD are the troll. You are the one placing rude remarks and causing people to be upset as well. Isn't hat is how you got placed on probation for awhile?
 
IgD said:
By "probation" I'm assuming you are referring to a period of time that I didn't post anything here. I basically lost interest and just stopped. It gets to the point where trying to post here is like paddling up a waterfall.

heres to hoping you lose interest again soon.

and as to the paddling up a waterfall; its great training to get you in shape for your USAF primary care career, so stick with it.
 
IgD said:
I found a lot of your stuff on here hard to believe. When I asked about being in a combat setting, I was attempting to validate your claim of being "on the front line".

Ive been "on the front line" In combat that is. Been shot at and almost blown up with an IED. Ive got a CAR. AND I agree with what has been posted by those you would Ban. Want to Ban me now as well?

Where have you been to be the self proclaimed validating service???

Doctors in civilian status talk about being on the front lines of health care all the time. Anyone with a brain read that statement as such.
 
Here is something we almost agree on. I don't think you should be censored I think you should be banned.[/QUOTE]


idg: Who are you?? What is your current situation that you would seep such poison?? You must be in the military, and probably in some position you may think you lead in?

Did you just not do the same thing you are accusing the people trying to pass on their experiences? Hijack a thread for your personal views.

Exactly what are your views of military medicine. Why don't you let us know how your experience has been. What level of competence you have observed, how many times you've been effortlessly able to take care of a persons complex medical problem and see it to resolution.


My observations being on this forum a short time, is that we are passionate people because medicine is important to us. We took an oath to do no harm, and in our experiences it has been close to impossible to comply with that oath, and no be in conflict with what some people see as a higher order: officership. Certainly we all agree there is a problem. I think we may disagree some on the size of that problem. Myself, I see it as a potential National Security Threat!! But the leadership does not, so I try, much as my other concerned colleagues, to let the people who may choose to do HPSP/FAP, whatever, what the real issues, as I know them, are.

If you have an everything is OK, here's my examples experience, by all means post it. I will contribute to it. But otherwise, be an officer and a gentleman, and do not threaten us because we want to inform people, passionate as we may get.

Homunculus: Thanks for your honesty. I hope you have a good experience, but with an 8 yr commitment, I just hope you have a good experience. However I would still like the 2 posts stickied.

I will also try to get current AD physicians who are living it today to post their experiences so we can get a more diverse mix into this.

Thanks
 
USAFdoc said:
heres to hoping you lose interest again soon.

and as to the paddling up a waterfall; its great training to get you in shape for your USAF primary care career, so stick with it.

LOL

The truth is I regret the confrontational posts here and wish the forum was different. I'm sure we could swap stories over a few drinks and have a good time.
 
usnavdoc said:
Ive been "on the front line" In combat that is. Been shot at and almost blown up with an IED. Ive got a CAR. AND I agree with what has been posted by those you would Ban. Want to Ban me now as well?

Where have you been to be the self proclaimed validating service???

Doctors in civilian status talk about being on the front lines of health care all the time. Anyone with a brain read that statement as such.

Instead of complaining about the tone of others' posts, perhaps IgD can post some counter-examples of his own, if his experience qualifies him to do so.

Demanding that the moderator ban another poster because 1., he posts frequently and 2., he has negative things to say about his experiences as a military practitioner makes me only wonder whether IgD has some ulterior motive. For what it is worth, the motives of the frequent posters seem clear to me; I only wonder at the motives of someone who cries about how frequently someone else is posting. No one has to read these pages.
 
Last edited:
Galo said:
Exactly what are your views of military medicine. Why don't you let us know how your experience has been. What level of competence you have observed, how many times you've been effortlessly able to take care of a persons complex medical problem and see it to resolution.

I'm a board certified specialist. I was chief resident of my program and a published author. I'm working in an operational setting. I speak for myself and don't want to give anyone the false impression that I'm speaking for anyone else.

I went to private medical school. Tuition was about 35k. After internship I was very fortunate and picked up for straight through training. The money worked out great for me.

I have experienced some detailing issues and learned some appreciation for the hard reality of the military: You might have to go anywhere at any time.

I don't think there is any medical system where you can "effortlessly" take care of a patient's complex medical problem and see it to resolution. I've faced many a complex situation both medically and administratively. For the most part things have worked out.

By and large I've been pleased with medical care in general and the quality of physicians in the military. For example, my residency training program had a board passing rate well above the national average.

The biggest challenge I've faced is understanding how medicine interfaces with the line. The mission always comes first. Medicine is always second. I think the biggest problem we face today is money. Medical care is very costly and there is never enough. At the same time the number of retirees is always increasing and putting further pressure on the system. I've also experienced a learning curve in understanding the culture of the military.

My biggest beef is red tape. It seems like anytime you want to get something done there are several layers of tape you have to cut through. Pay is also one of my biggest issues. I would rather get paid more up front and have a matching 401k contribution.

I think it would very difficult to be a leader in military medicine right now. I think our leaders are powerless to do more because of money and not because of competence. It seems logical to say reform this or that but the bottom line is the resources aren't there. The ideal situation would be to open a Level I trauma center here and make a fleet of 10,000 tanks to roll into Baghdad but it's not reality. I work to try to provide the best care with within the constraints of our system.

I think for most people a brief stint in the military can be rewarding both professionally and financially with the right expectations and flexibility.
 
I have experienced some detailing issues and learned some appreciation for the hard reality of the military: You might have to go anywhere at any time.

I don't think there is any medical system where you can "effortlessly" take care of a patient's complex medical problem and see it to resolution. I've faced many a complex situation both medically and administratively. For the most part things have worked out.

By and large I've been pleased with medical care in general and the quality of physicians in the military. For example, my residency training program had a board passing rate well above the national average.

The biggest challenge I've faced is understanding how medicine interfaces with the line. The mission always comes first. Medicine is always second. I think the biggest problem we face today is money. Medical care is very costly and there is never enough. At the same time the number of retirees is always increasing and putting further pressure on the system. I've also experienced a learning curve in understanding the culture of the military.

My biggest beef is red tape. It seems like anytime you want to get something done there are several layers of tape you have to cut through. Pay is also one of my biggest issues. I would rather get paid more up front and have a matching 401k contribution.

I think it would very difficult to be a leader in military medicine right now. I think our leaders are powerless to do more because of money and not because of competence. It seems logical to say reform this or that but the bottom line is the resources aren't there. The ideal situation would be to open a Level I trauma center here and make a fleet of 10,000 tanks to roll into Baghdad but it's not reality. I work to try to provide the best care with within the constraints of our system.

I think for most people a brief stint in the military can be rewarding both professionally and financially with the right expectations and flexibility.[/QUOTE]


idg:

Bravo!! You have just given a clear and concise critique of the system. You may be one of us more than you think. We also have made these critiques: lack of support, lack of leadership, poor money.

But I can tell you, that if you look at the lecture Brian Peyton gave in 2003, you will see that for surgical specialties, the number one gripe was loss of skills, lack of support, retention, deployment tempo, value attributed to us, and way down was actual money. I also must add to your critique of leadership. I have also mentioned the word powerless. But I think its been impressed on us that in addition to that, we get the perception that they do not care, do not understand, are unwilling, to do what it may take, and I think like an untreatable virus, MEDIOCRACY has set in and is accepted.

At this time I also differ with you in thinking that most people go into military medicine with the right expectations and flexibility, and therefore do not think that for most, a short stint will be benefitial. Especially in the state that it is now.

This is why we are here spending our time trying to educate people via our experiences and those of others who are just waiting to get out, and not look back.

Homunculus: See, looks like we made peace, and are all in agreement, there are vast issues people need to know other than what they are told by their recruiter.

Can you sticky this post, and AVOID MILI.............. now please?

I have put a call into others with experience to add to this post.

Galo
 
Homunculus said:
do i espouse this every opportunity i get? no, mainly becasue my "n" isn't that big. i will comment on what i've seen but no more. it not fair for me to discourage someone being a navy dive medical officer because last week i had a hard time getting durable medical goods ordered for one of my patients.

as i think r90t put it-- the signal/noise ratio amongst the "con" folks is often tilted toward "noise". one or two well thought out posts work much better than a hundred "bumps", "military medicine is teh suxx0r", or "i got screwed worse than anyone" posts.

I think these are great points and serve as evidence why this thread shouldn't be sticked under its current title. Although, from what I've read, I don't think a "Decline of Air Force Surgery" or "Avoid Air Force Primary Care" thread would get much opposition to being stickied.
 
IgD said:
Usually when someone says "on the front line" they are talking about being in a combat situation outside the continental United Stated.
He's definitely not the first person to use that phrase the way he did. There's no need to get wrapped up in the semantics!
 
I think these are great points and serve as evidence why this thread shouldn't be sticked under its current title. Although, from what I've read, I don't think a "Decline of Air Force Surgery" or "Avoid Air Force Primary Care" thread would get much opposition to being stickied.
__________________


Colbgw02:

I pose the same question to you. From what experience do you reap your knowledge. You've heard from at least the AF, and Navy. I do not specifically recall if anyone from the army has said anything, so should we call it "the decline of 2/3 of military medicine"

I'll say it again. People like you will become the inheritors and executors of the continuing decline, as you don't seem to want to acknowledge there is a significant problem impacting real peoples lives.

I'm getting tired of this.
 
IgD said:
I found a lot of your stuff on here hard to believe.
Many of the "stone throwers" have been very specific and up front about their assignments and careers. Therefore, they do have credibility. Especially when compared to people who don't give out that kind of information. The most details you've shared are that you are "a specialist" who does "operational medicine." That doesn't narrow it down much, especially when compared to somebody like x-milmd who's told us his field, exact duty locations, deployments, dates, etc.

Now don't get me wrong, I realize why you wouldn't want to share such information. But to remain ambiguous about your experience just doesn't give you enough clout to call the stone throwers trolls, or to demand they be banned.
 
there is now a "pro" and "con" thread stickied to the forum. knock yourself out.

--your friendly neighborhood appeasing caveman

p.s. now that we have that outlet, there will be zero tolerance for hijacking
 
Galo said:
You've heard from at least the AF, and Navy. I do not specifically recall if anyone from the army has said anything, so should we call it "the decline of 2/3 of military medicine"


we've heard from a few vocal people from each service. i'm not judging the entire service based on those few people, just as hopefully people don't judge the HPSP program based on what recruiters say. not to mention we don't have a representative cross section of specialties at all.

Galo said:
I'm getting tired of this.


tell me about it, lol.

--your friendly neighborhood fixin' dinner caveman
 
Galo said:
I'm getting tired of this.

Ditto. I've tried to be as humble and contrite as possible. I've mentioned several times how I have next-to-no knowledge on this topic. All I've done is emphasize others' points which I believe to be good ones and point out how I don't think that this strategy is the most effective in achieving the stated goal. I don't really see why I need any experience to do either of those things, but apparently I do.

Galo said:
People like you will become the inheritors and executors of the continuing decline, as you don't seem to want to acknowledge there is a significant problem impacting real peoples lives.

I also think it's presumptuous for you make any statements regarding what I acknowledge or don't acknowledge considering that I've never made a single statement denying that a very serious problem exists within military medicine. Nor have I said anything to the contrary. Once again, since there is apparently a need to be ipsative, I know next-to-nothing about this topic.

Galo said:
You've heard from at least the AF, and Navy. I do not specifically recall if anyone from the army has said anything, so should we call it "the decline of 2/3 of military medicine"

Yes, citing your own lack of evidence concerning the Army, I think it would be extremely reasonable to call it "the decline of 2/3 of military medicine", the slight to the Coast Guard notwithstanding ;) . In general, I try not to extrapolate conclusions without supporting evidence. Now, if several Army folks come forward in a similar fashion to provide that evidence, I think it would be perfectly reasonable to keep the title as is.

Seeing as I've elucidated my comments to the extent of my writing abilities, I'm going to retire from this thread.

Cheers.
 
Sledge2005 said:
The most details you've shared are that you are "a specialist" who does "operational medicine." That doesn't narrow it down much, especially when compared to somebody like x-milmd who's told us his field, exact duty locations, deployments, dates, etc.

Do a Google search on "operational security".
 
IgD said:
I found a lot of your stuff on here hard to believe. When I asked about being in a combat setting, I was attempting to validate your claim of being "on the front line".

I've said before there are good points and bad points about military medicine. I don't agree that everyone that disagrees with me should be banned. On the contrary, I think it's good to have diverse opinions. I think there are only 3 people (You, MilMD and Island Doc) who account for the majority of the posts as described above and should be banned.

You are advocating that we be robbed of our First Amendment Rights to Freedom of Speech, yet you have taken an oath to "support and defend the Constitution of the United States"???
 
island doc said:
You are advocating that we be robbed of our First Amendment Rights to Freedom of Speech, yet you have taken an oath to "support and defend the Constitution of the United States"???

No I'm recommending you be banned.
 
I'm glad homunculus finally placed the pro con post as stickies. Thank you for seeing the light, and allowing people to have easier access to information, even if I did have to link to this post.

Anyways, over the last 2 days I have been hitting up old contacts on active duty, and separated. It has been surprising how we deal with our experiences. I think alot of the people on active duty want to say their peace, but things like fear of retribution, a sort of I went through this let someone else do it, just don't want to deal with it, don't want to bring up old demons that they are just now realizing how unhealthy it was for them and their families, (including me). Many reasons for people to be reluctant to post. I am waiting to hear from a friend of mine who spent 4 years in the army system to finally be able to get a personal perspective on that part of it. Depite it all, I think by reading this forum there is plenty of evidence there is a great problem, (decline), in military medicine, and those thinking about it for whatever reasons, really should be informed by reading what people who lived it went through.


I remain available for personal contact by anyone who would like to talk, and get more personal insight, information, about surgery, the military, med school, whatever.

Galo

[email protected]
 
IgD,

Thank you for posting a thorough and broad evaluation of the military medicine you have experienced. I am considering going the route of HPSP, and have been reading a number of the threads concerning military medicine. I am 50/50 on whether or not I will be accepting the scholarship, but posts like #72 help potential candidates evaluate their options. The fact that you and the moderator both acknowledge the military's shortcomings and yet still look at it positively at your experience is encouraging to those still weighing the positives and negatives. To others that have posted, your comments are very helpful and have given me both doubt and excitement. However, for the unbiased onlooker such as myself, continued repetition of negatives makes one appear vindictive rather than helpful (the more one cries wolf, the less attention one receives). Once again, thanks goes out to all of you for your numerous threads and posts concerning your experiences in military medicine. They have made my decision a difficult one.

Jonathan
 
Jonathan,

To give information was the goal all along. As far as having to repeat our criticisms, it seems necessary sometimes when you have far less experienced people doubting your experience and the experience of the vast majority of physicians.

Now you have information to take to heart when you decide if you want to give up some things for others.

Good luck to you


G
 
jsmittyund03 said:
Thank you for posting a thorough and broad evaluation of the military medicine you have experienced...

Don't take my word for it or anyone else on here. If you hold a medical school acceptance letter, are seriously considering taking a HPSP scholarship and are undecided here is some advice: Fly out to a military facility and shadow a physician for a week. See with your own eyes and come to your own conclusion. It's worth the investment. It will either give you peice of mind or save you a lot of heartache.
 
jsmittyund03 said:
IgD,

Thank you for posting a thorough and broad evaluation of the military medicine you have experienced. I am considering going the route of HPSP, and have been reading a number of the threads concerning military medicine. I am 50/50 on whether or not I will be accepting the scholarship, but posts like #72 help potential candidates evaluate their options. The fact that you and the moderator both acknowledge the military's shortcomings and yet still look at it positively at your experience is encouraging to those still weighing the positives and negatives. To others that have posted, your comments are very helpful and have given me both doubt and excitement. However, for the unbiased onlooker such as myself, continued repetition of negatives makes one appear vindictive rather than helpful (the more one cries wolf, the less attention one receives). Once again, thanks goes out to all of you for your numerous threads and posts concerning your experiences in military medicine. They have made my decision a difficult one.

Jonathan

1) best wishes if you go mil med.
2) whatever your take and you want to call the docs, "crying wolf" is very innaccurate.
3) you have a difficult decision, but whatever you choose, you will still be fine in the end. Worst case scenario; you have high standards and work your way through a very frustrating first and only term in milmed. After that, civilian med smells like roses.
4) right now you are light years ahead of most HPSP students from the past (like me) who as it turned out, had absolutely no clue on what milmed is (its negatives). The positives I was aware of. When I got there I was just disappointed to say the least of how few they were, and how easily admin stacked up the neg pile.
 
IgD said:
Don't take my word for it or anyone else on here. If you hold a medical school acceptance letter, are seriously considering taking a HPSP scholarship and are undecided here is some advice: Fly out to a military facility and shadow a physician for a week. See with your own eyes and come to your own conclusion. It's worth the investment. It will either give you peice of mind or save you a lot of heartache.


this idea has been stated elsewhere and is valid and probably very helpful. It will be impt who you talk to. Go with a doc seeing patients, about 12-36 months in (since that will most likely represent you). The Commanders will be more like recruiters.
 
Preferably go to a place that has a couple of people doing what you want. The broader perspective you have, the better decision you'll be able to make. Clearly you know my position, and that of the other experienced physicians on this forum. I've yet to see an overwhelmingly positive responce from anybody with any experience even though we've called out for them.

Galo
 
Absolutely,

I live right in DC, so Walter Reed has been an important asset for me as I make my decision. So far, the physicians I have followed have been very positive about their military experience (both of whom are osteopathic physicians, which is the direction I'm going). They of course said much of the same things found on this forum, but have not had the horrible experience that Galo did. Thanks for all of the help and suggestions, I'll let you all know the outcome of your influence :).
 
I know I put this on the con post, but yet another reason to put another nail on the coffin of military medicine. As one of my commanders used to say about him writting us up for things like doing cases one had credentials for, or the same for walking out of a meeting, etc. The class of person who would clearly do something unethical because he was told.

http://www.veteransforcommonsense.org/?Page=Article&ID=6370
 
BOHICA-FIGMO said:
USAFGMODOC said:
I didn't mean to imply that DOs were inferior physicians..they're not. I simply meant to imply that the vast majority of graduates from medical professional schools in the U.S. (i.e., 125 allopathic schools @ ~13k physicians/yr vs. 20 D.O. schools @ ~3K graduates /yr) do not seem to be attracted to the military. That was all I was trying to point out with that stat. Sorry if I offended.

DO schools on average cost more than MD schools. More possible debt means higher incentive to join military. That's the major attraction to military immediately prior to starting medical school.
 
Well, I can say its been interesting being on this forum and seeing how emotional discussions can get on both sides. It still escapes me how people can defend something so blindly that they have not yet had full contact with, and I wish they would continue to post their experiences here. It also surprises me how many people there are signing up that still do not have a good picture of what their potential future in military medicine is going to be like.

I have been able to help a number of people make more informed decisions, and most would think that makes me feel great. Actually the feelings are mixed. On the one hand, I feel a great shame that our country has let the military get so screwed up, (at least in medicine), that a forum where people like me have to put out warnings. On the other, I feel good someone else won't have to go through the problems I experienced.

I one of my recent communications with someone, I actually got asked about the Army. Well, to not be labeled as not being an "expert," by the usual, hosts, I got on line, and called two separete army hospitals. William Beaumont, and Womack. I spoke to a surgeon who had been on AD three years. I told him who I was and was seeking info because someone wanted to get an opinion about surgery in the army. I could tell right away by his wording that he was unhappy. He told me he did not even have privileges at his hospital when he got sent to Iraq, and found himself doing a trama case he did not feel comfortabele doing. He's physically separated from his girlfriend, parents, and did not choose to go where he ended up. He feels like is his supervised like you would a grade school child, and said over 90% of the physicians there would leave first chance they get. I imagine he meant surgeons, but it be everyone included. He felt he was busy enough, but certainly not like civilian counterpart.

The next guy was a chief resident, 18 yr prior service!! He said he knew what to expect, but that certainly the vast majority of surgeons are shocked once they get there. He said out of training, unless you have some "in", you will likely end up in a hospital that cannot even support inpatient care. So basically you may spend your first 3 years in a place where you can do the bare minimum of surgery, and certainly nothing complex. He said most people at major medical centers have been somewhere in the system for a while. They are more busy. Deployments at this time, are a minimum 8 months every other year. Its a 6 month deployment, with a month or more on either end for training, downtime, etc.

So, not as an "expert" but as someone who had two casual conversations, I present the decline of ARMY MEDICINE as well, except of course where homumculus is training as a pediatrician now..........lol. Seriously, I can at least attest to surgery in the army being a place where you may not end up practicing to the fullest of your abilities, and certainly not as much as one should to keep their skills up. I can conclude that based on what everyone else has said here, that its not only surgery, but medicine as a whole in every branch of the military.

I again encourage anyone seriously thinking about the military to call up places and just talk to the doctors. It took me one phone call for the first, and 3 for the second to talk to a surgeon.

My email is open to anyone with questions:

[email protected]
 
I recently received one a medical journal we sometimes refer to as "throw away journals." They are usually case reports, and have a purpose, but are not in par with other more prestigious journals.

Anyways, I see a case report by a surgeon at the base I just left, and his title is General and Cardiothoracic Surgeon. Now I know for a fact there are no such surgeons at that base, so I call my buddy up who's unfortunately still in active duty, for only for 3 more months, and he confirms what I know to be true.

Now, I don't know, or presume that the actual author put this on his name, perhaps it is a mistake the magazine made, etc etc. What gets me, is that there are surgeons now in the AF, (not sure about army or navy), that are basic general surgeons that take a one year of additional training at the VA in Biloxi, and are then classified as vascular and thoracic surgeons by the AF, with full privileges to perform procedures falling under those categories. These surgeons are NOT board eligible for vascular or thoracic surgery boards. I have seen those wiht this training that limit themselves to procedures that any competent general surgeon with an emphasis on vascular and thoracic surgery may do, but I have also seen one that was totally incompetent, investigated twice, but allowed to continue as if nothing happened because of his rank, (0-6).

I'm I being just too picky, or is it appropriate for people to list themselves under a title that they just do not have?

Currently the only board certified fellowship trained cardiothoracic surgeons were at wilford hall eroding their skills because of lack of operating volume.

Just another one of my crazy rants.
 
It seems ridiculous, but not unbelievable to have some calling themselves CT surgeons when they aren't full up qualified. Maybe this is a mistake, or I hope it is....
 
USAFGMODOC said:
It seems ridiculous, but not unbelievable to have some calling themselves CT surgeons when they aren't full up qualified. Maybe this is a mistake, or I hope it is....


Its called Surgical Rounds. It is on the front cover of the current issue.
 
I am considering Psychiatry. Does the Navy need psychiatrists? How would my training be? Would I go straight through 4-yr residency?

thanks
C
 
I am considering Psychiatry. Does the Navy need psychiatrists? How would my training be? Would I go straight through 4-yr residency?

thanks
C

Yes, the Navy does need psychiatrists. And, according to the HPSP administration, the Navy is transitioning to allowing fourth year medical students to match for internship and residency training in both Family Practice and Psychiatry.
 
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