Usuhs

[Neogenesis]

Hi Everyone,

First off, thanks so much to everyone posting here. I have learned an incredible amount of information from past, present, and future military docs on this forum that wouldn't have been possible otherwise. The reason for my post is to ask previous or current USUHS students about when people typically move their household goods to the DC area. I'm sure the answer to this question is coming in future paperwork after I send in my commissioning paperwork, but I thought this forum would be an easy way to get a quick answer. I'll be attending COT from the beginning of July to the beginning of Aug, so it seems that people would either move in June or sometime during the first few days of Aug. I suppose that if the beginning of Aug is the answer, then my wife will have to basically take care of everything and I'll meet her in D.C. Oooh, I'm sure she'll love that! Then again, I guess she better get used to it

I moved to DC after OBC. We had the military move us, so there really wasn't anything to get ready. If you're going to have the military move you, I would call to set up your move date when you get your orders, because dates tend to get filled up. The other thing that I would recommend is trying to get out to DC beforer COT to find a place to live if possible. It is frickin expensive out here. Also, try to use USUHS to help you find a place. Some of my classmates fared better than I did in finding more affordable housing by doing that. Congratulations on your acceptance. I'll see you in the fall.

NG

---

Members don't see this ad.

 

[azran]

I moved to DC after OBC. We had the military move us, so there really wasn't anything to get ready. If you're going to have the military move you, I would call to set up your move date when you get your orders, because dates tend to get filled up. The other thing that I would recommend is trying to get out to DC beforer COT to find a place to live if possible. It is frickin expensive out here. Also, try to use USUHS to help you find a place. Some of my classmates fared better than I did in finding more affordable housing by doing that. Congratulations on your acceptance. I'll see you in the fall.

NG

Perfect, thanks very much for your response! That's what I expected, but it's nice to have confirmation. Thanks again and I'll see you in the fall.

 

[st0rmin]

Hi Everyone,

I'll be attending COT from the beginning of July to the beginning of Aug, so it seems that people would either move in June or sometime during the first few days of Aug. I suppose that if the beginning of Aug is the answer, then my wife will have to basically take care of everything and I'll meet her in D.C. Oooh, I'm sure she'll love that! Then again, I guess she better get used to it

Well, I found out 2 weeks before school started that I had been moved off of the wait list and onto the full acceptance list. I flew out on my own and left my 7-month pregnant wife handle things with the military moving us. We lived in an extended stay hotel for 2 months before moving into our place. That was challenging. My recommendation is heading out early, have the military move you. Use the housing office at the Navy hospital (NNMC, Bethesda) to help you find a good place.

Good luck. It's a fun, interesting adventure.

 

[Unusual1]

If this question has already been answered, I apologize.

I am probably going to make the Army Reserve O-4 list whenever they get off their butts and publish it. If I were to get into USUHS would I be there as an O-1 or an O-4? Thanks in advance.
(This would be about 3 years or so from now by the time I did prereq's, etc).

 

[Croooz]

If this question has already been answered, I apologize.

I am probably going to make the Army Reserve O-4 list whenever they get off their butts and publish it. If I were to get into USUHS would I be there as an O-1 or an O-4? Thanks in advance.
(This would be about 3 years or so from now by the time I did prereq's, etc).

o1....but not o1e.

 

[Unusual1]

o1....but not o1e.

Well, the "E" wouldn't make any difference since I am already over 10 years for pay I would be maxed out anyway, right?

 

[jsnuka]

Well, the "E" wouldn't make any difference since I am already over 10 years for pay I would be maxed out anyway, right?

I asked about that and I was told that it would be O1E. I was an officer for 8 years.

You could always contact the admissions office and ask them for clarification. When I asked the question, I understood the response to be that it would result in being an O1E during the medical school at USUHS and then quicker route to promotions upon graduation.

 

[Unusual1]

I asked about that and I was told that it would be O1E. I was an officer for 8 years.

You could always contact the admissions office and ask them for clarification. When I asked the question, I understood the response to be that it would result in being an O1E during the medical school at USUHS and then quicker route to promotions upon graduation.

I exchanged some e-mails with one of the reps for the HPSP program and he commented that I would likely make O-4 during my intern year given my previous service.

 

[RichL025]

I asked about that and I was told that it would be O1E. I was an officer for 8 years.

Not unless you _also_ have 4+ years of enlisted time. Unless you do, it doesn't matter how much officer time you have, you are not eligible for O-1E.

And the "E" grades are completely different than getting paid for time in service - look at the pay charts to see.

 

[Unusual1]

Not unless you _also_ have 4+ years of enlisted time. Unless you do, it doesn't matter how much officer time you have, you are not eligible for O-1E.

And the "E" grades are completely different than getting paid for time in service - look at the pay charts to see.

I'm pretty sure there is a point in the O-1, O-2, and O-3 pay charts where the benefit of the "E" runs out compared to the non-E pay chart. I seem to recall that it is at 6 or 8 years for pay purposes. I'm at 10 now so I don't think it would make a difference. When I was in the Guard they mistakenly processed me in as an O-3E but I couldn't really get anyone energized to fix it since there was no difference in my pay.

 

[RichL025]

I'm pretty sure there is a point in the O-1, O-2, and O-3 pay charts where the benefit of the "E" runs out compared to the non-E pay chart. I seem to recall that it is at 6 or 8 years for pay purposes.

Other way around. The "E" benefit becomes more pronounced the more time in service you have.

 

[NavyFP]

I'm pretty sure there is a point in the O-1, O-2, and O-3 pay charts where the benefit of the "E" runs out compared to the non-E pay chart. I seem to recall that it is at 6 or 8 years for pay purposes. I'm at 10 now so I don't think it would make a difference. When I was in the Guard they mistakenly processed me in as an O-3E but I couldn't really get anyone energized to fix it since there was no difference in my pay.

E only applies if you have enlisted time. Not commissioned service.
Agree that you would get entry grade credit that would put you in the O-4 range when you graduate from med school.

 

[Unusual1]

Other way around. The "E" benefit becomes more pronounced the more time in service you have.

http://www.military.com/military/benefits/0,15465,military_pay_charts,00.html

Just checked the Active Duty Pay Charts at the above address. Looks like after making O-3 and 4 years commissioned service the "E" and the non-E make the same. After O-4 the "E" goes away.

 

[VolatileNavyDoc]

http://www.military.com/military/benefits/0,15465,military_pay_charts,00.html

Just checked the Active Duty Pay Charts at the above address. Looks like after making O-3 and 4 years commissioned service the "E" and the non-E make the same. After O-4 the "E" goes away.

Check out this website and look further down the pay chart http://www.dod.mil/dfas/militarypay/2006militarypaytables.html

I think what RichLO25 was referring to was the fact that as an O-3, your pay maxes out at 14 years of service while O-3E continues to increase until 18 years of service. Until 14 years of service O-3 and O-3E pay are EXACTLY the same at every increment, except for years 1-4, b/c you can't get OE pay unless you have at least 4 years enlisted. The disparity is even larger for O-1 and O-2.

 

[Unusual1]

Check out this website and look further down the pay chart http://www.dod.mil/dfas/militarypay/2006militarypaytables.html

I think what RichLO25 was referring to was the fact that as an O-3, your pay maxes out at 14 years of service while O-3E continues to increase until 18 years of service. Until 14 years of service O-3 and O-3E pay are EXACTLY the same at every increment, except for years 1-4, b/c you can't get OE pay unless you have at least 4 years enlisted. The disparity is even larger for O-1 and O-2.

Gotcha, two different things. Basically unless you had LOTS of years enlisted, the E isn't doing much for you after you make O-3 and it goes away after O-4.

 

[jsnuka]

Gotcha, two different things. Basically unless you had LOTS of years enlisted, the E isn't doing much for you after you make O-3 and it goes away after O-4.

Damn, Damn, Damn!!!!!!!!

 

[Unusual1]

Damn, Damn, Damn!!!!!!!!

I take it you are one with some solid E time. If this winds up being my course of action, I'll come into it with a good 13 years of commissioned service for pay purposes and I'll be an O-4 as I come in. It would be highly entertaining to be an O-1 again, I think. That said, I'd likely pin O-4 right back on in my intern year, so not a bad deal overall, especially because I'd be an O-4 with 17 years of service for pay by then. Not too shabby.

 

[jsnuka]

I take it you are one with some solid E time. If this winds up being my course of action, I'll come into it with a good 13 years of commissioned service for pay purposes and I'll be an O-4 as I come in. It would be highly entertaining to be an O-1 again, I think. That said, I'd likely pin O-4 right back on in my intern year, so not a bad deal overall, especially because I'd be an O-4 with 17 years of service for pay by then. Not too shabby.

It makes it a little bit less appealing, to be honest with you.

If they counted the time in ROTC or if someone was in a service academy as Enlisted time, then it would be cool, but to lose those 8 years for pay purposes only to regain them for retirement purposes rather sux.

 

[RichL025]

That said, I'd likely pin O-4 right back on in my intern year, so not a bad deal overall,

Errr, you sure about that?

Not having been an O prior, I didn't pay much attention to the rules, but I _thought_ I heard that the only advantage was you would get 1/2 your prior O-3 time in grade as time in grade as an intern O-3 - meaning (say you made it in six) that as a brand-new MC officer, you would be an O-3 with 3 yrs time in grade. You might expect O-4 back in residency, but not in internship.

Caveat - like I said, I was an E before (15 years before med school), so I never paid that much attention about how that stuff worked. Be sure and have a long talk with your promotions people before you start budgeting that pay raise in, though....

 

[Unusual1]

I can't say I am "sure" about anything, but I have corresponded with one of the POCs for the HPSP and he was the one who told me that with that scenario "When you graduate you would get half credit for every year of commissioned service towards O-4. So you would put on O-4 around the time you graduate from intership. For pay you should be over 10 when you graduate from med school, because med school time does not count towards pay." Actually I am over 10 for pay now and by the time I got started I would be at about 13. The question would be whether time in USUHS counts towards pay (I assumed that it would since students are on active duty) which would take me to 17 years for pay by the time I finished the program.

 

[Milrad]

I can't say I am "sure" about anything, but I have corresponded with one of the POCs for the HPSP and he was the one who told me that with that scenario "When you graduate you would get half credit for every year of commissioned service towards O-4. So you would put on O-4 around the time you graduate from intership. For pay you should be over 10 when you graduate from med school, because med school time does not count towards pay." Actually I am over 10 for pay now and by the time I got started I would be at about 13. The question would be whether time in USUHS counts towards pay (I assumed that it would since students are on active duty) which would take me to 17 years for pay by the time I finished the program.

Your USUHS time counts for pay but not retirement until you otherwise reach 20 years in and then presto you get 4 more years when you retire.

You get 1/2 your officer time back towards promotion after you put on O-3 when you graduate (I believe) so if you are over 12 years AD = O-4.

Also related: if you had over 4 years enlisted time your "E" pay adds up because you are over X number of years pay rate and most others in your class are getting O-1 pay at the under 2 years rate. BAH is also higher.

 

[pgg]

Your USUHS time counts for pay but not retirement until you otherwise reach 20 years in and then presto you get 4 more years when you retire.

USUHS time does not count for pay. Upon graduation you are an O-3 with zero years time in service (unless you have prior service). The 4 years does get added on after you retire.

 

[RichL025]

USUHS time does not count for pay. Upon graduation you are an O-3 with zero years time in service (unless you have prior service). The 4 years does get added on after you retire.

Actually, I think it does. I went from "over 14" when I started USUHS to "over 18" now.

If it's not supposed to, please no one tell the Army

 

[Milrad]

USUHS time does not count for pay. Upon graduation you are an O-3 with zero years time in service (unless you have prior service). The 4 years does get added on after you retire.

I graduated from USUHS 1997 and it counted for pay they and still likely does. You will be an O-3 over 4 years unless they are screwing all of you now.

 

[Rudy]

I graduated from USUHS 1997 and it counted for pay they and still likely does. You will be an O-3 over 4 years unless they are screwing all of you now.

USUHS time absolutely does NOT count toward pay. All USUHS grads without prior service graduate as O-3 with <2 years service. There is a special "USUHS" code that essentially freezes your pay in time so that you do not accrue time in service credits during med school. This has to be removed when you are promoted to O-3 at graduation; I know because they forgot to remove mine and I was still "frozen" when I hit the two year mark during residency and I was not getting my pay raise. It was a total flog...I had to finally call DFAS directly to get it fixed after the finance office flailed around for 2 months. You will find that 99% of all finance personnel have absolutely
no clue what USUHS or the nuances that are specific to it.

I think all of this is actually spelled out pretty clearly in the USUHS bulletin that is handed out to all prospective students, and probably on the web somewhere as well.

I think that USUHS students should get some credit for wearing the uniform everyday for 4 years and working more hours than the majority of new O-1s in the military. For those of us without prior service and trying to support a family, funds are pretty tight.

 

[militarymd]

welcome back rudy.

 

[Unusual1]

I think that USUHS students should get some credit for wearing the uniform everyday for 4 years and working more hours than the majority of new O-1s in the military. For those of us without prior service and trying to support a family, funds are pretty tight.

I agree that they sure ought to get some credit for it, and it ought to be the same credit that anyone else on active duty gets. I'd even say that they ought to get promoted to O-2 while in school. Lord knows that I saw some people who had already pinned on 1LT when they showed up at my old battalion for their first real assignments. That said, and I don't want to start a whole "who has a bigger one" contest, but I wouldn't say that they work more than most O-1's. Lord knows I didn't get crate-loads of free time as an Infantry Platoon Leader or Company XO, what with the field training, deployments, and day to day work that goes on. 12 hour days were good days for us back then.

 

[NavyFP]

I agree that they sure ought to get some credit for it, and it ought to be the same credit that anyone else on active duty gets. I'd even say that they ought to get promoted to O-2 while in school. Lord knows that I saw some people who had already pinned on 1LT when they showed up at my old battalion for their first real assignments. That said, and I don't want to start a whole "who has a bigger one" contest, but I wouldn't say that they work more than most O-1's. Lord knows I didn't get crate-loads of free time as an Infantry Platoon Leader or Company XO, what with the field training, deployments, and day to day work that goes on. 12 hour days were good days for us back then.

My 2 cents is that time is time. 4 years active is 4 years service. Should count for pay. It doesn't, but what should be and what is are often different. I can accept the 4 years not counting for retirement, but members on full time outservice training get that counted towards retirement. No one said life was fair.

Unfortunately, I am not in a position to fix that, so I must merely make suggestions to those who are.

 

[Milrad]

My 2 cents is that time is time. 4 years active is 4 years service. Should count for pay. It doesn't, but what should be and what is are often different. I can accept the 4 years not counting for retirement, but members on full time outservice training get that counted towards retirement. No one said life was fair.

Unfortunately, I am not in a position to fix that, so I must merely make suggestions to those who are.

I'm sorry your right USUHS does not count towards pay. I looked at my pay statements. I guess you screw those with no power.

 

[rufM.D.]

Hey,

So I have been reading these threads (Pros, Cons, Avoid Military, etc...) as I sit here filling out my application to USUHS and had a question that I couldnt find in a couple searches so....

I understand that the service is not for everyone and the retention rates for MDs are particularly low for whatever reason. I was wandering how the guys who end their service after the payback period fair in civilian life (private practice, how well prepared you were in both medical and business sense, hospital setting, etc.).


Oh...i feel kind of stupid and selfish for asking for clarification on this last topic because I know it has been covered earlier and I hate to give the impression that it is my motivation for a career in medicine, but I think it is important to think about...so that aside and to be clear,

if I were to attend a med school costing 35k/yr in tuition and living and reached the average salary for xyz field after 3yrs in practice like 190k/yr or something

vs.

USUHS

even with tuition and everything covered and pay at usuhs, i would still come out financially behind after finishing my service period compared to the civilian docs with loans and malpractice?


Anyway....thanks for reading and if you dont feel like answering the second part that is fine, but i am really interested in the first part

Thanks again

 

[GMO_52]

I'm sorry your right USUHS does not count towards pay. I looked at my pay statements. I guess you screw those with no power.

The 4 years count towards your retirement multiplier if you stay to 20 years (ie at the 20 year mark, your retirement will be a 24 year retirement, so 60% instead of 50%).

This is off the USU website in the status and entitlements faq:

U.S. Code, Title 10, §2114 establishes that USUHS medical students...."shall serve on active duty in pay grade 0-1 with full pay and allowances of that grade...." U.S.Code, Title 10, §2126 precluded two benefits from being given to USUHS graduates, namely:

1) Time spent at USUHS will not be credible towards determining eligibility for retirement other than by reason of a physical disability incurred while on active duty (you have serve 20 years on AD after graduation).
2) The four years spent at USUHS will not count for pay purposes upon graduation. If you did not have prior AD before going to USUHS, you would have graduated as an 0-3 with O years for pay purposes.
The retired pay multiplier issue was addressed and adjudicated in April 1985, by the then Deputy Assistant Secretary of Defense (Manpower, Installation and Logistics), Mr. Jerry L. Calhoun. The opinion rendered was, "This Office of the Secretary of Defense has concluded that the students' request forredress with regard to the years as a student being credited for computationof retire pay is valid as a matter of law. Accordingly, this credit shouldbe granted administratively without referral to the Board for Correctionof Military and Naval Records."

This issue was redressed by the Bureau of Naval Personnel, Officer of Legal Counsel, in January 1996 to the Deputy Director, Retirement, Fleet Reserve, and Disability Retirement Division (PERS-27). The opinion rendered by the Legal Counsel's Office (Mr. James F. Morgan Jr.) is as follows:

"In retirement questions, the combination of U.S.Code, Title 10, §2126 or §2114 and §1405 results in an officer commissioned through the USUHS or AFHPSP not being able to count service while in professional school toward the 20 yearsrequired for retirement eligibility but, once the 20 years is complete,being able to count active service performed while in school in the compilation of retired pay (emphasis added).

U.S. Code, Title10, §2121 does not preclude the use of the pay multiplier for USUHS graduate at retirement eligibility.

 

[Dr. Dukes]

Hey,
I have been reading all of the Military Medicine threads, and I have a couple of questions. First of all, here's my background: I graduated from college in 2005, have been doing research since then, and have my USUHS interview next week. I'm relatively liberal, went to a liberal undergrad, and am a bit nervous about the stereotypical conservative politics of them military (don't want to be told what to do by a bigot with two bars on his shoulder instead of one).
I think I'm most interested in either the Army or Navy, but I'm not really sure. I know I want to do surgery, and I know I want to do a fellowship after residency. Will it be easier to get a good general surgery residency in the Army of the Navy? Will either branch/both of them let me do a civilian fellowship (Trauma/Critical Care or Cardio-Thorasic or Vascular) after residency, or are there military specialties? What are the "average" deployment schedules for the branches like (how much time "away" and how often)? What are the other questions I should be asking? To the young USUHS grads w/o previous military service, would you go back?
Any help would be much appreciated...

 

[MedicalCorpse]

I'm relatively liberal, went to a liberal undergrad, and am a bit nervous about the stereotypical conservative politics of them military (don't want to be told what to do by a bigot with two bars on his shoulder instead of one)

Danger, Will Robinson.

--
R
USUHS 1990, WHMC Anesthesiology 1994, Civilian 2005
http://www.medicalcorpse.com

 

[jkmasterson]

I'm in the class of '08 at USUHS. The Army offers the best shot at picking up general surgery (And you won't have to apply after your internship) after graduation. The Navy likes to send their docs to 1 year of internship followed by 2-3 years "in the fleet" as a general practitioner- Flight Surgeon, Dive Medical Officer, or General Medical Officer. You will have to be very competitive to go straight to a fellowship in the army after residency training. In the Navy, it probably won't happen. You'll have to do some time as either a surgeon or general medical officer before picking up a fellowship. But, that's a little far downrange for me, so maybe somebody has a better idea of how it works.

Deployment schedules change all the time. If I were you, don't worry about it. You're looking 10 years into the future. 10 years ago, the Army had the sweet life while the Navy was going on 6 month cruises. Now, there are guys in the army starting their 3rd tour in Iraq for a year.

My only recommendation is don't go to USUHS if you just want free schooling and are not up to military life. You have to be able to get along with people and not just be a brain that lives in a lab with a feeling of entitlement. You actually have to be in good shape. You will go to places you weren't planning on going. Once you graduate and finish residency, you owe 7 years. You will be making 6 figures as a board certified military doc, but your buddies after eating canned beans and taking out loans for medical school and residency will be raking in up to half a million.

As an aside, military medicine has a pretty good reputation for training. Take a look at the average pass rate for board certifications.

 

[Dr. Dukes]

I'm in the class of '08 at USUHS. The Army offers the best shot at picking up general surgery (And you won't have to apply after your internship) after graduation. The Navy likes to send their docs to 1 year of internship followed by 2-3 years "in the fleet" as a general practitioner- Flight Surgeon, Dive Medical Officer, or General Medical Officer. You will have to be very competitive to go straight to a fellowship in the army after residency training. In the Navy, it probably won't happen. You'll have to do some time as either a surgeon or general medical officer before picking up a fellowship. But, that's a little far downrange for me, so maybe somebody has a better idea of how it works.

Deployment schedules change all the time. If I were you, don't worry about it. You're looking 10 years into the future. 10 years ago, the Army had the sweet life while the Navy was going on 6 month cruises. Now, there are guys in the army starting their 3rd tour in Iraq for a year.

My only recommendation is don't go to USUHS if you just want free schooling and are not up to military life. You have to be able to get along with people and not just be a brain that lives in a lab with a feeling of entitlement. You actually have to be in good shape. You will go to places you weren't planning on going. Once you graduate and finish residency, you owe 7 years. You will be making 6 figures as a board certified military doc, but your buddies after eating canned beans and taking out loans for medical school and residency will be raking in up to half a million.

As an aside, military medicine has a pretty good reputation for training. Take a look at the average pass rate for board certifications.

Thanks a lot. I didn't mean to give the impression that I'm not interested in a career in the Military, I certainly am. That being said, I know the upsides of such a career, but I had these vague notions of downsides, and figured this place was the best place to get the answers.

 

[RichL025]

I'm in the class of '08 at USUHS. The Army offers the best shot at picking up general surgery (And you won't have to apply after your internship) after graduation.

Just to qualify his statement - you DO have to "apply" for an R2 slot after your categorical surgery internship. The difference between the Army & the Navy is that the overwhelming majority of Navy folks will have a 2-3 year hiatus between their R1 and R2 years. The army folks will by and large go straight through (note, however, that I did not say "all" army folks will...)

As for fellowhips, the army _does_ have their own CT and vascular fellowhips (both in the DC area) - both of them do much of their training at civilian institutions (I believe the entire CT fellowship is in civilian hospitals), but there are civilian fellowhips also that you can apply for - and as always, with the military - NOTHING is ever guarunteed - the needs of the army always come first.

Trauma / CC is entirely a civilian fellowhip.

 

[orbitsurgMD]

Just to qualify his statement - you DO have to "apply" for an R2 slot after your categorical surgery internship. The difference between the Army & the Navy is that the overwhelming majority of Navy folks will have a 2-3 year hiatus between their R1 and R2 years. The army folks will by and large go straight through (note, however, that I did not say "all" army folks will...)

As for fellowhips, the army _does_ have their own CT and vascular fellowhips (both in the DC area) - both of them do much of their training at civilian institutions (I believe the entire CT fellowship is in civilian hospitals), but there are civilian fellowhips also that you can apply for - and as always, with the military - NOTHING is ever guarunteed - the needs of the army always come first.

Trauma / CC is entirely a civilian fellowhip.

If you truly want surgery, find out ahead of time the number of categorical R2 slots that are available relative to the number of R1 slots. In the Navy, the reduction can be just plain absurd, two R2 GS slots versus 16 R1 slots, for example. The fourteen interns in excess (sixteen really, since none get selected to do PGY2 straight away) don't all decide to do ENT, gas or ortho; most of them leave after finishing their service as GMOs.


If you really want to do surgery, I strongly recommend you avoid the Navy, as the only thing the Navy seems committed to is producing GMOs.

 

[mitchconnie]

I think I'm most interested in either the Army or Navy, but I'm not really sure. I know I want to do surgery, and I know I want to do a fellowship after residency. Will it be easier to get a good general surgery residency in the Army of the Navy? Will either branch/both of them let me do a civilian fellowship (Trauma/Critical Care or Cardio-Thorasic or Vascular) after residency, or are there military specialties?

If you know you want to do surgery and think you want to do a fellowship, then I would suggest that you steer clear of the military, at least initially. It just limits your options so much—particularly if you go to USUHS, where you are required to do military residency. General Surgery training and practice have been in free-fall for the last five years in the Air Force and Army (with which I have direct experience) and probably the Navy as well. Case loads have fallen sharply at most facilities, with severe difficulties in getting adequate residency training and maintaining skills as an attending. Add to that a very high deployment tempo and very low retention rate for teaching staff, and you get a marginal quality residency. Yes, some programs do a lot of civilian rotations to boost case numbers, but scrambling for cases at four different programs all over the country is a terrible way to train. Whether military residencies in general are good is debatable, whether military general surgery residencies are good is not debatable—they are clearly weak (with maybe an exception or two).

And then if you do get decent training in the residency of your choice, getting fellowship is a total crap shoot. You would almost certainly have to do general surgery for a few years, and a deployment or two before they let you do fellowship—and that’s IF the fellowship you want is available at all. If you add up the USUHS time, military residency, general surgery time, fellowship time, and nine years of payback (7 for USUHS plus 2 for fellowship) you are already at about 20 years of military service. Why make such an extensive commitment and limit your options so much so early in your career?

That said, the Army does offer the best chance to go straight through surgery residency without a lot of GMO foolishness. Air Force currently has a perceived surgeon shortage and odds of going straight through are also very good. Both provide a near zero chance of going straight to fellowship. The Air Force has the possible advantage that they have completely given up on training surgeons at military hospitals and send the residents to nearby civilian programs (Wright State, UC Davis, and UT San Antonio). This may give a USUHS grad the opportunity to do largely civilian training in a “military” residency. Army program quality drops off sharply once you get past the big three (Madigan, BAMC, WRAMC). A recent graduate of the El Paso program tells me that he basically learned to operate at the Texas Medical Center in Houston—several hundred miles away—and that’s ridiculous. You can PM me for a couple of other stories which do NOT reflect well on some of the smaller military surgical programs. (Yes..I know..they have a great pass rate for the boards—that is TOTALLY irrelevant to becoming a competent surgeon).

As I’ve said in other posts, get your civilian surgery residency nailed down first, THEN think about the military if you are still gung-ho.

 

[former military]

The military is not a liberal organization... it is not as bad as what you hear at the AF academy... but it is assumed your generally republican and generally christian... you can be anything else but that is the assumption.... most are republican because of the presumption that party is better for the military in terms of defense spending, taxing your pay, and improving your pay, and the kickass policy toward foreign diplomacy....

Obviously, homosexuality is not encouraged. It is not a friendly concept for the girlfriend or fiance... since if they are not married they can't get on base and there is no domestic partnership.

Now I am republican, straight, and christian so I don't completely know but I would think you would feel a little on the outside of the clique if you weren't. I also think that the military is not very pro family.... The concept of moving from base to base for no good reason doesn't seem like your spouse could ever get a job other than at the local bank teller or at the mini mart. It also means you would have difficulty having your spouse go to college with the threat of moving out of their program....

If you think that this format is grounds for frustrating view points and debate, try talking to the folks who refuse to recognize harry potter books because of the devil and withcraft philosophy.

 

[MedicalCorpse]

If you think that this format is grounds for frustrating view points and debate, try talking to the folks who refuse to recognize harry potter books because of the devil and withcraft philosophy.

As a practicing Pagan, I must echo and agree with former military's remarks.
As the former co-ranking member of the 89th Medical Group Spiritual Wellness Committee, I have been approached by people from many minority religious/philosophical backgrounds, including, but not limited to, Judaism, Islam, Hinduism, Buddhism, Atheism, agnosticism/undecided, and, yes, Wicca/Paganism, who have felt discriminated against in today's One U.S.A.F. Under Jesus.

Read more here: http://www.medicalcorpse.com/oneUSAFunderJesus.html

For my Powerpoint presentations on the Pagan Sabbats to the 89th Medical Group, see
this page: http://www.notbob.com/pagan/

Read about the toxic Christianization of what used to be a secular institution, the U.S. Armed Forces, here: http://www.militaryreligiousfreedom.org

Blessed Be!

--
R, aka Frater Dreamquencher
Ex-LtCol, USAF, MC
Pagan and Proud Since 1985
http://aren.org/newsletter/send.html (ask for Mabon issue, and read my
interview there)
http://www.medicalcorpse.com

 

[Galo]

If you know you want to do surgery and think you want to do a fellowship, then I would suggest that you steer clear of the military, at least initially. It just limits your options so much—particularly if you go to USUHS, where you are required to do military residency. General Surgery training and practice have been in free-fall for the last five years in the Air Force and Army (with which I have direct experience) and probably the Navy as well. Case loads have fallen sharply at most facilities, with severe difficulties in getting adequate residency training and maintaining skills as an attending. Add to that a very high deployment tempo and very low retention rate for teaching staff, and you get a marginal quality residency. Yes, some programs do a lot of civilian rotations to boost case numbers, but scrambling for cases at four different programs all over the country is a terrible way to train. Whether military residencies in general are good is debatable, whether military general surgery residencies are good is not debatable—they are clearly weak (with maybe an exception or two).

And then if you do get decent training in the residency of your choice, getting fellowship is a total crap shoot. You would almost certainly have to do general surgery for a few years, and a deployment or two before they let you do fellowship—and that’s IF the fellowship you want is available at all. If you add up the USUHS time, military residency, general surgery time, fellowship time, and nine years of payback (7 for USUHS plus 2 for fellowship) you are already at about 20 years of military service. Why make such an extensive commitment and limit your options so much so early in your career?

That said, the Army does offer the best chance to go straight through surgery residency without a lot of GMO foolishness. Air Force currently has a perceived surgeon shortage and odds of going straight through are also very good. Both provide a near zero chance of going straight to fellowship. The Air Force has the possible advantage that they have completely given up on training surgeons at military hospitals and send the residents to nearby civilian programs (Wright State, UC Davis, and UT San Antonio). This may give a USUHS grad the opportunity to do largely civilian training in a “military” residency. Army program quality drops off sharply once you get past the big three (Madigan, BAMC, WRAMC). A recent graduate of the El Paso program tells me that he basically learned to operate at the Texas Medical Center in Houston—several hundred miles away—and that’s ridiculous. You can PM me for a couple of other stories which do NOT reflect well on some of the smaller military surgical programs. (Yes..I know..they have a great pass rate for the boards—that is TOTALLY irrelevant to becoming a competent surgeon).

As I’ve said in other posts, get your civilian surgery residency nailed down first, THEN think about the military if you are still gung-ho.

This is dead on advice. I was at Wright Patt, and the military residents thankfully (for themselves), only spent a few months during their pgy-1, and 4 months as a chief. Certainly all the faculty with few exceptions were just out of training.

If you really think you may want to do surgery followed by a fellowship, the military, especially USHUS, is the worst place you could go to.

I totally echo the advice that you should get civilian educated and trained, and then see what the current climate in the military is.

 

[7by11thenout]

USUHS = military career no matter how you cut it.

Yeah I though it meant career too when I was at USUHS, but IT DOES NOT!!!! even though you spend 14-15 years in you only get credit toward retirement for 10-11 years because your USUHS time does not count toward retirement time only retirement pay....SOOOOOO If you do a specialty like me - Anesthesia where you can make 300k /yr in the CIV world VS 120K in the Military it does not add up to stay 11 more years. Financially I will be better off to walk away after my 7 yr committment. Hency my name 7 by 11(2011) then out.


As for USUHS - if the rest of the Air Force was ran as good as USUHS I would stay and retire, but it is not....

USUHS was a great school. I got a great education, everyone I know has passed all their boards all the way through including residency etc.

IF you read my other posts and listen to my faults with Mil Med none of them are against USUHS. USUHS was the best time of my life, good friends, good education, good pay, good benefits. My only gripe was not pinning on 1LT during 3rd and 4th year because that would significantly increase my pay over my career. Now I would be )$ over 10 not O4 over 6 look up the pay difference and add that monthly for 11 years it adds up.

In the past 10 years I have seen many changes in Mil MEd so USUHS may not be the same as when I attended. The patient load is less, the GME is less, the downsizing of the hospitals has made keeping up your skills harder, but again that is a problem with MIl MED not USUHS.

 

[7by11thenout]

Hey,: I graduated from college in 2005, have been doing research since then, and have my USUHS interview next week. I'm relatively liberal, went to a liberal undergrad, and am a bit nervous about the stereotypical conservative politics of them military (don't want to be told what to do by a bigot with two bars on his shoulder instead of one).
What are the "average" deployment schedules for the branches like (how much time "away" and how often)? What are the other questions I should be asking? To the young USUHS grads w/o previous military service, would you go back?
Any help would be much appreciated...

If you dont want to be told what to do dont join the military period it doesnt matter what their religion, race or political affiliation is - to quote a former military guy who frequently posts on this forum "what good is having power if not to abuse it" Which he frequently refered to our bosses.

Deployment in the Airforce depends on what you do. IF you do critical war specialties, Anesthesia, Surgery, ER, IM, FP, ORtho psych or flight med rediology neurosurgery, you will go more frequently once every other year or sooner if they need you. for 6months. (the new depoloyment orders are 6 months at my base) You will be away from family alot for training and deployment. IF you do pediatrics OB neurology you may never get deployed.

 

[militarymd]

Yeah I though it meant career too when I was at USUHS, but IT DOES NOT!!!! even though you spend 14-15 years in you only get credit toward retirement for 10-11 years because your USUHS time does not count toward retirement time only retirement pay....SOOOOOO If you do a specialty like me - Anesthesia where you can make 300k /yr in the CIV world VS 120K in the Military it does not add up to stay 11 more years. Financially I will be better off to walk away after my 7 yr committment. Hency my name 7 by 11(2011) then out.


As for USUHS - if the rest of the Air Force was ran as good as USUHS I would stay and retire, but it is not....

USUHS was a great school. I got a great education, everyone I know has passed all their boards all the way through including residency etc.

IF you read my other posts and listen to my faults with Mil Med none of them are against USUHS. USUHS was the best time of my life, good friends, good education, good pay, good benefits. My only gripe was not pinning on 1LT during 3rd and 4th year because that would significantly increase my pay over my career. Now I would be )$ over 10 not O4 over 6 look up the pay difference and add that monthly for 11 years it adds up.

In the past 10 years I have seen many changes in Mil MEd so USUHS may not be the same as when I attended. The patient load is less, the GME is less, the downsizing of the hospitals has made keeping up your skills harder, but again that is a problem with MIl MED not USUHS.

There are changes in the market a foot in the civilian market...I wouldn't count on those big numbers you're quoting.

 

[7by11thenout]

There are changes in the market a foot in the civilian market...I wouldn't count on those big numbers you're quoting.

regardless of the pay when I am done, it will be more than 120K. I can get part time work for 120K.

The average pay for starting Anesthesiologist where I live 280K, and higher in other places. True no once can predict the market in the future, the point is the FUll time work plus deployments that we do in the military for part time pay does not financially add up to spend 9more years just to retire with 1/2 base pay which is currently 4850/mo /2 = 2425/mo.

My internist friend who was deployed for 5.5 months in 2005 if you actually calulate his total before tax salary including all bonus and divide it out by actuall muber of hours worked that year assuming a 24/d x 7 day/week deployment for 5.5 months and then working average of 50 hrs /week the rest of the year when he was not deployed (although he worked closer to 70/week in reality) you come up with a whopin Hourly salery for a board certified Interist of ----SIT DOWN---- $20.15 hr

My friend who sell furnature using his high school education makes more than that.

If I do the same calulation for my Anesthesiologist friend who just got back 3 months ago and went for 6 months (even though everyone else was only going for 4 months) his annual salary was $25.00 hr

The CRNA's I work with make 120/hr in their civilian jobs and the anesthesiologist make 150-180/hr in thier moonlighting jobs.......

 

[MedicalCorpse]

There are changes in the market a foot in the civilian market...I wouldn't count on those big numbers you're quoting.

Ya, well, here's the crux of the issue:

Regardless of bucks...

Regardless of hours worked...

If you don't like yer civilian job...

You

Can

Quit.

If my civilian hospital (where I have worked for more than a year now) told me to do the kinds of things that the USAF ordered me to do, I would simply say: See ya, wouldn't wanna be ya.

But they would not do so, because (drum roll) most of them would constitute Federal crimes in the civilian world: Unsupervised CRNAs; providing anesthesia while "supervising" CRNAs; acting as a de facto intensivist because the only intensivist is deployed, even though I lacked admitting priveleges; admitting kids to adult wards sans pediatrician coverage...etc.

--
R
http://www.medicalcorpse.com

 

[7by11thenout]

Actually, I think it does. I went from "over 14" when I started USUHS to "over 18" now.

If it's not supposed to, please no one tell the Army

DOnt spend that money. They did that to my entire class in the AF they processed us in at 03 over 0 then backpayed us 10,000k for the over 4 time they "forgot" to pay us, then took away our paychecks to take back the money they origionally gave us by mistake.

In my case they messed up my pay because I requested them to take back the money over 1 year instead of all at once, They did that but then they quit paying my Fed income tax for 3 years.... I had IRS penalities, I spoke with everyone in the pay office at Lackland, they said it wasn't their problem it was Denvers (as if I could leave residency and go to denver). I asked my commander for help, he sent an email, no help, I called my congressman, and finally at the start of my PGY4 year it was fixed. Then I had to refile all my Taxes for the prior three years because they were wrong.


YOU SHOULD NOT BE GETTING CREDIT FOR PAY FOR YOUR TIME AT USUHS - unless that clause has changed in the past 8 years.

 

[MedicalCorpse]

DOnt spend that money. They did that to my entire class in the AF they processed us in at 03 over 0 then backpayed us 10,000k for the over 4 time they "forgot" to pay us, then took away our paychecks to take back the money they origionally gave us by mistake.

The exact same thing happened to me at the start of my internship. For some reason, I was too busy working 100 hour weeks to read the fine print of my pay slips; I just knew I was getting direct deposit, and trusted (big mistake) the people in finance to pay me correctly.

Soon after I moved to San Antonio in 1991, I got a nastygram from Finance saying I "owed a debt" to the U.S. government, which they intended to take out all at once, thus zeroing out my monthly pay. I got on the phone, livid, as you may imagine. "Look, here I am working hundreds of hours per month as a physician. You guys make a mistake which I failed to catch. Now you say I 'owe a debt' as if I was a criminal? What, did I go to Fort Knox and increase my pay by stealing gold? No, you guys, 10 years after the first USU students graduated, failed to do your jobs by paying me the correct amount of money. I am not a criminal!"

Finance dweebs at multiple levels: "Sorry, sir, you still owe a debt." After much complaining, they told me about the ability to pay over a year, interest free...they did NOT volunteer that option to me ab initio, er, from the get go. After 4 years of flawless financial service from the most excellent folks at USUHS, this was my harsh introduction to the tragic level of service one can expect from base finance/MPF offices.

I won't even begin to regale you about the horror stories I heard from Reservists during my deployment: no pay at all for months, no authorization for combat pay, etc. I submitted a full travel voucher and financial info for my deployment at Incirlik AB's finance office per the orders of our deployment team leader: "That's why they deploy finance folks, to make sure you're taken care of before you return home"; everything seemed to be O.K. A few weeks after I got back to Andrews, they insisted I take time off from caring for patients to present personally to the finance office to re-do every single bit of my deployment finance paperwork. Even after that, I continued to get, unbeknownst to me, tax-free deployment status for several weeks after my return. It took even more of my time to get them to do their jobs correctly. I only wish there were a way to sue Finance/MPF for malpractice: that's the only thing that would get them away from their smoke breaks and back to their computers to do things right the first time, so that officers don't end up with "debts" due to the Finance gnomes' own galactic incompetence.

--
R.
USU 1990, WHMC Residency 1994, LOR 2001, Civilian 2005
http://www.medicalcorpse.com

 

[MeganRose]

Hey,
I have been reading all of the Military Medicine threads, and I have a couple of questions. First of all, here's my background: I graduated from college in 2005, have been doing research since then, and have my USUHS interview next week. I'm relatively liberal, went to a liberal undergrad, and am a bit nervous about the stereotypical conservative politics of them military (don't want to be told what to do by a bigot with two bars on his shoulder instead of one)....

Hey Bobcat, politically you and I are alike. I was ROTC undergrad, in the Army two years, now AFHPSP. I can tell you that the military on the whole is conservative and I've had more than a few moments cringing at comments supporting the current regime, times when my opinion was in the minority. Still, I can say that on the whole, I've been pleasantly surprised. At least in combat support (and combat branches), people respect the fact that your life may depend on the soldiers that surround you. Even working with a CO from Southern Missouri I knew was a racist, I still felt comfortable, like I belonged in the unit despite political differences. I'm still relatively new to the Medical Corps/ Medical Servc Corps but I don't think that you should have any problems.
Whether or not you should even be taking this route USHSUS/HPSP is the real question here. I say most definitely not. I think that a military-medicine free life is the best way to go. But failing that I will tell anyone that will listen to pay for medical school themselves, get more informed about the military, get your residency and *if* you still feel the need to serve, do FAP. Just some good advice,
Megan

 

[Homunculus]

from Southern Missouri

take it easy on the missourians we're not all that way

--your friendly neighborhood "show me" caveman