Would you do military medicine again?

[The White Coat Investor]

1) CBTs - Many civilian hospitals are using CBTs now (computer-based training) for training on sexual harassment, safety, etc . It's just too easy. In fact, truth be told, the civilian world is way ahead of the military in its usage of CBTs!

2) Annual SARC training - not sure what SARC is, but I'll give this one to you.

3) Skill atrophy - hear this complaint from many civilian docs too (except it's about the respective towns they live in, or clinics they work at).

4) Poorly trained nurses - all over the country, aka the new stories you here about nurses shooting up kids with ridiculous doses of heparin

5) Supervision by nurses - seasoned nurse practitioners are starting to call the shots in a lot of clinics/hospitals across the country. They're cheaper than MDs

6) Recalls - You're right on this one. You're nevery gonna be deployed or sent in harms way if you're a civilian.

I assume you're just being facetious on 7-8, these things can happen in any work environment (civi or military)
7) 4 hour waits to get an ID card
8) Gas mask fit testers who are only open 4 hours a week
9) Squadron PT- (If getting my heart rate up to 90 is a work-out, then I understand why the AF has a weight problem.)

10) GMO tours and the military match - True here. If you really don't want to do a GMO (heaven forbid you do something memorable and cool, to tell your grandkids about), and if don't want a military residency, then don't join.

I've worked in 6 civilian hospitals, none of them had CBT.

None of them made me do annual SARC training but I suppose they might send out emails about sexual harassment from time to time.

Those civilian docs with skill atrophy actually have the option to move somewhere else or change their practice. Not comparable.

I think a nurse with 4 years experience is a highly experienced nurse. Would you like to change your comment now? When I refer to inexperienced nurses, I'm talking about having an entire department full of 2 LTs with a 1 LT supervising them. The best nurses you get in the military are O-3s with 4-6 years of experience. By the time they get to 6 years they're moved into admin positions where they mysteriously change into your worst enemies as they try to make O-4.

Recalls don't refer to going into harm's way. We do recalls just to see if everyone went to SARC training.

Facetious? Are you kidding me? At my civilian moonlighting job there is someone whose sole job is to get me up to speed at the job. It doesn't take a month to in-process, it takes 1 afternoon (approximately 90 seconds to get my ID card) There weren't any gas mask fit tests either, and if there were, they'd come to where I work and do it between patients. Why would you pay a doc $150/hour (that's what it costs to have contractors cover my shifts while I make folders and do gas mask fit tests) to do secretary work?

The military match is advertised to prospective recruits as "similar to the civilian match" with "high match rates" and "excellent training." If recruits learn the truth prior to signing, they usually don't sign. I actually got what I wanted out of it (thanks to some lucky board scores and stumbling into the right rotation at the right time) but I'm still bitter no one told me how it works until October of my 4th year. What a nightmare that fall was.

I can't wait to tell my grandkids about the months I sat around a diarrhea and footrot clinic in the AOR and wasn't allowed to leave the base. If I had done one cool thing during my deployment it would be a different story.

Can you tell I had a bad day today? Thanks for letting me vent.

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[The White Coat Investor]

Quit pretending like you need special qualifications to talk about military medicine on an internet forum. If what someone says is wrong, then address it. Attacking the person's points by claiming the person doesn't meet some unknown level of experience is kinda lame and has been done to death.

I thought I did address his points and showed they were wrong. I also think it is important that readers are aware where posters are in the mil-med pipeline when they read their comments. IgD for example, was a lot more positive about mil-med 3 or 4 years ago then he seems to be now. That happens a lot here, although it isn't usually quite so severe.

 

[crazybrancato]

Ummm.....When I talk to people in person I tell them I'm happy and I'm glad I came on, especially if any of my leadership is listening. My specialty leader and my squadron commander both think I'm staying in for 20 years.

Ok, that's certainly your choice. I understand you're trying to play the political game, we all have to at some point, regardless of our chosen professions.

Word to the wise, as soon as they know they can't retain you they will send you on a very unpleasant deployment, don't kid yourself. "Someone has to go, why not someone who is getting out anyway" is how their thought process goes. They can always hurt you more. I you think I'm paranoid ask around a bit.

No I don't think you're paranoid at all. I've seen things like this happen plenty of times. You're quite right on the mark. You may not be conscious of this, but the military has made you politically-savy! (a quality that may be very beneficial to you in your future life as a civilian physician)

Despite policies against it, a doc I know just deployed 2 months out of residency...with the ARMY (he signed on with the AF) Good luck passing your boards buddy after spending your first year out of residency in the AOR instead of studying, going to board review courses, and actually practicing in your specialty.

No argument here. The potential for deployment (even a day out of training) is very real, and this IS a good reason not to join the military (no matter what your profession).

If you really want to know how someone feels about the military, try to catch them away from work when no one else is around. Then talk to their spouse.

I absolutely agree! Talking to a people in a free environment (and talking to their family members) is an excellent research method.

Thanks for posting something meaningful, as opposed to some of the other jokers here.

 

[kwick release]

^^^^^^^^^^^^^^^
How come you stayed in so long? Did you have an ROTC obligation on top of your HPSP?

Quit pretending like you need special qualifications to talk about military medicine on an internet forum. If what someone says is wrong, then address it. Attacking the person's points by claiming the person doesn't meet some unknown level of experience is kinda lame and has been done to death.

Did a long urology residency then fellowship. Total time in as recorded by the Navy 14 years, but as counted by me 18 years including medical school.


I'll address Crazy's points:

"1) CBTs - Many civilian hospitals are using CBTs now (computer-based training) for training on sexual harassment, safety, etc ...civilian world is way ahead of the military in its usage of CBTs!"

I have not been asked to do a single CBT course in 6 months. Enough said.


"3) Skill atrophy - hear this complaint from many civilian docs too (except it's about the respective towns they live in, or clinics they work at)."

From a surgeons perspective, totally untrue. Even in the smallest towns we are very busy unlike MilMed where you spin your wheels years on end.


"4) Poorly trained nurses - all over the country, aka the new stories you here about nurses shooting up kids with ridiculous doses of heparin"

1/3 to 1/2 of the nurses in the MTFs that actually lay hands on patients are hired civilian contract nurses. These nurses are worthless. In the Navy every case that I did in the ASU generated at least 2 unwarranted pages from the postop nursing staff. In private practice I can do 10 cases in under 4 hours and not get a single page. Guess what, they actually do their job!! Amazing. As for the attention grabbing headlines, I can not comment. Just can only give my personal experience.


"5) Supervision by nurses - seasoned nurse practitioners are starting to call the shots in a lot of clinics/hospitals across the country. They're cheaper than MDs"

All physician extenders in my area are directly employed and supervised by physicians. Only in the Military will you find NP, CRNAs, etc practicing beyond their abilities and training.


"7) 4 hour waits to get an ID card"

Please, on the civi side I had 2 escorts walk me around each hospital to check me in and get my ID cards in short order. Unlike the Military where you have to go to the ID shop and wait in line for hours with the retirees and dependents. Nice try.


"9) Squadron PT- (If getting my heart rate up to 90 is a work-out, then I understand why the AF has a weight problem.)"

It is a new politically correct Military now. Lots of fatties. No more comment.

There you go!

 

[crazybrancato]

Can you tell I had a bad day today? Thanks for letting me vent.

No problem!!! Totally understand . . .

Ok, we all have anectdotal stories about ID cards and such. I for one got my ID card in 10 minuts, and have NEVER had any problems with pay, or admin (pretty good after 7 years of service). Now, I'm not so naive as to think they everything is always so great, for all people. So I would never tout my wonderful experiences as reasons to join the military, just as how I don't think others should tout there anectdotal negative stories for reasons not to join.


Regarding your other points about nurses, CBTs, etc: Ok, points taken. I can't really speak heavily regarding those things, not having been in the system.

So let me ask you something: You're no dummy, so what (or how did you become) convinced you to join?

 

[kwick release]

Or so says the "attending" who overuses smilies and has 11 posts.

Obviously you need to hit the books more. Nearly 6000 posts and merely a resident.

 

[crazybrancato]

Did a long urology residency then fellowship. Total time in as recorded by the Navy 14 years, but as counted by me 18 years including medical school.


I'll address Crazy's points:

"1) CBTs - Many civilian hospitals are using CBTs now (computer-based training) for training on sexual harassment, safety, etc ...civilian world is way ahead of the military in its usage of CBTs!"

I have not been asked to do a single CBT course in 6 months. Enough said.


"3) Skill atrophy - hear this complaint from many civilian docs too (except it's about the respective towns they live in, or clinics they work at)."

From a surgeons perspective, totally untrue. Even in the smallest towns we are very busy unlike MilMed where you spin your wheels years on end.


"4) Poorly trained nurses - all over the country, aka the new stories you here about nurses shooting up kids with ridiculous doses of heparin"

1/3 to 1/2 of the nurses in the MTFs that actually lay hands on patients are hired civilian contract nurses. These nurses are worthless. In the Navy every case that I did in the ASU generated at least 2 unwarranted pages from the postop nursing staff. In private practice I can do 10 cases in under 4 hours and not get a single page. Guess what, they actually do their job!! Amazing. As for the attention grabbing headlines, I can not comment. Just can only give my personal experience.


"5) Supervision by nurses - seasoned nurse practitioners are starting to call the shots in a lot of clinics/hospitals across the country. They're cheaper than MDs"

All physician extenders in my area are directly employed and supervised by physicians. Only in the Military will you find NP, CRNAs, etc practicing beyond their abilities and training.


"7) 4 hour waits to get an ID card"

Please, on the civi side I had 2 escorts walk me around each hospital to check me in and get my ID cards in short order. Unlike the Military where you have to go to the ID shop and wait in line for hours with the retirees and dependents. Nice try.


"9) Squadron PT- (If getting my heart rate up to 90 is a work-out, then I understand why the AF has a weight problem.)"

It is a new politically correct Military now. Lots of fatties. No more comment.

There you go!

nice post, now see that wasn't so bad.

 

[Galo]

Seems in short time you've learned some important misconceptions about military medicine. Clearly speaking to something you have no experience yourself in, is not the way to make people believe in you.

As as active duty surgeon for 6 years, my experience and that of most physicians, non-surgeons included, is that military medicine has deteriorated into a very poor state. Its CRAP.

I agree with you that most people reading this forum to get information should call up AD physicians and learn from their current experience.

I would ask that you not take the path of some wacko's here, and denigrate our experience just because it's opposite of what you think yours may be, or have heard from others. Miltiary medicine is a near complete failure ruled by mostly incompetent leaders, or leaders who are unable, or unwilling to stand up for change that will likely never come.

Although there are problems in civilian medicine, they are no where near as devastating to a career as they are in the military. In the civilian world you are actually expected to work, and that work is mostly facilitated by a support staff that has a goal in mind, and training to do it.

Just like many here, if you do join milmed, be sure to let us know how your experience changes either for good, or bad.

Good luck

 

[deuist]

Ok, we all have anectdotal stories about ID cards and such. I for one got my ID card in 10 minuts,

At Lackland I needed 9 hours to get my hospital ID card, get it certified to work in the ED, and then to get my CAC card which, despite all of the trips to the technical support office, never worked for logging me into the hospital computers. At my civilian hospital, ALL of my med school's class (180 of us) was able to get ID's taken care in a total of about one hour.

 

[crazybrancato]

Seems in short time you've learned some important misconceptions about military medicine. Clearly speaking to something you have no experience yourself in, is not the way to make people believe in you.

First, true that I don't have any experience in milmed. But I do have other life experiences (military and civilian) that I could leverage from, in making important decisions (such as whether or not to go into milmed, and that's what this discussion is about). It's not like I'm going off about how to provide care or how to carry yourself in the OR. Those are probably the topics of other threads, which I steer clear of.

Second, I'm not trying to convince anyone of anything, except to practice the art of good decision-making. I'll be the first to admit (as I have in this thread) that there are some very good reasons not to join the military.

From an outsider's perspective (such as myself), what's confusing is this: As vehemently as you just expressed your negative feelings about milmed (and you're certainly entitled to do that), I can throw a rock her in my hometown and his someone that has many positive things to say about it. So then who to believe??? The answer is to take every opinion (good or bad) with a grain of salt, and make the decision based on your own personal sentiments.

 

[Galo]

First, true that I don't have any experience in milmed. But I do have other life experiences (military and civilian) that I could leverage from, in making important decisions (such as whether or not to go into milmed, and that's what this discussion is about). It's not like I'm going off about how to provide care or how to carry yourself in the OR. Those are probably the topics of other threads, which I steer clear of.

Second, I'm not trying to convince anyone of anything, except to practice the art of good decision-making. I'll be the first to admit (as I have in this thread) that there are some very good reasons not to join the military.

From an outsider's perspective (such as myself), what's confusing is this: As vehemently as you just expressed your negative feelings about milmed (and you're certainly entitled to do that), I can throw a rock her in my hometown and his someone that has many positive things to say about it. So then who to believe??? The answer is to take every opinion (good or bad) with a grain of salt, and make the decision based on your own personal sentiments.

I agree that taking internet postings with a grain of salt is probably wise. However, all the combined experience of prior and current active duty physicians here certainly seems to point people to look for the inconsistencies, (lies? misinformation?) that recruiters, or those who have not had those first hand experiences in military medicine, always seem to point out. Although we are a collection of stories, they mostly express the negative aspects of being a physician in today's military. If people want to be physicians, the military is not currently the best place to get trained or practice medicine in.

I'll mention again, that it's not a wise move to come on this forum and insult a large number of proud veterans who have given to this country in a capacity that you yet truly do not understand.

Here is a recent site of other "complainers" the majority of who never post here:

http://www.health.mil/Debates/Debate.aspx?ID=9&a=1

Its sad, but the reality is worse than you've been led to believe.

 

[crazybrancato]

I agree that taking internet postings with a grain of salt is probably wise. However, all the combined experience of prior and current active duty physicians here certainly seems to point people to look for the inconsistencies, (lies? misinformation?) that recruiters, or those who have not had those first hand experiences in military medicine, always seem to point out. Although we are a collection of stories, they mostly express the negative aspects of being a physician in today's military. If people want to be physicians, the military is not currently the best place to get trained or practice medicine in.

I'll mention again, that it's not a wise move to come on this forum and insult a large number of proud veterans who have given to this country in a capacity that you yet truly do not understand.

Here is a recent site of other "complainers" the majority of who never post here:

http://www.health.mil/Debates/Debate.aspx?ID=9&a=1

Its sad, but the reality is worse than you've been led to believe.

Ok, points taken, thanks for the link. Wasn't trying to insult anyone, there'd be no point in that.

I've said my peace here. You're all good people, "complainers" or not. Good luck in your future decisions, do whatever makes you most happy, seriously.

 

[The White Coat Investor]

So let me ask you something: You're no dummy, so what (or how did you become) convinced you to join?

I was a dummy. Seriously. I was simply misinformed and I only spoke to two active duty docs (one retired prior to the nosedive of military medicine, the other was a pediatrician who happens to be gung-ho army.)

I didn't know about the match. Heck, I didn't understand the civilian match.

I knew nothing about the status of med group/squadron level leadership (i.e. all the competent docs get out so the place is run by incompetent docs and nurses)

I had no idea of the frustrations of doing military-specific admin work.

I thought I didn't care where I lived.

I thought I was going to be an FP.

I thought I would come out ahead financially (I currently make ~40% of what my residency colleagues are making).

I had a peculiar aversion to debt.

I was sick of selling plasma for food money.

I wanted to do "cool stuff" and live overseas for a few years before settling down. (didn't get to do cool stuff and didn't get to live overseas save one six week TDY, which, admittedly, was pretty cool, and one 4.5 month TDY which was like being in prison, except you had to work harder.)

Deep down I had some vague sense of patriotism that occasionally shows up every now and then when I listen to Lee Greenwood.

My inlaws are all in the AF-two pilots, one in computers, one in finance. They were all very encouraging, but it turned out their AF experience really had no relevance to the medical corps.

I convinced myself somehow that I wasn't doing it for the money, but the truth is I probably did it for the money.

 

[Galo]

I was a dummy. Seriously. I was simply misinformed and I only spoke to two active duty docs (one retired prior to the nosedive of military medicine, the other was a pediatrician who happens to be gung-ho army.)

I didn't know about the match. Heck, I didn't understand the civilian match.

I knew nothing about the status of med group/squadron level leadership (i.e. all the competent docs get out so the place is run by incompetent docs and nurses)

I had no idea of the frustrations of doing military-specific admin work.

I thought I didn't care where I lived.

I thought I was going to be an FP.

I thought I would come out ahead financially (I currently make ~40% of what my residency colleagues are making).

I had a peculiar aversion to debt.

I was sick of selling plasma for food money.

I wanted to do "cool stuff" and live overseas for a few years before settling down. (didn't get to do cool stuff and didn't get to live overseas save one six week TDY, which, admittedly, was pretty cool, and one 4.5 month TDY which was like being in prison, except you had to work harder.)

Deep down I had some vague sense of patriotism that occasionally shows up every now and then when I listen to Lee Greenwood.

My inlaws are all in the AF-two pilots, one in computers, one in finance. They were all very encouraging, but it turned out their AF experience really had no relevance to the medical corps.

I convinced myself somehow that I wasn't doing it for the money, but the truth is I probably did it for the money.

Nice summary. In the end, I too did it for the money with much misunderstanding about the potential problem, and before Tricare assasinated the system along with all the other changes to include nurses as our leader. In the end though the money is still the biggest hook. What little we knew then!

 

[Chonal Atresia]

I am a "real military doc" that you so fondly reference; however, I agree with ActiveDutyMD. The reason that "happy" active duty docs do not log onto this forum is because THERE ARE NONE! Even die hard academy/ROTC guys that I know rip military medicine. You may say that this is my own anecdotal experience and you are right but ask yourself why you are in the the overwhelming minority of posts. The only thing people seem to agree with is that taking care of our solidiers is both professionally and personally rewarding.

It actually makes sense that you're not a doc or even a medical student for that manner b/c you have no clue. Anybody that thinks being underpaid (severely in many cases), required to complete worthless training, not being able to control who you hire/fire in your clinic/OR, constantly worrying about deploying as a GMO (glorified doc-in-the box) and living in sh..ty places in almost all circumstances is a good thing needs to have their head examined. If you think that a GMO is a valuable life-changing experience, talk to a transitional intern who has had his/her training interupted. Seeing phantom ball pain and sprained ankles will change your life, just not how you think.

The military does NOT value their physicians and it shows. I plead with all potential HPSPers and USUHS applicants out there to RUN AWAY. I wish this site was available when I was applying to medical school (pre-9/11).

 

[mann976]

I am a "real military doc" that you so fondly reference; however, I agree with ActiveDutyMD. The reason that "happy" active duty docs do not log onto this forum is because THERE ARE NONE! Even die hard academy/ROTC guys that I know rip military medicine. You may say that this is my own anecdotal experience and you are right but ask yourself why you are in the the overwhelming minority of posts. The only thing people seem to agree with is that taking care of our solidiers is both professionally and personally rewarding.

It actually makes sense that you're not a doc or even a medical student for that manner b/c you have no clue. Anybody that thinks being underpaid (severely in many cases), required to complete worthless training, not being able to control who you hire/fire in your clinic/OR, constantly worrying about deploying as a GMO (glorified doc-in-the box) and living in sh..ty places in almost all circumstances is a good thing needs to have their head examined. If you think that a GMO is a valuable life-changing experience, talk to a transitional intern who has had his/her training interupted. Seeing phantom ball pain and sprained ankles will change your life, just not how you think.

The military does NOT value their physicians and it shows. I plead with all potential HPSPers and USUHS applicants out there to RUN AWAY. I wish this site was available when I was applying to medical school (pre-9/11).

jeezz h. krist, so bitter!!! tell us how you really feel?

so what if crazybrancatto's not a doc nor student? doesn't he/she still have the right to express himself and and provoke conversation????

do us a favor and just get out today. that's right, go AWOL. you'll get an admin sep, maybe a little slap on the wrist, nobody will give two s**ts. and let us know where you work so we know who to avoid at medical. if you're really this bitter, god knows what you'll do to your patients . . and when you start wining about your civilian job 5 years into the future, come back here and start a new discussion

 

[mann976]

i've been reading this discussion very carefully. thank you for posting, especially those like ActiveDutyMD that at least post interesting comments rather than just venting.

i'm a Navy E6 thinking about going the med route.

I may be wrong, but it seems like most of the disgruntled folks here are Army and AF docs. Are there any Navy docs in this discussion? Care to comment as well?

Thanks again

 

[i want out]

i've been reading this discussion very carefully. thank you for posting, especially those like ActiveDutyMD that at least post interesting comments rather than just venting.

i'm a Navy E6 thinking about going the med route.

I may be wrong, but it seems like most of the disgruntled folks here are Army and AF docs. Are there any Navy docs in this discussion? Care to comment as well?

Thanks again

Army and AF don't have a corner on the market.

I was in the Navy, and couldn't get out quickly enough.

Navy medicine is falling apart to a point where they are willing to combine with the AF and Army.

The only service that really resisted the purple suit, was the Air Force.

My personal opinion is that they (AF) resisted because they aren't having much trouble recruiting Doc's yet.

Look up the numbers for HPSP scholarships given out over the past few years. AF almost always fills or comes close, with Army usually getting around 80% and the Navy getting as few as 50% of the slots filled that they need to keep the pipeline open.

good luck

I want out (of IRR)

 

[Chonal Atresia]

Response to mann976

Correct me if I'm wrong, but you did nothing to refute any of my observations?

You're absolutely right, everyone has the right to post their opinion. My only point is that those not in the medical field have no idea of the hypocrisy of milmed. Also, I'm trying to warn people like yourself not to make the same mistake that I made.

You think I'm bitter? Check out the website medicalcorpse.com

 

[mann976]

Response to mann976

Correct me if I'm wrong, but you did nothing to refute any of my observations?

You're absolutely right, everyone has the right to post their opinion. My only point is that those not in the medical field have no idea of the hypocrisy of milmed. Also, I'm trying to warn people like yourself not to make the same mistake that I made.

You think I'm bitter? Check out the website medicalcorpse.com

yes i have. the guy needs some serious therapy. ok i see your point.

and for "i want out" , thanks for sharing about Navy. do you guys have any links for the HPSP numbers?

 

[Galo]

Exactly what is your current status in military medicine, or the military?

Being exceedingly bitter at having been lied to and having to go out of your way just to practice medicine is quite frustrating, and most people who recently get out and find this site to vent, really go for it. Also, the vast majority go to find that although civilian medicine has lots of problems, they are nowhere near as bad as the crap that happens in military medicine.

I can totally understand Chonal Atresia's bitterness, and hopefully as time goes, he will heal, but most importantly I hope he stays around to warn others about the sad state of military medicine.

I remember when I had just got out and had all this anger and bitterness about my experience that this was the only place to find people who had gone through it.

What has happened to military medicine is a real disaster, and I see it only getting worse.

 

[Perrotfish]

At Lackland I needed 9 hours to get my hospital ID card, get it certified to work in the ED, and then to get my CAC card which, despite all of the trips to the technical support office, never worked for logging me into the hospital computers. At my civilian hospital, ALL of my med school's class (180 of us) was able to get ID's taken care in a total of about one hour

To be fair, this might be some necessary inefficiency. I could care less who has access to my medical school, and neither did they. There was no confirmation I was who I said I was other than that I knew the right place to show up for the ID. That would be absolutely unacceptable in a military enviornment. I want them to go through a series of very onerous security checks before they give anyone an O-3's military ID. I don't know if that was the problem, but I'm just saying.

I may be wrong, but it seems like most of the disgruntled folks here are Army and AF docs. Are there any Navy docs in this discussion? Care to comment as well?

Actually, on this board, Army is the least percentage of disgruntled docs. It makes sense: Not many GMOs and functioning GME. AF seems to have the most online venters. No idea about the real world, though.

 

[Yellowstone]

I don't know many docs staying in past their commitment, unless they are USUHS/Academy grads, but even then a lot of them are getting out ASAP. I see an overwhelming majority of O-4's getting out as soon as they can, and a lot of O-6's getting out once they've got their retirement pay secured. I'd be interested to see the dwindling numbers of physician O-5's, especially in the heavily deployed fields.

I am proud of my service, but I wouldn't do it again.

 

[sethco]

so what if crazybrancatto's not a doc nor student? doesn't he/she still have the right to express himself and and provoke conversation????

The problem is that poster does not have the required perspective to make a comment about this topic, as he is not currently in military medicine.

This would be akin to me saying what it is like to be a pilot in the AF. I have very little, if any, perspective on this as a flight surgeon.

I see you only have 3 posts to your name. I am going to assume you are not trolling, so please try to act civil. What experience do you have with military medicine to criticize others experiences?

 

[mann976]

The problem is that poster does not have the required perspective to make a comment about this topic, as he is not currently in military medicine.

This would be akin to me saying what it is like to be a pilot in the AF. I have very little, if any, perspective on this as a flight surgeon.

I see you only have 3 posts to your name. I am going to assume you are not trolling, so please try to act civil. What experience do you have with military medicine to criticize others experiences?

im a navy corpsman (IDC) been in for ~12 years. ive probably done more to help people than you have. "trolling?" you're trolling! and who cares if i am. why don't you guys sac up and sign your names at the bottom of your posts, that is if you got a pair . . . I was on that medicalcorpse website . . i may disagree with the guy on some points but at least he was man enought to put his name to his opinion . ok im done here. i'll troll elsewhere

 

[orbitsurgMD]

im a navy corpsman (IDC) been in for ~12 years. ive probably done more to help people than you have. "trolling?" you're trolling! and who cares if i am. why don't you guys sac up and sign your names at the bottom of your posts, that is if you got a pair . . . I was on that medicalcorpse website . . i may disagree with the guy on some points but at least he was man enought to put his name to his opinion . ok im done here. i'll troll elsewhere

And mann976 is your Christened name or your surname?

 

[notdeadyet]

why don't you guys sac up and sign your names at the bottom of your posts, that is if you got a pair . . . I was on that medicalcorpse website . . i may disagree with the guy on some points but at least he was man enought to put his name to his opinion .

If everyone was required to sign with their legal name and rank, I'd trust the opinions a whole lot less. Anonymity allows for honesty.

 

[thegunshow]

No. Wait, let me reconsider. No.

Isnt this dude still a medical student? I dont know about you, but as a medical student in HPSP we really have in pretty nice (pre-match at least). Maybe he'll have a reason to be bitter after the match, but seriously, is getting your school paid for and getting that check every 2 weeks that bad?

 

[sethco]

ok im done here. i'll troll elsewhere

OK. Have a nice day

 

[deuist]

is getting your school paid for and getting that check every 2 weeks that bad?

It is when I see the impending crisis of match. I was lied to by my recruiter, told that 98% of people match, that we got to go into whatever specialty we wanted, and that military medicine was great training. Now, I know that there is a greater chance of not matching than matching, that I have no choice on where to practice, and that military medicine is so paltry in its case load and student responsibilities that I learned more, saw more and did more as a third year than on my externships. And really, what is a check every two weeks if I'm going to come out financially behind at the end of it all?

 

[crazybrancato]

Ok, I wanted to get back in on this thread b/c I have some more specific questions . . .not asking in a condescending tone, I'm being honest, would appreciate your feedback . . .

It is when I see the impending crisis of match. I was lied to by my recruiter, told that 98% of people match, that we got to go into whatever specialty we wanted, and that military medicine was great training.

Sorry you got screwed, but recruiters are recruiters . . . I've never heard a nice word spoken about any recruiter, in any context . . . word to the wise, it behooves you to do research and confirm what you're being told . . .that lesson alone can be worth your military experience!

Now, I know that there is a greater chance of not matching than matching, that I have no choice on where to practice, and that military medicine is so paltry in its case load and student responsibilities that I learned more, saw more and did more as a third year than on my externships.

I'd like to ask you some more detailed questions here. Of course, you can answer as freely as you'd like (or not, I understand if you're trying to preserve your anonymity)

1. At what MTF are you doing your externships, and in what type of medicine? (I'm curious which MTF or which specialties are case-deprived)
In other words, the caseload does depend on the specific MTF and specialty, right? For instance, I got friends here in San Diego at Balboa, they're very happy with the caseload. But, I would suppose that's b/c Balboa serves nearly the entire SoCal DOD-affiliated population. Likewise regarding the MTFs say in the DC-Metro area. But maybe not such a heavy caseload, say at Travis AFB in Northern Cali.

2. Have you already gone through the match process? If so, what did you put down, and what did you get?

3. I echo again that you shouldn't be doing this just for the money, but since it was brought up again, I'll ask this:

Did you go to a private med or public med school? If private, I know the dept can be pretty heavy. If you consider interest, I've heard you can actually pay anything from $250-300K over the lifetime of the loan, and most hope to have it paid off by retirement (~age 65). So say you're an HPSPer. You do your training, you do your GMO and the rest of your payback, then you get out and join the rest of the civilian MD crowd. You don't have the 300K debt, you made more money while you were training, (yes the civilians made more money as junior attendings), but now you're a civilian attending with them. Aren't you still on top, financially speaking?

 

[crazybrancato]

I see you're still a student, so you probably haven't matched yet. Whatever, same questions to all of you . . .

It is when I see the impending crisis of match. I was lied to by my recruiter, told that 98% of people match, that we got to go into whatever specialty we wanted, and that military medicine was great training. Now, I know that there is a greater chance of not matching than matching, that I have no choice on where to practice, and that military medicine is so paltry in its case load and student responsibilities that I learned more, saw more and did more as a third year than on my externships. And really, what is a check every two weeks if I'm going to come out financially behind at the end of it all?

 

[orbitsurgMD]

Sorry you got screwed, but recruiters are recruiters . . . I've never heard a nice word spoken about any recruiter, in any context . . . word to the wise, it behooves you to do research and confirm what you're being told . . .that lesson alone can be worth your military experience!

Unfortunately, the recruiters are the front end of the accessioning process and function as the official liaison to the eligible recruit population. Saying glibly that you should never trust a recruiter is absolutely no excuse for their misrepresenting the opportunities the services offer. Disowning the recruiters is not acceptable; the Navy's recruiters represent the Navy morally in what they do.

Do "research" is right. Fortunately because of the internet, public forums exist where opinions contrary to the image the Navy presents (spending millions in tax dollars to make) can be heard.

I'd like to ask you some more detailed questions here . . .

3. I echo again that you shouldn't be doing this just for the money, but since it was brought up again, I'll ask this:

Did you go to a private med or public med school? If private, I know the dept can be pretty heavy. If you consider interest, I've heard you can actually pay anything from $250-300K over the lifetime of the loan, and most hope to have it paid off by retirement (~age 65). So say you're an HPSPer. You do your training, you do your GMO and the rest of your payback, then you get out and join the rest of the civilian MD crowd. You don't have the 300K debt, you made more money while you were training, (yes the civilians made more money as junior attendings), but now you're a civilian attending with them. Aren't you still on top, financially speaking?

No. You should be doing it for the money. Why else commit yourself so early in the process? You won't be getting retirement time or adding to time in grade. You won't really be working in a military organization while in HPSP, except for your drill periods, which are usually not available as electives until late in your clinical years. If you want to be in the service, you could apply to USUHS. The primary reason to be in HPSP is for the money.

The relevant question is whether the money value of the HPSP is worth the costs of loss of freedom in choosing the timing and location of residency training and the possibility of delay to that training, GMO assignment, and the risks that go along with that relative to completing your training and assuming the burden of loan debts. The answer depends on the very particular circumstances of each prospective student. The relative benefit of military vs. civilian will vary (but clearly for many, even those attending expensive private schools, the benefit weighs more toward taking the civilian pathway than you would think.) You have to model your own circumstances with your own preferences assumed using present-dollar analysis.

If you wanted to do it for any other reason, you could delay commissioning until after medical school and then consider your options: FAP, reserves, etc. Committing so early is really all about the money. And it should be done with a very clear understanding of the choice you are making. No one will do this for you, not the Navy (that's for sure) nor likely anyone at your medical school which financial aid officers usually lack the time and skill to understand and present the issues before candidates sign their contracts.

 

[crazybrancato]

Unfortunately, the recruiters are the front end of the accessioning process and function as the official liaison to the eligible recruit population. Saying glibly that you should never trust a recruiter is absolutely no excuse for their misrepresenting the opportunities the services offer. Disowning the recruiters is not acceptable; the Navy's recruiters represent the Navy morally in what they do.

Agree. if a recruiter did blatantly lie to you, and if you have documentation of that (say an email), then I'd pursue prosecution of said recruiter. The thing is, most of them don't blatantly lie, they speak in a qualitative sense, like lawyers. Recruits take their word to be gospel unfortunately.

The primary reason to be in HPSP is for the money.

Ok, point taken. So can you give us an example of when it is worth the money? when it's not worth it?

 

[orbitsurgMD]

Recruits take their word to be gospel unfortunately.

And the recruiters know that, unfortunately.

Ok, point taken. So can you give us an example of when it is worth the money? when it's not worth it?

I suppose I could make up a case, but what good would that do? If you had 13 years in toward retirement as an officer and were going to an expensive private medical school and wanted to do something that didn't pay as well as other specialties, like peds, then you might model a case where financially HPSP was worthwhile. Even then, you might still have to delay your residency training by doing GMO service, and the ultimate cost of that delay along with the total added service time (caused by adding obligation by residency) would have to be valued.

 

[The White Coat Investor]

Ok, point taken. So can you give us an example of when it is worth the money? when it's not worth it?

It's fairly simple:

1) Low paying specialty
2) Lots of prior service (makes the retirement mean more)
3) High rates on loans
4) Expensive med school

The more of that you have the better deal it is financially. But don't forget to discount into that model the very real costs of delayed training, more hassle, less say over your life, deployments etc.

 

[The White Coat Investor]

No. You should be doing it for the money. Why else commit yourself so early in the process? You won't be getting retirement time or adding to time in grade. You won't really be working in a military organization while in HPSP, except for your drill periods, which are usually not available as electives until late in your clinical years. If you want to be in the service, you could apply to USUHS. The primary reason to be in HPSP is for the money....If you wanted to do it for any other reason, you could delay commissioning until after medical school and then consider your options: FAP, reserves, etc. Committing so early is really all about the money. .

Man, I never really thought about it like that, but you're right. I nominate this post for the sticky.

 

[Mirror Form]

Ummm.....When I talk to people in person I tell them I'm happy and I'm glad I came on, especially if any of my leadership is listening. My specialty leader and my squadron commander both think I'm staying in for 20 years.

Ditto. This forum is where i can speak the truth. Do you have any idea what kind of **** storm I risk bringing down on myself if I got a reputation for telling recruits not to join??????

 

[Mirror Form]

im a navy corpsman (IDC) been in for ~12 years. ive probably done more to help people than you have.

Doubtful!

why don't you guys sac up and sign your names at the bottom of your posts, that is if you got a pair . . . I was on that medicalcorpse website . . i may disagree with the guy on some points but at least he was man enought to put his name to his opinion . ok im done here. i'll troll elsewhere

Oh that's a great idea! Instead of having an anonymous forum where people can read about the truth, we'll make it non-anonymous and everyone on here will be spouting pure BS about how much they love their job! Brilliant!

 

[SupraDOc]

Just wanted to say that I'm appreciative of everyone's opinion that has first hand experience of MilMed in this Military Medicine forum. Amidst all of the pre-med people that try to say otherwise (and like the previous poster said "everyone is entitled to their own opinion"), you've saved at least one person from joining the HPSP program, which is myself. I've always wanted to become a doctor and join the AF/Navy but not the way MilMed is going nowadays. At least in my case the cons outweigh the pros. Thanks and keep posting for more pre-med's sake!

 

[mann976]

Doubtful!



Oh that's a great idea! Instead of having an anonymous forum where people can read about the truth, we'll make it non-anonymous and everyone on here will be spouting pure BS about how much they love their job! Brilliant!

You Mirror don't need to identify yourself. With over 6,000 posts and 5 years of ranting, I'm sure it wouldn't be hard to do some research with my enlisted compadres and figure out who you are. Wouldn't that be fun?! You'd come to work one day and find a nice little sticky on your keyboard, "Hello Mirror Form!" (you'll be lucky if its just a sticky)

 

[Homunculus]

do us a favor and just get out today. that's right, go AWOL. you'll get an admin sep, maybe a little slap on the wrist, nobody will give two s**ts. and let us know where you work so we know who to avoid at medical. if you're really this bitter, god knows what you'll do to your patients . . and when you start wining about your civilian job 5 years into the future, come back here and start a new discussion

do you really think a physician would get a "slap on the wrist" and not give two sh*ts? maybe as an IDC you could pull that off, but not as a doc.

and as to your "god knows what you'll do to your patients"-- grow up. even the most embittered, p*ssed off military hating doctors *still* take care of their patients. in fact, the reason most people dislike them military is *because* they aren't able to care for their patients like they want. if you think a physician would intentionally harm a patient simply because they hate what their work environment you're either saying it for dramatic effect or grossly out of touch with reality.

--your friendly neighborhood not taking it out on his patients caveman

 

[Homunculus]

(you'll be lucky if its just a sticky)

what's that supposed to mean? i don't see you posting your personal info, lol.

--your friendly neighborhood waiting for his own sticky to show up caveman

 

[mann976]

what's that supposed to mean? i don't see you posting your personal info, lol.

--your friendly neighborhood waiting for his own sticky to show up caveman

now you I'm going to find and praise, for your username and avitar. show's you have great sense of humor. i loved this skit on SNL. i've looked for it on youtube and hulu, I think i only found one sketch. RIP Phil Hartman

"I'm just an IDC - - - I don't understand these things you call . . .'patients' and 'medicine' . . . but what I do know is this!"

In all professions, if you're truly that bitter about your job, it starts to show in the quality of your work and service. I've seen it happen many a times . . . many moping health care professionals starting to not care and provide less-than-par service . . . usually they're unconscious about it.

by contrast, those who try to see the brighter side of things (no matter how F-ed up the situation) become great clinicians.

there is a correlation b/w your mental state and job performance, especially in medicine.

 

[IgD]

In all professions, if you're truly that bitter about your job, it starts to show in the quality of your work and service. I've seen it happen many a times . . . many moping health care professionals starting to not care and provide less-than-par service . . . usually they're unconscious about it.

One of my colleagues said recently that junior talented physicians like many of the posters here are "voting with their feet". Who does that leave on active duty?

The other thing you have to keep in mind is most if not all of the concerns described here and elsewhere have been validated and are more than just "moping".

 

[Perrotfish]

The primary reason to be in HPSP is for the money.

Originally Posted by crazybrancato
Ok, point taken. So can you give us an example of when it is worth the money? when it's not worth it?

I think the primary reason to do Military Medicine is because you want to be a military officer. The primary reason to do HPSP (as opposed to FAP, or just signing up when you're done with residency) is because you couldn't afford to become a military officer by any other route. Even if I chose to live in abject poverty from age 24-32, at the end of my training I would have accumulated a little over 400K in debt. I can't pay off that kind of interest on a military doctor's salary (unless I want to live in poverty for another 4 years) and FAP would help me recoup a maximum of less than half of what I would owe. With HPSP I'm debt free at the end of medical school, and the residency pays significantly more.

As for doing military for the money overall, my calculations only have it coming out as a big GAIN if you're either

1) both going to a very expensive school and going into a very low paying specialty like FP (and there are other scholarships for those interested in primary care)

2) Less than 5 years from retirement in the military.

 

[crazybrancato]

I think the primary reason to do Military Medicine is because you want to be a military officer. The primary reason to do HPSP (as opposed to FAP, or just signing up when you're done with residency) is because you couldn't afford to become a military officer by any other route. Even if I chose to live in abject poverty from age 24-32, at the end of my training I would have accumulated a little over 400K in debt. I can't pay off that kind of interest on a military doctor's salary (unless I want to live in poverty for another 4 years) and FAP would help me recoup a maximum of less than half of what I would owe. With HPSP I'm debt free at the end of medical school, and the residency pays significantly more.

As for doing military for the money overall, my calculations only have it coming out as a big GAIN if you're either

1) both going to a very expensive school and going into a very low paying specialty like FP (and there are other scholarships for those interested in primary care)

2) Less than 5 years from retirement in the military.

nice summary, that sounds about right to me. Not to mention the fact that a good chunk of that $400K debt would be credit card debt (that you've used to get by on), which will come with an un-godly interest rate (i have some civi-med friends with nearly $30K in credit card debt!)

You could even make the case for some supposed "high-paying" specialties:

I was reading somewhere (forgive me where, don't remember, it was a hard copy) that civi hospitals are trying to weed out the senior (50+) specialists, to whom they've been paying large salaries . . .and are trying to replace them with younger ones, with much smaller deflated salaries. In this particular article, they were citing a GI that was making $400K, who retired at age 60, was replace by a freshly minted GI outta training for $250K (and on a payscale that would lead him to making at most $350K).

So if you'll only making $250K as a specialist, figure in malpractice insurance, that's nearing the equivalent pay of a milmed specialist . . .no?

 

[notdeadyet]

I was reading somewhere (forgive me where, don't remember, it was a hard copy) that civi hospitals are trying to weed out the senior (50+) specialists, to whom they've been paying large salaries . . .and are trying to replace them with younger ones, with much smaller deflated salaries.

This isn't so much a trend in medicine but a trend in business in general. Law, aviation, union work of any kind, etc. It ain't a medical thing.

So if you'll only making $250K as a specialist, figure in malpractice insurance, that's nearing the equivalent pay of a milmed specialist . . .no?

In salary surveys and when folks discuss salaries, they are almost always referring to post-malpractice salaries.

 

[Perrotfish]

I was reading somewhere (forgive me where, don't remember, it was a hard copy) that civi hospitals are trying to weed out the senior (50+) specialists, to whom they've been paying large salaries . . .and are trying to replace them with younger ones, with much smaller deflated salaries. In this particular article, they were citing a GI that was making $400K, who retired at age 60, was replace by a freshly minted GI outta training for $250K (and on a payscale that would lead him to making at most $350K).

So if you'll only making $250K as a specialist, figure in malpractice insurance, that's nearing the equivalent pay of a milmed specialist . . .no?

Not really. First, it's a sellers market for most types of physican skills right now and it's only getting worse as the boomers age (exception: pathologists). Hospitals can try to bring in cheap staff all they want, but I know very few experienced doctors worried about being downsized for younger blood. Also very few doctors pay their own malpractice unless they set up their own shop. Your hospital/group will be generally be paying your way, that 250K is an actual salary.

With the highest possible gain from the scholarship (about 500K compared to your civie peers, including higher pay during residency) I have a lower paid non-primary care specialty like military EM (200-250K/year) coming out even or a little bit below the civilian side of things for the first 4 years. Everyone who gets paid more in the civilian sector loses a ton of money though their decision to do military medicine, at least from a financial prospective

To be fair to the military, though: I maintain that money, like everything else, has a diminishing return. In terms of change in lifestyle, an extra 300-400K over the course a primary care doctors career is much more significant than a 2 million dollar loss for someone doing plastics. Paying off your first home is way more important than paying off your third.

 

[Mirror Form]

You Mirror don't need to identify yourself. With over 6,000 posts and 5 years of ranting, I'm sure it wouldn't be hard to do some research with my enlisted compadres and figure out who you are. Wouldn't that be fun?! You'd come to work one day and find a nice little sticky on your keyboard, "Hello Mirror Form!" (you'll be lucky if its just a sticky)

And now you're making threats, absolutely pathetic. I'm pretty sure you're doing a lot more than me to convince any premed reading this thread to never join.