Military Medicine?

I’ve been doing some research on military medicine. I was very interested on the scholarships (debt free), monthly stipend, malpractice insurance, and other opportunities, that you won’t find on the civilian side. But I have found a lot of regrets from people that went through it. I’m 25, married no kids, and will be applying to med school in about two years. I have talked to my husband about this option and he is concerned about me going away for too long but I guess that is one of the sacrifices. What I’m really concerned about is being able to finish med school and get into a residency, like emergency medicine, and being able to enjoy my time there, I love medicine and I wouldn’t like to end up like many people who never enjoyed practcing medicine while in the military. I would like to get advice from someone that’s been through this. What is the process like? Which branch would you recommend? In general was your experience positive or negative???

search for this topic, there have been LOTS of discussions. Bottom line is that your first intent should be that you want to serve through military service, and your SECOND intent should be to practice medicine.


BTW this isn’t limited to medicine… my son’s a Navy pilot because he really wanted to fly; he has to tolerate a lot of crap that he doesn’t like in order to satisfy his passion.


Mary

Hi milenamc85. Welcome to OPM. I’m a 1st year medical student in the Navy HPSP (Health Professions Scholarship Program). I was prior active duty enlisted for 10 years in the Air Force. I’m still kind of new to the medical side of the military, but I can share what I do know. I’ll see if I can address your concerns one at a time.


I have talked to my husband about this option and he is concerned about me going away for too long but I guess that is one of the sacrifices.


Unaccompanied deployments are always a real possibility that you should keep in mind. Aside from a short term deployment to a war zone, humanitarian relief mission, or natural disaster area, it is unlikely you will spend more than a year apart from your husband, if at all. Unless you were a flight surgeon or serving on a ship or submarine, you would likely be stationed at a medical center in the US and you would not need to be separated from your husband.


What I’m really concerned about is being able to finish med school…


Why would you not be able to finish med school? I think you’ve been subject to a lot of misinformation. A military scholarship (HPSP) is specifically intended to allow you to go to medical school and get your medical degree. The military is not going to spend tens, if not hundreds, of thousands of dollars to send you to a medical school that you are not going to finish. In fact, the financial penalties would be severe for you if you did not finish medical school and you would probably be discharged. They’re banking on getting a doctor in 4 years and they are going to protect their investment. You are required to finish med school.


…and get into a residency…


OK – this part is a bit trickier. Unfortunately, there are no guarantees here. GME (Graduate Medical Education) works a little bit differently in the military than it does in the civilian world. With few exceptions, you will have to do an intern year for your PGY-1 (Post-Graduate Year-1). During your intern year, you apply to residency. If you match and pass step 3 (of USMLE for MD or COMLEX for DO), you enter residency. If you don’t match (but pass step 3), you will do what’s known as a GMO (General Medical Officer) tour – the military equivalent to transitional medicine. The good news is you get brownie points in the military match system for each year of a GMO tour that you do. During intern year, you are NOT a deployable asset. You go to a designated military Medical Training Facility (MTF) as you would for residency. Once a GMO, you ARE a deployable asset. The Navy has the most GMO’s, followed by the Air Force, followed by the Army. The military in general is in the process of phasing out GMO’s so by the time you graduate medical school, you will probably be able to go straight through residency without interruption in your GME. As in the civilian residency match, some specialties are easier to get into than others. Also, as with the civilian residency match, the more competitive an applicant you are, the greater the likelihood you will match into your desired specialty/program and the greater the chance you will go straight through GME. If there are a limited number of residency slots available at military MTFs, but you are an otherwise competitive applicant for a specialty that the military really needs and can’t fill through other means, they will let you do a deferred residency. This basically means you continue to be a reservist after graduating from medical school while you complete a civilian residency. You don’t normally receive active duty pay or benefits; you get what the other civilian residents get. Occasionally there are subsidized deferred residencies that do give you active duty pay/benefits, but I hear these are rare. Regardless of whether you do an active duty residency at a military MTF or a civilian residency in a deferred status, you are NOT considered a deployable asset. You will not have to worry about being pulled out of residency once your training has begun. If you’ve done an internship first, you will start residency as a PGY-2.


…like emergency medicine…


It depends on the needs of the military, how competitive an applicant you are for EM and, specifically, on which branch of the Armed Forces you are in. About 8% of the Navy’s active duty residency slots are dedicated to EM. I’m not sure what the exact stats are for the Army or Air Force. The Army has the most number of military residency slots, followed by the Navy, followed by the Air Force. The Air Force has the most number of residents training in deferred status (i.e. at civilian residencies). The Army has the best match rate for military residencies. Here’s a link to Navy GME:


http://www.med.navy.mil/sites/navmedmpte/gme/ Pages…


…and being able to enjoy my time there…


This part is up to you. I would talk to a recruiter and ask to shadow some military docs if you’re unsure to get a feel of what it will be like for you and for what it is like for them. Recruiters can set this up for you. This is a big commitment and you don’t want to do it for the wrong reasons or if you think you may be unhappy with the military lifestyle. Caveat: Don’t rely strictly on information on SDN. I admit to going over there myself from time to time because there is no milmed forum on OPM. While there are some decent, knowledgeable people over there, I find it is mostly a venue for bashing the military.


I wouldn’t like to end up like many people who never enjoyed practicing medicine while in the military.


Who exactly are these people? If you graduate from medical school with an MD or DO, pass all 3 steps of your licensing board exams and complete at least an intern year, you will practice medicine in the military. You may not be guaranteed your choice of home base (though they do the best to accommodate people within the needs of the military), or your choice of specialty or residency program (this doesn’t always happen in the civilian world either), or that you will go straight through GME (though this is changing), but you will practice medicine. Whether you enjoy it or not is up to you.


What is the process like?


As a medical student in HPSP, you are considered a reservist, but not in the traditional sense. A regular reservist (ready reserve) is assigned to a reserve unit that drills 45 days/year with their unit that consists of 1 weekend/month plus 3 weeks active duty/year. HPSP is vastly different. You do your 45 days/year all in one shot. Either before you start medical school or in the summer between 1st and 2nd year, you do your first AT (active training) at officer training school (ODS in Navy, OBLC in Army, OCS in Air Force). You’re then promoted to O-1. The summer between 2nd and 3rd year, you’re preparing for step 1 (USMLE for MD/COMLEX for DO), so you will be on school orders; you will not be on AT, but you will be paid as if you were on AT. Between 3rd and 4th years or during 4th year, your AT will be an away rotation(s) at an MTF. This is actually a good thing; consider it an audition rotation for your desired residency. When you graduate from medical school, you are promoted to O-3.


Which branch would you recommend?


This part is up to you. My prior service was in the Air Force, but it wasn’t in medicine. I gave some basic stats above, but you may have to do some research on this. Caveat: the fine print in the HPSP contract states that you can be involuntarily transferred from one branch of the Armed Forces to another depending on the needs of the military. I’m not sure if this has ever happened or how often it happens. Voluntary transfers from one branch to another are also possible.


In general was your experience positive or negative???


So far, it’s been positive. Though I have already had a military career and my medical career will be an extension of that military career I have already embarked on. Thus, I may be a little biased, but I also know what I’m getting myself (back) into.

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I agree with most of what was said above. I am Air Force, about to enter active duty after completing my deferred residency. I did AF HPSP. The Air Force match is different than the Army and Navy match (at least it was 5 years ago). You matched into your residency as a fourth year medical student with all of your other classmates in med school. If you did not match, then you would be assigned an intern year and would serve as a GMO for 1-3 years and reapply into your specialty of choice after your GMO tour. Some people VOLUNTEER for GMO tours because of the extra points it gets you on the match board, particularly if they may not have the grades and board scores to get into a competitive specialty. The Air Force has also gotten away from pulling anyone from residency to serve as a GMO or deploy because you are far more valuable to them as a specialty trained physician than as a GMO.


However, you should ONLY consider the military scholarships if you want to serve in the military first and foremost. I am excited about becoming an officer again (was prior service Army for 5 years) as well as serving as a physician.


Hope this helps.

Thanks for all the good advice, great information.I think that shadowing doctors in the military is an awesoem idea, I’ll definitely keep doing more research about this opportunity.