please advise!!

[Urowife]

Just wanted to add/clarify something from my previous post. I talked with my DH about the quality of residency training. He said the military residency training is fine, but that they may see different types of patients. For example, in his residency program, they did 30 cystectomies a year (bladder removals), yet at the military residency, they saw maybe 2 a year. But, the military guys did tons of vas reversals, whereas my DH hardly did any at his particular program. Every specialty will be different, but for urology, there are generally fewer patients on service at the military residency and the patients weren't as sick. I hope that clarifies things a bit. The main difference with residency training in the military vs. civilian is the pay and the commitment payback accrual.

Thank you for replying, everyone. I really appreciate it. Andrew and I have been going back and forth about this. I will mention that his plan is to exit the military after his 4 years of service and then go straight to a civilian job at a hospital, eventually building his own clinic. I read many posts that say it is hard to "get out" of the military (even after your 4 years of service is up). What do you think? Will it be difficult? Thank you for posting, by the way. Every bit of information is helping us.

[Urowife]

I read many posts that say it is hard to "get out" of the military (even after your 4 years of service is up).

I wonder what they mean by this? Once your commitment is up, you can leave. Did they give details on what they meant? We plan to leave directly after the 4 years, and I don't know of any roadblocks.

[SoonerTexan]

Maybe because once you have paid back your time it is hard to leave when there are more possible perks for staying longer?

It was never a thought for my DH, but I am working to provide for us at least until residency, though I'd like to stay home with our daughter. We live in a low cost of living area with one of the cheapest med schools in the nation, though. We'd have 80k of student loans at the most leaving school of we choose not to pay any off and no consumer debt.

[Deebs]

I think you're referring to "Stop Loss.". I'm sure those in the military can better explain, but in time of national emergency the Secretary of Defense or President can order those who have completed their commitment to stay. I have no idea how frequently this happens but do know that it occurred as recently as Bush being in the White House (we have a friend who it happened to). I think it really does come back to whether your DH feels compelled to serve. Also, maybe USHS isn't right for him, but the Reserves or National guard is. DH had classmates that did both. Again, he could still be deployed - our friend who is in EM and National Guard has been deployed many times since residency (starting one month after he finished training). Is your SO on SDN? I think there's a ton of onto about pretty much everything on there.

[mommax3]

DH did HPSP through med school (Air Force), was selected for an active duty residency (combined Air Force/Army program in San Antonio), and did 4 years of payback in Wichita Falls, TX. He feels that he received excellent training during residency, but his payback years were painful in ways that would take me too long to describe right now, although he was never deployed, thank God. He got out as soon as he could and has been in the civilian world since 2005. In general, if he had been able to stay at a large military medical center for his payback, he (and I) would have been *significantly* happier than we were at a small base in the middle of no where. The lack of debt was nice,
but payback was a veeeerrrrry long four years for both of us.

[DCJenn]

I just copied my response from the other area.

If he's not already enrolled in the HPSP program then it's likely a moot point. If he's going to pursue HPSP, then he needs to get in and get a contract signed.

HPSP pay during residency is a stipend- I have no idea how much it is these days. Payback is (normally) 4 years after residency. There is another way to do military medicine that's a residency only thing but that's a little more complex to explain. My husband went to the military medical school and earned a full salary through medical school- this also included books and equipment.

He doesn't want to "join" the military, he needs to be commissioned into the military- Physicians are officers.

1. how dangerous is this?! is he going to be deployed? for how long? will i be a single mother for months on-end? It can be very dangerous or not that bad. Depends. Yes, he's going to be deployed. (even if he's not, assume that he is. Most physician deployments are 6 months to one year. So yes.)

2. will we have to move all over the country? can we pick where we go? what is the likelihood of us getting to move to our "choice"? There's no way to know where you'll move- it's speciality dependent. The more subspecialized he is, the fewer options there will be. That can either be really good or really bad, depending on the branch. The likelihood of getting your choice is entirely dependent upon the whims of the military and their needs at that time. There is no choice, there is only the illusion of choice.

3. what branch would be best to join if he did sign up? Again, he can't just 'sign up'. He needs to meet with the military people at his medical school. (not a general recruiter) He needs to do this ASAP. As for branch? These days, they're cross trained and cross-deployed. It kind of depends what else he likes to do. Navy docs can be send to sea for months, the Air Force has some really crappy locations. So does the Army. The Army and the Navy deploy a lot. That said, we have an Air Force anesthesiology friend who is on his fifth deployment. Our Navy psych friend deployed three times. My husband the child neurologist is looking at number two (first was to Iraq). That's another thing to know- pediatricians and subspecialists deploy w/ everyone else.
4. what is residency like in the military? does it pay more or less than civilian residencies? how are the hours? Residency is exactly like civilian residencies- in fact, a number of them are civilian residencies that the military pays for- depends on the program. Even military residencies are just like everyone elses- they generally pretty much suck. As for pay- we were paid well comparatively - but it was a military residency (at a military hospital). The military operates under the same hours restrictions as everyone else. They rarely deploy residents (but they will not give a residency if they don't need that speciality and then the doc can be deployed)

5. what is life like after residency for the 4 years that he must "pay back" in service? He'll work at a military hospital. It's more speciality dependent than military dependent. My husband leaves for work at 6:30 for 7:30 morning report. He has the luxury of seeing patients for longer appointments than his civilian counterparts and he can order pretty much whatever test or med that he thinks he necessary. That's a huge bonus as far as he's concerned. There are very nice benefits to the military- health care- free, medications- free, housing stipend, great retirement, etc. But- we're 18 years in. If you're not a lifer then things look different.

6. am i being too selfish by not wanting to do this? There are serious benefits to military medicine- including mostly debt free with lots of free stuff. There are lots of downsides. I personally wouldn't have changed a thing- yes, deployment sucked but no more than either the first 3 year fellowship or the second one year fellowship. Honestly- from this side of medicine- 12 years after medical school graduation- 4 years is nothing. My husband owes 4 more years- he'll get out that that time. I have every expectation he'll sign right back on as a contractor to the military. Are you being selfish? Well, if you seriously can't imagine seeing your spouse for months a time, then no. If you're fearing the unknown more than the military then I can assure you that it's really not that big a deal.

J.

PS- It is true that the population they see can be quite different than the general population. The children are the same but the adults, particularly the adult who is in the service is generally in better shape physically. Addictions tend to be the hidden kind- pills and booze. It's a great place to do ortho, burn medicine, psych, with the Iraq and Afghanistan veterans- they military gets awesome toys to play with and there's a ton of research going on.

[Cinderella]

There is a lot of good information here specific to your questions. FWIW I'll add my experience of being a military medical spouse though our situation is different since it was the Egyptian Army. In our case dh is from Egypt and they have compulsory military duty for all males. There are some exemptions and I won't get into all the details except to say that they take all doctors. Because of the situation I didn't get to see dh for 2.5 years. He was there serving and I was in the States. I guess that could be compared to deployment here. It's very difficult being apart like this. At one point during the Israel bombing campaign on the Gaza strip in 2008 the Egyptian military was coordinating a temporary medical point in Ramallah on the Egyptian side of the border there and they were deploying my husband to it. When I got the news I was literally freaking the eff out. A lot of my MENA friends at the time were very supportive of this operation because it was to help the Palestinians who were injured, but it wasn't their husband being deployed near a place where bombs where being dropped. At first I thought they were going into Gaza and that really had me worried but I was a little more relieved to learn it was in the border town. Still it's right on that border and people on the Egyptian side have been caught by stray bullets or intentional bullets and are wounded or have died right there, even little children who don't know it's not safe to play there. Luckily it was a short bombing campaign that time and everything ended quickly.

I hate for any of your SO's to ever have to face the realities of war and to go through that experience of being helpless during wartime deployment. For the OP I'll echo what some have already said. It is honorable if he wants to serve the country. However, if it's just about money then it is for the wrong reasons really and especially if you don't want him to do it. I envy that you guys have a choice where as we didn't. I certainly didn't choose it and wouldn't have wanted it either if we had the choice knowing what I know now. On the other side of that coin I also grew up in a military family as I suspect many people in the US have in one way or another at one time or another. It wasn't a medical military family though. I'm not sure if that makes much of a difference when it comes to war veterans though.

OP, I didn't realize there were so many responses here already, and I just wrote you a book over on the military forum.