USUHS rotations away from campus

[peggyfromwastate]

Hi- I was hoping that someone out there may have gone through USUHS and be willing to answer my question about the 3rd and 4th year rotations. My husband just went there to interview earlier this month, and he was told that most students rotate between different military teaching hospitals for the rotations. I was wondering if anyone has been through this? Since we have a family, and would have a child in school in the DC area, would he really have to be gone to other parts of the country during rotations? Does a student have much say in the matter? I thought that he could be gone for the really stressful rotations that demand a lot of his time, since we probably won't see him much then anyway...

If anyone has any input, once again I'd be very thankful!

Peggy

[DCJenn]

Peggy-

They pick their rotations. And outside rotations can mean Ft. Belvior, Walter Reed, Malcom Grow Medical Center (Andrews Air Force Base)- all of which are a 45 minute or less drive. My husband took full advantage of the options though and did 3 rotations in Hawaii, two in Seattle, one in San Diego, one in Portsmouth (VA), three here in San Antonio. They also dont' just stick to one service- (Above are Army, Navy and Air Force locations)

It's a good idea to try to get out to see the major medical training centers at least once, to get a feel for the location and the programs. He should try to do his rotations in what he's interested in doing at an outside location to seewhat those programs are like. He'll have to interview during 4th year for residency anyway, so it's a way to combine experiences.

My husband has friends who hardly left the DC area and other who, like him, spent the majority of time some place else. I thought it was great because Iwas able to visit Seattle once, California once, and San Antonio three times. Also, it helped with house hunting because once we knew he was coming to SA, I was able to fly in to look for apartments. I also started my job here before he graduated, which was nice.

Hope this helps-

Jenn

[peggyfromwastate]

Thanks Jenn- this does help. We were under the impression that he would be told where to go for each rotation, rather than have some choice. I bet he would be interested in taking a rotation or two in some of the programs he's interested in away from DC, but then again it all depends on how our kids are doing, etc. It's hard to predict the future, alas, but from what you say, it seems that he'll have lots of say in the issue.

By the way, I know that your husband is in the Army. My husband is hoping to go that way, too, but he is a bit worried about the weight restrictions. He has heard from some that a waiver is granted as long as he's within the body fat percentage allowed, which is what he's hoping for. He has an unusually big build, and is pretty muscular. He probably has a body fat around 8%, but it doesn't look like he'll make it to the Army weight limit for his height, which is 189 lb. Currently, he's just over 200. Do you have any thoughts? Some have said that it is a huge problem to the Army, but I just don't think that with his build he'll get down to 189, unless he gets sick or something!

Oh well.

Thanks again for all your insights!

Peggy

[DCJenn]

Peggy-

The weight thing is not that big of a deal, particularly with the Medical Corps. I mean it's a big deal, but... they aren't marching everyday for their jobs! Rick (my husband) gets taped every PT test because he's short and stocky. He's in great shape (just maxed the PT test!) but because he's so muscular, he gets taped every time. It's no big deal. The one's that it's a big deal for are the ones who barely pass the PT test (or don't!!) and don't meet the ratios.

The Army guys have kind of a 'competition' between each other. My husband doesn't care how well he does, so long as he beats one of his co-workers! (and his co-worker is the same way!) His wife and I just shake our heads.

The outside rotation thing is available to all of the military med students- including HPSP- that's how two very good friends of ours met- at Officer Basic- they fell in love and she ended up changing med schools! The thing about USU is that a lot of the military requirements that HPSP students have to squeeze in are taken care of during the school year.

Jenn

[peggyfromwastate]

Thanks Jenn! He'll be very relieved about the weight thing. He has his DODMERB (I think?) physical on Wednesday!

Thanks for all the info-

Peg

Dear Peggy,
I wouldn't worry too much about the 3rd and 4th year rotations at this point. My husband graduated from USUHS in 1994. We were married in 1990, so I have been through it all with him. The off site rotations were not that stressful for us. However, we did not have children at the time. The students do have a choice, but as you will soon learn--nothing is for sure with the military. Off site rotations can be a huge benefit to the student, especially when they want to pursue a specific area. During 3rd and 4th year is when they narrow down their choices for specialties. Certain off site rotations have benefits if they are pursuing a specific specialty. Also during the 4th year it is highly recommended that they do their sub-I (sub internship) rotation at the hospital where they hope to do their internship. For us that was Madigan at Ft. Lewis, WA. The sub-I is two months (the longest rotation). Most of the others are only 4-6 weeks depending on the year. I stress the word "only". You will find out down the road that those short separations become easy. If your husband pursues an Army carrier he can look forward to longer deployments once he is a fully trained medical officer. We just got back from
Germany and last year he was deployed a total of 5 1/2 months. My best advise to you is to enjoy these next four years, get involved with other spouses, and take one year at a time. We had a great time at USUHS and made a lot of friends that we repeatedly bump into as we move from base to base. Take advantage of the spouses club--it was a great group while I was there.

[peggyfromwastate]

Thanks again Shiela- great input! Where are you based now? From what you've written I'm assuming that your husband has done 2 years of payback in Germany already, 51/2 months of which he was deployed. Others have written that getting sent to Germany is sought after; did you guys request to go there?

Thanks again!

Peggy

Dear Peggy,
Yes, Germany was our first choice after residency and we loved it. Normally a assignment in Germany is a minimum of 3 years (and many people we know extend for 6 years), but you are allowed to apply for fellowships after 2 years. Since my husband got his fellowship request, we were only there 2 years. Allow I am happy he is now doing his fellowship, we both miss Germany. We had a great time and we were able to do lots of traveling (Italy, France, Holland, England, Copenhagen, Norway, and Austria--Oh, yeah--He saw Bulgaria and Nigeria as well). We are now in Dallas doing a sponsored fellowship in Vascular Surgery at Baylor Univ. Med. Center. Technically he is assigned or attached to Ft. Sam in San Antonio since there are no bases in the Dallas area. We will be here for 2 years and then on to our next assignment. We are hoping to go back to San Antonio, but as always we will go where the Army sends us.

As a third year resident, my husband is sometimes responsible for grading the 3rd and 4th year med students who rotate through his department. The ones who seem to do the best are the ones who have taken advantage of their rotations to really learn; also most of them have done rotations at several other facilities around the country. As someone already mentioned, as a military family, you may be separated at times anyway, and short rotations are a way to get used to that. I would look more on rotations as an opportunity for your spouse to get a good feel for where he'd be comfortable doing his residency, but that does mean that you'll have to hold down the fort at home for a few weeks. I know that it will be tough, but I think it's worth it to make sure that your spouse makes the best decision as to where he plans to go with his career. That, after all, will ultimately affect your family much longer.

[peggyfromwastate]

Thanks Jen for the input! I am starting to get the picture that separations are to be expected. Of course! But still, when considering where to go to med school (civilian or military) it takes a while to digest. I appreciate everyone's patience! I mean, you all as spouses have undoubtably been through separations and think 8 weeks is cake! I suppose at some point I may also! When Mac was gone for 1 week to interview, I was going CRAZY! Now, that's not entirely because I'm an overly-attached spouse , it's mostly because we have 1-year old twins! But, they will be older by the time 3rd and 4th year hits, and I'll be in the system and better able to adjust! 8) (Just let me think that it gets easier...)

The deployement issues have been bigger for me right now because within the past few months we've researched USUHS and military medical careers as much as possible, and we've found that first he goes to officer training camp (6 weeks), then 1 year of med school, then a summer field experience (5 weeks), then 1 year of med school, then who knows what but I'm sure there's something in that summer, then 3rd and 4th years, and they tell us that they usually go around to other hospitals during those years too!? 8O So, we've had a lot to digest, but it'll get easier.

Anyway, thanks for all your help everyone!

[DCJenn]

Peggy-

Don't forget that during these rotations you can go visit! OBC (Officer Basic) takes place here in San Antonio which is a very family friendly town. And at least with USUHS- this stuff is built in to their school year, unlike the HPSP students, some of whom are still squeezing in requirements! (And this is the last year of residency for us!)

The only place I didnt go when Rick was out and about during third and fourth year was Hawaii. I went to SA twice and California once for the cost of going to Hawaii.

Don't worry about that stuff now. You have plenty of time until you get there.

[peggyfromwastate]

Thanks Jen- I'll see. My husband absolutely loves San Diego, so if he goes there, maybe the kids and I can trek accross the country to visit. Who knows?

I was curious as to where in the DC area the rotations are, though. Are they all done at the Navy medical center there, or Walter Reed, or does it depend on your branch? If so, where is the AF Med Center closest to DC located?

I also had another question. Kind of strange, but here goes. I was thinking of trying to have another baby (last one I am planning on for sure) and was wondering what hospital one would use in the DC area. My concern is that previously my labors have moved quite quickly, and I can just see myself not making it all the way to Walter Reed if we don't live pretty close. Or can you as a military wife go to a civilian hospital if it's an emergency type situation and still be covered by your Tricare coverage? BTW, my husband is going with the Army, if that makes a difference.

Thanks!

[DCJenn]

Peggy-

The DC rotations can take place pretty much anywhere there's a hospital or clinic- some of the places Rick went were: Ft. Belvoir (Alexandria, VA), Walter Reed (DC), Navy (MD), Andrews (MD) and then he went to Portsmouth Naval Air Station for a rotation during third year which is about 3 hours away. I think there are even opportunities at some of the civilian hospitals. (Just FYI he's at the University of Texas PICU this month and the UT med students rotate through both the Army and Air Force hospitals.

Question #2-
Your primary insurance will be Tricare but there are certain things that you do in the civilian world and certain things you do in the military world. Eye care and dental care are civilian things- Tricare covers most of it. Your husband will be covered 100% by the military.

You and your kids will be seen by military docs- I assume at WR but I don't know for sure- we weren't married when he was a USUHS- maybe one of the others will know for sure! As for where you would deliver, it would be at whichever military hospital has a the actual department. Here, even though we're Army, BAMC only has outpatient clinics for peds and for OB/GYN, the actual deliveries are performed at Wilford Hall, the Air Force Hospital. It's another dual service program so here, anyway, you would have either service and actually both- i.e. you could have Air Force nurses, an Army GYN, Air Force peds interns, etc. (Sally's husband might know for sure where people have babies in DC! This isn't a pressing concern of ours at this point!)

Emergencies are emergencies and Tricare will cover them. But, I'm guessing that they would emphasize getting to the local military hospital ASAP rather than the local civilian one. I know the E.R's (the military ones) see civilians for traumas and they also occasionally manage peds cases although they try to transfer them to a civilian hospital once they are stable.

Sorry I wasn't more help!

Jenn

Peggy,
I wanted to answer your questions about medical care while at USUHS. Keep in mind it has been a while since we were there, so things may have changed somewhat. While we were attending USUHS (the "we" is figurative--trust me, by the time your through you will feel as if you went through it with your husband) there was a Family Practice clinic right on the USUHS campus. Most everyone I know went there for routine things and they took their babies/children there as well. I'm not sure if they did pre-natal visits or not, but I think they did. As for delivering, most of my friends delivered at the Naval Hospital right up the street from USUHS. It was convenient; however, you could choose to have the baby at Walter Reed or at Andrews. Tricare Prime will pay a portion (probably 80%) if you choose to go to a civilian hospital. Tricare is basically like an HMO so you would have to go with one of their providers. You can check with the tricare rep once you get settled. I know people who preferred to deliver at a civilian hospital while we were in residency who took this route. I had both our children in military hospitals (Wilford Hall in San Antonio and Landstuhl in Germany). I had good experiences with both and the care I received was excellent. I tell you this only because you are sure to hear horror stories about delivering in military hospital. Just keep in mind all the horror stories you heard from your civilian friends as well.
One other note. If you choose to deliver at Navy or another military hospital you can request that no residents or med students participate in the delivery. A lot of my friends were scared someone they knew would be in the delivery room. I never held the same concern, but then we didn't have children until into the residency years.

[peggyfromwastate]

Thanks you guys! I know I'm jumping waaayyy ahead here! BTW, Shiela, I have already heard horror stories about deliveries in military hospitals- my mom almost died after having my sister b/c the navy ob didn't "clean her out" properly. My dad, who was a flight surgeon for the navy at the time, even asked him if he was sure he got all the placenta, and the doc just brushed him off... anyway, there are bad docs everywhere, but I am not worried at all to deliver at a military hospital. I have indeed heard many horror stories from women who delivered in civilian hospitals! My primary concern was getting to the hospital in time for my epidural, etc. (Notice it's the epidural, not the actual delivery...)

Thanks for the advice!

Peg