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  • please advise

    ~~~I have also posted this in the Introductions section, so I'm sorry if its a little redundant!!~~
    Hello!!! I hope everyone is having a great week

    My name is Nancy and I will soon be venturing into the life of being a spouse of a med student. I am very excited to say that we are moving from Michigan to California so that my fiancee can attend UC Irvine this fall. I was just wondering if everyone might be able to give a little advice for us. We (Andrew and I) are having an epic discussion on whether the military is the best route for us or if we should continue med school as civilians. I am of the belief that we should stay civilians, and he wants to join the military (in order to not have student debt and to serve his country). We are a very open and honest couple who work through all of our problems, but this is one that is stumping us. I dont have a lot of friends who can give me advice about what life is like when you're the spouse of a military doctor. I desperately would appreciate your advice on this and would love anyones thoughts, negative and positive! some questions that have been bothering me are:

    1. how dangerous is this?! is he going to be deployed? for how long? will i be a single mother for months on-end?
    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"?
    3. what branch would be best to join if he did sign up?
    4. what is residency like in the military? does it pay more or less than civilian residencies? how are the hours?
    5. what is life like after residency for the 4 years that he must "pay back" in service?
    6. am i being too selfish by not wanting to do this?

    Again, please leave any comments. I am so grateful that this forum exists and that there are others out there that are in the same boat as I am. Thank you in advance! -Nancy

  • #2
    Hi Nancy! Good luck with this decision! I know exactly where you're coming from, as this is the same boat that my DH and I were in several years ago (2004, to be exact ). He wanted to join the military; I was vehemently against it. Needless to say, he joined, and I needed some time to get used to the idea. (FWIW, we were *only* dating at the time but were just months from getting engaged and had been talking about it for quite awhile.) In the end, though, I'm actually very glad that he did go into the Air Force. He's currently in his final year of residency and will be graduating from a military residency program in just about 2 weeks! He then owes 3 years on his military contract, and we're mulling over the possibility of his doing a fellowship while in the military, which would extend his commitment another 2 years. Unfortunately, the USAF wasn't offering any more med school scholarships the year DH first applied, so we do have +/-$35K in loans from his first year in med school. (He applied late, partly because I was so against the decision. Oops.)

    1. how dangerous is this?! is he going to be deployed? for how long? will i be a single mother for months on-end?
    **First of all, please keep in mind that my husband and most of the military docs in my social circle are residents and fellows. While in training, military docs are considered undeployable, so I have limited experience with docs that I know personally being deployed. That said, your husband is looking at a possible deployment several years down the road, and it's impossible to say what the deployment situation will be at that point. The only military medical personnel I know who are deploying now are going to Afghanistan (these folks are Air Force and Army; I have no idea what Navy deployments are looking like, as I don't know any Navy docs), and I certainly hope (though I'm not overly optimistic) that we'll be out of there in the next 5-9 years when your husband would be up for a deployment. Then again, who knows where else we might be by then! Ugh. Also, as it stands now, the likelihood of a doc deploying depends largely on his/her chosen field. My husband is in pathology, and in the past four years that my husband has been active duty, it has been very rare for a pathologist to deploy to a war zone. I know of a few pathologists who volunteered to go to Iraq, and I know of a few others who were sent on relatively safe deployments to "cushy" places like Qatar. Other specialties deploy much more often. (Though in my experience, nurses, medics, and midlevel providers such as PAs tend to deploy more than the docs do.) The length of a deployment varies among the different branches. Air Force folks going to Afghanistan these days tend to be gone for 6 months. I can't think of anyone that I know who has gone for fewer than 6 months, but I would imagine there are circumstances where that would happen. The Army tends to deploy for longer (though I don't know the current length of Army deployments- 9mo-1yr, maybe?). I have no idea about the Navy. For what it's worth, all of the military medical personnel I know who have deployed have come home safe and sound, although one Air Force nurse had a scary situation when her hospital in Iraq took some mortar fire. Unfortunately, if your DH deploys, you could end up as a "single" mom for several months. There's no way around it; that situation totally sucks. The good news is that military moms tend to be very supportive of one another, and we stick together when our spouses deploy. On that front, I would suggest making friends with other military moms/families are soon as possible after you arrive at your duty station. There are excellent spouses clubs and playgroups at most bases to help you get started.

    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"?

    Being in the military, yes, you will have to go wherever the military sends you, and whether you get an assignment that you want is pretty much a crap shoot. But I think it's helpful to keep everything in perspective. Being in medical training, military or civilian, many students and new docs find that they have to move far from home, either to a program that will accept them or to a place where the doc feels he'll receive the best training. DH ended up in a residency 1500 miles from "home," but then again, several of his civilian med school classmates also ended up in far flung places. That's just the reality when you're in medical training. Post-training, I would imagine that most civilian docs have more of a say in where they practice than military docs do. Last fall, the graduating residents & fellows in DH's program were given the opportunity to rank the possible assignments. The rank sheet specifically mentioned that the doc's preferences on where to go would be taken into consideration when possible but that the needs of the Air Force would always come first. After the "needs of the Air Force" were considered, the military informed everyone where they would be going in March. Honestly, it was kind of a stressful time, not knowing if/where we would need to move in the next several months. Fortunately for us, DH did get his first choice assignment. However, some of the other residents/fellows were very unhappy with what they got. Like I said, crap shoot.

    3. what branch would be best to join if he did sign up?
    I don't think anyone else can answer that for you. I will say that my DH chose the USAF partly because of the *perception* that they treat their people better than the Army does. I would imagine that the fact FIL is retired Air Force also played a role. I can't remember if DH entertained the idea of joining the Navy or why he might've chosen not to go that route.

    4. what is residency like in the military? does it pay more or less than civilian residencies? how are the hours?

    I have been very happy overall with DH's experience as a military resident. Military residencies do tend to pay more than civilian programs do. Basically, the resident receives a "base pay" based on his/her rank and time in grade. There is also a housing allowance (BAH) and a food allowance (BAS). Both BAH and BAS are non-taxable. BAS is set each year based on the cost of food, and BAH changes depending on location, rank, and number of dependents. In addition to pay, military members and their dependents receive free or low cost health case through the military's insurance, TRICARE. There are also typically raises each January and a raise for each year that the servicemember has been in. And he gets paid extra when he has to travel for work (Temporary Duty Leave/TDY), such as for an away rotation. We have been able to live a very comfortable lifestyle on DH's military pay. We're not rich by any means but have been able to purchase a nice house in a family friendly neighborhood, have two cars, money in the bank, etc. Military pay is very transparent. You can see the current pay table here. The work hours are subject to the same restrictions as in civilian programs.

    A nice perk of being a federal employee is that non essential personnel get all federal holidays off. There are also "training days" or "family days" built into the year at least a few times, so overall the number of working days is quite a bit less than in a civilian program. This past year, DH also got 15 days of leave. Next year as a staff doc, DH will probably make less than most of his civilian counterparts, although IMO the financial benefits that we've been enjoying these past 4 years make it worth it.

    Something that your DH needs to be aware of is that he may not have complete control over his choice of residency/field if he goes into the military. The military's needs ALWAYS come first--they make no bones about that--and your H could end up in the unfortunate situation of there not being any spots in his chosen field or of the spots being taken by someone with more rank, or who has graduated from the military's med school (USUHS), or who served time in the miltary before being a doc. If there are no slots in his chosen field, he could also end up being shuttled into a primary care role after completing his first year of residency. I have a friend whose husband didn't get into the residency of his choice and was therefore made a "flight surgeon" after his internship year. He served 2 years as a flight doc in a location where he and his family had NO desire to be, and he is just now gearing up to move again and go back into residency in July.

    5. what is life like after residency for the 4 years that he must "pay back" in service?

    I'll get back to you next year.

    6. am i being too selfish by not wanting to do this?
    No. Going into the military is absolutely something that you both need to go into with your eyes WIDE open. I have been happy with our military experience so far, but there are also tons of horror stories out there. (My MIL is still bitter about her family's military experience, and that was 30 years ago!) I suggest talking to as many military docs and their families as possible and trying to get info from folks who have been unhappy with the experience as well as those who have been very happy with it. Then, consider the worst possible set of likely circumstances (something along the lines of your DH gets a crap residency or you get stationed somewhere you hate just in time for him to deploy and miss the birth of one of your children) and decide whether you can live with that. Oh, and don't listen to the recruiters. They lie. Hope that helps! Good luck!

    Comment


    • #3
      Of your list of concerns, it's hard for me to pinpoint what is exclusive to military docs. Obviously deployments are unique to the military. I would like to point out that there is no specialist that is safe from deployment. I know a guy who is a radiation oncologist and was deployed twice to Iraq. They didn't need him to practice radiation oncology-- not exactly a front line specially--- so they deployed him as a Brigade Surgeon (basically administrative role-- not actually a surgeon just an admin guy overseeing other docs, etc.). That being said, deployments are ramping down a bit now. Personally I fully expect my dh to deploy when he's eligible after finishing fellowship. I just plan on it. If he isn't deployed, great!

      I would say the medical profession as a whole is likely to make you move to a place you don't want to live (either due to residency match or due to the job market), you can expect LONG stretches of time as a single parent (most residents I know in civilian programs do some away rotations-- or they work brutally long hours-- regardless single parenting is the norm especially during the training years and typically during attending years as well).

      As far as quality of training, my dh has done several rotations at civilian training sites. The types of cases he sees in the military population is in general different from the civilian pop, but that's not to say one is more rigorous than the other. My dh has far more experience in nose jobs (reconstructive) and facial traumas than his peer group in the civilian side. As long as everyone meets the acgme standards for what you need to learn, it's all good.

      Life as a military medical spouse in training is not that different from life as a civilian medical spouse in my opinion. I feel far more identified by my status as a wife of a resident than as a wife of an officer in the army. There's just no comparison.

      Don't underestimate the perks of the military. I really value the health care we get, completely free. I know some residency programs offer great med care too. For us it's been just great though. My kids have all had issues, 3/5 have had surgeries, 1 has to be seen by specialists regularly, I had 2 high risk pregnancies with awesome perinatologists, 2 NICU stays for my babies, 1 hospital stay for my ds when
      He was 9, plenty of ER visits.., we really have appreciated the health care.

      I know you are struggling with this. If your guy feels strongly the need to serve, I think you should analyze what is holding you back. If its the fear of deployment, that's a very real possibility that is unique to military. If its the fear of Loss of autonomy to decide where you will live, understand that the Evil Mistress Called Medicine will often send you to live in places you never wanted to live regardless. It's just the way it is. And if your fear is being a single parent for long stretches of time, that's part of medicine as a whole too. I don't see a huge difference between military docs and civilian docs on this front. All of the non-doc spouses wish we could see our spouses more. Medicine is never a 40 hour a week job and it always has emergencies that take precedence over family events. That's the nature of the profession.

      Anyway, I hope you find peace with either decision.
      Peggy

      Aloha from paradise! And the other side of training!

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