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  • So...

    To those of you who have gone the military medicine route--

    Is going the military way worth it? Would you do it again? I'm wildly curious as to what your answers will be.

    Kelly
    In my dreams I run with the Kenyans.

  • #2
    Absolutely, no regrets AT ALL.

    However, we did the all military all the time way and I think it's easier than trying to straddle both worlds.

    1) Since we owe 7 years after training and Rick already has 12 in, it's a no brainer. We have no choice but to stay to retirement and if he decides he doesn't feel like dealing with the civilian side of medicine, then we stay until he decides he wants to leave the military.

    2) He's so specialized now that we can only go to the large military hospitals and even if they would send him to a cross-service hospital, really the only truly sucky ones are the AF hospitals in the states.

    3) It's nice having 100% medical coverage, almost that for dental, access to lawyers, veterinarians, etc. Plus, the commissary/PX/travel offices, etc. We are absolutely no different in terms of how the Army considers us- the fact that he's a physician only matters in terms of bonuses twice a year, otherwise he's a Captain (Major this Spring) and that's that.

    I do believe the HPSP people have a different experience. Typically, they have no prior service experience or were officers straight from ROTC or a Service Academy. Those who have prior military service have a different experience than those without. We have a friend who enlisted, got his GED, used the GI bill for undergrad, went through ROTC, then went to USUHS and owes 10 years. We have another friend who went to the AF Academy, then USUHS, then did an ID fellowship (military) and she owes 12 years after she's done. Those of us who owe more than five years have a different perspective- we're in, might as well make the most of it. Everyone we know who owes 4 or fewer counts the days until they're done. (a rare few HPSP people become lifers in our experience- we know one couple who both got military fellowships (AF) and are staying in.)

    The war? doesn't factor in at all. Do I worry that he'll go? Not really. There's certainly nothing I could do about it one way or the other. and I'm sort of expecting that he will at the minimum have to go backfill in Germany at some point. Scary? definitely, but hey- they paid this ride, they can use him how they see fit.

    So, yeah, I'm glad we did it this way. But, am I also glad we're not at Ft. Polk or Ft. Drum or Ft. Erwin or any other tiny spots? Absolutely. I'm just glad he wanted to do neurology!!!

    Jenn

    PS- I also have spent a lifetime negotiating with insane systems and the military is one giant soul-sucking system. You just have to find the zen and keep on trucking because kicking and screaming gets you no where.

    Comment


    • #3
      I showed the initial post in this thread to DH, and he said "That is a really hard question to answer!" I agree. DH entered the Air Force prior to beginning med school on an HPSP scholarship. His (our) main motivation was $$$, but he did have a desire to serve in the military.....not a HUGE desire, but his Dad was in the Army for a while, and his gfather was in France during WWII and was awarded some medal (bronze star?) for things he did there. So I think the combination of the money aspect and the family history made DH want to go this route.

      During med school, the military paid us a stipend of ~$800 a month. I was working full time as a teacher and brought home around $2000-$2200 a month. When DH began med school, we had to get a second car and the stipend allowed us to buy a new (used of course ) car with money we borrowed from DH's parents.....and we were able to pay them back within six months because of the stipend. Also, when DH was required to do active duty time (which basically meant he did a required rotation at a military base instead of at his school) he got active duty pay, which became our savings account for the rest of the year. The biggest thing that the military made possible was the birth of our oldest son. I was feeling like life was passing me by while DH was in med school (I am a couple of years older than him) and really wanted to have a baby. Having the scholarship and the stipend made it possible for me to give up my job because DH hadn't yet taken out any student loans for med school (or undergrad, for that matter). So in April of DH's second year, we had Luke, and despite everything that came after that in our military experience......I would NEVER undo having had our son when we did!

      Residency.....being selected for an active duty residency was a HUGE shock to my husband and to me. Now that we have the benefit of experience, we know that OF COURSE he was going to have to do that....but we didn't know anyone else who was going the same route we did, so we were ignorant and thought if DH asked for a deferral, he would get it. WRONG!!! So we moved to San Antonio, and apart from the actual fact of residency (which would have sucked anywhere, civilian or military) we loved it there. DH feels very good about the training he received and has great respect for the attendings he worked with.....some of them had written chapters in the OB/Gyn textbooks he used in med school. We made life-long friends, and enjoyed a pretty nice standard of living in a city with one of the lowest costs of living in the US. He was paid an active duty salary, which was consideraby better than a typical resident's salary, plus all of the medical and dental care coverage that Jenn mentioned.

      For our four years of payback, DH got wind of a plan that the Army was "borrowing" OB/Gyns from the Air Force because the Air Force had too many OBs and the Army, not enough. There is an Army post where DH's parents live, and after four years (and one birth) far away from any family at all, living close to my in-laws sounded pretty good, so we decided that DH should pursue being "borrowed". It all looked good and we even had military physicians from that post call us to see if we would like to buy their houses because they had all heard that DH was coming. However, at the very end of the process for reasons that are too long to go into, but involved a physician ignoring her chain of command and subverting the whole assignments process, DH was bumped at the last minute. All of the choice Air Force spots were assigned by this time, so we got what was left over......Mountain Home AFB in Idaho. This was a huge shock to both of us and we basically went through mourning (and bought a Suburban ). A month later, (keep in mind it is April at this point and we will move in June) the assignment changed again, to Sheppard AFB in Wichita Falls. I was six months pregnant with two little boys and doing an in-state move (albeit SIX hours away) was much more preferable than moving from TX to ID with all of our family in eastern KS and IN. We knew absolutely nothing about Wichita Falls, and we fought to get a two day window to go up there and buy a house.....after buying the house, we STILL knew nothing about Wichita Falls!

      As most everyone who has been here for a while knows, DH and I absolutely hated our time in Wichita Falls. Being a staff OB/Gyn at a small base is a much different story than working at a medical center where there is teaching and research taking place. DH had basically no camraderie at work, which was very stressful for him as a new OB fresh out of residency. The base was short one doc for half the time we were there, and short one *competent* doc most of the time we were there. One bonus was that all the deliveries took place at the civilian hospital, so DH at least got some perks that way. The base hospital there was dying a slow and ugly death the whole time we were there.....by the time we left, there was no inpatient care being done there and in fact, there are no OBs at that base any more......all care in contracted out to civilian providers. It was like DH was on a sinking ship. He had no control over how his clinic was run or staffed, and the staffing changed at the whim of whoever was the administrator.....and that person changed 4 or 5 times while we were there, also. Our time there would almost make both of us say we wouldn't do the military thing again.......and yet......without the military, we would probably never have left Indiana and would have missed out on some great friends and experiences. I probably never would have become desperate enough to find this place! We have been forever changed by our military experience, and I am thankful for that, and of course, I can't imagine life without my son! So after this whole long post.......I guess my answer is "I'm not sure." Knowing what we know now, we would never have done it, but the only way you can know what we know now is to have gone through the experience, so ?????
      One thing is for sure......we were giddy with happiness to be done with the whole thing!

      Sally
      Wife of an OB/Gyn, mom to three boys, middle school choir teacher.

      "I don't know when Dad will be home."

      Comment


      • #4
        Ok, we did it a different way. They paid DW during her residency, then she owes them four years of active duty service. If we were at that crossroad again, we would take a different route.
        There is just many other things thrown into DW work day that are in no way related to her training of treating children. It is infuriating for her the amount of inefficiency that runs in the clinics/ER. I guess it is hard to get good workers in any setting.

        Comparing what some of her residency mates took as work, to what she took, she is lower paid. Sure, the benefits make a difference and the people are "typically" welcoming.

        DW usually has the most troubles with families of pilots, because if things don't happen ''Right Now' they are going to go up the chain'. She has been railroaded a few times by higher ranking, non-medical officers beacuse things were not getting done fast enough. Like she has control over the radiology department and their scheduling too. There have been other incidents of cancelling tests, being done by non-medical staff. When she files a complaint, it is rarely addressed. She feels that she needs to follow up with every ordered lab, x-ray...you name it. It seems to always be that the right hand doesn't have a clue with the left hand is doing.

        So, with that said, we are unique in that DW will be pinned Major in July. That is different because she has only been active duty for 15 months. It opens a lot of different avenues because at 4 years, she could sign on for more, taking the possibility that we be moved around about every 5 years ( that is longer than what it is now, about 3-4 years, but they keep losing doctors because of the constant moving, so they are changing it.). Or, the possiblity of more training ( ) but that would limit possibilities of some of the smaller bases, like Jenn's scenario. The retirement is the biggest draw for staying on for more time, DW could make it to Lt. Col, possibly even Col if she did some of the War University items or become a squadron command. Retirement at those levels is VERY GOOD.

        More than likely, we will be looking for work in the civilian world in about two and a half years.

        I don't know if this even makes any sense, but it is an answer to the question

        Comment


        • #5
          Re: So...

          Originally posted by kmbsjbcgb
          To those of you who have gone the military medicine route--

          Is going the military way worth it? Would you do it again?
          I don't think I can answer this yet. In about two or three years we'll have had enough experience to form an opinion.
          Who uses a machete to cut through red tape
          With fingernails that shine like justice
          And a voice that is dark like tinted glass

          Comment


          • #6
            I have to add that everything Matt says about his wife's work environment was true for DH when he was active duty. It is definitely NOT an efficient or well-run place to work.

            One example.....everyone knew that OB/Gyn was "closing" (being contracted out) beginning May 2005 at Sheppard.....BUT some non-medical administration type decided that it would be a good idea to move the Women's Health Clinic down one floor for the final six months of its existence. WTH?!!!! And yes, DH had to give up a Saturday to go in and move furniture......

            I also need to mention that DH now makes almost double what he made when he was military. If he wouldn't have done HPSP and had gone straight into civilian practice following residency, he could have paid off his student loans by now, even if he had borrowed the maximum each of the four years he was in med school. So financially, maybe HPSP wasn't the best idea for us in the long run after all......but it is hard to quantify the four years of residency when he made a nice (50K-60K) salary and had good health and dental benefits.

            A final note about deployment.....DH never was deployed and we were (and are!) very grateful for that. OB/Gyns function as surgeons in the field, so there was every possibility he could have gone....every Army OB/Gyn we knew has been deployed.....some more than once. So that was another huge relief when he got out, because with the OB/Gyn dept. closing at Sheppard, if he had stayed in, I think they would have sent him somewhere at that point.

            Sally
            Wife of an OB/Gyn, mom to three boys, middle school choir teacher.

            "I don't know when Dad will be home."

            Comment


            • #7
              But, to the defense of the military, from what we've all read here, the civilian world is not exactly well-run, either. (how many people never got paid from moonlighting?)

              However, we've had our share of battles, we finally gave up the O/E pay thing- we can't prove that Rick ever did his 'two weeks' while in the National Guard...

              But- hey, at least we get to deduct running shoes and athletic wear from the taxes!

              jenn

              Comment


              • #8
                Originally posted by mommax3
                OB/Gyns function as surgeons in the field, so there was every possibility he could have gone....every Army OB/Gyn we knew has been deployed.....some more than once.
                Ummmm, not to pick a fight here, but isn't that a bit frightening? My dh always carps about OB's as surgeons b/c they don't do a surgical residency (you know the specialty to specialt sterotypes). I argue that I'm sure they get surgical training involving the area they perform surgeries on during their OB residency (and he only did intern year of surgery so what the heck does he know). But for the Army to use OB's as surgeons in the field? That seems like a heck of a stretch to ask those folks to make.

                Am I missing something?

                Comment


                • #9
                  Nope- Since the OBs have a LOT more surgery experience than, well, anyone other than surgeons, when they're on the battlefield, they're used for that skill. (other than the occsional humanitarian delivery or GYN emergency, the skills with the chick parts aren't the reason why they're there.)

                  In fact, the pediatricians that are there aren't being used as peds, really, either- they're used as ER docs.

                  Bottom line is if you have a useable skill, and you're in a battlefield hospital, you'll be put to work doing whatever it is that you can do.

                  Jen

                  Comment


                  • #10
                    My husband says it's horrifying who's allowed to perform a vasectomy in the military--according to him, almost anyone.
                    Married to a hematopathologist seven years out of training.
                    Raising three girls, 11, 9, and 2.

                    “That was the thing about the world: it wasn't that things were harder than you thought they were going to be, it was that they were hard in ways that you didn't expect.”
                    Lev Grossman, The Magician King

                    Comment


                    • #11
                      Wow..OB's and pediatricians deployed? I never knew that. I think that's a bit scarey too. Why not keep the OB's on base where the women are in need of their ob/gyn services or something?

                      kris
                      ~Mom of 5, married to an ID doc
                      ~A Rolling Stone Gathers No Moss

                      Comment


                      • #12
                        I'm sure the military thinks it's better to have the psychiatrists deliver the babies, rather than be where people who are witnessing horrors could actually use the help.

                        Comment


                        • #13
                          Originally posted by PrincessFiona
                          Wow..OB's and pediatricians deployed? I never knew that. I think that's a bit scarey too. Why not keep the OB's on base where the women are in need of their ob/gyn services or something?

                          kris
                          From my understanding it's because military physicians are there primarily to serve the active duty members of the military. And, all dependant needs are secondary.

                          I am of the opinion right now that all dependant care needs to be contracted out to civilian physicians (ie just like any other normal insurance policy) and the military physicians left to focus on members of the military. Of course, that would mean the military would need substantially less doctors and those doctors would be deployed more often most likely. And, pediatricians in the service would be unnecessary. AND, if they shunted any pregnant service members into the dependant insurance system they would see civilian OB's and obstetrics in the military would become non-existant.
                          Who uses a machete to cut through red tape
                          With fingernails that shine like justice
                          And a voice that is dark like tinted glass

                          Comment


                          • #14
                            We know a few OBs and a reproductive endocrine guy that went to Iraq. We also knew an army lawyer (husband of a nurse) that was deployed and *killed* in one of the helicopter crashes a few years ago. Somehow the saddest part to me is that these people never expected to go. That may be their "fault" for not considering what they were signing on for...but it just seems so sad.
                            Angie
                            Gyn-Onc fellowship survivor - 10 years out of the training years; reluctant suburbanite
                            Mom to DS (18) and DD (15) (and many many pets)

                            "Where are we going - and what am I doing in this handbasket?"

                            Comment


                            • #15
                              Ummmm, not to pick a fight here, but isn't that a bit frightening?
                              No fight here.....that fact scared the crap out of DH. I have every ability in his gyn surgical skills, but any other part of the body......no. Supposedly, he would have been given a crash t-surg review before being deployed.....but still! His last rotation as an intern was a month on t-surgery, but he hadn't had anything non-gyn in terms of surgery since then. I really think he was more stressed about what he would be doing if he were deployed than the actual fact of being deployed.

                              (By the way, also in the vein of specialty to specialty stereotypes.....according to DH, general surgeons (NO offense meant to anyone!) are lightning quick to call a gyn consult on anything that REMOTELY presents involving "female parts", despite routinely dissing the surgical skills of gynecologists. )

                              I am of the opinion right now that all dependant care needs to be contracted out to civilian physicians (ie just like any other normal insurance policy) and the military physicians left to focus on members of the military.
                              I agree with you, Rapunzel, and I think this will eventually happen. However, it is EXTREMELY hard to find civilian providers that will accept Tri-Care (the military insurance) because it pays LESS than Medicaid. When OB/Gyn was closing at our previous base, DH was a liason to the civilian OBs in the area, and the only two willing to take Tri-Care were FMGs who were (in DH's humble opinion ) not competent in one case and seeing too many patients to be safe in the other case. The other more respected docs wouldn't take the military patients on because it would increase their clinic load substantially (and also their obstetrics....military folk are in an age range where they are having lots of babies) and the insurance wasn't going to pay enough to make it worth their while. The other issue (in OB anyway) was that military folk are transient and the civilian physicians didn't want the liability risk of "inheriting" a patient late in pregnancy who may not have had *any* prenatal care prior to becoming a military dependent, or who may have had substandard care somewhere else. This happened to DH all the time....here's the scenario. Johnnie and Susie are high school dropouts in Appalachia (or wherever....) somewhere. Johnnie knocks Susie up and is shipped off to Air Force basic training so he can provide for the coming bundle of joy. Susie stays home with mom because spouses are not allowed at basic training. They get married at some point. Susie joins Johnnie at his first assignment after basic training (which was our base.....the first stop for enlisted personnel after basic) having had no prenatal care whatsoever. She is not sure of the date of her last period and her pregnancy is so advanced that ultrasound is not a good indicator of her due date. For a military OB, this happens all the time. If the baby has problems (fortunately rare) the military OB is supposedly protected somewhat from litigation, but a civilian OB is not, so they are understandably leery of taking on a military population. The other issue regarding the need for military physicians is for the families who are in other parts of the world where getting medical care on the local economy is not preferable.

                              Also.....some of the OBs I know have actually ended up doing quite a bit of primary care stuff, both for soldiers and for Iraqis. So just because they *can* be used as surgeons doesn't mean they always are.

                              I have to end by saying this.....DH still gets (don't ask me why) a magazine called "Federal Practitioner" for military physicians. The issue that came today lists all of the federally owned healthcare facilities and the services each provides, with a contact person and phone # for each dept. I looked up our old base (where the hospital is nothing but a primary care clinic now) and every single thing they had listed there was out of date by about TWO YEARS! Every contact person had been out of the military for two years. The description of the hospital AS a hospital was in itself wildly inaccurate. And this is a publication OF the government about its own facilities. Just goes to show you, like Matt posted....
                              It seems to always be that the right hand doesn't have a clue with the left hand is doing.
                              Sally
                              Wife of an OB/Gyn, mom to three boys, middle school choir teacher.

                              "I don't know when Dad will be home."

                              Comment

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