Well, I'll be darned. . .

It looks as though we will be entering under the wings of Uncle Sam in a little under two years. It's so strange to think about that next stage of our lives - and admittedly, we don't even really need to think about it at this point! We were both under this optimistic impression that he would be granted another deferment to do a fellowship. The Air Force is only offering one position that year and it is with the AF - meaning we would accrue even more time to pay back so we said heck no! But you know my determined hubby - we'll just do it AFTER our 4 year commitment! Is this EVER going to end?? Are we ever going to be able to move to a city of our choice and *settle down*? Errrgh, I am so frustrated! So, anyway - here come the questions:



* I know that I've asked this a zillion times but let me just ask one more time since my memory is so weak! Are the chances pretty good that we would be placed in one of our top three choices for location (or do we even get any choices?) We would really like to end up in either NC/DC/VA/SC. I don't know if that is a "good" area for military surgeons or not. . .



*How important is the work you do in the military as far as getting a job after the commitment and getting into a fellowship? Otherwise known as, does it matter where you go or not? Small town as opposed to larger city?

[DCJenn]

Well- I'm not surprised about the fellowship. They don't want to train people and have them leave so they are really trying very hard to keep everyone in a military sponsored fellowship.



What are the chances of staying where you are? Depends entirely on where the Air Force in particular, the military in general needs a surgeon of your husband's qualifications. That said, surgeons don't typically end up at the really small bases- they usually send the airmen to the larger hospitals if the need surgery. (For example, we were at the airport last summer heading back to San Antonio and there was a soldier from Oklahoma on order to head back to BAMC for followup to sholder surgery.- BAMC is the Army hospital)



Sally will be able to tell you a bit better where those are in the Air Force- I am really only familiar with the Army. However, the services are getting more and more integrated in certain areas, medicine being one of them. One of the Air Force peds graduates ended up in Germany in an Army slot- so, again, there's really no way of knowing.



You can request your preferences- we have to put in our list in December. If my husband isn't accepted in to the fellowship that he's applied for, we put in our list and then we should find out where we go in March. But as Sally can tell you, just because you put in your list doesn't mean you get to go where you want to.



Junior officers (Lt, Capt., and Maj) really don't get as much pull as senior officers. One of the Colonels, a neonatologist, just retired after being here for over 20 years. It can be done, obviously!



Jenn

[mommax3]

Claudia,



Sorry it has taken me so long to reply to this. Did I post a link for you here once about which bases have which specialties? I thought I posted it for someone -- if it wasn't you, let me know and I will look for it and re-post it.



I know you would like to be close to your families, but you also need to consider what your day-to-day desires are -- do you prefer a larger city? If so, fill out your preference sheet with all the bases in/near big cities at the top. Really think honestly about what you want and where it might be fun to live. San Antonio was no where near our families, but it is a great tourist destination, so we had lots of visitors. Is there a better part of the country for your career? All you can do is preference what you want and then hope for the best. We totally got screwed and my husband was extremely well thought of by the directors of his military residency, so there is no predicting how things will go. The needs of the Air Force are paramount and seniority, like Jenn said, helps a lot. Your husband probably knows who his assignments officer is -- he should stay in contact with him/her and with any military surgeons he may know. I don't think the assignments people are out to make anyone unhappy, but it becomes a numbers game to them, quite honestly.



Some of the smaller bases may only have one or two surgeons, which can be unsettling for someone just out of residency -- I know the orthapedic surgeon here is the only one and it was hard for him, coming straight out residency to a situation where there was no one to run things by. So keep that in mind. At a larger base, there may be surgeons in the specialty that your husband wants to do a fellowship in that could perhaps serve as references for him later on. He also needs to consider if he wants to be involved with a residency program or not.



The up-side to doing the military time is that his schedule will be a lot easier, and the financial squeeze will ease up a little. It might be a perfect time for you to be in the trenches (so to speak) of pregnancy and early-childhood.



Anyway, just some things to think about. If you have any more questions, let me know.



Sally

Did your husband consider only deferred fellowships or did he try for a sponsored spot? My husband is also a general surgeon and he is currently doing a sponsored fellowship in vascular surgery at Baylor University Medical Center in Dallas. The Army was only offering one military spot at Walter Reed, but this year they also offered one sponsored spot. The difference between a sponsored spot and a deferrment is that the government continues to pay you at your current salary with bonuses. If you are deferred you are basically separated from the military for the duration of the fellowship and payed by the training hospital. We would have not taken a deferred position.

In answer to your questiond about getting one of your top choices--it depends. So much is depended upon the needs of the government. It sounds as though your husband is currently in a residency program. (If I'm wrong let me know.) We were lucky and got our first choice in staff assignments, but others aren't so lucky. It is good to research where the openings are. If you list a hospital where there are no surgical spots then obviously you minimize your chances. We are Army so my experience is from that perspective, but I think it is also harder to get into a major medical training facility straight out of residency. It isn't totally unheard of, but it can be difficult. Just keep in mind that your wish list is exactly that--your wishes! Most of our friends have gotten one of their choices, but you always hear about the horror stories. Having his program directer give him a good recommendation is always a good idea. It is also good that you are planning ahead. We just started our fellowship year and aready Brian is talking the the powers that be about where he wants to go after he finishes in 2 years. That is another thing to keep in mind. If your husband decides to do a fellowship before his committment is up your choices are narrowed. Many surgical sub-specialties are only in the major medical centers. That narrows our next assignment down to 6 possible locations.

As for your second question--yes, I think it matters. For surgeons it is all about the number of cases your do and the variety of those cases. I would think he would want to look for a balance of both. Although he shouldn't be lacking in job offeres. Military surgeons are recuited very heavily. We get offers every other week and our committment isn't up until 2010.

Good luck.