Well it is detailed information if any one wants to know the criteria of scoring and procedure of recruitment. If you have already joined military service than you will get some bonus points. I am busy in mcts practice exams these days otherwise i am completely qualifying for all criteria of selection this year. But next year i will apply with full preparation.
Thanks for this post. I read the article closely. The article alleges that Army recruiters were pressured to meet hard productivity numbers, forced to work long hours and berated. It's difficult to read into suicide numbers because it is so infrequent. Suicide is measured per 100,000 persons so to look at a meaningful trend you really have to look at a trend amongst millions of people. What can you read into a possible suicide outbreak in a very small number of people?
With that being said, service members especially those in the infantry are extremely tough. They need to be this way in order to kick down doors and run into combat with their bayonets drawn. I have seen cases where leaders berated service members who were struggling. Their intentions were good. Leaders thought they could strengthen their service members with tough love but it backfired. My experience has been simple education can correct this hopefully infrequent leadership mistake.
If I understand you correctly, you are suggesting that there is a difference in the % of interns who are required to complete GMO tours. In the Navy I think it is around 40-50%. Not sure what it is in the other services. It would be nice if each branch released a detailed matching report with the numbers for transparency and to allow for comparison.
BTW I know you from student doctor net AKA Bliss72, so I signed up for your site. Just FYI, my buddy felt compelled to post here, so it is not me...Just in case you go nuclear LOL. Anyway, good to see you.
I am in the Army and I didn't have any GMO tour, I am in an anesthesia residency in the Army after I graduated from the HPSP. The only residents I know who were GMOs were in the Navy. No one that was HPSP with me were GMOs. Are you implying that all HPSPs serve as GMOs or just the ones in the Navy? The reason I am asking is because I don't think most of the non military types realize there are differences in the services and you are quoting GMO like all the services have mandatory GMO time. If I am mistaken please correct me. I do not want to assume anything.
Unfortunately, its been my bad experience that, (with few exceptions), by the time a "physician" stays long enough to become a Col, they have bought into the system lock stock and barrel. Very often they are part of the problem, and rarely the solution, as it well should be.
Galo, that's a great article. I worked at an overseas military hospital that was the equivalent of a small community hospital when I served in the Navy. We ran into issues like this where we felt we needed more staff and tried to ask the senior members of our community for help. Our perception was there was a conflict of interest because the senior military medical leaders worked at the big stateside hospitals and would drag their feet on any issue that would result in realigning key personnel. For example, fixing the issue at Fort Leonard Wood might require moving a psychiatrist from Walter Reed. The leaders would say things like "it's bad everywhere" and "things are worse here". Our perception was things were much better off at the big hospitals because they had a number of GS physicians, contractor physicians and a strong Tricare network. On overseas and small rural bases like Fort Leonard Wood, there is little or no Tricare network and its difficult if not impossible to hire a contractor. Another thing is the detailers would put the most junior personnel at the small hospitals. Maybe if more senior, experienced personnel were placed into billets at small hospitals they could prevent this type of situation from occurring. I wonder what would have happened if CPT Lee would have been a COL?
It is critical that the leadership does not understand the clearly seen early failure of this policy, and would be crazy to persue it. Certainly clear is the fact that this would cost alot more money, as this civiilan work force is going to demand compensation at least on par with any other civilian practice. Once again, there is a total disconnect between the people in command, and the people who are in the trenches doing the work.
This is a good critique. I also think the financial incentives are very misleading especially when comparing the civilian salaries for practically every specialty with the possible exception of pediatrics and family medicine.
You have some funny math there. First of all, if your $300,000 civilian pay is accurate for whatever field you are in, that is AFTER malpractice. When you join a practice or hospital group, they pay your malpractice for you. You don't each pay for it individually out of your paycheck! You'd know this if you had ever joined a private practice.
Also, to have a $60,000 per year retirement after 20 years, you need to invest $35,000 per year at 8 percent a year (below the average of the past 100 years in the stock market). Where in the world did you get $95,000 from??? Why were you assuming a 0 percent return??
Using correct math from your $300,000 starting point, we have $300,000 - $35,000 = $265,000 as a civilian doctor. That's more than twice as much as a military doctor makes.
you sound like another burnt out blame it on the military physician....who, although you are a military doc you obviously did not come from "a pool of less competitive candidates". im not going to get into semantics with you, anyone here can look up the numbers...but, for the sake of argument.
300,000 civilian pay - 50000 malpractice - 95000 per year you have to invest to have a 60000 per year retirement when you are 47 or 48 = 155000.
Any one considering joining the military to 'help pay for medical school' should seriously look at these numbers and reconsider. If you are joining because you want to serve your country - then that is a different story.
A quick search for physician salaries will reveal a large discrepancy in military physician compensation.
Many who join the military to help pay for medical school aren't accustomed to going into large debt for professional education, but should be reassured that it is not unusual to do so. If you were to take the difference in the military salary and civilian salary and apply it toward your medical school debt for the first few years out, you would quickly have it paid off - not that anyone would do this with the low interest rates being what they are for now.
Military medicine apologists will tell you that there are 'hidden benefits' such as the use of base grocery and department stores which are tax free, medical health care for you and your family, and freedom from worry about medical malpractice.
In truth most physicians do not live on the base and use closer more convenient stores for shopping - making the benefit of marginal savings at the commissary and base exchange nonexistent. Frankly, i find it insulting that this is even considered a benefit at all - it is like telling a civilian doctor that the flowershop in the hospital is part of their benefits package.
As far as the benefit of you and your family recieving medical care in the military medical system, consider a few things: the large disparity in compensation and the threat of deployment have scared away most intelligent capable potential physicians. the result is a pool of less competitive candidates for the military medical school and HPSP scholarships. On average this results in less competent and capable physcians at the end of training. I know this sounds harsh and extremely biased. Unfortunately experience as born it out to be true. further complicating this issue of military physician competence is the lack of fear of malpractice as described below. As a new military doc i was a bit surprised to find a few of my colleagues who, for example, would refuse to let their wives give birth at a military hospital for fear of a bad outcome. My own wife went out of her way to find a means of making sure that our kids could see a civilian pediatrician who took tricare rather than have to recieve care on the base - based off advice from logterm colleages who had prior poor experiences.
While the freedom from malpractice seems appealing, keep in mind that in an environment where there are few repercussions to poor practices, there will be more and greater examples of medical 'misadventure.' I feel much better practicing with appropriate malpractice coverage in an environment where all the other physicians I work with have the same motivations to practice safe competent medicine.
Other financial aspects that are not included in reports that compare civilian to military medicine is retirement savings. most academic center and groups offer some sort or contribution matching for savings. This will go a long way over the course of a career at the physicians level of compensation. The military does not contribute in such a way, further increaing the gap in compensation.
Other reported perks that the military will proffer include time and funds for conferences, CME, etc. In reality these are subject to budget restraints and I have found repeated instances where only a few people in the group have been able to get the benefit due to budget or personell shortfall.
I am frankly surprised that this website purports to not be affiliated with the military and yet does not include some of the realistic information that speaking with any military physician who is not more 'officer' than physician will yield you.
Pay during HPSP comes in the form of a monthly stipend that is irrespective of rank and time in service. I believe that the only time you receive pay based on your rate and rank is during the 45 day periods of annual training as you mentioned.
In HSCP, you receive active duty pay as an E6 and time in service for medical school. Not sure if you would get credit for time in service with HSCP.
FAP is similar to HPSP - the recipient receives a monthly stipend and annual bonus during civilian residency.
I believe internship is dead time. Therefore after completing a military internship you would still owe 4 years active duty time for a 4 year ROTC (or HPSP) scholarship. I think internship does count towards the statutory service obligation.
If one has a 4 yr ROTC ADSO and attends a military internship (FYGME) what is the remaining ADSO? otherwise put, does the internship count toward or add any ADSO time?
Thanks for pointing this out. There was a permissions problem that was preventing anonymous users from downloading the attachment. The page was updated with a source link.
Thanks for the post. I put it under dermatology.
Well it is detailed information if any one wants to know the criteria of scoring and procedure of recruitment. If you have already joined military service than you will get some bonus points. I am busy in mcts practice exams these days otherwise i am completely qualifying for all criteria of selection this year. But next year i will apply with full preparation.
Thanks for this post. I read the article closely. The article alleges that Army recruiters were pressured to meet hard productivity numbers, forced to work long hours and berated. It's difficult to read into suicide numbers because it is so infrequent. Suicide is measured per 100,000 persons so to look at a meaningful trend you really have to look at a trend amongst millions of people. What can you read into a possible suicide outbreak in a very small number of people?
With that being said, service members especially those in the infantry are extremely tough. They need to be this way in order to kick down doors and run into combat with their bayonets drawn. I have seen cases where leaders berated service members who were struggling. Their intentions were good. Leaders thought they could strengthen their service members with tough love but it backfired. My experience has been simple education can correct this hopefully infrequent leadership mistake.
If I understand you correctly, you are suggesting that there is a difference in the % of interns who are required to complete GMO tours. In the Navy I think it is around 40-50%. Not sure what it is in the other services. It would be nice if each branch released a detailed matching report with the numbers for transparency and to allow for comparison.
BTW I know you from student doctor net AKA Bliss72, so I signed up for your site. Just FYI, my buddy felt compelled to post here, so it is not me...Just in case you go nuclear LOL. Anyway, good to see you.
I am in the Army and I didn't have any GMO tour, I am in an anesthesia residency in the Army after I graduated from the HPSP. The only residents I know who were GMOs were in the Navy. No one that was HPSP with me were GMOs. Are you implying that all HPSPs serve as GMOs or just the ones in the Navy? The reason I am asking is because I don't think most of the non military types realize there are differences in the services and you are quoting GMO like all the services have mandatory GMO time. If I am mistaken please correct me. I do not want to assume anything.
Unfortunately, its been my bad experience that, (with few exceptions), by the time a "physician" stays long enough to become a Col, they have bought into the system lock stock and barrel. Very often they are part of the problem, and rarely the solution, as it well should be.
Galo, that's a great article. I worked at an overseas military hospital that was the equivalent of a small community hospital when I served in the Navy. We ran into issues like this where we felt we needed more staff and tried to ask the senior members of our community for help. Our perception was there was a conflict of interest because the senior military medical leaders worked at the big stateside hospitals and would drag their feet on any issue that would result in realigning key personnel. For example, fixing the issue at Fort Leonard Wood might require moving a psychiatrist from Walter Reed. The leaders would say things like "it's bad everywhere" and "things are worse here". Our perception was things were much better off at the big hospitals because they had a number of GS physicians, contractor physicians and a strong Tricare network. On overseas and small rural bases like Fort Leonard Wood, there is little or no Tricare network and its difficult if not impossible to hire a contractor. Another thing is the detailers would put the most junior personnel at the small hospitals. Maybe if more senior, experienced personnel were placed into billets at small hospitals they could prevent this type of situation from occurring. I wonder what would have happened if CPT Lee would have been a COL?
It is critical that the leadership does not understand the clearly seen early failure of this policy, and would be crazy to persue it. Certainly clear is the fact that this would cost alot more money, as this civiilan work force is going to demand compensation at least on par with any other civilian practice. Once again, there is a total disconnect between the people in command, and the people who are in the trenches doing the work.
This is a good critique. I also think the financial incentives are very misleading especially when comparing the civilian salaries for practically every specialty with the possible exception of pediatrics and family medicine.
Comment move to proper location.
You have some funny math there. First of all, if your $300,000 civilian pay is accurate for whatever field you are in, that is AFTER malpractice. When you join a practice or hospital group, they pay your malpractice for you. You don't each pay for it individually out of your paycheck! You'd know this if you had ever joined a private practice.
Also, to have a $60,000 per year retirement after 20 years, you need to invest $35,000 per year at 8 percent a year (below the average of the past 100 years in the stock market). Where in the world did you get $95,000 from??? Why were you assuming a 0 percent return??
Using correct math from your $300,000 starting point, we have $300,000 - $35,000 = $265,000 as a civilian doctor. That's more than twice as much as a military doctor makes.
you sound like another burnt out blame it on the military physician....who, although you are a military doc you obviously did not come from "a pool of less competitive candidates". im not going to get into semantics with you, anyone here can look up the numbers...but, for the sake of argument.
300,000 civilian pay - 50000 malpractice - 95000 per year you have to invest to have a 60000 per year retirement when you are 47 or 48 = 155000.
the pay is obviously way better as a civilian.
Just completed civilian residency, serving 4 years in Navy payback for HPSP. Am I eligible for GI bill, and can I transfer this to my dependents?
Any one considering joining the military to 'help pay for medical school' should seriously look at these numbers and reconsider. If you are joining because you want to serve your country - then that is a different story.
A quick search for physician salaries will reveal a large discrepancy in military physician compensation.
http://www.allied-physicians.com/salary_surveys/physician-salaries.htm
Many who join the military to help pay for medical school aren't accustomed to going into large debt for professional education, but should be reassured that it is not unusual to do so. If you were to take the difference in the military salary and civilian salary and apply it toward your medical school debt for the first few years out, you would quickly have it paid off - not that anyone would do this with the low interest rates being what they are for now.
Military medicine apologists will tell you that there are 'hidden benefits' such as the use of base grocery and department stores which are tax free, medical health care for you and your family, and freedom from worry about medical malpractice.
In truth most physicians do not live on the base and use closer more convenient stores for shopping - making the benefit of marginal savings at the commissary and base exchange nonexistent. Frankly, i find it insulting that this is even considered a benefit at all - it is like telling a civilian doctor that the flowershop in the hospital is part of their benefits package.
As far as the benefit of you and your family recieving medical care in the military medical system, consider a few things: the large disparity in compensation and the threat of deployment have scared away most intelligent capable potential physicians. the result is a pool of less competitive candidates for the military medical school and HPSP scholarships. On average this results in less competent and capable physcians at the end of training. I know this sounds harsh and extremely biased. Unfortunately experience as born it out to be true. further complicating this issue of military physician competence is the lack of fear of malpractice as described below. As a new military doc i was a bit surprised to find a few of my colleagues who, for example, would refuse to let their wives give birth at a military hospital for fear of a bad outcome. My own wife went out of her way to find a means of making sure that our kids could see a civilian pediatrician who took tricare rather than have to recieve care on the base - based off advice from logterm colleages who had prior poor experiences.
While the freedom from malpractice seems appealing, keep in mind that in an environment where there are few repercussions to poor practices, there will be more and greater examples of medical 'misadventure.' I feel much better practicing with appropriate malpractice coverage in an environment where all the other physicians I work with have the same motivations to practice safe competent medicine.
Other financial aspects that are not included in reports that compare civilian to military medicine is retirement savings. most academic center and groups offer some sort or contribution matching for savings. This will go a long way over the course of a career at the physicians level of compensation. The military does not contribute in such a way, further increaing the gap in compensation.
Other reported perks that the military will proffer include time and funds for conferences, CME, etc. In reality these are subject to budget restraints and I have found repeated instances where only a few people in the group have been able to get the benefit due to budget or personell shortfall.
I am frankly surprised that this website purports to not be affiliated with the military and yet does not include some of the realistic information that speaking with any military physician who is not more 'officer' than physician will yield you.
Pay during HPSP comes in the form of a monthly stipend that is irrespective of rank and time in service. I believe that the only time you receive pay based on your rate and rank is during the 45 day periods of annual training as you mentioned.
In HSCP, you receive active duty pay as an E6 and time in service for medical school. Not sure if you would get credit for time in service with HSCP.
FAP is similar to HPSP - the recipient receives a monthly stipend and annual bonus during civilian residency.
I believe internship is dead time. Therefore after completing a military internship you would still owe 4 years active duty time for a 4 year ROTC (or HPSP) scholarship. I think internship does count towards the statutory service obligation.
If one has a 4 yr ROTC ADSO and attends a military internship (FYGME) what is the remaining ADSO? otherwise put, does the internship count toward or add any ADSO time?
Thanks for pointing this out. There was a permissions problem that was preventing anonymous users from downloading the attachment. The page was updated with a source link.
does anyone have a link to this report?
Keep in mind that USUHS graduates are required to perform a military internship
Just a quick correction. During medical school you are an ENS if in the navy and a 2LT if army or air force.