- Joined
- Jun 8, 2007
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Prior Service: USMC enlisted --> Interservice transfer to USN enlisted (corpsman)
Prior Service Years: 4 (reserves)
MilMed Program: USUHS
Branch of Service: Navy
MilMed Time in Service: 7 years post-USUHS
GMO Tour: None
Internship/Residency: Orthopedics
GME Training Location: Naval Medical Center Portsmouth
First Duty Station: Overseas (Okinawa, Japan)
Fellowship: Accepted FTOS 2020
MilMed Deployments: None
Other: Wife is USUHS classmate. Internal Medicine. 2 kids (ages 5 and 2)
Remaining Obligation: 7 years
USUHS Experience: Overall very positive. Great education. Set me up well for great Step scores. Many experiences which helped provide reprieve from med school grind and provide impact to future self. Met love of my life and fortunately we were same branch of service. We traveled for free for many of our rotations (Hawaii, Seattle, Pensacola, San Diego). I did 2 weeks in England for operational medicine course.
Internship Choice: We specifically chose Portsmouth due to more blue collar feel. Less politics than Bethesda. Higher volume and broader mix of cases for me. Solid medicine program for wife.
GMO climate for us: At the time about 50% of ortho interns were going out for GMO tours. Higher for Internal Medicine. We maintained top 50% of our intern classes and made known to our programs that we were interested in going straight through. We established solid relationships with people in our programs. We both went straight in to residency. Mil-Mil helped I am sure.
Residency: Overall very positive. Ortho had a broad mix of cases and as much volume as I could want (except in Joints, Trauma and Pediatrics). These rotations were outsourced to High Volume civilian centers. Personally I enjoyed the reprieve from daily MilMed grind. Allowed for some travel and change of scenery and really gave us a ton of independence in the OR as staff at these locations loved the active duty trained residents. My wife graduated and was selected as chief resident, then was able to stay on 1 additional year at same location as junior staff to align our rotation dates. The chief resident application was a very deliberate decision to ensure we stayed together. This also facilitated them keeping her at NMCP for 1 junior staff year as they preferred the continuity. Luck and timing were on our side but we also personally did much behind the scenes with our programs which we think influenced their likelihood to advocate for us.
Post-Residency: We both decided NOT to try to go straight to fellowship. We wanted a break from training and an opportunity to focus on becoming independent physicians in the military as well as focus on our family for a few years. This was absolutely the right choice and I recommend it to most I talk to now. I know much more about myself as a surgeon and will undoubtedly have a 100% different experience in fellowship than if I were to have gone straight in. It also helped solidify that I wanted to stay active duty and do fellowship in the military as well as helped solidify my choice of sub-specialty. The writing is on the wall that if you aren't relevant to operational readiness then you may be shooting yourself in the foot as it relates to MilMed. This is fine if you are already mentally a civilian, just don't be surprised if you are miserable during your payback.
We very deliberately chose Okinawa as first choice. Our research told us that it would be the best clinical experience, lifestyle experience and travel experience. As Junior O4's it also would allow us to have a bigger command impact given that it is a smaller command. If our clinical experience was lacking we would at least be helping our fitreps/careers. Regardless, we wanted to get away from the large MTF's for a while. A lot of the smaller stateside commands had fewer partners, variable amounts of cases and a lot of unknowns in terms of downsizing. We knew case complexity/acuity might be low but this is a factor at every location. We didn't want or need to moonlight so overseas was great for us. My research also told me that my case volume would be moderate, contain about 90% sports, 10% basic trauma and that I would have plenty of partners (also an indication that case volume is decent). Also helps call situation. The case mix is exactly what I wanted as I was pursuing sports for fellowship as this would keep me as relevant as possible to the operational military (and thankfully it is also what I am interested in). If I were planning on doing Joints, Spine, Trauma then I might have been miserable.
Okinawa turned out to be exactly what we were expecting.
Clinical Environment: Moderate/OK. No ability to moonlight. We send out complex trauma after performing damage control. We send out complex revision sports cases. Otherwise it is about 90% sports, 10% basic trauma. I had no issues collecting enough cases for boards. Boards were a breeze. My wife has moderate to poor clinical environment. Few complex cases. Few procedures for her. Lots of clinic. She has kept up with academics via question banks, journal clubs, etc.
Family/Lifestyle: Excellent. Call schedule is a dream. Work hours are great. Wife drops off kids, I routinely pick them up. We have traveled to at least 8 different countries while in Asia. Burned over 90 days of leave in 2 years.
Career/Promotion: Excellent. Small command allowed us to have big impact even as junior O4's. Many PI projects in joint environment. Established 2 working groups that have broad DHA relevance and progress will travel with me to next duty station. We should both have excellent first looks for O5.
Command/Climate: Good to excellent. No concerns from leadership forcing our hand to do anything not within our scope. Patient safety concerns always trump and administrative/business concerns. DSS very knowledgeable about the Navy and job as DSS. Supportive of surgeon ideas/concerns. Typical MilMed pitfalls but I am able to actually improve some annoying inefficiencies given small command and that people are willing to listen. Being department head for 2 years now also helps.
Remaining Obligation: 7 years now that I accepted FTOS. Wife just got orders to co-locate to where I will be doing fellowship. I chose to only interview at locations close to MTF's we could both work at. I am hoping to roll in to same command as she after I am done. Wife only has 2 more years to pay back. No plans for fellowship. We are discussing her getting out but no reason to at this time as the Navy has been good to us. I imagine deployments are lined up for us in next 2-3 years so will have to wait and see how climate is. Not too worried about DHA transition as it seems downsizing and consolidation will continue. Lots of talk about more and more opportunities to practice in civilian sector so win-win for us. Will keep updating as I receive first hand experience through this transition. I know A LOT of colleagues leaving the service ASAP. Typical for ortho but anecdotally it seems higher now. I am not surprised.
Quick Financial Discussion: We have zero debt. We are going to hit a 7-figure net worth before we turn 35. NEVER choose MilMed for the money but if you end up joining the short term financial benefits are real if you are smart about how you spend and use your benefits. Both kids have a GI bill to use. We have 1 rental home.
Summary: We have been very fortunate therefore we are still happy with what MilMed is doing for us. This can change very quickly. Being Mil-Mil, same service has definitely helped our ability to negotiate, stay together and maintain a great household income. It also guarantees we both maintain employment wherever we go. Both of these are not as easy with a non-military working spouse or different branch military spouse. Still, I think there is a lot that the individual service member can do to maximize their chances of success and clinical experience. We were proactive about lowering chances of disappointment via the ways we communicated with detailers/specialty-leaders/program directors/commands, researched duty stations and utilized our connections. The other big thing is that we let the military guide our decisions. We of course have our own personal desires but when personal desires align with military expectations it is a win-win. When they don't you have two options: Fight the beast or just take advantage of the positives that you can find.
Feel free to use this as you see fit. Premeds can ask whatever questions they would like. Current Active Duty MilMeds can copy and paste the template for their own thread to help others in different branches, specialties and/or duty locations. The more information we have the more benefit we can provide to each other and those coming after us. I will keep updating throughout my career.
Prior Service Years: 4 (reserves)
MilMed Program: USUHS
Branch of Service: Navy
MilMed Time in Service: 7 years post-USUHS
GMO Tour: None
Internship/Residency: Orthopedics
GME Training Location: Naval Medical Center Portsmouth
First Duty Station: Overseas (Okinawa, Japan)
Fellowship: Accepted FTOS 2020
MilMed Deployments: None
Other: Wife is USUHS classmate. Internal Medicine. 2 kids (ages 5 and 2)
Remaining Obligation: 7 years
USUHS Experience: Overall very positive. Great education. Set me up well for great Step scores. Many experiences which helped provide reprieve from med school grind and provide impact to future self. Met love of my life and fortunately we were same branch of service. We traveled for free for many of our rotations (Hawaii, Seattle, Pensacola, San Diego). I did 2 weeks in England for operational medicine course.
Internship Choice: We specifically chose Portsmouth due to more blue collar feel. Less politics than Bethesda. Higher volume and broader mix of cases for me. Solid medicine program for wife.
GMO climate for us: At the time about 50% of ortho interns were going out for GMO tours. Higher for Internal Medicine. We maintained top 50% of our intern classes and made known to our programs that we were interested in going straight through. We established solid relationships with people in our programs. We both went straight in to residency. Mil-Mil helped I am sure.
Residency: Overall very positive. Ortho had a broad mix of cases and as much volume as I could want (except in Joints, Trauma and Pediatrics). These rotations were outsourced to High Volume civilian centers. Personally I enjoyed the reprieve from daily MilMed grind. Allowed for some travel and change of scenery and really gave us a ton of independence in the OR as staff at these locations loved the active duty trained residents. My wife graduated and was selected as chief resident, then was able to stay on 1 additional year at same location as junior staff to align our rotation dates. The chief resident application was a very deliberate decision to ensure we stayed together. This also facilitated them keeping her at NMCP for 1 junior staff year as they preferred the continuity. Luck and timing were on our side but we also personally did much behind the scenes with our programs which we think influenced their likelihood to advocate for us.
Post-Residency: We both decided NOT to try to go straight to fellowship. We wanted a break from training and an opportunity to focus on becoming independent physicians in the military as well as focus on our family for a few years. This was absolutely the right choice and I recommend it to most I talk to now. I know much more about myself as a surgeon and will undoubtedly have a 100% different experience in fellowship than if I were to have gone straight in. It also helped solidify that I wanted to stay active duty and do fellowship in the military as well as helped solidify my choice of sub-specialty. The writing is on the wall that if you aren't relevant to operational readiness then you may be shooting yourself in the foot as it relates to MilMed. This is fine if you are already mentally a civilian, just don't be surprised if you are miserable during your payback.
We very deliberately chose Okinawa as first choice. Our research told us that it would be the best clinical experience, lifestyle experience and travel experience. As Junior O4's it also would allow us to have a bigger command impact given that it is a smaller command. If our clinical experience was lacking we would at least be helping our fitreps/careers. Regardless, we wanted to get away from the large MTF's for a while. A lot of the smaller stateside commands had fewer partners, variable amounts of cases and a lot of unknowns in terms of downsizing. We knew case complexity/acuity might be low but this is a factor at every location. We didn't want or need to moonlight so overseas was great for us. My research also told me that my case volume would be moderate, contain about 90% sports, 10% basic trauma and that I would have plenty of partners (also an indication that case volume is decent). Also helps call situation. The case mix is exactly what I wanted as I was pursuing sports for fellowship as this would keep me as relevant as possible to the operational military (and thankfully it is also what I am interested in). If I were planning on doing Joints, Spine, Trauma then I might have been miserable.
Okinawa turned out to be exactly what we were expecting.
Clinical Environment: Moderate/OK. No ability to moonlight. We send out complex trauma after performing damage control. We send out complex revision sports cases. Otherwise it is about 90% sports, 10% basic trauma. I had no issues collecting enough cases for boards. Boards were a breeze. My wife has moderate to poor clinical environment. Few complex cases. Few procedures for her. Lots of clinic. She has kept up with academics via question banks, journal clubs, etc.
Family/Lifestyle: Excellent. Call schedule is a dream. Work hours are great. Wife drops off kids, I routinely pick them up. We have traveled to at least 8 different countries while in Asia. Burned over 90 days of leave in 2 years.
Career/Promotion: Excellent. Small command allowed us to have big impact even as junior O4's. Many PI projects in joint environment. Established 2 working groups that have broad DHA relevance and progress will travel with me to next duty station. We should both have excellent first looks for O5.
Command/Climate: Good to excellent. No concerns from leadership forcing our hand to do anything not within our scope. Patient safety concerns always trump and administrative/business concerns. DSS very knowledgeable about the Navy and job as DSS. Supportive of surgeon ideas/concerns. Typical MilMed pitfalls but I am able to actually improve some annoying inefficiencies given small command and that people are willing to listen. Being department head for 2 years now also helps.
Remaining Obligation: 7 years now that I accepted FTOS. Wife just got orders to co-locate to where I will be doing fellowship. I chose to only interview at locations close to MTF's we could both work at. I am hoping to roll in to same command as she after I am done. Wife only has 2 more years to pay back. No plans for fellowship. We are discussing her getting out but no reason to at this time as the Navy has been good to us. I imagine deployments are lined up for us in next 2-3 years so will have to wait and see how climate is. Not too worried about DHA transition as it seems downsizing and consolidation will continue. Lots of talk about more and more opportunities to practice in civilian sector so win-win for us. Will keep updating as I receive first hand experience through this transition. I know A LOT of colleagues leaving the service ASAP. Typical for ortho but anecdotally it seems higher now. I am not surprised.
Quick Financial Discussion: We have zero debt. We are going to hit a 7-figure net worth before we turn 35. NEVER choose MilMed for the money but if you end up joining the short term financial benefits are real if you are smart about how you spend and use your benefits. Both kids have a GI bill to use. We have 1 rental home.
Summary: We have been very fortunate therefore we are still happy with what MilMed is doing for us. This can change very quickly. Being Mil-Mil, same service has definitely helped our ability to negotiate, stay together and maintain a great household income. It also guarantees we both maintain employment wherever we go. Both of these are not as easy with a non-military working spouse or different branch military spouse. Still, I think there is a lot that the individual service member can do to maximize their chances of success and clinical experience. We were proactive about lowering chances of disappointment via the ways we communicated with detailers/specialty-leaders/program directors/commands, researched duty stations and utilized our connections. The other big thing is that we let the military guide our decisions. We of course have our own personal desires but when personal desires align with military expectations it is a win-win. When they don't you have two options: Fight the beast or just take advantage of the positives that you can find.
Feel free to use this as you see fit. Premeds can ask whatever questions they would like. Current Active Duty MilMeds can copy and paste the template for their own thread to help others in different branches, specialties and/or duty locations. The more information we have the more benefit we can provide to each other and those coming after us. I will keep updating throughout my career.
