Army Surgery Residencies

[JM.]

I am starting med school in the fall, and I am in the HPSP program (Army). While I know that my interests may change through medical school, at this time I am very interested in surgery. My question is basically - which Army teaching hospitals have the best surgery programs? Are these programs comparable to civilian programs? I would also like I know that I may request a civilian deferment for my residency training and I was wondering if this is an optiong that I ought to pursue (I read that deferments must be requests two years in advance.)

---

Members don't see this ad.

 

[GeoLeoX]

While I can't speak specifically to the quality of the Army surgery programs as I do not have first-hand experience, I can tell you that for the most part they are comparable or better than most civilian programs. One can thank the Army for a number of the major advances in surgery.

One thing that I can address is the issue of the "deferment". It is a term that is tossed around a lot, but I think that the concept is frequently misunderstood. For the most part one does not "apply" for a deferment. All graduating seniors apply for the deferment. All this means is that should a deferment come your way you have apply for it. However, who is selected for the civilian deferment is up to the Army. I have never heard of the "two year advance sign-up" that you mention. This is the way that it works. The Army projects a need for say, 7 ENTs in the future. They will offer 7 spots for training. Say, also for example, that the Army only has two residency positions. That means that there will be 5 deferments available. Now in this case, if you are a very competitive candidate you will likely be able to defer based on your choice. Those 2 spots will likely go to the highest ranked candidates who choose to go into the spots and frequently to USUHS students (as they are not eligible for civilian deferments, unlike us HPSPers). This does not imply that the USUHS students have an advantage over us, as they will be quick to say that because they cannot defer they are more likely to get into a residency spot they did not list as there top choice if they choose a field such as I have defined above.

I hope that this helps explain the much-misunderstood deferment. It is not an "opt-out" card. For most specialities most HPSPers will train at Army programs and there is nothing that they can do about it. Many surgery specialties are exceptions (ortho, ENT, urology, etc) and there is more of an opportunity for deferment, but that scenario is outline above.

Geo

 

[JM.]

Ok - I understand, and thankyou for the clarification.

So, is there any particular Army teaching hospital that excels in the area of GS or are all the programs fairly equivalent? Will good board scores and a strong medical school performance be adequate for matching into GS, or am I likely to get hosed?

If the Army has a five program min, and suppose there are only two slots for ENT - then what does that Army person list as 3-5 (I understand that they would grant 5 deferments for ENT, but what if you matched higher into another Army program?) If you would rather do EM than an IM or FP residency can you list that specialty as 3-5?

Trying not to sound like a neophyte on this topic.

 

[GeoLeoX]

Like I said before I personally can't address the particulars of each program, but I am sure that most if not all are top-notch. General Surgery as far as I know is not one of the most competitive residencies. There have been a number of highly-rated programs that didn't fill positions for the last few years.

Anyways, about the other spots - that's where you fill in what else you would like to do. You must specify a career goal on your preference priority (the list of your top 5 programs) list. If you specify surgery and try to match into an EM program, there could be questions. What most do (and they recommend that you do) is to specify all the surgery programs on your list (I think that there are 6 GS programs in the Army) in the order that you wish. For the specialties where there aren't 5 programs one usually chooses transitional programs, as they are designed for just such a contingency (among others).

Hope this helps,
Geo

ps. don't worry about asking these questions - the answers are things that have taken me years to discover.

 

[JM.]

Thanks for the info. There are 6 programs - I guess all I would like to do now is find out which see the most surgical cases and give their residents the best training.

 

[GeoLeoX]

Something else to keep in mind is that some of the programs are 4 year and some 5 year. That means two things. First, if you do one of the 5 year programs you will now have a 5 year repayment. Second, the extra year in a 5 year program is a research year. You have to decide if this something that you would like to do. I think the Walter Reed (NCC) program is the 5 year program.

Hope this helps,

Geo

 

[JM.]

Originally posted by GeoLeoX
Something else to keep in mind is that some of the programs are 4 year and some 5 year. That means two things. First, if you do one of the 5 year programs you will now have a 5 year repayment. Second, the extra year in a 5 year program is a research year. You have to decide if this something that you would like to do. I think the Walter Reed (NCC) program is the 5 year program.

Hope this helps,

Geo

Wait - I thought that the civilian GS programs were all 5 years. Is the army doing in 4 what is typically done in five? What is being left out? Why an extra year of repayemnt - I was under the impression that no residency years added to or deducted from payback time?

 

[GeoLeoX]

Most GS programs are 5 years (from what I know). At least at my school the 4th year is a research year (all year). You return to the world for the 5th year (chief). I assume, but do not know, that a 4 year program gets rid of the research year.

And I don't know where you heard the bit of fiction that no residency will add to your obligation. Sounds like recruiter-speak. There is a nutty complicated scheme that the Army uses that I will attempt to elucidate. The following example assumes that you have a 4 year HPSP scholarship (like me) and that you do your residency at an Army facility.

1. You have a 4 year HPSP scholarship
2. You owe 4 years of "payback"
3. You begin your payback of those years during residency (despite what they say. However, there is a catch - You incur an obligation now for your residency years!)
4. You pay back your residency obligation.

Example: 3 year IM residency - paid back 3 years of HPSP, still owe one year of HPSP + now 3 years for your IM residency. Total obligation post-residency = 4 years.

Example: 5 year GS residency - paid back all 4 years of HPSP, but now owe for 5 years of GS. Total obligation post-residency = 5 years.

I am not sure why the Army does it this way. I think that it is for calculation of retirement active service years or some such thing. I hope that this helps,

Geo

 

[JM.]

Nice to know that now. I am still interested in GS though - so I will have to deal.

 

[Navy Dive Doc]

Just to clarify some misinfo on this string...
General Surgery requires five years of residency, civilian or military. The numbers quoted are likely numbers of years IN ADDITION to the internship. The Navy will quote their residencies as being 4 years for surgery, radiology, etc. They mean PGY-2 and up, they're assuming everyone already has their internship done. So, the ones with 4 years mean no research year, total of 5 years internship + 4. The other includes the research year.
Hope this helps. The numbers about the active duty obligation are true. Internship doesn't count for or against you for payback, though. So for my 4 year scholarship I'll spend 12 years, minimum, in the Navy. 1 year of internship, 3 years as a GMO (actually DMO, Dive Medical Officer), 4 years of residency and 4 more years paying that back. Of course, I could leave in 2005 after my 4 years are paid back (5 with internship), but then I'd have to suffer the paycut to go to a civilian residency...not likely with my situation. Glad I like the Navy.
Hope this helps, Go Navy
DD

 

[maxheadroom]

Just to reinforce the divedoc;

No one is board eligible in General Surgery with less than five years of clinical training. Lots of civilian programs are 5 years of gen surg plus anywhere from 1-4 years of research. But they still do five years of clinical surgery. Often they stop after PGY 2 or 3 for the research time.

 

[GeoLeoX]

Thank you for the clarification. I am not a surgeon, though I play one on TV. As I mentioned at the beginning of the string, I can't speak for the specifics of surgery - but I do know about the Army HPSP.

 

[JM.]

Originally posted by maxheadroom
Just to reinforce the divedoc;

No one is board eligible in General Surgery with less than five years of clinical training. Lots of civilian programs are 5 years of gen surg plus anywhere from 1-4 years of research. But they still do five years of clinical surgery. Often they stop after PGY 2 or 3 for the research time.

Know anything about the specifics of the Army programs?