life beyond residency

[dyk33]

what is the percentage of military doc's applying for fellowships, such as heme/onc, endo, GI, cardio, etc.? is applying for medicine subspecialty encouraged during military residency training? are they competitive? does any one know?

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[Andrew_Doan]

Originally posted by dyk33
what is the percentage of military doc's applying for fellowships, such as heme/onc, endo, GI, cardio, etc.? is applying for medicine subspecialty encouraged during military residency training? are they competitive? does any one know?

Fellowship training is dictated by the need of the force. There is a GMESB (Graduate Medical Education Selection Board) that meets every winter. In fact, the GMESB just met last week to decide the fate of numerous physicians. Fellowship applications are encouraged from active duty physicians and residents. Physicians will receive "points" towards their application based on aptitude, qualifications, military service, research, etc...

The number of fellows that can train per year for each specialty is pre-established by policy makers. For example, the Navy is allowed to send two fellows in the field of ophthalmology per year for fellowship training. Many fellowships are provided by the military; however, there are opportunities to complete fellowship in civilian institutions. In ophthalmology, the fellowships are completed at civilian institutions; thus, physicians receive full military physician pay as a fellow in a civilian training program. Given that military physicians are "free" to a program, they are highly competitive for positions at the most competitive programs, e.g. Johns Hopkins, Harvard, Yale, etc...

I'm currently a resident in the Navy FAP. I've submitted an application for fellowship training after my residency, and I expect to hear the GMESB decision in two weeks. If I fail to receive permission to pursue fellowship training, then I'll work as a general ophthalmologist for the Navy first. Then I'll re-apply after I gain military experience, which will make me more competitive for GMESB selection. Additionally, if I do fellowship later, then I'll receive full physician pay as a fellow rather than the FAP funding of $40K/year.

In regards to the percentage of physicians applying, I don't have the numbers for each specialty. If you're in a military scholarship program, then I encourage you to contact the specialty leader/consultant.

Here's a Navy website about GMESB. The other services also apply to the GMESB so this site will answer most of your questions regardless of your affiliation.

http://nshs.med.navy.mil/gme/MCPP.htm

 

[GMO_52]

All of the above is true, however...for IM subspecialties, most people ultimately get what they want. The same specialties that are popular in the civilian sector are popular in the Navy. If you go straight through for residency, you might not get a fellowship without doing an intervening utilization tour. For those folks who complete GMOs, almost all get their fellowship. One exception is Nephrology. because the Navy trains 1 person a year. Don't get too caught up in the GMESB numbers for IM fellowships as the number of people selected has been higher in recent years. When the selection message comes out, you can get a good idea of the real numbers.

 

[Mirror Form]

One nice thing is that the military will often fund you to do a fellowship at a civilian institution. As a result, you can get into to almost any program you want b/c that institution won't have to pay you anything.

Out of curiousity, does anybody know the policy on how doing a fellowship will affect your commitment?

 

[R-Me-Doc]

There are 3 ways to do fellowships in the military:

1. Do a military fellowship at a military facility.

2. Do a "military funded fellowship" at a civilian institution. The military keeps paying you as if you were active duty, but you work at a civilian hospital. Sledge is right: the civilian places love this because they get free labor, and you can pretty much walk into any program. The downside: you owe the military 2 years of payback time for every 1 year of fellowship they fund; 3 year fellowship = 6 more years in the military when you're done.

3. Do an unfunded civilian fellowship. The military "deactivates" you and you work as a civilian at a civilian hospital, then come back into the military when you're done. The up side is that you don't owe the military any extra payback time. The downside is you are paid by the hospital (making less $$ than you would if you were in the military) and from what I am told it is a real administrative pain to arrange this because of all the military deactivation and reactivation red tape. You have to start arranging this 2 or 3 years in advance.

 

[bobbyseal]

2. Do a "military funded fellowship" at a civilian institution. The military keeps paying you as if you were active duty, but you work at a civilian hospital. Sledge is right: the civilian places love this because they get free labor, and you can pretty much walk into any program. The downside: you owe the military 2 years of payback time for every 1 year of fellowship they fund; 3 year fellowship = 6 more years in the military when you're done.


I believe that this calculation is incorrect. The commitment is a year for a year of training with minimal commitment being two years. Heres' a quote from http://nshs.med.navy.mil/gme/NAVMEDGME.htm#FULL-TIME OUTSERVICE (FTOS)%20PROGRAMS:

"FTOS trainees incur a minimum 2-year obligation plus 1 year of obligation per year of training greater than 2."

Remember you need this level of commitment adds up to any you currently owe.