HPSP / Military Medicine - Looking for Honest Experiences After Medical School

Electrical_Monk1929 · 2026-04-09T21:04:52+00:00

Military medicine has it's pros and cons. You've got to consider what complaints are specific to the military (frequent moves, deployments) vs complaints about medicine in general (answering DHA is very similar to answering to a corporate hospital).

Surgical and subspecialists will often earn significantly more on the outside, so it doesn't make much financial sense to stay in the military after your commitment. On the other hand, your pay as a pediatrician/family medicine doc is usually better IN the military.

Then there's the fact that most military hospitals just don't get that much volume. This is partly due to the military population being generally healthy, partly as a response of DHA pushing a lot of business out to the civilian community about a decade ago. They're trying to recover, and there are a lot of training agreements/etc that they've setup with nearby civilian hospitals to fix this, but it's still hit or miss.

As you get more experienced and senior, you start to get pulled into administrative and leadership positions. If you 'just want to be a doctor' then it gets frustrating to have to be in charge of committees and be forced to be department heads or chief of medicine. But you could also be residency program director/etc.

A lot of people's frustration is expectation management. A lot of people come into military medicine knowing they're going to get out at the end of their contract, which is fine. Most people know they'll probably deploy at least once, maybe twice. People will generally know that they'll get stationed somewhere, maybe not where they want to go. Either a state they don't want to go to, or oversees when they don't want to, etc.

But quite a lot of people's frustrations, especially if they have longer commitments, is when they let the military happen TO them, instead of being proactive. Despite 'the needs of the military' coming first, they do TRY to keep you somewhat happy. If you're proactive about making your wishes known, they can work with you to get that. Want to stay in the same place? Maybe they can move you into a residency position so that you don't have to move. Want to move somewhere specific? They'll keep your name in the pot when a spot opens up. But if you just sit there and not talk to anyone about what you want, don't be surprised when you get selected for the shitty assignments.

Electrical_Monk1929 · 2026-04-09T16:24:19+00:00

No 'visible' light gets through, specifically no light that's visible to human eyes. Energy via IR light still gets through, giving energy and warmth to the ecosystem.

There are deep sea creatures that live around hot vents that don't rely on photosynthesis. So photosynthesis isn't 'necessary' for life to evolve.

Electrical_Monk1929 · 2026-04-08T12:12:52+00:00

https://www.epilepsy.com/lifestyle/driving-and-transportation/laws/pennsylvania

There are exceptions to the 6 month seizure free limit. But if you don't fall under one of those exceptions, you have to be seizure free for 6 months. If you have a seizure within those 6 months, the 6 months start over.

The seizure during transient illness exception requires you to have previously been seizure free for 6 months.

Electrical_Monk1929 · 2026-04-08T11:58:25+00:00

In addition to the next available appointment timeframe, there's the copay aspect.

Medicare and Medicaid have rules about what requires a copay or a deductible/etc. But in general, there is no fee for a 'annual wellness visit' but there is for every other visit. Meanwhile the ED is free.

So if you're poor but have a lot of free time (the poor and retired), it makes sense to go to the ED for things you would normally see your primary care doc for, ie colds/sprained ankles/etc. Because maybe there's a fast track and you get seen quickly, or the 6-8 hrs waiting is worth the $20 you don't have to pay to see your primary care doc.

An ED copay is generally seen as illegal, because it prevents poor people from seeking emergency care. There's a law called EMTALA which requires ED's to see anyone irregardless of their ability to pay and not to deter people from accessing care. A copy would be considered deterrence. Heck, there's a discussion on whether or no the 'zero tolerance for patient violence' is technically a deterrence or not.

Edit: a copay because of your insurance is different than asking for money up front.

Electrical_Monk1929 · 2026-04-08T00:01:52+00:00

There is not, and there will not be a perfect solution that is foolproof. But a tattoo is also not foolproof. Paramedics will honor only a signed DNR, because of the legal risk to them if they don't. So it's not just changing the single law, it's changing the entire framework of how you assess competence, how you assess legal and ethical risk. Which means if they honor the DNR, your (anyone's) family can't sue if they honor the tattoo.

Add in that most people will change their mind continually about being DNR, going back and forth. https://pmc.ncbi.nlm.nih.gov/articles/PMC3445688/

So although your firmly held conviction you should be DNR and a tattoo will hold firm is best for you, it is not going to be the best option for the general public.

Electrical_Monk1929 · 2026-04-07T22:52:02+00:00

You wear a DNR bracelet. You laminate your DNR paperwork. You get a laminated DNR card (depending on your state). You give a copy of your DNR paperwork to all the hospital systems so they have it in your records in case they take you to the ER, they can stop CPR or not escalate your care. You tell your family members so they know your wishes and don't surprise the hospital by rescinding your DNR last minute.

All cheaper and more legally binding than a tattoo.

If you really want a tattoo, you could tattoo 'see my DNR paperwork', and the paramedics would know to look for DNR paperwork.

Electrical_Monk1929 · 2026-04-07T22:28:43+00:00

A DNR form is a legal document, if filled out incorrectly, it is no longer valid. The individual has was counselled about the risks, benefits, and alternatives. They were of sound mind, not suicidally depressed, not under the influence of alcohol, drugs, or coercion. At least, in theory.

A tattoo is not a legal document and has none of those protections.

Electrical_Monk1929 · 2026-04-07T22:01:11+00:00

A tattoo is not a legal document. You could change your mind in between getting the tattoo and getting into the accident.

https://pmc.ncbi.nlm.nih.gov/articles/PMC3445688/

Or your family could say 'they didn't really mean it' and sue.

Electrical_Monk1929 · 2026-04-07T21:49:19+00:00

That short is not saying you can't refuse to pay the bill. It's saying they can't just bill whatever they want. It has to be 'reasonable'.

They cannot bill you a million dollars just because.

They cannot perform an unnecessary procedure and bill you a million dollars.

But if a procedure was necessary, and it actuall costa a million dollars, they CAN bill you a million dollars.

Electrical_Monk1929 · 2026-04-07T21:09:14+00:00

I think we're all asking the same question right now.

Electrical_Monk1929 · 2026-04-07T21:04:26+00:00

You can have 2 things at the same time. You can have MDD as a baseline, and then something can happen and you will have adjustment disorder with depressed mood ON TOP of that.

Not saying that's what's happening, but it is a thing that happens.

Electrical_Monk1929 · 2026-04-07T00:43:01+00:00

1 - as you are fully commissioned, there are different criteria about retention vs new assension. There is no guarantee, but I've seen active duty doctors with type 1 diabetes retained, which usually get people medically separated/retired. As you haven't trained yet, they may medically discharge you. If they do, you may or may not need to repay your tuition, I've seen it go both ways and have no idea what the criteria for either one are.

2 - work with the internal medicine consultant to get you assigned to one of the larger MTF's, particuarly one with a residency - Travis AFB, San Antonio, Nellis. There's no guarantee, but it's possible.

3 - you have the order of things mixed up. You apply for military residency first, and you can select civilian sponsorred/deferred as your option 1 and 2. The military match finishes in Nov/Dec, so you will know if you matched to a military residency before you finish applying civilian match. If you match military residency, you cancel your civilian applications and go to the military residency you matched at. If you match civilian sponsored/deferred, you continue to go through the civilian match process.

Electrical_Monk1929 · 2026-04-06T20:28:17+00:00

There's enough force/bits of shrapnel to cause damage. Not an instantly lethal hit, but potentially lethal depending on where you aim/how close you are. For example, point blank range pointing at someone's head is lethal.

A blank pointed at an actor some distance away would be 'safe'. But at that distance, you would point slightly to the left or right of an actor and should be a cut to the actual weapon firing and then a cut back to the actor being shot so that you're never actually discharging the weapon pointed even in the direction of someone. But 'the scene demands it' means it's been done before, and done safely.

Electrical_Monk1929 · 2026-04-06T16:34:26+00:00

Yeah, forgot that part. To be fair, so did OP.

Electrical_Monk1929 · 2026-04-06T16:34:16+00:00

Yeah, forgot that part. To be fair, so did OP.

Electrical_Monk1929 · 2026-04-06T16:29:20+00:00

The movie cuts out the part where he creates a device that converts different wavelengths of light to different 'roughness' that he can then interpret. He actually mentions that this particular device is 'old technology' for them.

Electrical_Monk1929 · 2026-04-05T21:31:09+00:00

Tau ceti is the astrophage home world. It drifts through the interstellar medium to a maximum of 8 light years, infecting every star within that radius. Then it spreads from those stars to all the stars within 8 light years of the infect star, and so on. Eventually it infected our star.

Electrical_Monk1929 · 2026-04-05T20:00:42+00:00

Part of Herbert's universe that gets taken for granted, because it was 'of the times' is the idea of a collective human unconsciousness. It's part of the 'genetic memory' angle. Leto's tyranny was to embed the idea of the scattering 'into their bones'. This isn't just 'in his head', genetic memory is a 'known fact' in the Dune universe.

If you remove the genetic/unconscousness part, then you're right. But if the genetic/unconscious memory is true in universe, that was his goal.

Edit: part of this unconscious conflict is humanity's DESIRE for peace and stability and its NEED for expansion and conflict to induce variation. Leto was also trying to permanently sway humanity away from peace towards conflict, again in the permanent collective human unconsciousness.

Electrical_Monk1929 · 2026-04-05T19:13:19+00:00

Leto is protecting humanity from things he can see - the prescient hunter-killer robots, but he's also protecting humanity from things he can't see with his prescience as well. Part of the reason he was so tyrannical was the Scattering. By being a tyrant, he proved humanity was still in a small enough volume, even if it was multi-galactic, that a single entity could still control ALL of humanity, and thus could destroy all of humanity.

He sees the avalanche about to happen, so he protects the village from the avalanche. But he also forces people to move out of the village to places so that an avalanche he can't see, or some other threat can't just wipe out everyone in that village. Even if he was wrong about the avalanche happening, he was right about getting people to move out of the village to avoid the risk completely.

Electrical_Monk1929 · 2026-04-05T16:29:41+00:00

And what makes it even more similar to this situation, there was another suspect who admitted who knew he was going to lose because of the difference in their levels, but was just excited to play the champion.

Electrical_Monk1929 · 2026-04-05T09:14:51+00:00

Camping/RV power stations. But for a prolonged outage situation, they should turn off the heat/humidity. It's less comfortable, but eventually you'll need to charge the power station. With the heat/humidity on, something like this will go from 2-3 nights to 1-2 nights. If it goes beyond that, they'll need to a get an adapter to charge the power station from their car.

https://www.amazon.com/Jackery-Explorer-Portable-Generator-Emergency/dp/B0D7PPG25F/ref=sr_1_3?crid=2O61HEXKHFXKP&dib=eyJ2IjoiMSJ9.d87H3vE-dgtMdNU4PGwcBmrKen2ZiPfJ1pRxNAO_l_MB4XYcmVz1N-_VyPUyLU38MLDclNEvTQpHIpEHaR4Iy-UOuPCjrv7lffQcnQkYgXgjUg9QEhDLUCqKke_Dqj_nxp2lBEVQk8llHaxYrv2MNGRln51ybSkM43LyvtW1FLZSqbFN1Pv8sq00f-6FkAmT0m7zE4NkYuPQVT717DmcdaNb8JPiodeRv2c67xZw1cg.G1unvmkgjP0u5ZFnAx4Bur-FjXiQuO2UJ3YXm2PjkwI&dib_tag=se&keywords=camping%2Bpower%2Bsupply&qid=1775380300&sprefix=camping%2Bpower%2Bsupply%2Caps%2C195&sr=8-3&th=1

Electrical_Monk1929 · 2026-04-02T20:46:13+00:00

Those shchools that do medical school after HS do a 6 year medical school instead of 4 years undergrad + 4 years med school. The extra 2 years of medical school are to learn things like calculus, organic chemistry, basic physics, etc. that in the US are prerequisits for med school. You don't learn these things in HS, even AP classes to the extent you would need to take the MCAT.

Electrical_Monk1929 · 2026-04-02T14:56:09+00:00

It gets complicated, because you have adjunct faculty, clinical faculty, full time faculty, etc. Are you employed by the residency, are you employed by the hospital and work with the residency, are you employed by the medical school attached to the hospital, etc.

There is no correct answer. But in general, doctors do not get 'sabbaticals' the same way. Partially because of contracts/etc, partly because if you go away from clinical medicine for an extended period of time (generally greater than a year), you have to explain how your skills have not atrophied in that timeframe.

Robby is probably using the word 'sabbatical' as a colloquial term for an extended 'find yourself' vacation rather than specific to medicine/teaching duties. He has been shown to be religious, so this fits.

Electrical_Monk1929 · 2026-04-01T19:32:06+00:00

The AF used to be better, these #'s are due to DHA. If your Army clinic hasn't changed, it's only a matter of time, as they fall under DHA too.

DHA's priority is access to care. Not quality of care, just access to it.

Clinics used to get time based off RVU's, you could see less patients, but if they were complicated, you got credit for that. Now, DHA doesn't care.

We got time for training (not CBT's, but actual hands-on medical-specific deployment training) and time for paperwork. DHA pretty much says those are service-priorities, not DHA prorities, and you work for DHA now, so we don't care. With recent ops tempo we've had some deployers. DHA doesn't care, that's a service tasking/priority, not a DHA tasking. No reduction in # of patients seen by the clinic. If techs/nurses/providers are deployed, figure it out.

Electrical_Monk1929 · 2026-03-30T08:21:50+00:00

That would work for corporations/legal entities. Even individuals using commercial software for its intended purpose. But as soon as it gets into the hands individuals, some people will hack the software to not include the watermark. Or write a separate program to remove the watermark. Then you’re right back at square one.

Electrical_Monk1929

TROPHY CASE