Tuesday, May 10, 2005

that's dr. cannon-fodder to you

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i had a classmate take the above with his cell. they're little squishy dolls from the air force, part of the constant recruiting efforts to get more indentured servants- i mean, medical service members into the military. those dolls did their job well- if their job was to distract us from lecture for hours on end as we "modified" them. some students built a scary clone army which valiantly defended the center right back row from the seat-stealing insurgents. it is our god-given right to sit in the seats we have become accustomed to, and to rain down like fire on any person that tries to take that liberty away from us.

so no doubt if anyone is reading this, i'll get some hate mail of some sort. as you might be able to tell, i'm not a fan of the military. they called me relentlessly after high school, offering me all sorts of booby prizes like "money for college" or "structure". i told them i had a real issue with waking up early and was described by my parents as "congenitally insubordinate", and told them to kindly fuck off. thankfully they did, until i started med school. now i get lovely letters from the navy all the time telling me how awesome it will be on a big fat fucking boat stuck somewhere in the persian gulf.

according to the bureau of labor statistics, there were 25,563 officers in the category of "health professions" in all branches of the armed forces in 2003. i really, really wonder how many of them wish they were somewhere else.

plenty of my classmates are on the flag-draped coffin scholarship, and will be spending this summer in officer basic, which they describe as "kinda like basic training, but way easier!". um, somehow i doubt that. but nonetheless, i don't hold anything against them for wanting to go military- on the surface, it promises job security, a good residency and it's free! the ones that have already served and are coming back for more (thinking of med school as an extended leave if anything) will be happy to be back in, and will make fantastic military docs. the others i worry about, many because they are doing it for the money. money is THE big issue, because most of us will come out into residency 200 grand in debt, and we make like 40 grand starting. so it makes sense that some people want to get a free ride.

it's a free ride alright. for uncle sam. he ponies up some cash and buys your well-educated ass. there's a year for year commitment required, which doesn't include school, internship, or residency. with all the stop-loss orders and creative data fudging going on, i wouldn't be surprised if some people end up career military docs because they just can't seem to get discharged. cuz remember: they own you.

they will tell you all sorts of lovely things to get you to join up. between repeating "we pay for medical school! we'll even give you some money!" over and over, they tell you you'll get the cush residency of your choice, then a nice appointment at a VA somewhere, where you can sit back and rake in the dough, knowing that those patients you treat can't sue you if something happens. it's the same old bullshit as what is being told to high school seniors everywhere. the world is promised to the potential recruit, a world of endless choices.

when you sign up, you discover these choices are all theirs.

you specialize in what they tell you to specialize in. wanna do derm? sorry, they have enough derms, but they need more IM docs. so, you get to do IM. want to live close to your family? sorry, you get to live where they tell you to live, be it north carolina or baghdad. don't want to die? sorry, if you are told to go mend severed limbs in an active combat zone, you go knowing you might be another blurb on the evening news, described as "name will not be released until family members have been notified". i wish i could find data on how many military physicians are ever in active combat areas. if anyone can provide this data, i'd be curious to see how often docs are put in direct danger. is your life worth 200 grand and a $1200 a month stipend?

i found a short article from a military doc detailing his views of the current problems with the system. he makes a good point, in that sometimes the free tuition doesn't add up when you factor getting to practice a specialty you want, the ever-present autonomy factor and a system of insulting pay and little ability to advance. it sounds like a shitty job, not a calling.

just so you know, i do see the irony in my above statements. medicine (surgery especially) is the same beast as military service when it comes to the structure. i know i will get my ass handed to me many times in the near future and for the most part i welcome it. but the difference i see in my future civilian career is that i can go into the specialty i want to go into, as long as i have the stats. i can leave it anytime i like, with crushing debt but my medical license intact. that's not what i'd get if i told the armed forces "sorry, you know this kinda sucks. i'm giving my two weeks as of today, cuz i think i'd be better off somewhere else".

there are other ways to get a free ride through med school than wearing camo. NHSC sounds like a fantastic deal, but they only want primary care docs. i guess poor people don't really need surgery that much. but there are other loan repayment programs sponsored by state agencies, which allow for a greater amount of autonomy, less threat of a horrible painful death at the hands of some asshole with a rocket launcher, and the ability to actually get out when you're supposed to. that to me seems much more inviting than signing away your life to someone who won't even acknowledge those two little wars going on "over there".


since i have always wanted to work at a county hospital serving the poor and indigent, i know i won't make piles of money once i graduate. money isn't a huge thing for me, but the freedom to choose how to practice medicine is. it's scary thinking of how many of my classmates will hold up their end of the bargain, sacrificing what they worked so hard to procure, only to be kicked in the nuts when they realize the military is only looking out for itself. it's their choice though, and i hope they thought long and hard before they signed those papers.

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