Chris Choe, University of Tennessee College of Medicine MS3
Rose Miller, The Ohio State University College of Medicine, MS3
General Overview about Military Match
While currently a rare topic of discussion, IR opportunities in the military are increasing. Medical students choose a career in military medicine for various reasons. For many trainees, the opportunity for service and financial benefits are important incentives. Dr. Alana Wade (Army) and Dr. John Pavlus (Air Force) have spoken with SIRRFS to help shed some light on the details of the IR military match and the effect of the recent changes in the IR residency pathways.
Because the military does not offer an IR fellowship, applicants traditionally had to match into a military diagnostic radiology residency before applying for a civilian fellowship via civilian deferment. With the establishment of the integrated IR residency, students will now need to apply for civilian deferment when applying for residency, not fellowship. To repay the military after training, Dr. Wade states that the military typically requires an obligated year of service for each year spent during residency.
Typically, military match occurs the second week of December. During the summer and fall of the fourth year of medical school leading up to the match, applicants rotate at different sites offering their chosen specialty. Unlike the civilian match, applicants do not have to be invited to interview. Instead, medical students have access to the contact information for every specialty via MODS, the application system employed by the Air Force, Army, and Navy. It is up to the student to contact the coordinator for each site to set up an interview and possibly even a rotation.
Military match can be stressful. The military offers residency positions according to the needs of the service, so each branch (Army, Air Force, and Navy) has its own specialty consultants who decide how many openings to offer for a given specialty then request those application spots from a general board. The list of open positions is created two years before they would become available, so fellowship applicants would apply to these spots a year before the actual civilian match. This year is called the preselect year, which offers civilian sponsorship for the IR fellowship. Civilian sponsorship means remaining an active duty officer with military salary and benefits. Those who are unable to secure a military residency position can still apply to the civilian match. However, these applicants will no longer be considered active duty officers and will be on a civilian deferred fellowship, acting as regular fellows and receiving payment from civilian institutions rather than by the military.
With the creation of the integrated IR residency, this experience will be slightly different. Between M3 and M4 year, Dr. Pavlus says there will most likely be a list that comes out with the number of positions available in the IR residency in each service. After applying for residency, applicants would find out in December whether they received a position for IR or could continue in the civilian match. Dr. Pavlus says this can be difficult, because the needs of the service always come before the personal needs for one’s career. This requires military applicants to give up some control of their career and be agreeable with the outcome. Ultimately, the needs of the military come first.
Note on Differences Between the Branches
According to Dr. Wade, the main difference amongst the different service branches is that the Army has the largest medical corps, which equates to them having the most residency positions available. Another important factor to consider is the concept of the General Medical Officer (GMO) in the military. GMOs serve as medical officers in many different military-specific areas, such as assignments to the Marine Corps, flight surgery (PCP to pilots), and underseas medicine. While generally being phased out of the other branches, the GMO still plays a fairly prominent role in the US Navy. However, both Dr. Pavlus and Dr. Wade say a GMO tour is not an uncommon detour prior to actual residency training. In particular, Dr. Wade states that due to the very competitive nature of radiology in the Navy, many applicants do a tour as a GMO following their PGY-1 year to boost their resume and credentials. However, while being a GMO represents a unique opportunity, some medical students may not want to delay their residency training. In regards to the Air Force, Dr. Pavlus reports there are only six interventional radiologists for the entire service. However, he believes the military is starting to understand the usefulness of IR, both at hospitals and in a deployed setting. As a result, Dr. Pavlus thinks IR could become a larger part of military medicine as a whole.
Reasons for Choosing Military Enlistment
Both Dr. Pavlus and Dr. Wade spoke on why they chose military medical service. For Dr. Wade, the main benefits were the opportunities to travel and work with the military patient population as well as the financial benefit of no loans and a steady income during medical school and residency. Dr. Pavlus noted similar reasons and benefits for choosing military service, and he emphasized that taking care of this particular population is very rewarding and special. While military physicians may not see as many patients in a typical day as their civilian physician counterparts, they are often able to spend more time with their patients.
An important consideration in military medicine is the plethora of different service settings and opportunities. Dr. Pavlus mentions the opportunities to practice in trauma, disaster relief, and other humanitarian efforts that are unique to the military. As a corollary to this, Dr. Pavlus also states the military can make practicing IR interesting. At times, IR physicians are given the chance to push the boundaries of IR due to their limited resources in the field (e.g., having to use handheld ultrasound). Dr. Pavlus speaks about Dr. Steven Farha, a now-retired US Navy Captain who was an IR pioneer in the military. He was deployed as a diagnostic radiologist, despite being IR-trained, to the USNS Mercy hospital ship during a tsunami crisis. His ability to perform IR procedures served as a huge benefit to the whole operation, leading the Navy to realize the importance of IR as a medical field.
Another positive aspect of military medicine is the leadership experience. These leadership experiences are an added resume bonus when looking for a job in the future. Dr Pavlus reminds readers that “you are not just a doctor in the specialty, but also an officer in the military.”
At the end of the day, Dr. Pavlus explains that “there is a bit of pride when you put on the uniform and realize you’re doing something other than for yourself.” While the military will require sacrificing time and a career in the civilian sector, it will offer opportunities that enlistees would not be able to have in the civilian world.