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Navy HSCP Billet Options


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Hi Everyone,

I've done some searching on the forum and online, but haven't found any recent information regarding Navy HSCP Billets. I was selected for HSCP and enlisted this past June. Currently, I'm in my 3rd term of didactic (just started back up today). I won't graduate until May 2019, so I have a lot of time, but I'm curious of the options for PAs in the Navy. I realize there are the 3 Naval Medical Centers, but aside from those, how can I find out other options that are likely to be given to me once I graduate?

I'm originally from Maryland, attending school in CT. I'm young and would love to get out and explore the US (I've never left the east coast). Is there a list of all the possible locations that I could be sent? I'm just curious to see the options! Thanks for any help.

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http://www.med.navy.mil/SiteInfo/Pages/default.aspx

Check out tabs 2 & 3 for most likely options ("Naval Medical Centers and Hospitals" & "Ambulatory Care Clinics").

Note this chart does not represent operational commands, such as Marine Corps battalions and aircraft carriers (currently the only shipboard billets for PAs, with one PA on each of 11 (?) carriers in service). I think it's generally unlikely for a direct accession PA to an operational command rather than a shore-based MTF for their first assignment, but I suppose it's not impossible.

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16 hours ago, HMtoPA said:

http://www.med.navy.mil/SiteInfo/Pages/default.aspx

Check out tabs 2 & 3 for most likely options ("Naval Medical Centers and Hospitals" & "Ambulatory Care Clinics").

Note this chart does not represent operational commands, such as Marine Corps battalions and aircraft carriers (currently the only shipboard billets for PAs, with one PA on each of 11 (?) carriers in service). I think it's generally unlikely for a direct accession PA to an operational command rather than a shore-based MTF for their first assignment, but I suppose it's not impossible.

Thank you HMtoPA! That is exactly what I was looking for! I was told that my first duty station would be somewhere in the US, and from what I understand that lasts two years? I owe a 3 year commitment, would I be eligible for a year with a Marine Corps battalion or on an aircraft carrier after my first two years in the US? I feel like that would be an amazing experience. Thanks again for the help.

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4 hours ago, vb315 said:

Thank you HMtoPA! That is exactly what I was looking for! I was told that my first duty station would be somewhere in the US, and from what I understand that lasts two years? I owe a 3 year commitment, would I be eligible for a year with a Marine Corps battalion or on an aircraft carrier after my first two years in the US? I feel like that would be an amazing experience. Thanks again for the help.

 

Yeah, currently for PAs shore tours are 3 years and operational tours are 2 years. You can sometimes extend a year at a duty station, but they won't generally send you somewhere for just a year (there are sometimes unaccompanied tours that last 12 months, but I don't know if we (PAs) have any - maybe Bahrain?).

But like Schmittie said, you can be deployed from a shore tour. I have 2 or 3 IPAP classmates who got deployed with Marine battalions from their first commands (CONUS shore-based MTFs). I went to a Marine battalion right out of IPAP. Now at a shore clinic, and there are pros and cons to each side.

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20 hours ago, SCHMITTIE120 said:

Typically shore duty (a non-operational command) is a 3 year tour.  If you are wanting to go operational then you are most likely going to have to commit to another tour. 

There is always a chance that you may get deployed in your first command.

Thanks! I was unaware that shore duty was 3 years, so that's definitely good to know! As far as I'm concerned now, I'd love to go operational (I might just be naive). When you say I have to commit to another tour, would that be another 3 years, or something longer? I've been wanting to join the military forever, so I've had it in my mind that I'd stay in for a while, but I've never been in the military before so only time will tell. Thanks for the help.

19 hours ago, HMtoPA said:

 

Yeah, currently for PAs shore tours are 3 years and operational tours are 2 years. You can sometimes extend a year at a duty station, but they won't generally send you somewhere for just a year (there are sometimes unaccompanied tours that last 12 months, but I don't know if we (PAs) have any - maybe Bahrain?).

But like Schmittie said, you can be deployed from a shore tour. I have 2 or 3 IPAP classmates who got deployed with Marine battalions from their first commands (CONUS shore-based MTFs). I went to a Marine battalion right out of IPAP. Now at a shore clinic, and there are pros and cons to each side.

Thanks for the info. I heard that you can deploy from a shore tour; is this essentially deploying with a Marine Battalion and providing medical for them wherever they go? It sounds like it would be a great experience, my grandfather was a Marine during Vietnam and my main motivation for wanting to join the Navy. Thanks for the help!

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So what I mean by committing for another tour is that usually you have to extend for orders in order to execute a PCS (Permanent Change of Station). So like, in your example, if you have a 4 year obligation, and you start off with a 3-year shore tour, and then you want to take a 2-year operational billet, you're going to have to extend your obligation for the additional year (i.e., they generally won't send you for just your remaining year).

If you were unwilling to extend and adamant about separating after 4 years, they would most likely let you finish out your term at your original duty station.

Yes, as a PA with a Marine battalion you deploy with them, go where they go, and do what they do (within reason). It was definitely a food experience for me, but I had also down a tour with the Marines as a corpsman, so I very much knew what to expect in terms of the culture and lifestyle, and knew I would appreciate doing it again as an officer. After 2 years, I was ready to move on to different things - part of that was a function of age (turning 41 this year), and the other big part was feeling the need to get into a real clinic and cut my teeth on some bread-and-butter primary care (not an issue if you go the clinic route first, I suppose).

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On 8/30/2017 at 11:29 PM, HMtoPA said:

So what I mean by committing for another tour is that usually you have to extend for orders in order to execute a PCS (Permanent Change of Station). So like, in your example, if you have a 4 year obligation, and you start off with a 3-year shore tour, and then you want to take a 2-year operational billet, you're going to have to extend your obligation for the additional year (i.e., they generally won't send you for just your remaining year).

If you were unwilling to extend and adamant about separating after 4 years, they would most likely let you finish out your term at your original duty station.

Yes, as a PA with a Marine battalion you deploy with them, go where they go, and do what they do (within reason). It was definitely a food experience for me, but I had also down a tour with the Marines as a corpsman, so I very much knew what to expect in terms of the culture and lifestyle, and knew I would appreciate doing it again as an officer. After 2 years, I was ready to move on to different things - part of that was a function of age (turning 41 this year), and the other big part was feeling the need to get into a real clinic and cut my teeth on some bread-and-butter primary care (not an issue if you go the clinic route first, I suppose).

This is great, thank you so much for the info and for your service! It must've been awesome to serve as a corpsman and an officer. I was one conversation away from leaving college to become a corpsman (partially for financial reasons), but I decided I would finish school and try to become an officer, and so far I'm on the right path.

On another note, I've always wanted to go into primary care and I've read on a few forums here that there's almost no better primary care experience (as far as initial training goes) than as a Navy PA. Can you attest to this? I know that your first job is vital in informing your future practice as a clinician (i.e. learning to practice good habits right off the bat). 

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Well, I don't really have anything else to compare it to. I feel like my program (IPAP) makes really good PAs, but that's not a knock on any of the civilian programs (which I know nothing about). And as a new PA, I think almost any job can be a good experience, so long as you're not being held back and having your growth stunted. I sometimes read stories on here about people being dissatisfied with the way their supervising physician treats them or something like that, and that's a non-issue in the Navy. Here, you're very much expected to work at the limits of your license, and be as independent as possible, with very few limitations on scope. I'm sure there are plenty of civilian jobs like that, too, but then there seem to be others that are not.

But even in the Navy, your first job is going to be a function of where you go. When I was at a Marine battalion, I had some friends that worked at the Family Medicine clinic at the base hospital, which was fairly large with a wide variety of services available. They were very busy, and saw few active duty patients (because most all of the AD people had their own medical services embedded in their units) - from what I heard, they spent a lot of time seeing dependents, mostly wives (since a lot of the kids saw Peds). I wasn't there, so I can't speak to what it was really like, but according to them that was the bulk of their work. I think they had admitting privileges, and there was also a Family Medicine residency in the clinic, so I think they shouldered the clinic load in terms of volume, while the residents probably got preference for procedures, etc. On the other hand, they did say they had unfettered access to the residents' attendings for informal consultation, which I guess is a good resource.

I pretty much just had UpToDate, lol. But all my patients were young, relatively healthy guys. For two years I saw no peds, almost zero female patients of any age, and did no real management of diabetes, hypertension, hyperlipidemia, hypothyroidism, etc. Kind of crazy. I did see all kinds of acute stuff, mainly MSK and derm stuff (by the way, absolutely do a derm rotation in school if you have a choice - you will be head and shoulders above many of your colleagues in clinic). Plenty of lac repairs, & EIC/lipoma removals. And there was the occasional zebra. 

Now I'm in a clinic at what is basically a rural community hospital. The only inpatient service is OB. Almost every referral has to go out on the economy, and there are long wait times, so we try to manage as much as we can at our level. My panel seems like a pretty even mix between active duty, dependents (mostly spouses, but some kids too), and retirees. Good mix of acute and chronic, and really full spectrum of complaints. Volume is much more consistent, about 18-20/day. With a little initiative, I was able to get supplementary privileges to do IUDs/Nexplanon, got training as a sexual assault forensic examiner (not really by choice, lol), and am working on getting Accutane prescribing authority. I mean, nothing major, but my point is they seem willing to let you take on the responsibility you think you can handle.

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I work at a family residency on a marine base, maybe the one HMtoPA is talking about or maybe the one on the other coast.

there is no better primary care experience than where I am. We see primarily spouses but lots of kids (I would say the minority are in the peds clinic), retirees (plenty of geriatrics), and a few naval active duty. I don't get in the procedures clinic, so I don't get a dedicated procedure day, but the residents only get procedures from my panel I let them have.  Sometimes my coworkers refer patients to me for procedures instead of sending them to the resident's procedure clinic. I can perform any procedure I want in my own clinic that I'm credentialed for, which is pretty much everything but colpo and endometrial biopsies. I even do nexplanon insertions and IUDs daily. I even schedule in my clinic and perform vasectomies, but I had to make some sacrifices to get that training. We just got dermatoscope equipment and soon we'll be trained on it so I'll be dramatically reducing my derm referrals. No OB but I will see them for pretty much any acute issue up to 20 weeks. Credentials for 1 month old to 99 years. I don't have admitting privileges as none of us work inpatient, but I've done the work up and had several admitted directly from my clinic. Allowed to manage whatever I want. I manage several pituitary adenomas, thyroid nodules, heart failure, lupus, and other medical type patients. I only send out things that are surgical or for evaluation only such as echo, Holters, EMG, etc. Sometimes I get a little overwhelmed because I'm only allowed 20 min appointments, so sometimes I'll send someone to the specialist because my plate is too full. I have access to the resident preceptor for questions, but I rarely use them as I have one or 2 genius attendings I have as go to for questions. Often the random preceptor in the office doesn't have a much better idea than I do about something and I end up calling the on call specialist anyway or reading sources such as uptodate.

It is exhausting though. ACPs are the work horse and see 95% of the flow from the clinic. See all the residents patients when they are out of clinic for their off service rotation and the attendings patients when they have admin time, which has to be 50% according to ACGME rules. So you are flogged with patient load.

 

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Thank you HMtoPA and LT_Oneal!

I appreciate the detailed posts about your guys' experience, it really gives me some insight into what my experience may be like! It sounds like there's opportunity to learn knew things as long as you're willing to seek it out, which is awesome. 

I just hope to have a good learning environment, which I'm sure won't be an issue. After that, I hope to take in and learn as much as possible, and as you guys describe it, it seems like there are great resources to turn to in case I'm hung up on a case/pt. Thanks again for the insight, I didn't expect to get so much important information from my initial post!

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