Differences in military/civilian residency?

Not military, but the 40 hours is totally bogus. I know guys at BAMC and Madigan and they work just as hard as the rest of us. My good friend went through the military match and rotated at several. I think the work environment varies significantly from program to program. The locations for the Army are Madigan (Seattle), BAMC (San Antonio), Trippler (Hawaii), Walter Reed (Washington DC), Beaumont (El Paso), and Eisenhower (Ft Gordon, GA). There may be one more that I'm missing. I don't know anything about the Air Force program. Quality seemed to vary significantly as well.

I guess the bottom line is that the military reflects the civilian world, just on a smaller scale. There is a wide variety of personalities amongst the programs as well as quality of training. Someone else here probably has a bit more info for you.

In my opinion...military residencies are equivalent to any of the civilian programs. The curriculum is the same, because they have to adhere to the same accredication requirements as civilian programs. I believe they are part of the ACGME, or at least abide by it, and have the same work hour restrictions.

I spent a month at Wilford Hall where the Air Force orthopedic program is and they had a solid program. The residents worked up to the 80 hour work week and had excellent didactics (Rockwood comes 1 - 2 times a month to go over cases).

You do get paid a little more as a military resident versus a civlian resident, and that time counts towards rank. I guess afterwards you'll have to serve time in the military regardless of if you defer to a civilian program. And depending on the year with the popularity and demand of orthopedics, it could be easier to match into a military ortho program (most likely not the case though). Plus, you'd find out in December that you matched.

I think either way you'll be well trained. You seem many military trained orthopods doing very well in the civilian world after they leave the military.

Just my thoughts.

I am not a military resident, but had the pleasure of roatating with a number at Shock Trauma - yes, even the military sends their residents out for better Level I trauma experience.

My insight would be that military residents are well-trained and capable, but that their exposure to elective Orthopaedics has suffered greatly as a consequence of our international engagements. The number 1 priority of the military medical establishment is the care of returning soldiers, and the prompt return to action of those with "minor" injuries. This is obviously appropriate, but it does mean that the education of Ortho residents is on the back burner.

Military residents report that they are currently inundated with serial washouts of traumatic amputation stumps. They do some interesting reconstructions, and have a relatively good overall trauma experience, although much of it is referral trauma. The also manage to squeeze in a good amount of sports (Can't let meniscal injuries and ACL tears keep the soldiers away from Iraq).

When it comes to joint replacement, however, there is no room on the OR schedule. Patients who need elective surgery are being deferred until there is less of a backlog from war injuries.

This situation may or may not change with time, but I know the military residents looked at the Case Logs of thier civilian colleagues with envy.

These are just my observations. Find military residents. Ask them.

Just a note... not all programs in the military are alike. We see different populations based on evacuation strategies, location, etc. I'm a resident at William Beaumont. Not only do we see joint here at home (WBAMC), we also spend 3 months doing joints at Rush. And in our case, we go across town to a civilian Level 1 trauma center (Thomason/Texas tech) where we see the majority of our major trauma (though that's not to say we don't see that at Beaumont as well).

point is, programs in the military world have different personalities and curriculums, just like civilian programs, and educationally speaking you should consider them on an individual basis rather than en masse. The only exception to that would be pay and military obligation.