# Medical officer specializations for advancement.



## Tuna

I have 2 basic questions involving medical specializations, the first is just a matter of terminology, I know that there is in fact titles such as "base surgeon" are there any other similar positions? and second, what is the best specialization to take in regards to advancement in the CF? (if hypothetically one had all of them to choose from at the same time)


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## medicineman

If you look up the word surgeon, you will find two meanings - one is what most people think, someone who slices and dices humans and puts them back together again and the other is a hold over from days of old that is a title/rank of a military physician (there was a time when they didn't hold rank).  The Base Surgeon is the senior medical officer (read - physician) in a base clinic and their duties include medical supervision of subordinates, delegation of medical responsibility to subordiantes, being the SME on medical policies and the authority on the base for ensuring they're met, second or third signature on medicals, among other things.  You're generally made Base Surgeon after you reach the rank of Major/LCdr.

As for specialization, if you enter via the Medical Officer Training Plan or Military Medical Training Plan, you're specialty will be family medicine.  If you're a trained specialist upon entry, you'll likely stay there.  If after a period of service you're interested in another post-grad specialty, you can apply for those as they come open.  Most commonly they're psychiatry, internal medicine with a slant towards critical care, emergency medicine, general or orthopaedic surgery, anaesthesiology, or public health.  There are occasionally residencies available in diving and undersea medicine and aerospace medicine in the US when the need is envisioned.  Which one is best - all depends on what floats your boat.

MM


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## Tuna

and is this job bestowed upon most Majors/LCdrs? or is it just a few? does the process differ if one is posted to a field ambulance unit?


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## MedCorps

LCdr / Majors are Wing or Base Surgeons in 13 locations in Canada. We also have three LCol GDMOs who are Base Surgeons for the larger centres (Pacific, Ottawa, Atlantic).  

The field ambulances have both a Base Surgeon and Brigade Surgeon if staffed properly.  The Base Surgeon looks after the medicine at the Base Medical Clinic (the garrison side ) and the Brigade Surgeon oversees Role 1 and Role 2 clinical issues as well as being the principle medical adviser to the Brigade Commander (the field side). 

We have quite a few Major GDMOs but only 19 spots to be a Base / Wing / Brigade Surgeon and as such these are pretty critical locations.  If we followed our succession planning guidelines a little better (although we are doing better then we used to) these would be key appointments to have in order to be promoted. 

MC


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## Tuna

and the base surgeons are all GP? continuing on, if GP medical officers can become base/wing/brigade surgeons eventually, what is the promotion path for specialists like? how does a high ranking specialist's duties differ from a lower ranking one's? or is it just years of service?


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## MedCorps

Specialists have a bit of a unique career progression. All ranks are working ranks with the senior specialist in each specialty having the additional duties of being the adviser to the Surgeon General on their specialty.  These officers do not assume command roles within the Canadian Forces Health Service, and truth be told all report to the Commanding Officer of 1 Canadian Field Hospital while in Canada, who is a HSO LCol. Specialists, despite being under command of 1 Canadian Field Hospital, for the most part work in civilian hospitals in order to keep their skills finely honed. They then come out of the civilian hospital for short periods to teach, train and deploy as required by the needs of the service. A good example is our senior CF trauma (general) surgeon who works full time at Sunnybrook Hospital in Toronto where he is the Medical Director of the Trauma Centre, an Assistant Professor at U of T, and a Associate Scientist. Another example is our senior internal medicine physician who works in London as a Scientist, Attending Physician (trauma critical care) and as an Assistant Professor at University of Western Ontario School of Medicine. Again when we need them to teach, train, or deploy we call them out of these settings and they do so. 

The entry rank rank as a specialist medical officer is Major with progression to LCol as appropriate. The LCol does the same thing as the Maj with a little more governance within the clinical specialty as required.  There is then one Col for medicine (anesthesia or internal), one for surgery (orthopedics or general), and one for psychiatry.  This system is somewhat flexible to meet the needs of the service and the specialists, so these numbers are not always absolute. They cap at the rank of Col and cannot as it stands currently (ironically) be appointed as the Surgeon General. They will not be base/wing/brigade surgeons as specialist medical officers.  Most specialist medical officers were GDMOs prior to selection to become a specialist medical officer. This is different then the civilian model where you go from medical school into say surgery.  The specialist medical officer is often duel qualified in family medicine and spent a few years as a junior GDMO before going onto to do a specialty and get promoted to Major via that route. We have on occasion had Major GDMOs seek selection and be selected for specialty training.  We also have had in recent times a few direct entry specialist medical officers, who indeed enter the CF at the rank of Major. 

All other qualified medical officers are GDMOs.  They are able to progress from Captain to BGen and assume various clinical, staff, and teaching positions as well as some clinical leadership and command roles as they progress (or do not progress) throughout the ranks. These officers are GDMOs, who are certified in family medicine, but may have short additional specialty training (1-2 years) in emergency medicine, aerospace / public health medicine, or dive / public health medicine. 

MC


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## Tuna

another question or 2 (sorry) I am sure that all of these things change over time, and are a lot of the time up to chance, but what would be a more likely posting, Field ambulance, Field Hospital/or on an RCN/RCAF base? and what specialization does the CF usually need more of, or is it solely based on who retires when?


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## medicineman

You could be posted pretty much anywhere - depends on need and how well you grease your career manager's palms (just joking...well kind of).  If you're going to specialize, make sure you pick something you're interested in, not what you think the military might need - some of those residencies are 5 years long, so make sure you're in for the long haul and are sure that's what you want to do before committing to them.  As for what's needed, depends on, as you say, who's going and who's staying - you'd have to talk to the MOSID/recruiting adviser.

MM


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## MedCorps

I will build on the reply of my esteemed colleague. 

As any CFMS officer you are looking at a posting every 3-5 years.  So it is quite possible that you could do a field ambulance, a clinic in support of the RCN, a clinic in support of the RCAF, and a staff job in Ottawa at HQ, and time at the Canadian Forces Health Services Training Centre during your 25 year career.  It is all based on the needs of the service and your ability to progress in responsibility and rank. 

As is the specialist selection.  It all depends what is open the year you want to apply.  Each year a list of openings is published to all GDMOs and if you are interested you can make the application to one of these spots and see if you get selected by the board.  This is a hard predictive business for the military because it takes five years to make most of these specialist MOs and we need to come up with an educated guess (based on declared intention to release, rumor of release, and historical trends) on how many of X specialists we will require five years.  Sometimes we hit the head on the nail and sometimes we fall short or have overages.  If you wish to specialize, as mentioned, you need to have a real interest and passion because the schooling is quite intense / all life encompassing and that is what you will be doing for the rest of your CF career. It is a one-way hole once you are trained in a specialty this is the field that you will practice until you retire. 

MC


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## fruitflavor

Try to get into a medical school first, then think of asking these questions.
Also are you trying to become a doctor or a pilot? It seems you're not quite sure what you want.
If you do decide to follow the path to become a doctor, good luck.


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## Good2Golf

fruitflavor said:
			
		

> Try to get into a medical school first, then think of asking these questions.
> Also are you trying to become *a doctor or a pilot*? It seems you're not quite sure what you want.
> If you do decide to follow the path to become a doctor, good luck.



Here's a thought....you may be the only person on this site who is wondering how sure Tuna is about becoming a doctor.  The word 'pilot' has been used only once in this thread, and that was by you.  Not by Tuna, and certainly not by MedCorps or Medicineman.  Tuna posted in the Medical Group forum...not aircrew.

Perhaps best to let those who are and/or were in the CF and the medical field answer Tuna's question.

G2G
Milnet.ca Staff


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## Gunner98

fruitflavor said:
			
		

> Try to get into a medical school first, then think of asking these questions.
> Also are you trying to become a doctor or a pilot? It seems you're not quite sure what you want.
> If you do decide to follow the path to become a doctor, good luck.



There have been uniformed doctors and specialists who began their careers as uniformed pilots, artillery, signals/CELE etc., so getting into Medical School may not be there first step in a uniformed doctor's career.  Dream the dream, then live it!


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## Tuna

Good2Golf said:
			
		

> Here's a thought....you may be the only person on this site who is wondering how sure Tuna is about becoming a doctor.  The word 'pilot' has been used only once in this thread, and that was by you.  Not by Tuna, and certainly not by MedCorps or Medicineman.  Tuna posted in the Medical Group forum...not aircrew.
> 
> Perhaps best to let those who are and/or were in the CF and the medical field answer Tuna's question.
> 
> G2G
> Milnet.ca Staff



 I have posted on aircrew before about the Pilot and ACSO trades, as well as engineering trades in the past, I am leaning a little further towards medical officer, as I have taken CPR courses and would like to pursue some sort of medical career in which I can directly make a difference in people's lives, however I am still unsure about medical school due to it's length, sorry for causing any confusion


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## Good2Golf

Tuna said:
			
		

> I have posted on aircrew before about the Pilot and ACSO trades, as well as engineering trades in the past, I am leaning a little further towards medical officer, as I have taken CPR courses and would like to pursue some sort of medical career in which I can directly make a difference in people's lives, however I am still unsure about medical school due to it's length, sorry for causing any confusion



Noted that earlier, but that was over in the Aircrew sub-forums.  Here you were pretty clear.  It wasn't your issue here.

Regards
G2G


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## Tuna

Simian Turner said:
			
		

> There have been uniformed doctors and specialists who began their careers as uniformed pilots, artillery, signals/CELE etc., so getting into Medical School may not be there first step in a uniformed doctor's career.  Dream the dream, then live it!


I am sorry about my lack of knowledge on the subjects, I would talk to a recruiter if I could, but I do not live in Canada at the moment (I am a born citizen)


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## Tuna

Good2Golf said:
			
		

> Noted that earlier, but that was over in the Aircrew sub-forums.  Here you were pretty clear.  It wasn't your issue here.
> 
> Regards
> G2G



Thanks for keeping the thread pure


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## medicineman

Simian Turner said:
			
		

> There have been uniformed doctors and specialists who began their careers as uniformed pilots, artillery, signals/CELE etc., so getting into Medical School may not be there first step in a uniformed doctor's career.  Dream the dream, then live it!



I'll echo that - alot of the MO's I've worked with in the past were something else before they were docs - there is the Military Medical Training Plan for those that wish to reclassify to MO from whatever they were before, so if you want to be a pilot or engineer or infantry officer, go ahead, and if you're still leaning towards medicine later, apply to med school and MMTP.

MM


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## dapaterson

Minor pedantic correction:



			
				MedCorps said:
			
		

> We also have had in recent times a few direct entry specialist medical officers, who indeed enter the CF at the rank of _*Second Lieutenant with immediate promotion to Major*_.



...as all officers begin as 2Lt, though their tenure may be exceedingly brief at that rank.


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## Tuna

can you give me any more info on MMTP? it sounds like an interesting path that I have not considered yet. are there any trades that are preferred for MMTP? is it easier to get into MMTP than it is to get into MMTP?


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## mariomike

Tuna said:
			
		

> can you give me any more info on MMTP?



This might help:
http://www.google.com/cse?cx=001303416948774225061%3Aqhcx9pz3dku&ie=UTF-8&q=MMTP#gsc.tab=0&gsc.q=MMTP&gsc.page=1

Military Medical Training Plan:
http://www.forces.gc.ca/health-sante/rec/phys-med/mmtp-pmem-eng.asp

"Hot Tips for MMTP & MMTP(SI) Applicants";
http://www.forces.gc.ca/health-sante/rec/phys-med/mmtpti-pmemci-eng.asp


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## medicineman

Tuna said:
			
		

> can you give me any more info on MMTP? it sounds like an interesting path that I have not considered yet. are there any trades that are preferred for MMTP? is it easier to get into MMTP than it is to get into MMTP?



Usually have to be a Capt/Lt(N) and it doesn't really matter what classification you're from - you need the academic pre-reqs and reccomendations.

MM


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## aesop081

Tuna said:
			
		

> is it easier to get into MMTP than it is to get into MMTP?



Read that 5 times...........tell me whats wrong.........


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## MedCorps

What I can tell you is that is it HARD to get into MMTP.  Especially now that we have reasonable levels of GDMOs and are not in a crisis situation anymore. 

I have seen many a junior officer who is well qualified from an academic, leadership, experience, and loyalty point of view *not *get accepted. All of these officers would have made excellent GDMOs in my opinion. I think this year in fact we only took four officers from across the entire Regular Force if that is any indication on how few MMTP spots we have.  

It is doable but it is a hard fight to get one of those spots.  That being said MOTP is also very competitive and at looking at the numbers to 2016 we have foretasted an equal number of MOTP and MMTP GDMOs being produced. I suspect (but do not know for sure) that this will continue to be the trend with a 50/50 intake split between the program with a goal of taking in 10 GDMOs per year.  In my opinion this is a good split and produces a well balanced and affordable MOSID. 

DEOs are rare to see walk into a CFRC and will continue offset additional attrition beyond the 10 per year (likely) or offset the subsidized programs (less likely).  This could quickly change if we have more than the foretasted number of GDMOs release. 

It is good times and once again we can take the best of the best who want to serve with the CF. 

MC


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## Tuna

CDN Aviator said:
			
		

> Read that 5 times...........tell me whats wrong.........


yes sorry, I was meaning to write MOTP on the second one


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## Tuna

MedCorps said:
			
		

> What I can tell you is that is it HARD to get into MMTP.  Especially now that we have reasonable levels of GDMOs and are not in a crisis situation anymore.
> 
> I have seen many a junior officer who is well qualified from an academic, leadership, experience, and loyalty point of view *not *get accepted. All of these officers would have made excellent GDMOs in my opinion. I think this year in fact we only took four officers from across the entire Regular Force if that is any indication on how few MMTP spots we have.
> 
> It is doable but it is a hard fight to get one of those spots.  That being said MOTP is also very competitive and at looking at the numbers to 2016 we have foretasted an equal number of MOTP and MMTP GDMOs being produced. I suspect (but do not know for sure) that this will continue to be the trend with a 50/50 intake split between the program with a goal of taking in 10 GDMOs per year.  In my opinion this is a good split and produces a well balanced and affordable MOSID.
> 
> DEOs are rare to see walk into a CFRC and will continue offset additional attrition beyond the 10 per year (likely) or offset the subsidized programs (less likely).  This could quickly change if we have more than the foretasted number of GDMOs release.
> 
> It is good times and once again we can take the best of the best who want to serve with the CF.
> 
> MC



and i take it from this that any almost any DEO can make it in more easily than MOTP/MMTP applicants?


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## MedCorps

I would suggest that this is correct.  

Why? 

1. Well you have already proven that you can make it through medical school (MD) and get a license.  Therefore it is little risk to the CF that you will fail out of school part way through, be unable to pass your board exams at the end of school, or pass everything academically and after up to six years of pay and academic sponsorship and fail BOMQ, or the Basic Medical Officer Course.  All of these events have occurred before during my time in the CF. 

2. It is *considerably* less expensive to recruit a DEO GDMO who is already qualified. 

3. In an ideal world these MDs would already have some real world experience in family medicine, and even more ideally have emergency medicine / wilderness medicine / humanitarian medicine / aviation medicine / hospitalist, experience.  Experience counts compared to someone who is one day out of residency. Especially then said experience is at no cost to the Crown. 

I could not foresee a situation where they would not take a DEO applicant who is suitable and meets the professional, academic, and service entry requirements. Even in the unlikely event that this means decreasing the 10 MOTP or MMTP spots. 

MC


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## catalyst

Random question - but does age come into factor (via years of service remaining) for MMTP selection? ie - myself entering the RegF at 30.....do my initial years (say, 10), enter medical school at 40, graduate at 46 and then have 14 years til CRA....vice say, a young'un who applies at age 30 for MMTP?


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## MedCorps

As long as you have enough time left to pay back the obligatory service (2 months for each 1 month of training not to exceed 5 years) and can complete the terms of your current service (contract) you should be fine. 

MC


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