# Seeking Information For Incoming Medical Officers



## resolute

Greetings,

I am just in the beginning of me 2nd/final year of family medicine residency, and the reality of my employment with the CF is starting to solidify in my mind.  All I have done thus far is IAP.  I have done my best to search these (and other forums), and the Internet in general, and there seems to be a dearth of information on the training and operations of physicians in the Canadian military.  I have been reading up on the situation in the US military, but there appears to be a lot of negativity in that medical community (at least in my sporadic searching) which I hope does not parallel the Canadian experience.

I was wondering if perhaps anybody could enlighten me on:

1. The sequence of training I can expect post-residency.  Would somebody in my situation tend to be coursed to BOTP first, and then BMOC later?  Does anybody have information about BMOC itself (course content, length, theory vs. practical)?  Apparently there is also an advanced version, called AMOC?

2. Is it true that there is a "separate stream" for medical/dental personnel for IAP/BOTP/basic training now?

3. Do "support services personnel" participate in the "harder core" training like CAP or SQ (I have read posts on this topic which seemed discrepant to me)?

4. Can anybody provide a capsule summary of how "a day in the life" for me would be different in the CF vs. civvy-side?

5. I specifically 'chose' Army as my element, hoping to someday be involved in environmental/survival type training.  Is that a realistic option for me?

6. Can anybody comment on being involved in a supportive medical role for some of the specialized CF units (e.g. JTF-2, etc)?

I realize this is a lot of questions.  But if anybody has the time / expertise to comment on one or more of them, I would be much obliged.

Like I said before, I have tried my best to search around these issues, but answers are not easily forthcoming.  I think this is because:  a) I don't have internal / DWAN access yet, and b) I think there are <200 MO's in the CF ... not a large population for people to commen on (and maybe they don't even post here, I don't know...).  I have been a longtime "lurker" here, but have posted little because I don't pretend to have much knowledge of the "inside" worth contributing. 

I look forward to learning from anybody who cares to assist me.  Thanks for your time.

I am also excited about soon being able to contribute towards maintaining our fighting force.


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## Armymedic

I'll hit the questions I believe I can answer:

3. There are "harder core" training, but that will in the course of the MO training you will receive. As you already mentioned, there is not enough MOs in the CF, hence their employment is better served taking care of patients and not learning how to do infantry section attacks or patrolling. Not saying it can't happen, just saying it is not likely.

4. A "day in the life" is dependant on your role. As a Capt/new MO, patient care will be the same as family practice, except in the CF all your patients will be between 18-50, mostly healthy, with heavy emphasis on MSK/sports medicine, and more challenging is dealing with new onset of lifestyle illness (HTN, NIDDM, hyperlipidemia). Most GDMOs do CME in ER or family medicine to maintain their skills with pediatrics and geriatric medicine.

5. Uniform colour has no bearing on which service you are employed with. Choose you base/health support unit carefully, that will have more influence on the training you may get.

6. CANSOFCOM takes MOs the same as any other support trade. Show proficiency, show physical fitness, show willingness to learn, taking on new challenges and show willingness to teach, and you should not have any problems getting a spot in one of the CANSOF posns when you apply a year or so after getting to your first base. Background in trauma and/or emergency medicine will serve you well. Remember there is only a handful of positions, and lots of applicants.

Others may have better answers.


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## Gunner98

resolute,

PM inbound with point of contact/info

Med Offr careers seem to unfold differently for each individual based on grad dates, destination and courses available.

There are some Med Offrs who lurk here (infrequently at best) so you may receive other PMs.


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## resolute

Thank you both (SFB and Frostnipped Elf) for your forum replies and/or PM's.  I have been fortunate enough to have made an additional contact, who is looking into these issues for me.

If it is of interest / use to this forum, I will report back later with the answers to my questions, for anybody else who might benefit.  In addition, perhaps I will post a more comprehensive "day in the life of..." sort of summary for MO's / differences from civvy healthcare once I have more first hand knowledge (not until next summer, 2010 though).   

Thanks again everybody.


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## david_wright

Perhaps someone can confirm the rumours I've been told that the CF already have as many anaesthetists as they can have/need and don't want anymore. Put a bit of a dampener on my aspirations to join.


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## Gunner98

There are a significant number of gas passers (11+/-) but it would depend on what phase you are in - thinking about it, in school, fully-trained.  Of the ones currently serving they cover the spectrum from recent grad (in the last few months) to almost ready to retire.  Having people enter the pipeline at the right time has always been the key, there was a time when there were more on the "off ramp" than on the "on ramp" and we were very short (3+/-).


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## david_wright

Well, I've passed the Australian feloowship exam and have until September 2010 as "time in rank" I suppose until I obtain the fellowship. The problem is that should i decide to move to Canada long term, then I'll need to do the Canadian fellowship exam too.
I have a fellowship job in Edmonton for 2011 in paediatric anaesthesia. With any luck I'll be able to hook up with the local reserve medical detachment and participate in some capacity: blanket folding/counting etc.


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## vincent.escanlar

Resolute,

I was in your shoes last year totally clueless about what's ahead so I will try to help with what I've picked up myself over the past year:



			
				resolute said:
			
		

> 1. The sequence of training I can expect post-residency.  Would somebody in my situation tend to be coursed to BOTP first, and then BMOC later?  Does anybody have information about BMOC itself (course content, length, theory vs. practical)?  Apparently there is also an advanced version, called AMOC?



As you have already done IAP I don't know what other Basic Officer-type training you would be required to do.  (More on that in question 2 below.)

BMOC is about 6 weeks, broken up into 4 modules:  first, a 1-week distance learning package including basics about the CF in general (eg relevant regulations, organisational framework, bits about law, etc), and the Expenditure Management Course (so when you are in an admin role you can obtain things for your unit).  This is all on-line, with quizzes (both multiple choice, and short-answer cut-and-paste from the source document) to submit.

Second, a week in Ottawa and another in Borden learning about the details of Garrison Medicine (eg relevant paperwork, how to assign MELs, medical categories, how the medical chain of command works, the "new" CDU care delivery model).  This is all PowerPoint and lectures.

Third, a week in Borden on Tropical Medicine and medical aspects of CBRN (eg everything from malaria prevention to nerve agent treatment).  Mostly PowerPoint lectures, with a few hands-on sessions (eg looking at malaria slides), and multiple choice quizzes (on paper).

Finally, 11 days in Operational Medicine, which usually involves a exercise with a medical field setup, how to set up CBRN decontamination lines, etc, and some more classroom time about how things work in theatre (what Role 1/3 mean, mortuary affairs details, etc) and how to do "medical estimates" (eg calculating the medical needs of an operation).  There is also a graduation parade.



			
				resolute said:
			
		

> 2. Is it true that there is a "separate stream" for medical/dental personnel for IAP/BOTP/basic training now?



"HS BOTC" (Health Services BOTC) is a 6-week Basic Training course at Borden; we had doctors and nurses on mine last fall, about 20 in all.  It's supposed to include the full content of IAP/BOTP but compressed to get us back to the clinic sooner.  HS BOTC (or equivalent), plus BMOC make up the Basic Medical Officer Qualification that all MOs are supposed to have to practice in the CF.

For the batch of new FM grads in '08 we did HS BOTC Aug-Oct and then BMOC the following Jan-Mar; others (eg some DEOs) did it the other way around, whatever course came available first for them.  Doesn't matter either way, but I think it makes more sense BOTC before BMOC, so the "military" in general isn't as much as surprise to you by the time you're expected to learn the MO-specific stuff.



			
				resolute said:
			
		

> 3. Do "support services personnel" participate in the "harder core" training like CAP or SQ (I have read posts on this topic which seemed discrepant to me)?



I am not aware of any other MOs who have; a few of the nurses did the Basic Field Course (is that "harder core"?  I don't know) this summer though.



			
				resolute said:
			
		

> 4. Can anybody provide a capsule summary of how "a day in the life" for me would be different in the CF vs. civvy-side?



SFB summed it up nicely.  Every clinic has some variation on Sick Parade (walk-in clinic) first thing in the morning (eg 7.30-10.00), then appointments thereafter.  There is supposed to be MCSP time to work in Emerg or other related civilian facility but it is very inconsistent how that works out.  Some organise a block of Emerg (eg 1 mo) instead of trying to fit in the 1 day/wk that is usually described in the recruiting material.  With the military clinic workload there is plenty of time to organise moonlighting shifts in the week, however.



			
				resolute said:
			
		

> 5. I specifically 'chose' Army as my element, hoping to someday be involved in environmental/survival type training.  Is that a realistic option for me?



As SFB said your uniform does not factor into your employment.  Getting onto courses depends on if your base can spare you whilst away, if your base needs you to have a certain course (eg aviation, dive medicine) - "the requirements of the CF", as they say.  As Frostnipped Elf said it can vary greatly depending on your timing, where you happen to be (location and career-wise) when an opportunity arises.  Main thing is keeping your ears open to what comes up and letting your chain know you're keen.



			
				resolute said:
			
		

> Like I said before, I have tried my best to search around these issues, but answers are not easily forthcoming.  I think this is because:  a) I don't have internal / DWAN access yet, and b) I think there are <200 MO's in the CF ... not a large population for people to commen on (and maybe they don't even post here, I don't know...).  I have been a longtime "lurker" here, but have posted little because I don't pretend to have much knowledge of the "inside" worth contributing.



I hear you - we're a small group (~180 GDMOs + ~40 specialists) and much is passed on by word of mouth and connexions from courses and conferences.  Things will make much more sense when you are "in" - having other MOs in your clinic to ask, meetings others at conferences/tour, the occassional mass emails about upcoming courses/trg opportunities/taskings, etc.

Do ask if you have any other questions; but don't worry about it too much whilst still in residency, just know there is a lot to look forward to, and it will all make sense soon!  In my 1st year in I've gotten BOTC, BMOC and Basic Aviation courses, and 3mo at Camp Mirage; another went straight to work-up for Afg after BOTC and out to KAF after BMOC; others are now in the middle or starting pre-deployment trg also - so you can get to get busy right away.  Living the dream...

Best,

vpe

_Edited for clarity and example_


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## Tuna

I know that in a field ambulance, officers are very rarely seen, however, do officers exist withing field ambulance regiments? also, what is the demand for anesthesiology in the CF? and finally can anyone give me any info on the posting process (I know location is basically a dart board but I have heard some contradictory info on the branch posting and uniform assignment)


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## MedCorps

I would say that officers are seen all the time in field ambulances.  But what do I know  

Do they exist yes.  In the Regular Force field ambulances (we have three of them) they come in one of a few varieties, some tastier than others. 

Health Services Operations Officer 
Medical Officer
Health Care Administration Officer 
Pharmacy Officer 
Nursing Officer 
Dental Officer 
Logistics Officer (the only non-Canadian Forces Health Service officer on doctrinal strength with a Field Ambulance)

You will also find Social Work Officers and Physiotherapy Officers assigned to the field ambulances in non-doctrinal, garrison support positions. 

What do they do (it really depends on who you ask, but according to the books) the are the CO, DCO, Ops O, Adjt, Watchkeepers, Brigade Pharmacy Officer, Brigade Surgeon, Coy Comds, Coy 2ICs, Pl Comds, Medical Officers, Role 1 Med Det Comds, and Dent Det Comds. They are also fun in the mess.   

That sounds like a lot of officers to me.

There is a demand for anesthesiology in the CF when ever we need to control pain or put someone to sleep to do surgery.  It is one of the six clinical medical / surgical specialties in the Canadian Forces Medical Service for Specialist Medical Officers.  The others are Internal Medicine, Psychiatry, General Surgery, Orthopedic Surgery, and Radiology. 

Postings.  Uniform is not important.  Locations will be assigned as required by the needs of the service.  

MC


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## Tuna

Thank you, but I have another question stemming from that one, what are the differences in life for a medical officer in a field ambulance vs. a field hospital? and also, a question regarding specialties, how does the pay work when studying a specialty? does one go back to residency pay from MOTP? or is it full pay? or reduced pay? thank you


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## MedCorps

The life of a general duty medical officer is pretty much the same. 

In the field ambulances the GDMO is the senior clinician and rules the roots with respect to medicine.  In the field hospital it is the specialist medical officers who rule the roost.  Life in the field for a medical officer in a field ambulance is more austere (especially if attached to a combat arms unit for role 1 medical support) than in the field hospital.  Within an advanced surgical centre (a component of a field hospital) the Captain GDMO's doctrinally (and more or less in reality) work in the resuscitation section with Nursing Officer and Medical Technicians taking in casualties and doing the initial evaluation and resuscitation. The resuscitation officer also covers the wards at night for medical orders of a minior nature which do not require the waking of the specialists.  This is largely because there is always a GDMO resuscitation officer in house whereas during quite periods the specialist medical officer may be sleeping in their quarters versus the duty bunks. 

In the field ambulance the Capt GDMO is employed (doctrinally) in Role 1 medical support of the infantry, armoured, artillery and service battalion. In these roles they lead the medical detachment (Physician Assistant and Med Techs) which provides care to the guys who do the business.  They also work in Role 2 medical facilities (medical platoons) which are (doctrinally) medical staging point between role 1 and the role 3 (advanced surgical centre). The most notable of these role 2 facilities is called the brigade medical station, which is like the walk in clinic / minor hospital for holding the sick / emergency room for the brigade.  

The GDMO who is selected for specialist medical officer training (residency) retains their pay as a GDMO (Capt or Major) (from 122K to 190K) while in residency.  This is a good gig for them and often they are making more then all the other residents by a notable amount. There is no reduction in pay when they go back into a residency.  When they pass their board exams (and the requirements for promotion to Major, if not already a major) then the get specialist medical pay (starting at 205K as a Major per year plus a special military differential of 20K / year). 

MC


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## BadEnoughDudeRescueRonny

Slightly off topic, but what are the major differences between a Health Services Operations Officer and a Health Care Administration Officer with regards to overall duties and purpose?


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## MedCorps

A Health Service Operations Officer is a MOC which is fed at the rank of Major from Health Care Administration Officer, Nursing Officer, and Pharmacy Officer MOCs.  Once a Major in any of these three feeder MOCs has two years in rank they are eligible for selection (by board) for voluntary occupational transfer to the Health Services Operations Officer MOC. 

The HSO MOC was designed to be the leadership of the Canadian Forces Health Service. For HCAs they cannot progress beyond the rank of Major unless they are selected to be a HSO. For Nursing Officers and Pharmacy Officers there is a limited number of LCol positions (three and two respectively) that are in positions which govern their respective MOCs or provide specialist knowledge at the Senior Staff Officer level versus leading the organization as CO's.  If you are not a Medical Officer or HSO you cannot be promoted to full Col in the Medical Branch.  

There are about 40 Major ranked HSOs and 20 LCol ranked HSOs in the Medical Branch.  They are generally in positions which lead or influence the organization. The three core competencies of the HSO officer is lead the HS, plan HS operations, and administrate the HS. 

MC


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## Tuna

I had no idea of the existence of that special military differential of which you speak, can you give me some more information? and also, do you have any information on the signing bonus for med officers?


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## MedCorps

I think we are now at capacity for GDMO's so we are no longer offering the "crisis" signing bonus as was done in the past.  I know we are still recruiting, but it is not like the days gone by when we were offering sacks of money to sign on the dotted line.  Talk to the CFRC for the most up to date policies as I am not an expert in this area. 

See Compensation Benefit Instruction 204.216 (3) for the information on the pay of medical specialist officers. Sub section (b) talks about the special military differential and table G indicates the amount. 

It was my error.  The special military differential (20K) is only paid once a year (not monthly as I indicated above - that is a huge difference - I will change the post if I can for future readers).  My error. 

MC


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## Tuna

and would there be many differences if I was posted to navy or air force? any information on the other branches?


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## MedCorps

Med Techs work in all three environments (Sea, Land, Air) as well as special operations, joint headquarters, recruiting centres and the training system.  The colour of of your uniform does not matter. We are all as they say "purple". 

Med Techs provide health support to the CF on large and small bases (Navy, Army, Air Force) at the medical clinics as part of Canadian Forces Health Services Centres. They also serve on ship and can be posted to the Air Evacuation Flight at CFB Trenton to conduct fixed wing air evacuations.  At recruiting centres they provide medical screening and at headquarters they conduct administrative tasks as a member of a team. Those in the training system teach, provide logistic/administrative support to teaching, or if experienced are assigned to provide standards oversight to teaching. 

GDMOs also work at large and small bases in CF Health Services Centres across the CF as well as at some more remote detachments. They work with the RCN but are less likely to sail on ship than a Med Tech as we only have them on the two AORs.  They support the RCAF as flight surgeons on the ground but do not often fly aeromedical evacuation missions (but can if required).  You will not find them at recruiting centres but will find them in joint HQs doing all sorts of duties and in the training system doing instruction and standards. Again the colour of the uniform does not matter. 


MC


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## Tuna

and what about deployment, what are the conditions like for medical officers? the same as other officers? how often will I generally go on deployment in the course of 4 years? are there any operations that may be similar to Afghanistan in the near future or are we just going to focus on northern sovereignty etc.? and are the opportunities for advancement usually the same for all branches?


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## aesop081

Tuna said:
			
		

> are there any operations that may be similar to Afghanistan in the near future or are we just going to focus on northern sovereignty etc.?



Your crystal ball works just as well as the rest of us..........


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## Tuna

hello, I am wondering what life on base and on deployment is like on a day to day basis for medical officers in the CF. I know that the day generally starts with sick parade in the morning. but after that it is much like working at a private practice, am I correct? how much "military" type things does one do as an army medical officer on base? what about on deployment? does this vary depending on a field ambulance/hospital? can anyone give me a run through the average day on deployment for a medical officer? thank you


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## SMCS157

Hi everyone,

I'm interested in, among other trades, possibly becoming a Pharmacy Officer. Do any of you guys know if PharmOs count as Medical Officers on the pay scale, and therefore receive the Medical Officer differential, or do they count as General Service Officers. Please don't think I'd select Pharmacy only for the possibility of extra pay, as nice as it would be; it's really more of an understanding all my options sort of thing. 

Also, just so I have a full understanding of what I might be getting into, does anyone have any general information in terms of the day-to-day role of a PharmO. E.G. posting on base (field ambulance, med det, etc) or operational deployment opportunities. I understand the Pharmacy is a pretty small niche in the CF, so I understand if you guys aren't able to help. However, any tidbit of information would be appreciated.


Regards,
SMCS157.


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## dapaterson

Pharmacists are general service officers.  Only MDs are paid as medical officers.


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## resolute

SMCS157,

I'm an MO, not a PharmO.  But I work with PharmO's from time to time.  If working in a Clinic Coy, PharmO's are pretty much like civilian pharmacists - dispensing medications (doing appropriate checks for indication, dose, allergies, interactions, checking into formulary vs. special auth status), giving patient counseling information, and occasionally (and usually justifiably) giving MO's / NP's / PA's a friendly slap on the wrist if the Rx is somehow inappropriate / incorrect.

In a Med Coy / Field Ex / Op ... above duties may be only 25 - 50 % of what they actually do.  Another big chunk is set aside for inventory / FMed ... much like managing a warehouse of drugs and medical supplies, negotiating transport of same (with concerns for refrigeration, legality / security (e.g. controlled substances), general stock maintenance (expiry, re-orders), etc.  Think wandering around with a clipboard and a pencil behind your ear...

And like most officers, PharmO's are fair game for random "secondary duties" that might range from SportsO to TrainingO to whatever PseudoO designation the CO wants to fabricate.

The above is an MO's point of view of what PharmO's do.  I apologize for any inaccuracies, but I believe the gist is correct.

Interestingly, MO's are generally "spared" most of the secondary duties (at least until they end up on somebody's fecal matter list).  I think this is because there is usually no shortage of clinical duties to attend to, and there is a sense that they should be doing patient care as much as possible to "justify" their wages ... which are sometimes viewed as exorbitant by GSO's, despite that fact that most MO's knowingly enter the CF out of interest / call to serve and accept a significant pay CUT relative to what they would be paid civvy-side.

That's all I've got.  Maybe a PharmO is lurking nearby that could provide a more authoritative / informative answer.

Good luck, either way.


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## CombatDoc

Resolute has provided an excellent summary of Pharm O from the perspective of a Medical Officer. As he noted, there are essentially clinic duties and field duties. Clinic duties are similar to those of a civilian pharmacist, while field duties primarily concern medical supply/stock. The same dichotomy exists on deployed ops. Typically, the Captain pharmacist will run the clinic or hospital pharmacy. A Major Pharm O on a larger op will often be responsible for the Forward Medical Equipment Depot (FMED), ensuring adequate medical stores, med reapply, cold chain management, etc.

Do you already have a pharmacy degree?


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