mgc87 said:
. . . The 'part-time' option is appealing, but I was told there are is no "current need" for Otolaryngologists on staff. This is understandable, but I wonder if there is a path to join to contribute in other means (performing research, quality improvement initiatives, health resource planning & logistics) and wait in the wings until a clinical need for an ENT is determined. I have substantial experience in academics (40+ peer-reviewed publications), leadership roles on national committee's, etc. I suspect I'd have value to add from these avenues immediately.
Buck's advice should be taken as the most knowledgeable on these means re medical recruiting; he is the resident expert currently working in that field.
To add a little for your benefit. When Buck et al listed the few types of specialists that the CAF is recruiting for the Regular Force, that is not simply because there are currently openings for those specialists and something in another specialty may open at a later date. They are the only specialties that are authorized to be paid as specialist medical officers in the Regular Force. According to
CBI 204.216 - Pay – Medical Officers (this section refers
only to Regular Force and Class C)
clinical specialist means:
a. a medical officer in the rank of major, lieutenant-colonel or colonel who holds a fellowship certification through the Royal College of Physicians and Surgeons of Canada in one of the following clinical specialties:
I. general surgery;
ii. anaesthesia;
iii. internal medicine;
iv. psychiatry;
v. orthopaedics;
vi. diagnostic radiology;
vii. Physical Medicine and Rehabilitation (Physiatry)
Years ago (my personal experience with MOs with other specialties was probably before you were born) there were a wider range of clinical specialists in uniform, including ENT, urology, dermatology, ophthalmology . . ., but we also were larger, operated our own hospitals and had a few locations where we provided care to dependants (and civilians).
We They don't any longer. Now, the military health services either provide that specialist care through detachments that are located in civilian hospitals or by the same means that every other Canadian gets to see a specialist, by referring CF members to civilian physicians and surgeons and paying the bills. In fact. that was how we provided a significant portion of our specialist care even back in the old days when we had hospitals. Since the less than seventy thousand who are eligible to receive day to day health care from the CF are spread out across the country (the world?), then it is a better utilization of scarce tax dollars to only have the full-time medical specialists that would most likely be deployed on operations (i.e. those that would be necessary to patch up casualties before returning them to Canada). When they are not deployed they generally practise their medical specialties in civilian hospitals (as full time Regular Force members) keeping their skills fresh seeing CF and/or civilian patients.
It is admirable that you hope, in the event of not practising your trade, to be able "to contribute in other means (performing research, quality improvement initiatives, health resource planning & logistics)". However, be aware that the military is a bureaucracy and military health services is both a military and medical bureaucracy. The preference is that only those who come from within (those who know how the system works) get to do the planning. While your experience is laudable, compare it to those who may currently be doing the "health resource planning and logistics". For those in uniform they will be physicians, administrators, pharmacists, nurses, physiotherapists, bioscientists and logisticians who will have had (usually at a minimum) several years of progressive military service experience, often with one or more overseas operational tours, many will have had sub unit and sub-sub unit command experience and previous staff (read "military planning") training and experience as well as several years of clinical experience for those whose occupations require it. While the CAF does have some facilities that do military related medical research, someone of your qualifications would more than likely be hired as a civilian rather than military (even if there was a requirement for your particular skill set). Often, medical research that the CAF needs is contracted out or done in conjunction with the clinical practice of serving specialists.
Hopefully, none of my previous comments dissuade you from trying to serve in some capacity. As suggested in other posts, you should see if the Reserves can satisfy what you wish to do. While it is unlikely that you will have the opportunity to see patients as an ENT in the Reserves, it is not unheard of for specialists of many stripes to serve in the Reserves. Even the definition of "specialist" in the CBI that deals with Reservist pay expands the list to include more fellowship certifications.
204.52 - Pay – Officers (this refers to
Reserve only)
clinical specialist means
1. a medical officer in the rank of major – or lieutenant-colonel or colonel – who holds a fellowship certification through the Royal College of Physicians and Surgeons of Canada in one of the following clinical specialties:
2. General Surgery;
3. Anaesthesiology;
4. Internal Medicine;
5. Psychiatry;
6. Orthopaedic Surgery;
7. Diagnostic Radiology;
8. Physical Medicine and Rehabilitation (Physiatry);
9. Cardiology;
10. Dermatology;
11. Emergency Medicine;
12. Gastroenterology;
13. Infectious Disease;
14. Neurosurgery;
15. Obstetrics and Gynecology;
16. Ophthalmology;
17. Otolaryngology – Head and Neck Surgery;
18. Paediatrics;
19. General Pathology;
20. Plastic Surgery;
21. Thoracic Surgery;
22. Urology; or
(TB, effective 1 April 2011)
My experience with reserve medical units is very dated, but years ago I was the commanding officer of a reserve medical unit (I was an HCA, not a doctor). At that time all the doctors in my unit were specialists, however it mattered not the flavour because they were not employed in their specialities. On the few occasions that they saw patients (usually only when on exercise), it generally was primary medical care. Of note, back then (in my unit at least), when those medical officers were at the rank of Captain, they were not paid as specialists. There was an expectation that there was a "military" learning curve and even doctors were expected to spend time at the Captain level before promotion to Major. In the clinical specialist pay table there is no Captain scale.
If your desire is to practise your speciality with CAF patients, here is a suggestion. Try to be the ENT of choice that CF doctors refer to. If you are located in an area that has a large CAF population (i.e. near a major base), make whatever supporting medical unit aware that you are available to see CF patients. They do pay outside any provincial health insurance plan. There wouldn't be enough of a case load to sustain a practise (probably not even enough to justify dedicated days), but it may be a way forward especially if you are also in the Reserves. I do recall, decades ago, that one of the civilian specialists that we referred to from the base hospital (a primary care clinic actually) would do a few days a month in our MIR seeing referrals. Since he was also a doctor in the Reserves, he would sometimes show up in uniform, especially when it coincided with days that he also had parade nights. Of course such an arrangement would depend on what the business circumstances of your civilian practice entails - partnership, association, cost sharing, hospital affiliation. etc.
Of course, take whatever I've provided with a grain of salt. My military medical experience is, as I previously stated, very dated. I am now long retired and things may have changed considerably. If I'm well off track, hopefully one of the other CFMS types will come by and set me straight.
