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Thread: Military and Civilian medical equivalents

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    Default Military and Civilian medical equivalents

    I've always wondered about the different levels and how they equate with each other.

    Are all Army docs MDs?
    Do they go to traditional med schools?
    Civilians seem to have about 1700 levels of nursing certification. Where do Army nurses fit in the spectrum?

    Is an Army medic closer to a nurse or an EMT? Can they get out of the service and walk on to a civilian job?

    And WTF is a PA, over?


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    Default Re: Military and Civilian medical equivalents

    PA is Physicians Assistant......that is the only question I can answer.

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    Default Re: Military and Civilian medical equivalents

    Quote Originally Posted by Zimmy View Post
    I've always wondered about the different levels and how they equate with each other.

    Are all Army docs MDs? Yes

    Do they go to traditional med schools? Yes, I'm fairly certain. If I recall, most are already MDs who get direct commissions, or are sent to medical school by the Army.

    Civilians seem to have about 1700 levels of nursing certification. Where do Army nurses fit in the spectrum? Actually, nurses only have two levels of licensure (RN and LPN). There are (like you said) numerous available certifications (I hold two). Some only require classes and competency verifications, others require advanced degrees (i.e. Advanced Nurse Practitioners, who are physician extenders like PAs).

    Army RNs are part of the Nurse Corp. They are required to have a BSN. I believe their ANPs have master's degrees.

    Army LPNs are 68Ws (Medics) with the additional training to get the M6 identifier.

    Is an Army medic closer to a nurse or an EMT? Can they get out of the service and walk on to a civilian job? Much closer to an EMT. I'm not sure if they can challenge the EMT courses or not. I fairly certain the one's who attend the SOCOM medical course do receive certification. There's a thread over on ar.com that discusses it.

    And WTF is a PA, over? Physician's Assistant. Another type of "physician extender" (like an ANP), who can perform some assessment, diagnosis, and treatment under the supervision of an MD. A good description is here: http://en.wikipedia.org/wiki/Physician%27s_assistant
    My answers are above.

    Some of it I knew, some of it I looked up. Some of it is probably wrong....
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    Default Re: Military and Civilian medical equivalents

    Quote Originally Posted by Zimmy View Post
    I've always wondered about the different levels and how they equate with each other.

    Are all Army docs MDs?
    No, some are also DOs. But these days they operate interchangeably with MD's in civilian as well as military medical centers. There was a difference a hundred years ago, but not really now. My oldest brother is a DO, and when he graduated med school, the Navy made him a Flight Surgeon.

    Now, if you want to talk about specialties and stuff, then it really gets confusing. For instance, even having not yet been to residency, my bro being a Flight Surgeon was essentially the GP for his squadron (or whatever you call it).

    I have read that when dentists get called up for active duty, they are sometimes put in the triage or "expectant" area of the combat hospitals (or whatever you call them). Since they are still also doctors, they get put in charge of IV's and other stuff when they aren't needed for facial stuff.

    I also read an article in one of my Peds journals about a pediatrician who was called up and served as Battalion Aid Surgeon (or whatever you call it) at a forward area in Afghanistan. Sounds crazy, but I guess they put you where they need you.


    Quote Originally Posted by Zimmy View Post
    Do they go to traditional med schools??
    Yes. They either graduate from civilian med schools, or attend the Uniformed Services University in Bethesda. Residencies vary. Again you can do a civilian one on the military's dime somehow, or do one at a military hospital. My brother did his Residency at a Naval hospital in San Diego after his stint shipboard in the Persian Gulf War. My former residency director (who recently went back active duty), did some of his training at an Army hospital in Hawaii.


    Quote Originally Posted by Zimmy View Post
    Civilians seem to have about 1700 levels of nursing certification. Where do Army nurses fit in the spectrum?
    Ops has ya covered.

    Quote Originally Posted by Zimmy View Post
    Is an Army medic closer to a nurse or an EMT? Can they get out of the service and walk on to a civilian job?
    I don't think they can just "walk on" - they have to have their certifications first, if they don't already. And it depends on what level of medic. It is also my understanding that an "independent duty" medic is the military equivalent of a PA.

    Quote Originally Posted by Zimmy View Post
    And WTF is a PA, over?
    PA= Physician Assistant.
    What they are allowed to do varies by state. Some places they can prescibe, some they can't. All have to have some level of physician oversight, though not necessarily immediately on the premises. Education is also not standardized. Some places have it as a "ultra"BS-level program, and others as a Master's Level program.





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    Default Re: Military and Civilian medical equivalents

    A DO is a Doctor Officer?


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    Default Re: Military and Civilian medical equivalents

    Quote Originally Posted by Zimmy View Post
    A DO is a Doctor Officer?
    Doctor of Osteopathy, also known as Osteopathic Physician. (Good catch, LadyDoc....I forgot about them completely.)

    I'll let LD fill you in on the details about DOs. I have a small nation in the Pacific preparing a sacrifice to me. My volcano is waiting.
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    Default Re: Military and Civilian medical equivalents

    Quote Originally Posted by Zimmy View Post
    A DO is a Doctor Officer?

    Doctor of Osteopathy - or an Osteopathic physician
    http://www.nlm.nih.gov/medlineplus/ency/article/002020.htm

    A Doctor of Medicine - MD - is an Allopathic physician

    It all goes back to 150 or so years ago when there were several different schools of thought about the origin of disease and the way to treat it. There was Allopathy, Osteopathy, and Homeopathy - among others.

    Learning medicine used to be an apprenticeship type thing, but gradually there were groups that came together to build medical schools and hospitals which followed their particular philosophy. Homeopathy gradually fell out of favor as the scientific method came onto the scene, and then Osteopathy and Allopathy's paths gradually came closer together in the late 19th and early 20th centuries. Today they are virtually interchangeable, the only "difference" is that DO's spend a little more time in school on the musculoskeletal system, and have training in some manipulation techniques (different than Chiropractic), and generally are trained to have a little more "whole body" approach. There are DO's in every medical specialty including surgery.

    The med school you go to determines what letters you have after your name. My older brother went to an osteopathic med school, so he has a DO after his name, and I went to an allopathic med school, so I have an MD after my name. We are both physicians.

    It's also important to realize that there are other "doctors" too, that aren't exactly the same. "Doctor" is actually just an academic designation, thus: Doctor of Medicine (MD), Doctor of Podiatric Medicine (DPM), Doctor of Osteopathy (DO), Doctor of Optometry (OD), Doctor of Chiropractic (DC), Doctor of Dental Medicine (DMD) /also Doctor of Dental Surgery (DDS), Doctor of Veterinary Medicine (DVM), and Doctor of Philosphy ( PhD).

    I'm sure I've forgotten something, but that's the idea.





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    Default Re: Military and Civilian medical equivalents

    Zimmy, this is all good information however at the end of the day a jerk off is still a jerk off.
    "Every normal man must be tempted at times to spit upon his hands, hoist the black flag, and begin slitting throats." -Henery Louis Mencken (1880-1956)
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    Default Re: Military and Civilian medical equivalents

    My bro-in-law is a P.A. here in PA..... . He's a surgical PA who withdraws removes viens used in heart bypasses. That is his main job and he makes a nice living doing it. He's gotten so good at it that he also farms his work out to other cardiac surgeons looking for assistance. Mercenary PA.

    His ass should be in the Army Reserves tho. They have been recruiting him heavily too. I told him to join the local Civil Affairs unit, get on status and finally earn respect from me!

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    Default Re: Military and Civilian medical equivalents

    There is also a bunch of talk about accrediting JFKSWCS as a Junior College so that they can award the Associate Degree and administer the NREMT-P exam. I don't know where that currently stands. (18D)


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    Default Re: Military and Civilian medical equivalents

    What about CNA's? Are they considered nurses or just technicians, so to speak?

    I've been told that an 18D is basically a P.A. (though they don't carry that title) and often is better trained and experienced at trauma treatment to include some surgery than most M.D.'s who don't have a background/specialty in trauma/surgery.

    Just telling you what I heard.


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    Default Re: Military and Civilian medical equivalents

    What about CNA's? Are they considered nurses or just technicians, so to speak?
    Roughly technicians. Not allowed to assess, evaluate or treat. (Although in a few states they're allowed to do some very simple wound care and other basic procedures). If well trained, though, they can certainly help identify a change of condition almost sooner than anyone, as they spend more time with the patient than anyone.

    I've been told that an 18D is basically a P.A. (though they don't carry that title) and often is better trained and experienced at trauma treatment to include some surgery than most M.D.'s who don't have a background/specialty in trauma/surgery.
    I wouldn't argue with that in the least. Many SF guys will ask the team medic to check out a family member before taking them to the doctor. These guys are worth their weight in gold, IMHO. Wish I'd been smart enough to go that route back when that avenue was still open to me.
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    Default Re: Military and Civilian medical equivalents

    I will speak to the Medic,

    It really depends on the individual Medic and their Supervisor; MD, PA, etc.

    All Medics are NREMT-B in order to graduate from Sam Houston. That is only the first 6 weeks of their training. There is an additional 9 weeks, I may be off a little bit on that one since I have been out for too many years, of training.

    As a Medic I built a trust with my Docs and ran the Sick Call with full capabilities except dispesning Narcotics for long term use, usually no more than an in clinic treatment. I would chart and leave all documentation for the MD to review. He would then decide if he agreed with me or needed to see the pt again. This worked as long as I proved to be competent and did not make any mistakes. This helped out because I could suture lacerations that did not involve the face, order Xrays for injuries for the doc to read later if there was nothing obviously wrong and of course all emergencies would be stabilized and transferred to the ER.

    I was able to prescribe most antibiotics and the Doc and I worked out a list of about 40 drugs we stocked that I could give out. If a drug was given the chart was reviewed and the Pt seen back in 3-5 days by the Doc. If the Doc was unavailable and the pt needed any blood work, they were drawn in the BAS and rescheduled the same day to see the Doc with those results in hand for diagnosis and treatment. Since we were an avaition unit anyone on flight status that was given anymore than a few certian OTC drugs were grounded and an appointment set up with the MD, the rules were very strict on this.

    This was set up so I could do morning sick call and the Doc could have later hours to accomodate the mission schedule and see pilots for flight physicals. Basically I was the Primary provider for all non flight personel.

    I had one medic that really had a desire to learn and he was very quickly becoming competant in the BAS. On the other end I had one that had to be directed to apply a bandaid correctly. There are a few medics out there that would call me an asshole because I demanded they learned while under me and evolve into competant medics. I was not the ranking medic in the BAS but was the one the Doc tuned to for everything.

    An Army Medic can be anywhere from a EMT-B to a Provider based on their level of desire to learn and their supervisor. Typically a Reserve Medic has more experience since they work in a civilian capacity with Pt contact far more than an Active Medic assigned to a "line" position would stateside.

    Edited to add:

    If the state they leave the military to go to is one that recognizes National Registry EMT certifications they can work as an EMT-B. Indiana will accept it but you have to take the State skills and written tests. The thing that makes them valuable is the experience. Even if they have to start training over the experience cannot be replaced. There are little things that I notice now with pts that get my attention because of experiences down range, both medical and trauma. Everyone that I know that was a Military Medic usually out performs anyone that does not have that experience.
    Last edited by DOC; 08-05-2009 at 12:48 AM.
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    Default Re: Military and Civilian medical equivalents

    Good post, Doc. A good medic is worth his/her weight in gold.
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