Both a doctor and a soldier

As Army physicians (and future Army physicians), we know that our daily lives force us serve two--or more--masters, but never had I had such a good demonstration of this as today during a rather unusual noon conference--COL Salerno, the Internal Medicine Residency Director, giving his farewell address before deployment tomorrow.

An Army doctor, even a colonel, being deployed is not an unusual event, but his story is a little different, because he is a residency director. In 2005, the Army and the ACGME (American Council of Graduate Medical Education) formed a written agreement allowing residency directors to deploy for no longer than 90 days. This was a concession on the part of the ACGME, as previously residency directors could not deploy, due to accrediting regulations that require residency directors to be on-site, supervising their residents.

That being said, COL Salerno is not going to be gone for 90 days--he'll be gone for 10 months. After several "deployment scares" that prevented him from joining various committees that would be good for his career, he decided to volunteer for deployment, to get the waiting and wondering over with. Instead of taking a simple 90 day deployment working at a CSH (Combat Support Hospital), he volunteered for a position as an administrator of an Army-Iraqi medical team (he kinda explained, but I didn't really follow). He was going to split the deployment with another colonel, which would allow him to be gone for his 90 days and return to Tripler. He had written promises from a brigadier general and the other colonel that he would only be deployed for 90 days, to avoid any problems with the ACGME. However, as things have a tendency to do with the government, it fell through. After scrambling for two months trying to rectify the situation and applying for exemptions with the ACGME, nothing changed. Since 10 months is obviously a violation of the 90 day rule, he had to officially step down as Internal Medicine Residency Director at Tripler, which was not in the career plan he had set for himself.

However, things did work out for him. When he returns from deployment in August, he'll take over as the Director of Medical Education at Madigan. I was a little sad to hear about this, which had nothing to do with COL Salerno. LTC Wiesen, the Preventive Medicine Residency Director at Madigan, was applying for that position, which would have caused a shuffle in the preventive medicine residency programs beneficial for LTC Littell and MAJ Soltis, two staff members I enjoyed working with at Madigan and WRAIR, respectively. However, COL Salerno does outrank LTC Wiesen, so it's not too surprising.

Medical education positions aren't always easy to come by in either the civilian or military worlds, but rarely do civilian physicians have to worry about what will happen if their 90 day vacation to a war zone gets extended.