 I've been completely around the world on Navy ships. I've flown in jet aircraft helicopters. I've been on dives and submarines. I've been on aircraft carriers and surface ships. Nobody in civilian practice can say that they've done all of those things. When you arrive at a hospital, no matter where you are in the world, you are the surgeon or the internist or the pathologist or whatever. You're the general medical officer or the general or the family practitioner and you have at that moment your practice. Physicians in civilian life have always been treated with reasonable amounts of respect. In the Navy it's you're an officer and then you're a physician and as an officer you command that respect. Actually I think that a clinical practice of psychiatry in the Navy is a lot more free and open. You can do a lot of different things. You're challenged to do many different things. I arrived at Navy medicine through poverty. I couldn't afford to go to medical school and I was made aware of the health profession scholarship program and I applied actually to all three services and was accepted and chose the Navy. What makes teaching these students unique is that you know that all of these students will be your colleagues one day. They'll be your peers. They'll be for those of us that retire from the military. They'll be our future doctors. I like family practice. I like assisting in surgery. I like doing obstetrics. I like pediatric care and I get to do the diversity of it in the Navy. I've never been challenged in that and I'm only helped by the specialty staff that work in the hospital that I am. My job in Navy medicine is Deputy Surgeon General, Deputy Chief of the Bureau of Medicine Surgery and Chief of the Navy Medical Corps. And from this corner of the world that I view Navy medicine from I get a very clear unobstructed view of this total package called Navy Medicine. Now I have been in private practice. I've been privileged to teach in medical schools. I was very fortunate to be President of the American Academy of Family Physicians. But this job that I have right now is the most challenging and most gratifying job I've ever had managing Navy medicine and its broad implications. I see it as tremendously responsive and vigorous as it's got to be to serve our worldwide community. It's true we know the Navy does take care of its own. Our physicians are more than clinicians. They're Navy officers who share a uniform. They share a mission and they share a long tradition in Navy. Those that come to this and seat up close earlier in their medical careers can feel the difference. We're proud of our young doctors who receive financial support through medical school and return for commitment for a number of years in uniform and who wind up staying in the Navy or if they leave return someday. But whether they stay or go the typical bottom line is respect for the competence and skill the extra and very special responsibilities of a naval medic officer and the tradition of service to our nation that goes with being a Navy physician. In Bethesda I'm Director of Surgical Services. This hospital is unique in that this is the hospital that the President of the United States comes to get his care. We also care for a great number of senators and congressmen and justices of the Supreme Court that adds a little flavor to our practice here it's a little bit out of the ordinary. Navy medicine is the same as medicine any place else in the United States. Especially a teaching hospital like this one we have a full gamut of patients from the very young to the very old with a full range of diseases from hernias to very sophisticated surgery like open heart surgery which we do here. The only difference is that we are prepared incapable of supporting the armed forces any place they go in the world. If we're ready to move we have the training in the background to take care of mass casualties and trauma as well as routine everyday surgery. I'm a Navy flight surgeon in my opinion is probably one of the best jobs that the Navy has to offer. It's a multifaceted job some of the missions that I'm on involve medivac runs when patients are injured on ships that come to this area. Aircraft mishaps. I am the doctor that attends the patients I get on the healer and we pick up the patients take them to either the hospital here on base or to a civilian hospital. She was alert morning at times three physical exam, HENT, head she's got about six centimeter lacerations down to the bone small step off is noted. She's pearl, extract the muscles are intact, fundi or normal. My main job as a flight surgeon is the fact that I take care of the pilots. I take care of things that have to do with rapid changes in altitude pressure changes so anything that's physiologically associated with aviation in flight surgery it's really a feel that you can do a lot of research. If you're the type of physician that wants to get involved in research it's probably the way to go. Okay, who has the next case? I very much enjoy teaching medical students. Currently I'm the chairman of the department of medicine at the national naval medical center and the program director for the internal medicine residency. It's really exciting and it's good for me. It keeps me in my toes to have the opportunity to work with the inquisitive mind the mind that's learning the student the intern the resident they're very interested in learning and it's exciting to teach somebody who really wants to learn and I enjoy that very very much I enjoy that. We have an excellent residency my residents when they graduate generally do extremely well in their internal medicine boards and in fact in this this last group their average as a group was in the 99th percentile so you can't you can't beat it I think our training programs are great I think my residents are great and I'm very proud of them very proud of them. I trained in a civilian hospital in anesthesia and actually was on staff there so I have preserved quite a bit of my ties with the civilian anesthesia community and while there's often some banter of that goes to and fro that they probably make three to four times the salary I do they can't say that they get up every morning and cycle in to work at 6 30 in the morning amongst the palm trees and the tropical breeze. I get to spend a lot of time with my kids which is a lot of what my civilian counterparts don't do. I don't think you're isolated medically being unable to position for one thing they're very big on continuing medical education and even though this is a smaller medical center I've managed to get a few things published so if you're interested in an academic career such as I am it's possible even in a in a far corner of the earth where you're not in the mainstream of American medicine to be able to pursue that and that's a very positive aspect that's something I didn't count on when I was going to be coming down here. Ready to go? Hi sir. How you doing DeLauri? Got that healing feeling? Yep. I'm the diving medical officer here at the naval station Roosevelt roads in Puerto Rico. Basically means that I'm responsible medically for our hyperbaric chamber which is really state-of-the-art. Let's go ahead and get the oxygen mass on. Basically we use oxygen at depth in the chamber to increase the speed of healing of wounds that have failed conventional medical therapy. How does it feel? Comfortable? Had six months training in diving and hyperbaric medicine paid for and and through the navy who basically wrote the book on diving medicine. On the bottom okay in the chamber? The feel of hyperbaric medicine is really very new and given the fact that we have such a state-of-the-art chamber I'm able to really be at the forefront of of hyperbaric oxygen therapy. I can feel that little guy kicking both of us. You feeling that? All the time. You're doing a couple weeks and I think that that due day is just about perfect for you. Everything's going just like it should. Professionally the best thing the navy's probably done is to allow me to practice what I was trained in and family medicine in particular. In the civilian sector the docks just aren't getting to do what they were trained in often. The liability crisis has gotten to such a point that they can't do obstetric care and I think that in family medicine if you don't do obstetrics you lose some pediatric patients. I'm able in the navy to practice a full array of primary care family practice medicine. That's what I was trained for and I'm quite happy to be doing it. Good morning. Everybody all set? Good morning. Mr. Crawford right? How are you? I'm Dr. Robinson. Do you understand what's happening today? Yes sir. What we're going to do today is we're going to take a tube with a light on the end. After finishing a civilian internship I was selected for residency training after my general medical officer year and I decided to stay in the navy because the graduate medical education programs were and are still very competitive. Staying in the navy beyond that has been my choice because of the practice that I'm afforded and the opportunities the opportunities to travel to go to sea to do new and interesting things. I would like to make more money as a navy physician and think I deserve more but I don't my practice is not dependent upon upon the economic constraints that the private sector has. The navy has financed my practice very well. Now I want you to retroflex the scope. Okay. I want you to take your head. I have a worldwide referral base. I have excellent facilities. I have excellent residents and staff members with which to work and I cannot duplicate that anywhere else. It's a different kind of medicine in practice in civilian life. I have freedom here in some of the imaging that I do that I might not have in civilian life. The MRI is to care for patients but I'm not worried about whether each individual patient will be able to pay their bill. I'm more interested in does the doctor need the study and can I provide that service. Ordinarily as a clinical psychiatrist I'm in an office-based practice at Naval Hospital Bethesda very much like any civilian practice would be but when I would come on board comfort my clinical skills are going to be applied very differently. For instance several years ago when I was on the the Radmouth the rapidly deployable medical facility not only was I the the clinical psychiatrist but I also was in the casualty receiving center doing primary triage and and resuscitation of patients as well as being on the cardiac rescue team which kept my my skills up to date. The casualties who have landed on the flight deck from helicopter. Today we've toured the comfort which is quite a bit different than being in a land-based hospital it's quite a facility prepared to handle a large number of casualties larger than any shock trauma center I've seen before. It's prepared to go any place in the world at any time for humanitarian reasons as well as anything that the Navy would require. It's one of those many experiences that you can have in the Navy that you wouldn't get any place else that certainly gives you a different slice than you get just sitting in an office all day seeing patients. Part of the reason that I am in the Navy is that I really do enjoy a variety of things and a lot of active things that can be very exciting. I like to ski scuba dive hand glide I run every day the Navy certainly encourages you to keep in physical shape and and also challenges your skills as well. Well I think the Navy community is a unique one it's the only experience I've had where you can move into a place whereby you're totally far into the area and instantly have 100 friends people knocking on your doors giving you food you're displaced you don't have your cookware or your household goods and neighbors that you don't know from Adam will show up at your doorstep with casseroles and dishes it's very much a small town atmosphere even though some Navy areas are in major urban centers I found that that's quite unique and for spouses as well you have an instant community an instant sorority so to speak and it's also good for the kids in terms of bake here we're in a community where we have lots and lots of young couples and it's very easy to put the kids into a a neighbor's house for a weekend we flew off to one of the islands and had a second honeymoon. After finishing my internship I saw about two to three months of sea duty and that's one of the big myths in the Navy is that going to a ship is bad or is dangerous or is something that you wouldn't want to do if you were a doctor. Two to three months of that time were some of the funnest times I've had in the Navy. Being at sea is actually very beautiful I like being on a cruise ship on my honeymoon I like being on aircraft care when I was on it shortly after completing internship. Join the Navy and see the world is literally true at least you'll have the opportunity not everybody does that but at least you have the opportunity to volunteer to see the world. One thing that people forget is that the Marine Corps does not have its own physicians so Navy physicians become the physicians to the Marine Corps. The Marines have MR deployments which is a medical mobile ready action team in essence it is a hospital that comes out of boxes but more basic than that it is a group of people that are specifically trained to do this function with the Marine Corps. A Navy physician has to go above and beyond just being a physician or being a surgeon you have to know what the sailors of this country do for a living you have to know what the Marines of this country do for a living. There is no better career I think no matter what your professional expertise may be than the United States Navy. I think that most people who have come into the Navy those of those even people who have not stayed in the Navy cherish their Navy experiences. I'm sure in my later years I can look back and say yeah you know yes I took the scholarship yes they paid for it but I also worked four years for the government and not everybody can say that and I think that's a good thing. And that's one of the reasons that I've stayed in the Navy is because I've had this opportunity to teach and see patients and it's outstanding. I feel that having lived in both worlds I know what it's like to practice in civilian life and I know what it's like to practice in the Navy and I think that for my life and for my lifestyle I far prefer to practice in the Navy. But everyone's a little different and what goes into a career for one person may not be ideal for the other. But let's assume you're open-minded you can sit down and look at what your options are for a ideal career for you. You know ideal patients ideal location ideal challenges in your career ideal lifestyle and ideal economics of your practice. List all of these things then look at your options and include the Navy in those options. I wish you success in this and I wish you every success in your career choice.