Uncle Sam wants YOU? The Canadian Forces want me!

On several occasions, I’ve been introduced to the idea of a career in the Canadian Forces (CF). In first year of medical school, I met a few of my classmates who had enlisted early. This meant their medical training was paid for in exchange for a 4 year return-of-service contract. Tuition, textbooks, and a stipend. Wow, that’s a lot of bones! Lucky? I wasn’t sure. Guns and war and contracts are not really my thing. Maybe I’ll think about it later.

Three years later, at an Emergency Medicine Update Conference in Whistler, BC, there was a talk about what it is like to practice in Kandahar, Afghanistan. First, the medical officers described the structure of their ranks, the portable operating rooms, and equipment available to them. They showed photos of the Air Base, the horrible pathology, and the dramatic outcomes. I sat and chatted with a recruiter who was a female GP. She spoke frankly about things. “If you like fashion, don’t join. This is the uniform,” pointing to her pretty plain and unflattering garb. Another woman remarked that she sometimes wore he husband’s flight suit, just for variety. “If you have a family, don’t join.” If you want adventure, it’s for you. There are opportunities to jump out of airplanes, get your wings, take a year of French language training, and more. During wartime, these promises are not often kept. But if you keep yourself in line, there may be many rewards. And there is an enormous signing bonus!

A year later, on an elective Radiology rotation, I met a young woman who’d been a GP with the CF for a few years. Healthy young patients on home turf, and really really injured ones overseas. It sounded like a roller-coaster, but by switching professions, maybe she was seeking a more balanced experience. I listened to her, because she was a great teacher and good at her job. She was doing something right. The CF were paying her a regular salary to go back and train as a radiologist. Biiigggg salary, plus no competition with other applicants for ‘re-entry’ positions, since the CF was basically paying for the residency spot in its entirety. In return? 1 year of service for every year of training, to a maximum of 5 years. She’d owe them that, but in so doing, she would creep closer and closer to a higher rank, and with it, a higher salary, and she would also shorten the gap until her pension would start accruing [after 25 years, you become eligible].

Job security, a huge salary, no overhead, and a decent pension. But the real draw would be adventure, tradition, and the experience of working outside the confines of the public system. But I can already see a lot of drawbacks. While I’m not paralyzed with fear, there is obviously an element of danger when working overseas in conflict areas. I would feel safer under the umbrella of the military than I would working with MSF in the same area, but there is a risk regardless of how well-defended the portable clinic may be. Another big hangup is a moral one. I would be lying if I described myself as devoutly pacifist, but I do believe armed struggle should be a last resort  for Canada. We chose to intervene in scenarios where obvious human rights abuses are occurring, and that I can support to a certain extent, but we also get involved sometimes when our intentions are less pure. The problem as a military physician would be this, “Am I supporting the perpetuation of war (killing people) by treating the soldiers and administrators involved?” Well, yes and no. The CF doctors treat Canadian Forces, any allied forces, as well as civilians injured in the fray. Providing aid to the latter is quite a redeeming thing, and one wonders if a war, without medical personnel, might just continue happening anyway. One of the women I mentioned earlier also felt the same moral hangup. But she overcame it by re-framing the situation. Health Care is a human right. Anyone – no matter what good or bad they have done – deserves to have their ailments and injuries attended to. I think that’s a good way of reconciling being a doctor with being part of a war machine, but it still requires some amount of self-convincing to really be satisfactory.

There are personal issues as well that can’t help but be a barrier to application. When joining the CF, one is limited to living and training in one of the domestic CF bases. Those in certain cities are more popular than others. So, for example, someone wishing to be placed in Esquimalt or Comox might instead be located in Ottawa, simply as openings demand it. Likewise, when there are tours overseas, one can’t exactly refuse. You go where you are told. You do what you are told. And there’s not a lot of room to challenge that system. It can also be difficult for those who are married with families, for obvious reasons, but also for the single person who may find it challenging to find or keep a mate with such a geographically fragmented existence.

What am I going to do? Keep it on the back-burner until I finish my residency. Depending on my personal situation, my world views, and the state of armed conflict, I’ll re-evaluate the problems and advantages in the life of a military doc. That, or maybe I’ll be lucky and get to be one of the few non-CF physicians who gets a contract with the CF, and get a taste for what it’s really like ‘out there.’

Never having had a life in the military or being close with anyone who was/is, I obviously don’t know much about it. What do you think would be your biggest worries and greatest rewards?