Serving in Residency

July 30, 2021
Tale of Two Doctors

This is an article our newest Featured Flight Doc, Lt Col Robert SOJU Ryu, authored when he was just a lowly Major and a resident back in 2019. In this piece, SOJU detailed his experience flying fast jets with the Ohio ANG all while enduring the grueling training of an Orthopedic Surgery resident. Published originally for the SoUSAFS FlightLines Vol 32, Winter/Spring 2019. Enjoy!

  So there I Shaw Air Force Base (AFB), getting ready to take terminal leave with my last day of active duty quickly approaching. I had just completed my fini-flight with “The World’s Greatest Fighter Squadron,” the 77th Fighter Squadron. It was a bittersweet moment, realizing it was likely the last time I would ever fly in the F-16 viper fighter jet. Yet, I was excited to move on with my medical career and start my orthopaedic surgery residency at The Ohio State University (OSU). I started to reminisce about the previous 3 years I had spent on active duty. The Air Force had taken me on multiple adventures from Alaska to Afghanistan, amassing over 300 flight hours in a dozen different types of aircraft along the way. Realizing that I would never enjoy such unique opportunities again, I decided I wasn’t ready to discontinue military service entirely.Through various contacts, I reached out to leadership at the medical group of the 180th Fighter Wing, with the Ohio Air National Guard (ANG), inquiring about a need for an additional flight surgeon. I had heard that one of their former flight surgeons served as a traditional guardsman, while in his emergency medicine residency. I asked if I could do the same during my residency. I was met with enthusiasm. At the time, the unit had five traditional guardsmen flight surgeons including a family practice physician, an emergency medicine physician, a colorectal surgeon, a hepatologist, and an internist. And lucky for me, they were looking to add more.

Low Key Flex

Eventually, I was put in contact with their recruiter and got the process started. At the time, I signed a 3-year, $75,000 bonus, paid out $25,000 per year for 3 years (current bonus is up to $90k). To ensure there was no break in service, my start date in the ANG was set for the day following my active duty separation date. After completing my first 3 years in the ANG, I signed an additional retention bonus contract. Ultimately, I was assigned to become the Squadron Medical Element of the 112th Fighter Squadron.To ensure I maximized my financial benefits, I applied to take advantage of my GI Bill (GIB) benefits during residency training. During my first 36 months of residency, I received roughly $2,000 per month in MGIB benefits, which is huge considering the nominal salary a medical resident makes. Once I exhausted my MGIB benefits, I applied for additional benefits under the Post 9/11 GIB, which was approved for an additional 12 months of benefits. I had effectively matched my salary as an active duty flight surgeon who receives the ASP bonus, flight pay, combat tax exclusions, family separation pay, SDP, among other active duty financial benefits.Of course, I had to have the approval of my residency program. Fortunately, OSU is a very military friendly institution; more so, our residency program is exceptionally military friendly. When I started, 6 of our 30 residents were former or current military members, one of whom was a former active duty Navy flight surgeon who was serving in the U.S. Navy Reserves while in residency. He had laid the groundwork for me, and therefore my program director was understanding and completely supportive of me serving in the ANG while in residency. I was warned, however, that during my first couple of years in residency, due to a heavy call burden, there would be months in which I might not be able to drill. This was anticipated, but an issue that had been encountered and overcome in the past. I discussed these challenges with the med group commander, who ensured that it would not be a problem and that there were alternative means for fulfilling drill days. Over the subsequent 4 years, I


attended more than 90% of my drills. For the months I was unable to fulfill primary drill, I took advantage of makeup drill days and went in on alternative days to work. Additionally, I fulfilled drill with CME courses or conferences. On a number of occasions, I used ATLS or ACLS training or attendance at an orthopaedic conference in lieu of drill. I have been able to successfully complete four good years since starting in the ANG. To complete a good year, you must complete a minimum of 48 drill periods, which comes to 12 weekends. One drill weekend is made up of four 4-hour drill periods.On a typical drill weekend, I spend Saturday completing Periodic Health Assessments (PHAs), occupational health exams, and shop visits. Sunday is normally reserved for training and meetings. A drill weekend can be extremely busy, filled with over 150 PHAs on Saturday and FOMWG, OEWHG, DAWG, and AMC meetings on Sunday. Yet, there is always time to spend on the operations group side of the Wing. In addition to maintaining a state of individual readiness with deployment mobility and fitness and medical requirements, I have been able to maintain my flying currencies. There have been ample opportunities for me to accomplish all flying requirements including local area survival training, aircrew flight equipment familiarization, conduct after capture training, water survival training, hanging-harness/egress training, and aircrew chemical defense equipment training. I was even able to renew my physiology training by attending the high-altitude, hypobaric chamber course at Wright-Patterson AFB. Maintaining these currencies has allowed me to fly on a routine basis—on average once or twice every few months. I have accomplished roughly 25 flying hours over the past 4 years, adding up to 160 hours total flown in the F-16 Fighting Falcon.For a guardsman, there’s no shortage of temporary duty, or TDY, opportunities. The Ohio ANG has given me some unique and special TDY experiences. In September 2015, I took a week of vacation from residency to travel with the squadron to Tyndall AFB in Panama City, Florida, for Air-to-Air Weapon System Evaluation Program (WSEP), also known as Combat Archer, an exercise where pilots practice shooting live missiles at drones. And I went back to Tyndall in September 2018 for another WSEP exercise. My second TDY with the unit occurred in May 2017 when I traveled with the squadron to Kecskemét, Hungary, for a multi-national exercise called Operation Load Diffuser. This was an incredible experience, including my first trans-Atlantic flight in the F-16, stopping in Keflavík, Iceland. Once in Hungary, I was able to interact with air force members from the Czech Republic, Slovenia, Slovakia, and Hungary. I was even able to get a backseat ride in a Hungarian Saab JAS-39 Gripen.

These TDYs were great opportunities to provide medical support, fulfill flying requirements, and build relationships with the pilots and other members of the unit, while taking advantage of the travel and local culture. Numerous other TDY and deployment opportunities have come up, including trips to Red Flag Alaska, Red Flag Nellis, Guam, Estonia, Hickham, Lakenheath, and Ramstein. All of these TDYs and deployments were divvied up among the other flight surgeons. As an OSU employee and resident, I am entitled to military leave in addition to my normal vacation days. My program has been completely supportive of me going TDY. Nevertheless, I have not taken advantage of my military leave benefit, but rather used my vacation days to go TDY. This was a personal choice based on my priority of being an orthopaedic surgery resident first, seeking to optimize my time off and minimize time away from clinical training.

Study Study Study: It ain't easy being a resident

I believe the biggest difference between the ANG and active duty is time—everything seems to happen faster and more efficiently than it does active duty. One drill weekend often feels like the equivalent of 1 month of active duty. For example, as mentioned above, we can accomplish over 150 PHAs in 1 day, and we usually accomplish FOMWG, OEWHG, DAWG, and AMC meetings all in one morning. I pinned on major 2 years ahead of my peers and will be eligible to pin on lieutenant colonel nearly 4 years ahead of my peers. The time between drill weekends seems to fly by. Despite spending a fraction of the amount of time with the squadron as I did with my active duty squadron, I still feel a special tight knit connection to the unit. I know crew chiefs and operations group support staff by first name, and they know me by call sign. Everyone is incredibly welcoming and easygoing without forgoing military decorum.

Would I do it all over again? Absolutely, I would do it all over again! I loved my time in the active duty Air Force, and I have loved my time in the ANG. The ANG has allowed me to continue to meet amazing people, travel to faraway lands, have incredible adventures, and fulfill my passion for aviation and aerospace medicine, all while progressing with my civilian medical career. I plan to continue serving for the foreseeable future.

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