When he was in high school, Lt. Col. Timothy Ruth attended a science exhibition with his parents at a local museum in Minnesota. There was an educational video of an open-heart surgical procedure playing in one of the exhibits. The sight of the video nearly made him ill.

“My mom jokes about how I almost got sick watching it,” said Ruth. “My parents were a bit surprised when I later told them I wanted to go to medical school.”

Ruth was not surprised, however, since his interest in medicine had sparked earlier as a young kid assisting in surgeries and other pet care from his dad’s veterinary practice in their Pennsylvanian home.

He said the act of performing medical tasks was easier for him then just watching them. He also enjoyed the challenge of the field and helping others.

“It seemed to be the perfect career for me,” said Ruth. “Being a doctor meant I got to help people by using what I’ve learned, talents I have and gifts I’ve been given.”

After four years of college, four years of medical school and three years of residency, Ruth became a family practice physician.

Today he serves as a tradition Guardsman and flight surgeon for the 124th Fighter Wing’s 190th Fighter Squadron. He also works full-time as an urgent care provider and senior Federal Aviation Administration examiner for St. Luke’s hospital in Boise, Idaho.

Military first, medical school second

Joining the military was something Ruth wanted to do before he ever considered being a physician. Getting to do both was just the icing on the cake, he said.

After moving from Pennsylvania where he was born, to Minnesota where he graduating high school, Ruth joined the College of St. Thomas’ Air Force ROTC Program in St. Paul.

“I think I always had an interest in the military that started with talking to my grandfather who served as a Seabee in the Navy during World War II,” said Ruth. “It just so happened my college had ROTC, which interested me because it allowed me to try out the military before committing to it.”

Ruth graduated with a bachelor’s in chemistry and a minor in aerospace studies, while also commissioning into the active Air Force as a second lieutenant in 1993. He was then accepted to medical school at the Medical College of Wisconsin, where he received a full scholarship under the Health Profession Scholarship Program.

After medical school, Ruth continued onto his residency at the University of Wisconsin where he specialized in family medicine before starting his eight-year active duty commitment.

In 2000, he received his first duty assignment as a family physician at Grand Forks Air Force Base in North Dakota. Three years later he transferred to Mountain Home Air Force Base in Idaho where he continued to serve in family medicine before attending flight surgeon school and switching to flight medicine in 2004.

The ‘flight physician’

Despite the name, flight surgeons do not perform surgery and do not have to be surgeons. Rather they tend to be physicians of family medicine, emergency medicine, internal medicine or something broader, Ruth said.

Their duties include conducting flight physicals, reviewing medical records, performing physical exams, inspecting work place safety hazards and collaborating with various occupational health programs to maintain the overall flight safety and safety of the organization’s pilots.

“Contrary to the name, you aren’t doing surgery on anyone much less in the air,” said Ruth. “You are a physician and your job is flight safety and taking care of the flyers. A better name for it would be flight physician.”

Since flight surgeons are rated officers and required to perform flying duties, they go through similar survival training as pilots, including water survival, egress and hypoxia chamber training. Going through these types of training, as well as flying with the pilots, give flight surgeons the ability to provide adequate care in their unique situation, Ruth said.

“The medicine that you practice and the things that happen to people at 1g on the ground are very different then what happens to the human body at 9gs,” he said. “When you fly with them, you understand all the physical and physiological demands placed on their bodies.”

After serving another five years in the Air Force, deploying to Ecuador in 2004 and to Afghanistan in 2007 with the 366th Fighter Wing, Ruth left the military completely. The day after he got out and was hanging up his flight suit, Ruth said he had a change of heart and decided to join the Idaho Air National Guard in 2008.

Not ready to hang up his flight suit

“I just wasn’t ready to walk away from that whole unique experience of flight medicine and military comradery,” said Ruth. “Military medicine offers some very unique opportunities that civilian medicine does not, like getting to participate in the whole flying world.”

As a flight surgeon with the Idaho Air National Guard, Ruth collaborates with the organization’s medical group to maintain the flight safety and medical readiness of approximately 50 pilots who fly the A-10 Thunderbolt.

The medical group consists of approximately 80 enlisted and commissioned Airmen who serve as physicians, advanced practice providers, nurses, ER doctors, surgeons and medical technicians. Some serve as ground surgical teams and critical air transport teams, while all are responsible for maintaining the medical readiness of the Idaho Air National Guard’s approximately 2,000 Airmen.

When not serving in the military, many of the Guardsmen work in similar civilian jobs within the medical field like he does, Ruth said. Being able to pursue a civilian career while also serving close to home makes the Guard more appealing then active duty, he added.

“It’s an amazingly diverse group of people,” said Ruth. “All of these Airmen on the civilian side work in everything from ER doctors and cardiothoracic surgeons to fire fighters and police officers. That’s the nice thing about the Guard, you get to do your civilian job but still get to be part of the military. That’s what appeals to me most.”

A civilian physician

On the civilian side, Ruth has worked as a family physician for St. Luke’s since 2008. He currently serves as the director of its urgent care facility in Boise, where he practices urgent care and treats patients with a variety of issues.

“I like the challenge,” said Ruth. “Every person that comes in has a unique challenge or circumstance and if you have the skills to help them it’s very gratifying.”

Within the same facility, Ruth also conducts Federal Aviation Administration examinations for private and commercial pilots who need to recertify their medical credentialing. Like the medical group, many of the Idaho Air National Guard’s pilots also work in similar civilian jobs and fly outside of the Guard.

Ruth said he enjoys getting the opportunity to serve his fellow Airmen and friends on the civilian side, as well as on the military side.

“Most of my friends are pilots and I enjoy having the ability to help them with their annual FAA examinations,” said Ruth. “Civilian FAA exams are similar to military flight exams so it’s a pretty natural bridge from flight surgeon to FAA examiner.”

Last year while deployed to Bagram Air Force Base in Afghanistan, Ruth had the opportunity to use his FAA credentialing to administer examinations to approximately 40 civilian pilots who were unable to return home due to the COVID-19 pandemic and needed to update their medical records.

“It was not something I had imagined doing on a deployment but I was able do that for those people and save them a big hassle in the end,” said Ruth. “It’s just another example of the unique opportunities medical providers get to experience through the Guard while serving others.”