Introduction/disclaimer
This program should be considered by ANYONE considering applying for or taking an HPSP scholarship. I made an good faith effort to be factual, please correct wrong numbers and information. I am biased in thinking that this (or the reserves/guard) is a better route for anyone not previously associated with the military to take towards service as a military physician (note, I’m a veteran). For prior service and/or military brats, the HPSP makes sense. Note I didn’t get into active duty pay etc, which can be found elsewhere.

This sticky is intended to summarize several components of the Financial Assistance Program (FAP) that likely would be of interest to pre-med and medical students considering entering the military the help pay for medical school. This program is also of interest to current or soon-to-be residents considering practicing in the military.

In very short, the FAP is financial program that individuals sign into immediately before residency, or while in residency. The application process may be started before starting residency, but the contract starts when you sign (for practical purposes of discussion, immediately before the first day of residency).

The financial benefits
In this program you receive two types of payments during the residency year:
1) You receive a large check at the beginning of your residency year (e.g. July 1st 2006), and on each subsequent start of the next residency year (i.e. July 1st 2007, July 1st 2008 and so on) through the start of the last residency year. For example, an internal medicine resident signing before the start of a 3 year program will receive 3 large checks. In another example, a surgical resident in a 5 year program signing up at the beginning of his/her 2nd year will receive 4 large checks (for years 2 – 5).
2) You receive on a monthly basis a stipend (in addition to the annual check).

The current payments are (may be higher, subject to change, likely only “up,” but not by much in the current fiscal climate):
1) Annual check $25,049.
2) Monthly payments of $ $1,185.

The contract obligations
The contract obligation for this program requires individuals to enter active duty service on a “year for year plus one” basis. This means you must repay the service for each year you receive benefit plus one year. For example, an IM resident who received benefits for 3 years while in residency must serve on active duty for 4 years. In another example, a surgery residency who signed up at the beginning of their 2nd of 5 years of residency will have to go on active duty for 5 years. In addition to active service, you will have to remain in the inactive reserves (you don’t drill on the weekend etc, but you may be called up during time of war, vote appropriately) for a period equaling 8 years. For example, if you served on active duty for 4 years, you must remain in the reserves for an additional 4 years; if you served 5 years on active duty, you must remain in the reserves for 3 years.

If you drop out of residency, snort coke, etc, you will wish you were dead. There are stiff penalties for not completing the obligation; read on this elsewhere. This is not dissimilar to any other military financial program.

The practical benefits
-YOU decide and match into whatever CIVILIAN residency you choose, THEN sign into the military (unlike the HPSP)
-(Worth over-emphasizing) In this program YOU have COMPLETE control over the specialty you will enter, and the location/program (unlike the HPSP)
-Enter the fleet as a FULLY TRAINED physician in your specialty (unlike the HPSP for many)
-I am not 100% sure of this, but you may enter the FAP after HPSP (for those who know that the military is for them…as the obligation years really pile up)
-With this program you can delay your decision regarding whether or not to go into the military until AFTER medical school
-In residency you will make your regular residency salary (roughly $40-50K) PLUS the FAP payments (roughly $40K), allowing for a better standard of living during residency
-NO GMO tour if choosing the Navy route
-Practically speaking: have a pulse, not a fatty, not openly gay, in a competitive specialty, you’re in (no GPA, MCAT, etc worries, unlike the HPSP)
-While repaying your obligation requirements, you will earn a little more in that you’ve completed residency (possibly at a higher rank, possibly with board certification pay benefits)

Arguments to “wait and join the FAP later” instead of signing early for the HPSP
-You may decide during medical school that you don’t want to go into the military
-MANY HPSP recipients regret their decision (not so much the prior service recipients)
-Much of the positive HPSP feedback is either from prior service recipients who knew the military and knew what they were getting into, or from “new to the military” HPSPrs for whom the military is still new, exciting, and interesting—caveat emptor
-No military duties/rotations/service while in medical school
-Even though the concern of student loan debt is understandable when starting medical school, you will likely realize during medical school that the debt is a pittance in the long run, thus making a “grin and bear it” choice to enter the military less desirable means to finance medical education
-No military commitment hanging over your head in medical school
-Living circumstance in medical school may change (e.g. meet a significant other not fond of being a military spouse, children may enter the picture, etc)
-You may head to medical school interested in a lower paying specialty where the military financial trade-off doesn’t seem that bad (e.g. Family Practice) but may end up in a specialty where you could theoretically pay off your loans in one year (e.g. Radiology), making any long-term financial benefit moot.

Detractors against the FAP
-In the end, it’s still the military, and military medicine (read these boards)
-Almost NO ONE taking a military route will be financially ahead of their classmates who took student loans and a subsequent civilian job
-Earning ~$80k+ during residency will likely mean that you will have to go into student loan repayment, which for most people means spending ~$10k a year in payments
-FAP payments outlined above are subject to tax (at least the “large check” is)
-The HPSP allows you to live the ‘high life’ while in medical school on ~$1,185 a month, at least for those for whom $1,185 is the ‘high life.’
-I knew one emergency medicine resident who was taken out of residency for Gulf 1. People say this isn’t possible. In researching this I found no specific order, but I did find reference to the point of “not being eligible to enter the service as a practicing medical officer until the individual holds a license to practice medicine.” This could mean after PGY-1. My story is an anecdote; research the orders on this if this is a concern regarding signing.

Again, I’ve tried to be fair in outlining the above. Please throw in any additional information or make corrections to errors.

I worked it out for myself using current pay tables:

If I went the FAP route, as a Navy Lieutnenat (O-3) with seven years prior active duty service as an enlisted Marine in my first four year of active duty I would make about $91,000 per year for Family Medicine assuming I was drawing BAH for my current ZIP code. After four years my pay would jump to about $130,000 assuming I am calculating ISP and MSP correctly and that ISP runs concurrently with MSP. (if not subtract $15,000)

I would be 44 when I finished residency so while on paper I could do it, I would probably be unable to serve the additional 13 years I need to retire.

Plus there is the specter of deployment. I spent half of my Marine Corps career either at sea or deployed but I was single then. I don't have the same relish for the roving life that I used to.

The so-called "military bull****" doesn't bother me. I mean, it's the military. If there was no military bull**** it would be the civilian world. Seems like this sort of thing just goes with the territory. Navy physicians cannot possibly have to endure anything near the discipline expected of a Marine infantryman.

Navy physicians cannot possibly have to endure anything near the discipline expected of a Marine infantryman.

Amen, brother.

Dry Dre

Very well written and thought out summary of the FAP program as it compares to HPSP. You were only slightly off on on two points: You can't participate in both FAP and HPSP simultaneously. Two totally different programs. The other is, both the FAP lump sum payment and the monthly stipend are fully taxable. BTW....increases in both payments is generally tied to whatever cost-of-living pay raise congress authorizes for the military each year.

You can't participate in both FAP and HPSP simultaneously. Two totally different programs. The other is, both the FAP lump sum payment and the monthly stipend are fully taxable. BTW....increases in both payments is generally tied to whatever cost-of-living pay raise congress authorizes for the military each year.

Thanks for the clarification on taxes.

Regarding FAP and HPSP, I meant to say that I believe that individuals who went through med school on the HPSP can then sign up for the FAP after completing med school (assuming that they are headed to a civilian residency). Again, the combination starts to add up the obligated years, but for those seeking a full military career (including completing 20 after prior service) it may be an attractive option.

Regarding respecting military BS: I'm a Marine Corps veteran (swung with the wing, go ahead and poke my soft belly). I did serve on embassy duty and know a thing or two about discipline. I would hope that sometime in the future of our armed forces there develops an atmosphere where old-school BS starts to become passe. I don't think that it is fair for our service members to maintain institutions that turn off and turn away great potential resources, just for the sake of the relative minority that get off on military BS. It isn't just the medical corps that is suffering from recruiting/retention problems...

is there no way after you fniish your 7 years, that you cannot open up your own practice? I am curious, thank you.

[QUOTE=dry dre]Introduction/disclaimer
This program should be considered by ANYONE considering applying for or taking an HPSP scholarship. I made an good faith effort to be factual, please correct wrong numbers and information. I am biased in thinking that this (or the reserves/guard) is a better route for anyone not previously .............




Dry dre,
first, I congratulate you on the above note.. honestly very timely. I have, in the past, posted a long thing or two on FAP, but always seems to get lost... some how..

I am an FAP participant in general surgery. Not only have I research this very well, I personally have meet and know most decision makers for surgery, in the navy. So with that I would like to add a couple of points that I find very essential, although might seem miner to some.

1) Your part of a small club when you are in the FAP, unlike other programs. If I need something, I have direct access to the head of gme at Bethesda, to my surgical Subspeciality and to my detailer, and trust me they are very flexible with you because you are "valuable" to them. You, are a full trained doctor.. so non of the GMO abuse..

2) Once you are in FAP, its not an irreversible thing. So, for example lets say you loose your mind and go into a surgical residency. As part of the FAP program it means that you will owe 6 years (as explained by dry dre). That is of course if you sign up prior to entering the residency. Well, let say in your third year of residency you decide that you no longer wanna be in FAP, for what ever reason ( you got married and your spouse make money, or your moon lighting now.. whatever).. well, you can actually switch from FAP to NADDS and not get paid for the remainder of your residency, and then owe less time. So if you switch out after being paid for three years, then you will be in NADDS for two year (no money from the navy) and then you go to active duty with only a four year obligation (cause you only got paid for three years). This is an option in any year.

3) Fellowships: The chance of going directly into a fellowship (which involves getting approval by the GME board) requires an act of god. It has been done, however, after talking to many many people high up in the process DO NOT COUNT ON IT.. So if you choose that you want to do a fellowship, then plan on doing a year or two after your residency in your Speciality and then going to fellowship. Of course the fellowship should be something that is needed by military. However, I have to tell you that if it is something that the mil. needs.. its not a problem to get. I have inside info on how many apply to each fellowship (in surgery that is) and you many times competing with one or two people only.

4) Where you end up after you finish your residency: This depends on a few things. and I only know the navy, so keep that in mind. But in the navy its is very much dependent on a couple of things. The most important thing is does your Speciality leader and detailer KNOW who you are or not. I am not saying have your worked with them, because the answer for most of us is no. I am just saying, have you bothered to call and introduce yourself. you would be very surprised how important that is. Now, traditionally you will be on a non-conus rotation before you are on a conus rotation, but then again, early birds many times get the warm.

5) Remember that you do get promoted during your residency, NADDS or FAP. and your rank starts from when you finished medical school, not necessarily when you entered FAP. So I have a friend who is finishing surgery this year, but is a PGY 9 (did 4 years of research/PhD) in his surgical residency. Well, guess what. He has 9 years in the navy (for promotion purposes) even though he only joined FAP when he got his second child two years ago (so only three years in FAP). You might ask, so what. well, your right to ask, cause all these years DO NOT count towards retirement, however, they do count towards rank, which counts towards your salary.

6) lastly, for anyone that thinks that this is a financially stupid thing to do. I have received three offers from academic inst in NY and Chicago (not knowing am in the navy) and they range from 120-160K. If you look at what the national recruiters for physicians published last year (for national wide), surgeons in their first three years of practice (post residency) make 94K(low), 200(high), and 125(average). This goes up by about 40k each in years 4-6. If you look at what I will be making, or my friend that I mentioned above in our first years of surgery in the navy (well, it depends on where we are and dependents and so on), but just to give a flavor, I will be making (NET, after all the taxes) about 100. Now, the numbers I gave you above are gross.

I tried to be as honest as possible about this, and really give only facts. however, any feedback is appreciated and please let me know if I can help in any way.

Thank to dry dre once more. great job :thumbup:

A

Thanks to dry dre for the FAP information above. Although I considered the HPSP, it seemed to me that the FAP might be a better option. After reading the posts above, I think I'll take that route!

The original poster stated you have "complete control" over what special of medicine you go into via FAP. That isn't exactly the case. The Navy won't give you a scholarship if they are overmanned in the specialty you are getting trained in.

One advantage of HPSP is that you get your training in a military environment. If you haven't experienced military medicine you could experience a certain culture shock when coming straight out of residency. I worked with 2 physicians and they went through a steep learning curve. Military medicine has so many unique aspects to it such as limited duty and medical boards.

Something else worth mentioning is promotion. It's relatively straight forward to make it to CDR/O5. However to make it to CAPT/O6 your record looks better if you have done some operational stuff like a GMO tour where you were a department head.

What about Commissioned Officer Training? When does that take place? Also, do you enter the military after residency as a Captain like the other HPSPs?

The original poster stated you have "complete control" over what special of medicine you go into via FAP. That isn't exactly the case. The Navy won't give you a scholarship if they are overmanned in the specialty you are getting trained in.

One advantage of HPSP is that you get your training in a military environment. If you haven't experienced military medicine you could experience a certain culture shock when coming straight out of residency. I worked with 2 physicians and they went through a steep learning curve. Military medicine has so many unique aspects to it such as limited duty and medical boards.

Something else worth mentioning is promotion. It's relatively straight forward to make it to CDR/O5. However to make it to CAPT/O6 your record looks better if you have done some operational stuff like a GMO tour where you were a department head.


IGD,
I have to disagree with you here.
In FAP, you do have complete control in the speciality you enter. In fact, you don't even enter the navy/mil until you have already MATCHED in a residency of YOUR choice. That means you choose not only the speciality , but also the program and the location of the program.. just like any other civilian medical student. In fact, exactly like any other medical student. You are right, however, in that the navy will not take you in FAP if you so choose a speciality they don't need. But, in the ironic world we live in, that would have been a problem if you went into HPSP anyway, so it kinda all equals out. But if you in an the FAP program, then you have for certian choosen your speciality without any mil. part in the decision (since it was made prior to enven talking to them).

Regarding your second point, with promotion. By the time you are up for 06 (CAPT), you have spent post residency (in the navy) at least 10 years (1-2 years as LT, depending on how long your resdiency was)( 5 yrs as LTCD)(5 yrs as CMR). I garentee you that by that time you have done many deployments, and may dept head positions that you will NOT be relying on your 1-3 year GMO deployement to make you a CAPT. Remember also that the vast vast vast majority of physicians do not choice to stay that long anyway.

Thank you for your input
A.

What about Commissioned Officer Training? When does that take place? Also, do you enter the military after residency as a Captain like the other HPSPs?


OIS happens after you finish your residency. So you NEVER have to do even ONE day of active mil durning your residncy (even though you get paid for 45 days a year).

What rank you enter the mil at depends on when you finished your medical school (and partially on how long your residency is). you start as a O3 as soon as you graduate and then calculate after that.
Two examples:
Student A finsihed med school 98, did 2 years research, 5 years surgical residency. Thus as a O3 +7 years= he has been an O4 for 2 years. So entered the mil at O4 with 2 years in O4, thus up for O5 in 3 years.

Student B (me) finished med school 00, did 5 years of resency, thus O3+5 years = entered the mil this years as a O4. Infact I don't get to put the O4 on for another 2 months, so I am acually an O3 for 2 months then an O4. Not up for promotion for another 5 years..

hope that helps.
A

Just wondering:
When I enter medical school, I will have 10yrs prior Navy service. Before I felt my decision was essentially b/w USUHS and HPSP, but now I'm wondering whether FAP isn't a better route even if my residency won't start the clock towards retirement (considering tuition in state of residency is relatively moderate). It seems like it preserves my options until I'm at a point where my decisions will be better informed. Any thoughts would be much appreciated.

Regarding your second point, with promotion. By the time you are up for 06 (CAPT), you have spent post residency (in the navy) at least 10 years (1-2 years as LT, depending on how long your resdiency was)( 5 yrs as LTCD)(5 yrs as CMR). I garentee you that by that time you have done many deployments, and may dept head positions that you will NOT be relying on your 1-3 year GMO deployement to make you a CAPT. Remember also that the vast vast vast majority of physicians do not choice to stay that long anyway.


If you joined the Navy after completing a 4 or 5 year civilian residency, you'd likely come in as a LCDR. With no prior military experience, you might be perceived as inexperienced by your peers. It is very possible that your first tour might be at a MTF to help you get acclimated. The first tour might last 3-6 years.

If you compare someone head to head who completed a GMO tour with someone who did not (all things beings equal) the person with the GMO tour wins out every time.

If you joined the Navy after completing a 4 or 5 year civilian residency, you'd likely come in as a LCDR. With no prior military experience, you might be perceived as inexperienced by your peers. It is very possible that your first tour might be at a MTF to help you get acclimated. The first tour might last 3-6 years.

If you compare someone head to head who completed a GMO tour with someone who did not (all things beings equal) the person with the GMO tour wins out every time.


IgD,
with all due respect.. you keep on missing the point with FAP.
There is NO way that any GMO is or ends up in a better situation than an FAP person. I know this from the countless other people I work adn talk to daily.
Let me explain. Once you are done with residency, you are a valuable person to the navy. They can not just slap you anywhere. You go where you can practice your trade. Sure some spots are better than others.. but any spot that an FAP person goes to is way way way better than most of the spots that GMO's go to.. by far.. there is NO comparasion. Let alone the pain of LITERALLY WASTING YEARS of your life doing mostly nothing (as a gmo.. and that is what most gmo's would say).
I have gmo's calling me weekly to come and scrub with me or rotate in my clinic because they are bored out of their skulls, and guess what.. I am a FAP person with "no experiance" as you so nicly state it.

how about after the GMO person finishes wasting years of their life and goes to residency (once the mil finally gives him/her the blessing) are they equal to the FAP person.
Well, from personal expariance, I am working with two others now in the same dept that acually went the HPSP route and did the GMO thing and wasting years of their life and then finally did the residency and now are in the same tour as I am (the non-experiance person, as you say it) and guess what... I AM THEIR BOSS...
so their you have it.
I don't want to make people in the HPSP/GMO world feel bad.. but if you have a choice.... FAP kicks ass..
this is NOT my opinion alone.. this is the opinion of EVERY hpsp, every gmo, and every fap person I have spoken too.. except maybe IGD...

sorry if my email is harsh.. but i just wanted to make some facts striaght..
A.

you keep on missing the point with FAP...Once you are done with residency, you are a valuable person to the navy.


From my experience, the detailers try to assign fresh civilian graduates at a major CONUS MTF so they can get their feet on the ground. I remember when a new civilian graduate showed up at our command with pink hair. (true story)


I am working with two others now in the same dept that acually went the HPSP route and did the GMO thing and wasting years of their life and then finally did the residency and now are in the same tour as I am (the non-experiance person, as you say it) and guess what... I AM THEIR BOSS... so their you have it.


It is not necessarily a matter of positional authority. Did you all three graduate in the same year group? Let's say that you were all in the same year group at the same command fresh out of residency. It's a point thing just like for the GME selection board. You might have seniority in your workspace but if you add up the billet points there might be a difference. Check out your officer data card that lists all the billets you've held.

I've observed a certain political advantage as well. For example, who should we send on a deployment? "Bill and John are the most junior guys in the department. John already did a GMO tour lets send Bill."

I always viewed the GMO tag as a trump card for the GME selection board. For promotion and other issues I don't think it helps as much but it is a small factor.

[QUOTE]
this is NOT my opinion alone.. this is the opinion of EVERY hpsp, every gmo, and every fap person I have spoken too.. except maybe IGD...
[/QUOTE

:)

I've observed a certain political advantage as well. For example, who should we send on a deployment? "Bill and John are the most junior guys in the department. John already did a GMO tour lets send Bill."

So, you're saying that doing a GMO tour is an advantage in terms of not getting deployed b/c . . . you already got deployed?



I always viewed the GMO tag as a trump card for the GME selection board. For promotion and other issues I don't think it helps as much but it is a small factor.


Yeah, GMO tours are big advantages in terms of GME selection. If the GMO tour helps you get into a specialty that you couldn't have matched into otherwise, then the tour was well worth it.

From my experience, the detailers try to assign fresh civilian graduates at a major CONUS MTF so they can get their feet on the ground. I remember when a new civilian graduate showed up at our command with pink hair. (true story)



It is not necessarily a matter of positional authority. Did you all three graduate in the same year group? Let's say that you were all in the same year group at the same command fresh out of residency. It's a point thing just like for the GME selection board. You might have seniority in your workspace but if you add up the billet points there might be a difference. Check out your officer data card that lists all the billets you've held.

I've observed a certain political advantage as well. For example, who should we send on a deployment? "Bill and John are the most junior guys in the department. John already did a GMO tour lets send Bill."

I always viewed the GMO tag as a trump card for the GME selection board. For promotion and other issues I don't think it helps as much but it is a small factor.

[QUOTE]
this is NOT my opinion alone.. this is the opinion of EVERY hpsp, every gmo, and every fap person I have spoken too.. except maybe IGD...
[/QUOTE

:)


IgD
I guess what I am trying to say is that although the fact that you have spend a few years of your life doing things that you don't want to do and that serve nothing but to make you loose your skills and knowledge (ie. gmo tours) puts you at an advantage when it comes to other residents that have not done gmo tours.. THIS ADVANTAGE IS VERY VERY MINUTE IF IT EXITS AT ALL.. WHEN IT COME TO FAP PEOPLE SIMPLY BECAUSE WE ARE ALREADY FULLY TRAINED PHYSICIANS.

Thus even though I am a fresh fap grad, I already have the world of surgical specialty and others to get selected this year in the gme board, and with regards to deployment.. guess what it is a rotation. So we rotate who goes to deployment.. does not matter if you are a LT or a CAPT.. the rotation just goes around...

Thus while I can see your point when it comes to gme for residents prior to going to residency.. but that does not apply to us FAP.. because we are already beyond all that headache..

Another thing.. just remember that the navy never ever owes you anything.. thus simply because you wasted years of your life doing ...... does not mean that they will feel like they have to give you what you want. There are countless GMO stores to prove that point.

have a nice day..
A.

[QUOTE=IgD]
I guess what I am trying to say is that although the fact that you have spend a few years of your life doing things that you don't want to do and that serve nothing but to make you loose your skills and knowledge (ie. gmo tours) puts you at an advantage when it comes to other residents that have not done gmo tours.. THIS ADVANTAGE IS VERY VERY MINUTE IF IT EXITS AT ALL.. WHEN IT COME TO FAP PEOPLE SIMPLY BECAUSE WE ARE ALREADY FULLY TRAINED PHYSICIANS.


Your description of a GMO tour is different than the vision that has been passed down to me. Completing a GMO tour conveys a longlasting benefit to the military physician in terms of operational and leadership experience, for promotion and political reasons. There is especially an added benefit if a physician gets a pin like for flight surgery, undersea medicine, surface warfare or now FMF.

In terms of medical knowledge, FAP physicians are "fully trained". However most of the time FAP physicians don't have *ANY* training in military culture or operational medicine. Most physicians graduate through military training programs because we need the latter.

Get out of the clinic/MTF and go green. You'll never go back.

[QUOTE=aatrek]

Your description of a GMO tour is different than the vision that has been passed down to me. Completing a GMO tour conveys a longlasting benefit to the military physician in terms of operational and leadership experience, for promotion and political reasons. There is especially an added benefit if a physician gets a pin like for flight surgery, undersea medicine, surface warfare or now FMF.

In terms of medical knowledge, FAP physicians are "fully trained". However most of the time FAP physicians don't have *ANY* training in military culture or operational medicine. Most physicians graduate through military training programs because we need the latter.

Get out of the clinic/MTF and go green. You'll never go back.


I guess what is clear is that we both value completly different things. As much as I value my position in the military.. I am a doctor to the core.. I live and breath surgery and medicine.. and that is why spending anywhere from 2-5 years doing no medicine expect dressing changes and healthy PE and paper work is a true death sentence.
so simply (to those who are reading this..)..
If you want to be a doctor.. then go FAP.. simply because you don't have to deal with the crazy mil politics., you don't spend 2-5 years on a boat or in the middle of nowhere , and then have to (beg) to be allowed to go to a residency (and be limited in which residencies you can go to)... and remember that if you get deployed after FAP.. you get deployed as an attending.. and depolyed doing what you choose and trained to do..

But if you are not sure what you want to do yet.. and spending some time in the field taking care of marines and so (which is needed.. and honorable).. then HPSP/GMO is for you. Just please.. remember that when you get into a GMO.. don't be crying about it (cause that seems like all GMO's do.. )
I understand the frustration that GMOs go through. I mean it must be crazy frustrating to take care of patients when you have almost NO training to do your job.
I mean. I get consults from GMO's that have been treated wrong for weeks.. this happens EVERYDAY .. and I am not exagerating.. and I also don't blame them.. I mean I would have certianly made the same mistakes if all I had was medical school training. ..

In anycase.. as I said there is a place for everyone.. and I do know one GMO who is a flight surgeon who choose that path and is happy with her choice, simply because she has NO idea what she want to do yet..

so there you have it.
and that is all I am going to say about this topic. I think we have killed it like ten times..

thanks for your input IgD.
A.

Hello All,

I've been just totally agonizing about whether or not to enter the FAP program. I'm matched to a FP residency in Washington State; I've got 4 kids and a ton of debt. We're looking at a pretty slim 3+ years without some financial assistance.

So, I was pretty much SURE I'd sign. I grew up in Colorado Springs, where the Air Force has a pretty big presence (Pete Field, AF Academy), so I figured I'd go AF. The recruiter I'm working with hasn't really been too knowledgeable, so I tracked down a guy from my residency program who did HPSP but has a pretty good take on what to expect if you're HPSP or FAP.

His response is below. As always, it's only 1 guy's opinion, but was pretty revealing to me. Also, it's slanted toward FP, so take it for what it's worth. It's just something that might be helpful for anyone else out there sitting on the fence with this military thing like I am:

-----------------------------------------------

My assignment now is, I think, about the best there is for an FP. I am the only doc at a very small clinic, and am doing alot of procedures, including vasectomies. No FPs in the AF are doing OB, and hospital work is very limited. I'm getting out this summer, and am going to start a solo private practice.

A couple things to consider:

1. You get very little say in the first assignment--I was offered my choice of 2 bases in OK and 2 in MS, chose MS, but ended up in AR at the last minute. All in all, it was a decent place to be, but I thought I would get at least some say. A buddy of mine here went to Korea for the first year (he was FAP), which is unaccompanied (no families). You'll fill out your "dream sheet," but it carries little weight in the decision-making process.

2. Everyone deploys now, usually to Iraq; most docs are on a 15 month rotation and deploy for three months; docs entering now can expect to ddeploy 2-3 times in their committment time. My recruiter told me deployments were rare, which is not at all true. There is talk of going to a system like the Army's, with 12 month deployments, and this will likely come soon. Honestly, this is a huge reason why I'm separating this summer.

3. More and more docs are being pulled out after their first year in residency to be GMOs. I was lucky and made it through, but it is not uncommon to be pulled out. The AF desperately needs docs, and they don't look at the long term benefits of residency trained docs, they just want them now.

4. Financially, the deal isn't great. I am making about $120K now, but started at about $80K for the first few years. In contrast, my fellow graduates have found first year contracts in the $130-150 range, and in retrospect, are probably better off financially.

5. Believe what the contract says, not the recruiter. I was told all sorts of things that weren't true. Remember, their job is to get you to sign on, then you won't see them again.

I was in a similar situation to start--quite a bit of debt, three kids at the start of residency. All in all, in retrospect, I wouldn't do it again, because I've seen that the financials are often better with just working towards a good contract, and there are alot of military demands placed on you. If you sign on, you just need to be prepared to deploy, face the prospect of having to leave residency after the first year, and have little say in where you'll be assigned. I was told by my recruiter that these things are nothing to worry about, but they are. To me, the loss of the freedom of choice was the biggest sacrifice.

So what are you going to do?

this is simple - don't do it for the money. seriously.

Simultaneously wring my hands, masturbate, smoke, drink and run around the block until I finally make a damn decision. :eek: Actually, I'm not freaking out THAT bad...yet. But it IS the most pressing issue on my mind at this time.

Thinking about reserves (almost the same amount of money). And thinking about just freaking welfare and keeping my freedom. I have a wife and 4 kids. Once upon a time, getting sent to Korea would been awesome. But not if I have to separate from them for a freaking year. Kids will take their dad + poverty over no dad + 4bd house any day. So would the wife, she tells me.

In fact, one of the big reasons I wanted to sign was because of the possibility of getting stationed overseas. Sounds like that's pretty much BS. Instead it's Arkansas. Or at least, it is highly probable I'll be somewhere I wouldn't choose.

However, the deal-breaker is deployment length and practice opportunities. Really, I guess, it's reserves or nothing at this point. I don't think active duty is for me.

Simultaneously wring my hands, masturbate, smoke, drink and run around the block until I finally make a damn decision. :eek: Actually, I'm not freaking out THAT bad...yet. But it IS the most pressing issue on my mind at this time.

Thinking about reserves (almost the same amount of money). And thinking about just freaking welfare and keeping my freedom. I have a wife and 4 kids. Once upon a time, getting sent to Korea would been awesome. But not if I have to separate from them for a freaking year. Kids will take their dad + poverty over no dad + 4bd house any day. So would the wife, she tells me.

In fact, one of the big reasons I wanted to sign was because of the possibility of getting stationed overseas. Sounds like that's pretty much BS. Instead it's Arkansas. Or at least, it is highly probable I'll be somewhere I wouldn't choose.

However, the deal-breaker is deployment length and practice opportunities. Really, I guess, it's reserves or nothing at this point. I don't think active duty is for me.

A wise decision on your part.

Simultaneously wring my hands, masturbate, smoke, drink and run around the block until I finally make a damn decision. :eek: Actually, I'm not freaking out THAT bad...yet. But it IS the most pressing issue on my mind at this time.

Thinking about reserves (almost the same amount of money). And thinking about just freaking welfare and keeping my freedom. I have a wife and 4 kids. Once upon a time, getting sent to Korea would been awesome. But not if I have to separate from them for a freaking year. Kids will take their dad + poverty over no dad + 4bd house any day. So would the wife, she tells me.

In fact, one of the big reasons I wanted to sign was because of the possibility of getting stationed overseas. Sounds like that's pretty much BS. Instead it's Arkansas. Or at least, it is highly probable I'll be somewhere I wouldn't choose.

However, the deal-breaker is deployment length and practice opportunities. Really, I guess, it's reserves or nothing at this point. I don't think active duty is for me.

What are the major differences between the FAP and the joining the Reserves?

I just started considering this as the extra cash would be nice, and I have always had the thought of medicine in the military in the back of my mind. Would love to know what to expect from the reserves in terms of my commitment and my risks of getting screwed (ie sent to Iraq for a long ass time) vs. what they will pay me and what some other bennies may be.

Any help would be great!

Actually I believe it should be FAP or nothing. Either go all the way with active duty or nothing. The reason is because in the Reserves you will get activated and deployed. So now you will lose the private practice you worked so hard to get going....and your family will still have to remain in the states and potentially lose that house. :thumbdown

It's not worth it. You either go in all the way or none at all.

Considering current shortages, is it possible that in the near future that FAP docs could get pulled from residency for GMO tours as well? Or is that a concrete thing in the contract, no repayment until the completion of residency?

Considering current shortages, is it possible that in the near future that FAP docs could get pulled from residency for GMO tours as well? Or is that a concrete thing in the contract, no repayment until the completion of residency?



No, No and again No. It is against the DOD's best interest to pull residents to be GMOs. The military trains to requirements and if they have a person in FAP it is because there has been an need noted in that area.

I find it far more likely to restrict interns from entering residency. At present the GMO community is 150% manned in the Navy. What typically happens is when a GMO finishes the first operational tour and does not go on to residency they are given non-operational billets(*), so they can reapply or finish payback and get out. If there is a huge crunch, GMOs in non-GMO billets will be tagged to go back to operational units. (my opinion)

(*)This is a general rule. Please don't start posting all the individual annecdotes of the exceptions, I know there are some. Most who do back to back operational tours do it by choice.

Well, that's definitely good to hear.

Out of curiousity, what specialities are NOT needed by the military? Does it vary by branch, or do they all need the same thing?

Well, that's definitely good to hear.

Out of curiousity, what specialities are NOT needed by the military? Does it vary by branch, or do they all need the same thing?
Different from service to service and year to year.

Well, that's definitely good to hear.

Out of curiousity, what specialities are NOT needed by the military? Does it vary by branch, or do they all need the same thing?

The majority of FAP awards are designated to Surgical related fields. If a general surgeon wants FAP, they will get it. Primary care is less likely to have slots available. I does depend on how a particular community is manned. If it is 95% or above manned, we will not offer FAP slots.

can anyone please tell me what the total package for FAP will come to with the new stipend structure.

Are OB/GYNs typically FAP candidates? Or is that "overmanned"?

They are occasionally offered, but you won't know until the year you apply.

Does anyone know if you can go into the FAP after HPSP but before doing your tour? I mean, will they pay for your four years of medical school then your 3 year residency and then you just pay back like 7 years?

Are you kidding me? Look, maybe I'm not blind, I had prior service, but you ain't going to get FAP benefits after doing HPSP. Like it or not, they're getting their pound of flesh, and this time it is without the caveat of no drop of blood. I hate to sound like the heartless boob, but if you didn't know what you where getting into, that's your fault. Why in the world would you then subjugate yourself to more time? Do the GMO tour and go match if that is how you feel, you can't play both sides against the middle. All you have done is that point spent more time in the military building your pension against lost wages on the outside worl, only to throw it away. Makes no fiscal sense.

Let me break it down for us in terms we can understand. If you are HPSP, you have commited to the fist step, unreversible pathway.
1. Do your time (20 years) to get a pension plus whatever indepentally you did. (fiscally seems to be better)
2. Do your minimum time and get out. You will make more money under the current system with this route.
This is where all other factors come into play, how much do you need to make, how much is curtailing to a healthy patient base a hinderence or plus to you, how much crap from the beaucracy can you take, how much is deployment an impediment, how willing are you to move. Those questions drive the equation, you and only you can give the answer.

What do I hope, that the system realizes its shortcomings. You know how the military solves problems, throw money. You knew times were bad in the Navy when the SWO's started getting a bonus. If people short the system, the Walter Reed saga is going to resurface, and the solution will be money. Until then, are you willing to leave under the current understaffed model? My experience unfortunately in subs is that the competent leave.

Does anyone know if you can go into the FAP after HPSP but before doing your tour? I mean, will they pay for your four years of medical school then your 3 year residency and then you just pay back like 7 years?

If you are given a full deferrment for residency, you can apply for FAP. Pay back is years of residency plus one and it is consecutive with your HPSP payback. So in your example of 4 year HPSP and 3 year FAP, you would owe 8 years.

If you are given a full deferrment for residency, you can apply for FAP. Pay back is years of residency plus one and it is consecutive with your HPSP payback. So in your example of 4 year HPSP and 3 year FAP, you would owe 8 years.

How do you apply for a full deferrment? I mean, I know you can do the NADDS thing but I thought that through that program you had to pay for school on your own.

My local recruiter agreed that it'sFAP time plus 1 year but that the HPSP time that would be served out was served concurrently vs consecutively when I went back in, thus just four years for a 3 year residency and 4 years of dental school if you do HPSP then FAP. Is there any official contracts or paperwork that I can read somewhere online?

I did HPSP and am now doing FAP on NADDS. It is consecutively. Really.

My contract spells that out quite clearly;
Paragraph 7e. "I will not be relieved of any previously incurred ADSO as a result of participation in the AFHPFAP. I cannot serve any part of the ADSO incurred from AFHPFAP participation concurrently with any other ADSO. My total ADSO will be served consecutively and will be the sum incurred from all sources. Obligations are served in the order incurred."

spang

is it possible to switch services with FAP...for example can you do army HPSP and then afterwards do a airforce FAP...I paid back my army ADSO with a GMO tour....I recently separated and now in a civilian residency program.

I did HPSP and am now doing FAP on NADDS. It is consecutively. Really.

My contract spells that out quite clearly;
Paragraph 7e. "I will not be relieved of any previously incurred ADSO as a result of participation in the AFHPFAP. I cannot serve any part of the ADSO incurred from AFHPFAP participation concurrently with any other ADSO. My total ADSO will be served consecutively and will be the sum incurred from all sources. Obligations are served in the order incurred."

spang

Please help me understand the timeline to do the NADDS and FAP. Here's an example of what I think the order is. I just don't know and it would be great to have someone who's done it give a breakdown.

-Apply for NADDS by June between Junior and Senior year in dental school.
-Get a response from NADDS if you can defer, that July.
-Do an externship at the school/program you want to get into that same summer.
-Apply for that program that summer as well.
-Once accepted, apply for FAP

Is this right or do apply for NADDS in between sophmore and junior year? Any input or information I didn't think about is appreciated.

I did HPSP and am now doing FAP on NADDS. It is consecutively. Really.

My contract spells that out quite clearly;
Paragraph 7e. "I will not be relieved of any previously incurred ADSO as a result of participation in the AFHPFAP. I cannot serve any part of the ADSO incurred from AFHPFAP participation concurrently with any other ADSO. My total ADSO will be served consecutively and will be the sum incurred from all sources. Obligations are served in the order incurred."

spang

Check my understanding: You did a HPSP scholarship then signed up for FAP. So you probably owe about 8 years active duty (The sum of HPSP + FAP obligations)?

How did you sign up for both HPSP and FAP? Did you complete a GMO tour and then get out of the military?

I did med school on 3 year HPSP, got a full deferment (5 years for urology) and then applied for FAP as soon as I started my residency. There's nothing that says you can't do both, just have to be in a specialty that qualifies for FAP.

I owe 9 years of active duty, but I had almost 13 on active duty before medical school. They get a specialist for 9 years and I get about 200K after taxes in the bank, over the 5 years. Seemed like a deal to me since I already owed 3 yrs so would be at 16 yrs and thought chances were atleast 50/50 I'd stay to 20 yrs so why not take the cash upfront, all of which goes right to my stocks and mutual funds.

spang

For the Navy HPSP's that are thinking of specializing

So, apparently, the year before graduation you get an application to apply for a residency. If DUINS doesn't deny you, you will fall into one of four groups. They would be FTIS, FTOS, NADSS, or FAP. Since we haven't done a tour yet, FTIS is practically out of the question. If you're a real hot shot, you may get FTOS. For the rest of us, it will be NADSS. If you want the Navy to sponsor you, you apply for FAP, otherwise, you pay for yourself and avoid less AD. Does anyone concur?:thumbup::thumbdown

Let's say that I am in an ENT residency (pgy1) and I intend to sign FAP (Air Force) for PGY2-5 in return for 5 years of active duty. But, I also had a PhD and 12 years of work experience prior to medical school. My questions:
1) What rank would I likely start at after residency (and what ray rate)?
2) What kind of incentive pay is available for surgical subspecialists?
3) How likely is an ENT going to be deployed in Iraq vs. Germany vs. CONUS?

Any advice would be helpful.
Thanks in advance,
KY_DO_PhD (formerly phd2b)

Let's say that I am in an ENT residency (pgy1) and I intend to sign FAP (Air Force) for PGY2-5 in return for 5 years of active duty. But, I also had a PhD and 12 years of work experience prior to medical school. My questions:
1) What rank would I likely start at after residency (and what ray rate)?
2) What kind of incentive pay is available for surgical subspecialists?
3) How likely is an ENT going to be deployed in Iraq vs. Germany vs. CONUS?

Any advice would be helpful.
Thanks in advance,
KY_DO_PhD (formerly phd2b)

Assuming your PhD is science related you would definitely get credit towards rank for that. I'm not sure how many years. I suspect you would start as a LCDR. Fresh out of residency you pick from the bottom of the barrel and can expect to go on a "utilization tour".

Check out http://www.militarymedicine.com/node/36 for a detailed explanation on the pay.

Let's say that I am in an ENT residency (pgy1) and I intend to sign FAP (Air Force) for PGY2-5 in return for 5 years of active duty. But, I also had a PhD and 12 years of work experience prior to medical school. My questions:
1) What rank would I likely start at after residency (and what ray rate)?
2) What kind of incentive pay is available for surgical subspecialists?
3) How likely is an ENT going to be deployed in Iraq vs. Germany vs. CONUS?

Any advice would be helpful.
Thanks in advance,
KY_DO_PhD (formerly phd2b)


I did the FAP, and I have a MD-PhD too. But the promotion boards did not give me credit for the PhD.

If your PhD was received together with your MD degree, then you will not get credit. It's still worth a shot to write to the reserve promotion board and ask for credit for the PhD.

On the other hand, you receive "years of service" credit during your ENT residency. In the Navy, the ENT FAP candidate was promoted during her last year of residency to 0-4 (LCDR for the Navy and Major for the Airforce). I was promoted to O-4 right before OIS, and then pinned on rank a year later. You should contact BUMED and make sure your FITREPS are in order. Keep copies of your FITREPS. Make sure the RESERVE PROMOTION BOARD reviews your records for promotion to 0-4 during your PGY-5 year.

When you go to OIS after completing residency, you should be at least an O-4 with 4 years of service. The years of service is a HUGE thing. It means you get paid $923.70/month more than an O-4 with less than 2 years of service(http://www.dfas.mil/militarypay/newinformation/WebPayTableVersion2006updated.pdf). At year 6, you get another increase in your pay: $3150/year for 6 years of service and another $7000/year raise when your VSP goes up (http://www.militaryconnection.com/2007-pay-charts/2007-medical-dental-pay.asp). This is in addition to your $15,000/year ASP, $30,000/year ISP, and board certified pay which starts at $2500/year.

Your $45,000 ASP/ISP comes to you in one lump sum in July, and you should get the paperwork done during check in. If you don't fill out the request each year, then you won't be paid. The board certified pay and VSP are paid over 12 months.

I did the FAP, and it's a great deal! I hope this info helps.

I did the FAP, and I have a MD-PhD too. But the promotion boards did not give me credit for the PhD.

If your PhD was received together with your MD degree, then you will not get credit. It's still worth a shot to write to the reserve promotion board and ask for credit for the PhD.

On the other hand, you receive "years of service" credit during your ENT residency. In the Navy, the ENT FAP candidate was promoted during her last year of residency to 0-4 (LCDR for the Navy and Major for the Airforce). I was promoted to O-4 right before OIS, and then pinned on rank a year later. You should contact BUMED and make sure your FITREPS are in order. Keep copies of your FITREPS. Make sure the RESERVE PROMOTION BOARD reviews your records for promotion to 0-4 during your PGY-5 year.

When you go to OIS after completing residency, you should be at least an O-4 with 4 years of service. The years of service is a HUGE thing. It means you get paid $923.70/month more than an O-4 with less than 2 years of service(http://www.dfas.mil/militarypay/newinformation/WebPayTableVersion2006updated.pdf). At year 6, you get another increase in your pay: $3150/year for 6 years of service and another $7000/year raise when your VSP goes up (http://www.militaryconnection.com/2007-pay-charts/2007-medical-dental-pay.asp). This is in addition to your $15,000/year ASP, $30,000/year ISP, and board certified pay which starts at $2500/year.

Your $45,000 ASP/ISP comes to you in one lump sum in July, and you should get the paperwork done during check in. If you don't fill out the request each year, then you won't be paid. The board certified pay and VSP are paid over 12 months.

I did the FAP, and it's a great deal! I hope this info helps.

Thanks for the respones. I'm still trying to figure out all of the military acronyms (I'm not prior military). So, what is "BUMED" and "FITREPS"?

My PhD and master's work was completed independent of medical school, if that ends up mattering.

I have been in touch with a healthcare recruiter, so I'm waiting to see what she says. I'm not in a hurry to sign anything and am in data collection mode now.

Thanks again and more later,

Thanks for the respones. I'm still trying to figure out all of the military acronyms (I'm not prior military). So, what is "BUMED" and "FITREPS"?

My PhD and master's work was completed independent of medical school, if that ends up mattering.

I have been in touch with a healthcare recruiter, so I'm waiting to see what she says. I'm not in a hurry to sign anything and am in data collection mode now.

Thanks again and more later,


If your PhD is related to medicine and your field, then you can ask for entry as an O-4.

FITREPS are you evaluations by your senior officer. BUMED is The Bureau of Medicine and Surgery.

Good luck!

Besides aging into promotions, how is the system set up to reward competence with advancement? Another way, how short of time does it take to go from an O-4 to an O-5, as an example? What are the steps needed to make that happen (or accelerate the process)?

Besides aging into promotions, how is the system set up to reward competence with advancement? Another way, how short of time does it take to go from an O-4 to an O-5, as an example? What are the steps needed to make that happen (or accelerate the process)?

For doctors, going from O-4 to O-5 requires about 6 years. If you do tours in Iraq, take up early leadership responsibilities, or in a command that really supports you, then you may receive "must promote" at 4-5 years after receiving the O-4 rank. O-4 to O-5 is fairly easy. O-5 to O-6 is much harder. To get to O-6, I've heard from senior officers that you must become less of a doctor and more of a military leader/administrator. It's tough wearing both hats.

Besides aging into promotions, how is the system set up to reward competence with advancement? Another way, how short of time does it take to go from an O-4 to an O-5, as an example? What are the steps needed to make that happen (or accelerate the process)?

Speeding up the process from O-3 to O-4 can be accomplished by entry grade credit. Your PhD may give you an additional 3 years towards O-4. Going from O-4 to O-5 is pretty much a 6 year cycle. There are about 2-3 individuals selected for early promotion, but they are by far the exception. Publishing, being a great clinician will help in the long run, but they won't get you selected early. O-5 to O-6 has gotten easier this year. Selection rates had been in the 50-60% range but now have gone back to 80%. This too is a 6 year cycle.

Good answers to simple questions. Here's another: realistically, what types of destinations could a surgical specialist (ENT) be expected to make during AD? Assume 5 years of duty for 4 years of residency support? How often, for how long, and where?
Thanks in advance,

What are the major differences between the FAP and the joining the Reserves?

I just started considering this as the extra cash would be nice, and I have always had the thought of medicine in the military in the back of my mind. Would love to know what to expect from the reserves in terms of my commitment and my risks of getting screwed (ie sent to Iraq for a long ass time) vs. what they will pay me and what some other bennies may be.

Any help would be great!

Just as a tip and for other people reading this, if you are thinking
of deployment in terms of "my risks of getting screwed" then you will
really not be doing yourself a favor by joining. You have to realize that
you will be making a sacrifice, you have to want to treat soldiers, serve
your country, and not think that you are "getting screwed".

If you think you are getting screwed as a physician in the military,
i think the infantrymen who are the ones actually laying down their lives
for this country right now might think differently.

Just as a tip and for other people reading this, if you are thinking
of deployment in terms of "my risks of getting screwed" then you will
really not be doing yourself a favor by joining. You have to realize that
you will be making a sacrifice, you have to want to treat soldiers, serve
your country, and not think that you are "getting screwed".

If you think you are getting screwed as a physician in the military,
i think the infantrymen who are the ones actually laying down their lives
for this country right now might think differently.

1) I completely/100% agree on your thoughts about deployment

2) Absolutely one of our soldiers (and thier families) pay a bigger price/sacrifice than any physician getting "screwed".

3) Having said that, I hope you are not also inferring that what is going on in milmed should cause us to "look the other way" as physicians since "whatever" is going on is not the ultimate sacrifice and does not compare to what those who have died in the line of duty sacrifice.

I feel I can safely speak for many milmed Primary care docs when I say it is not 4pm tee-times, leather lounge couches and more pay that we have been asking for.

But when milmed chooses to staff our clinic below a safe minimum, when there are/have been to pt charts available, unneeded beurocracy, broken referral protocols and much more...AND....when milmed chooses to remove the people with the responsibility for the care (the doctors) from having any authority to correct the above problems.................well, that when you see docs leaving, patient care declining and in my experience, USAFcore values a thing of the past (replaced by your friendly neighborhood money and metricsman).:thumbdown

can someone quickly summarize what 'metrics' are?

can someone quickly summarize what 'metrics' are?

below is a definition copied from a net site. The problems with USAF metrics are numerous including that USAF metrics are frequently innaccurate and metrics have replaced local control and site visits. Basically they are a method so that somebody thousands of miles away from an issue can justify their business decisions. Interesting that the Vietnam War was very much "run" using metrics. The part missing from the "net definition" below that I feel is most important are the ACCURACY (what good is the metric if the number is wrong and derrived from false info) and BIG PICTURE (what good is a metric if the decisions made/based on it go against the very reason we do medicine to begin with)

At its simplest, a metric is a generic term for nothing more than a standard measure to assess performance in a particular area. For example, a business that has recently invested in providing a customized order status page on their Web site to minimise time customer service operators spend on the phone, may decide to monitor the percentage of delivery status inquiries answered via the Web interface, versus those answered on the phone.


Metrics should be SMART i.e. Specific, Measurable, Actionable, Relevant, and Timely:


“Specific” in that your metrics are targeted to the area you are measuring;
“Measurable” in that you can collect data that is accurate and complete;
“Actionable” in that the metrics are easy to understand, and it is clear when you chart over time which direction is “good” and which direction is “bad”, so you know when to take action. Using the delivery status example, if the metrics were to indicate customers are not using the Web order status page as much as expected, the business can attempt to analyse why this is happening, and then take appropriate action based on this. Continuous monitoring should help create the desired result;
“Relevant” simply means don’t measure things that are not important. A common downfall is to measure everything, which produces many meaningless measures;
“Timely” metrics are those for which you can get the data when you need it.

At the end of the day, metrics should be simple. If they require a lot of explanation and definition, then collecting and translating data into actions becomes more difficult. Easy to understand metrics are also easier to sell, and have a stronger impact on the process and people who use it.


Clearly by collecting this data it is possible to analyse current performance and then set short and long-term objectives, as well as meet competitive or industry benchmarks.

Do all military branches have the FAP? I could not find it on the Air Force's Website.

Thanks.

Do all military branches have the FAP? I could not find it on the Air Force's Website.

Thanks.

Yes, but the numbers and specialties are often different. Not sure what the AF numbers look like.

Do all military branches have the FAP? I could not find it on the Air Force's Website.

Thanks.

Information for AF medicine can be found at http://airforcemedicine.afms.mil. (http://airforcemedicine.afms.mil)

If you're looking for what specialties you could do with FAP, look at the 2008 IFB results. Those list all specialties/fellowships that the AF is in need of for the upcoming fiscal year. For FAP, you would have to look for those specialties/fellowships that are granted Def/RDef, meaning that you would be serving absolutely no time towards your ADSC.

Additionally, if you click here, Medical Link for Deferred/ReDeferred FAP (http://airforcemedicine.afms.mil/intradoc-cgi/nph-idc_cgi.exe?IdcService=GET_FILE&dDocName=CTB_047026&allowInterrupt=1&RevisionSelectionMethod=Latest), you can see a document that should answer some of your questions about AF FAP.

If you think you are getting screwed as a physician in the military,
i think the infantrymen who are the ones actually laying down their lives
for this country right now might think differently.

If I wanted to dodge bullets and cap off Arabs, I wouldn't have gone to college.

I guess I'm missing your point. What exactly was it again?

If I wanted to dodge bullets and cap off Arabs, I wouldn't have gone to college.

I guess I'm missing your point. What exactly was it again?

I think he was just trying to give you some perspective. You know, life could always be worse type of thing.

I don't believe this was mentioned in the OP's post, but let's say that I enter a civilian residency, sign up for FAP, but then decide afterwards that I don't like my specialty and want to switch residencies, which i heard is not an uncommon scenario. Would I even be allowed to switch residencies under FAP and would I be subject to the "stiff penalties" mentioned by the OP?

I read this today on a military medicine web page.

"The DoD has increased pay for HPSP and HAP. This month the stipend for HPSP and FAP was increased from $1305 to $1605. In July 2008, the stipend will be increased to $1907. In 2007 the annual grant for FAP participants remained the same but will be increased from $28,454 to $45,000. The stipend increases amount to 18% per year and the grant increase is 58%!"

My main question is this. Since the FAP benefits are taxable, how much of the 28k or 45k can you expect to really be able to use to pay off your loans?

Also, is the HPSP stipend taxable as well?

I read this today on a military medicine web page.

"The DoD has increased pay for HPSP and HAP. This month the stipend for HPSP and FAP was increased from $1305 to $1605. In July 2008, the stipend will be increased to $1907. In 2007 the annual grant for FAP participants remained the same but will be increased from $28,454 to $45,000. The stipend increases amount to 18% per year and the grant increase is 58%!"

My main question is this. Since the FAP benefits are taxable, how much of the 28k or 45k can you expect to really be able to use to pay off your loans?

Also, is the HPSP stipend taxable as well?

Both HPSP and FAP stipends and grant are taxable.

One good thing is that you don't have to pay social security taxes. The amount of federal and state taxes you pay depend on your state of residence and number of exemptions.

This new FAP increase will allow you to make over $100,000 per year as a resident! This is amazing.

Assuming your residency pays you $40,000/year, your total taxable income will be $107,884/year.

Use this calculator to determine your federal tax: http://www.irs.gov/individuals/page/0,,id=14806,00.html

Your federal taxes (single with standard deductions):
$23,366

State taxes:
~$8000

FICA/SS on the $40,000:
~$3000

After tax income: ~$73,518/year (~32% goes to taxes)

You should consider purchasing a home to reduce your tax burden and possibly make some money from your home after leaving residency.

Assuming you live only on your resident salary (after taxes): ~$27,258

You should have $73,518 - $27,258 = $46,260/year to pay off student debt.

Thus, you'll have the following to pay off debt for a:

4-year internship/residency program: $185,040
5-year internship/residency program: $231,300
6-year internship/residency program: $277,560

Hope this helps. Keep in mind that the above is a fairly high tax rate based on standard deductions and single person.

Wow, thanks for all of the detailed information. I was concerned that perhaps a lump sum payment like that would be taxed at a higher rate or something like the military does with some other types of lump-sum payments like money for moving, re-enlisting, etc.

That makes it seem like a very attractive route to take and competitive with HPSP.

Is FAP used to make up shortfalls in the recruitment of doctors in specific fields?

I know that the Army only recruited something like 69% if its required docs last year.

FAP is used to recruit doctors in areas with shortages in man power. FAP, in my opinion, is better than HPSP as you'll get to pick your civilian program AND specialty. After you match, then you sign up with the FAP. Also, if you don't have a lot of debt, $100K+ per year during residency is a ton of money!

I read this today on a military medicine web page.

"The DoD has increased pay for HPSP and HAP. This month the stipend for HPSP and FAP was increased from $1305 to $1605. In July 2008, the stipend will be increased to $1907. In 2007 the annual grant for FAP participants remained the same but will be increased from $28,454 to $45,000. The stipend increases amount to 18% per year and the grant increase is 58%!"

My main question is this. Since the FAP benefits are taxable, how much of the 28k or 45k can you expect to really be able to use to pay off your loans?

Also, is the HPSP stipend taxable as well?

are you sure your information is correct?? they are actually increasing the stipend from roughly 28k to 45k?? that doesn't sound right to me...45K total (stipend + grant) per year...but increasing the annual grant by 58%??

Here is where I got the info on FAP being increased.

http://www.militarymedicine.com/


More specifically

http://www.militarymedicine.com/files/HPSP%20Stipend%20and%20FAP%20Increase%20Memo%20Sig ned_a.pdf (http://www.militarymedicine.com/files/HPSP%20Stipend%20and%20FAP%20Increase%20Memo%20Sig ned_a.pdf)

are you sure your information is correct?? they are actually increasing the stipend from roughly 28k to 45k?? that doesn't sound right to me...45K total (stipend + grant) per year...but increasing the annual grant by 58%??

Lump sum grant will be $45K
Stipend is the same as for HPSP which will be $1907

Annual income about $70K

Does anyone know about how many FAP scholarships (if you can call them that) are offered each year? Just a general number as I am sure it varies year to year. I have yet to run into a mil-doc who took FAP, does anyone know of people who took it?

Does anyone know about how many FAP scholarships (if you can call them that) are offered each year? Just a general number as I am sure it varies year to year. I have yet to run into a mil-doc who took FAP, does anyone know of people who took it?

20 this year for Navy. It is a small portion of the total docs on AD. They also tend to get out with greater regularity.

20 this year for Navy. It is a small portion of the total docs on AD. They also tend to get out with greater regularity.

I read in a congressional report from 95 floating around on the internet that FAP is by far the cheapest way to put docs in, partly because they don't stay in so there is no obligation to pay benefits for life. USUHS on the other hand costs a fortune for the government.

I was pretty set on not signing up for HPSP...but now that I am getting financial aid packages and looking at the debt down the road (with interest about 160k at my cheapest school 225k at my most expensive) and it really is staggering, especially since I have a family.

FAP looks like a nice option, although it doesn't seem so widely used. btw I appreciate your posts on military medicine, they are informative and factual which is great.

There is one big benefit to taking HPSP over FAP. In the Army FAP is not a guarantee. Not all specialties are offered FAP PGY1 and although all can take it PGY-2 and higher. It is still on a case by case basis who the Army decides to offer FAP, this is based on the needs of the Army. If you are in a critical specialty like surgery or ortho then you will probably get it, your chances are almost non-existent if you are in something like Nuclear Medicine. So the one thing that HPSp does have over FAP is that more people are selected for HPSP while with FAP your specialty could deny you that opportunity. BTW the stats and amounts you have listed for HPSP and FAP are old.

Sincerely,
Bliss72 (a recruiter who got a 35 on his MCAT, Med school here I come!!)

Bliss72 (a recruiter who got a 35 on his MCAT, Med school here I come!!)

Does this mean you believe your own lies?

Sincerely, BomberDoc (an anti-recruiter who got 39 on his MCAT, med shool, I miss the good old days)

Edit...

Thank you for all the helpful information.

I'm prior service 12 years. 6 active and 6 reserve. I ultimately hope to match in PM&R. Currently second year med student.

Again, can you still get FAP if you obtain a military residency?


Also, if anyone cares to comment on the pros and cons for finishing up 20 years based on the fact of my time in service would be appreciated. Do I have to do 20 active to collect pension?

Thanks for your time.

Is FAP a NAVY only or all service program?

Is FAP a NAVY only or all service program?


All services, but all have different needs from year to year (i.e. Next year, the AF may have a greater need for IM docs than the Navy and thus will offer more FAP spots)

I realize that FAP freely changes their numbers from year to year, but is there a website out there anywhere that lists what specialties are available this year? I'm mostly interested in the Navy.

For a recruiting effort, it's amazing how much they keep their programs on the QT. Finding info on HPSP is easy, but I couldn't find anything on the Direct Accession Bonus outside of SDN (still haven't found the dollar amount by specialty. HRLRP was only mentioned in passing on the web. The only info I could find about FAP for the Navy was on a general site that listed old amounts.

When you go to OIS after completing residency, you should be at least an O-4 with 4 years of service. The years of service is a HUGE thing. It means you get paid $923.70/month more than an O-4 with less than 2 years of service(http://www.dfas.mil/militarypay/newinformation/WebPayTableVersion2006updated.pdf). At year 6, you get another increase in your pay: $3150/year for 6 years of service and another $7000/year raise when your VSP goes up (http://www.militaryconnection.com/2007-pay-charts/2007-medical-dental-pay.asp). This is in addition to your $15,000/year ASP, $30,000/year ISP, and board certified pay which starts at $2500/year.

I just met with a recruiter, and he suggested that my time in residency would not count towards retirement (I almost certain he's right here) and in computing years of service for pay purposes (I think your post conflicts here), but that it would count for rank (I think he's right here, too).

He printed some information for me, USAREC Reg 610-37 as labeled on the bottom of the page. 21-4 "FAP" e.3 "FAP participants will be assigned to control group officer active obligor at HRC-St. Louis during the duration of their residency or fellowship program training. As such, time spent while participating in FAP will not be counted in determining eligibility for retirement or in the computing years of service for pay purposes."

This last phrase, for computing years of service for pay purposes... I'm assuming that means I'd start with 0 years of experience for pay after FAP? For promotions, do my residency years count?

Thanks for the information.

I just met with a recruiter, and he suggested that my time in residency would not count towards retirement (I almost certain he's right here) and in computing years of service for pay purposes (I think your post conflicts here), but that it would count for rank (I think he's right here, too).

He printed some information for me, USAREC Reg 610-37 as labeled on the bottom of the page. 21-4 "FAP" e.3 "FAP participants will be assigned to control group officer active obligor at HRC-St. Louis during the duration of their residency or fellowship program training. As such, time spent while participating in FAP will not be counted in determining eligibility for retirement or in the computing years of service for pay purposes."

This last phrase, for computing years of service for pay purposes... I'm assuming that means I'd start with 0 years of experience for pay after FAP? For promotions, do my residency years count?

Thanks for the information.

This is my understanding. Residency counts towards promotions. My colleagues and I were promoted to 0-4 right after residency.

In regard to years of service for pay purposes:

This is from the U.S. Code about the HPSP and FAP

(b) Service Creditable for Certain Purposes. - (1) The Secretary

concerned may authorize service performed by a member of the

program in pursuit of a course of study under this subchapter to be

counted in accordance with this subsection if the member -

(A) completes the course of study;

(B) completes the active duty obligation imposed under section

2123(a) of this title; and

(C) possesses a specialty designated by the Secretary concerned

as critically needed in wartime.

(C) possesses a specialty designated by the Secretary concerned as critically needed in wartime.

Any ideas what these areas are?

Currently, FAP are not gaining time towards pay. Oddly, those in deferred status are. Not saying it is right or wrong, merely stating what is being applied. FAP members are given similar status to HPSP when it comes to pay/retirement points etc.

Currently, FAP are not gaining time towards pay. Oddly, those in deferred status are. Not saying it is right or wrong, merely stating what is being applied. FAP members are given similar status to HPSP when it comes to pay/retirement points etc.


So the years spent as FAP prior to active duty do not add up towards rank?

So the years spent as FAP prior to active duty do not add up towards rank?

No, those years DO count towards rank, just not pay. (yes, I shake my head in wonderment too.)

Does anyone know if it is possible to be selected for FAP as a podiatric resident? Thank you.

Does anyone know if it is possible to be selected for FAP as a podiatric resident? Thank you.

Not in the Navy.

I'm a Marine Corps veteran and third-year medical student interested in EM. I received a flier from the Navy concerning the FAP and am very interested. So for those who have done it, the big question is "Would you do it again?".

Also, I am sure that I do not want to do it if I can be pulled from residency to serve as a GMO. Has this happened to anyone participating in the FAP (not HPSP)?

I'm a Marine Corps veteran and third-year medical student interested in EM. I received a flier from the Navy concerning the FAP and am very interested. So for those who have done it, the big question is "Would you do it again?".

Also, I am sure that I do not want to do it if I can be pulled from residency to serve as a GMO. Has this happened to anyone participating in the FAP (not HPSP)?

If you join FAP, you will not be pulled into service as a GMO unless you request it or fail out of your residency.

Can anyone comment on the frequency and length of deployments as an EM physician in the armed forces? How about differences in Army vs. Navy vs. Air Force in regards to the FAP?

Thanks to everyone for the very informative thread. :thumbup:

Does anyone know [or can point me to] the reference that mentions how much credit my MS "gets" me towards O4? I am prior service (a hair below 6 years) and going into a 3y EM program.

For those interested, I found the powerpoint (http://www.med.navy.mil/sites/navmedmpte/accessions/Documents/Recruiters%20Presentation%20-%20Website.ppt)given to Navy health care recruiters, found at the "Recruiters" link on this page (http://www.med.navy.mil/sites/navmedmpte/accessions/Pages/FinancialAssistanceProgram_Prospective.aspx).

Thanks to everyone for the very informative thread. :thumbup:

Does anyone know [or can point me to] the reference that mentions how much credit my MS "gets" me towards O4? I am prior service (a hair below 6 years) and going into a 3y EM program.

For those interested, I found the powerpoint (http://www.med.navy.mil/sites/navmedmpte/accessions/Documents/Recruiters%20Presentation%20-%20Website.ppt)given to Navy health care recruiters, found at the "Recruiters" link on this page (http://www.med.navy.mil/sites/navmedmpte/accessions/Pages/FinancialAssistanceProgram_Prospective.aspx).

Credit for your MS would depend on what your MS is in. It has to be directly applicable to your performance as a doc in the military. You can get up to 2 years.

For Navy guidance look at OPNAV INST 1120.4.

Credit for your MS would depend on what your MS is in. It has to be directly applicable to your performance as a doc in the military. You can get up to 2 years.

For Navy guidance look at OPNAV INST 1120.4.
Awesome. Thanks for the pointer.

Question about something first mentioned on the thread:

One of the points for HPSP>FAP:
"-Earning ~$80k+ during residency will likely mean that you will have to go into student loan repayment, which for most people means spending ~$10k a year in payments"

I don't understand this point. Isn't the financial purpose of FAP to, essentially, pay off your student loans for you? With the ~$45k/year (though, for many schools, that would probably not pay off loans at all.)
And then you live on your regular resident pay and monthly stipend?

Am I totally off the mark here?

You do not have to go into student loan repayment when under the FAP program your still technically a resident, you can forbear during your residency while receiving FAP.