Air Force: Likelihood of being assigned to Walter Reed as an AF HPSP doctor?

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As an Air Force doctor planning on specializing in Internal Medicine through the HPSP scholarship, how likely is it to be assigned to Walter Reed to complete the 4 year Active Duty requirement? If it is highly unlikely, how does the post assignment system work? Does aptitude in Med School or specialization determine which location/base you're assigned?

I would appreciate any and all input. Thanks!

Originally Posted by myungcheee

As an Air Force doctor planning on specializing in Internal Medicine through the HPSP scholarship, how likely is it to be assigned to Walter Reed to complete the 4 year Active Duty requirement? If it is highly unlikely, how does the post assignment system work? Does aptitude in Med School or specialization determine which location/base you're assigned?

I would appreciate any and all input. Thanks!

There are few Air Force billets at Reed/Bethesda, which is primarily an Army/Navy institution, but they do exist (not sure if there are any AF internists at Reed, though). I think most of the Air Force people are technically assigned to Malcolm Grow, but their orders state that they work at Reed. Med school is unlikely to have anything to do with post-residency assignments.

The likelihood of being assigned at any single installation [insert name here] - even within one's own service - are very low. Combine that with a primary care field, like IM, your first post-training tour, and an installation that is overwhelmingly staffed by physicians from other branches, and your odds become miniscule. Not zero, but miniscule.

How does Walter Reed now being tri-service change the likelihood of Air Force physicians being stationed at Walter Reed?
If one sub-specializes, say in cardiology or critical care, does that change the situation regarding base placements a little?

Thanks!

You could try to get assigned to USUHS as faculty and practice at Walter Reed. Probably not going to happen in your first tour though.

How does faculty placement at USUHS work? And what is the length of the tours? I've seen 2 years is average.

Originally Posted by fior1

How does faculty placement at USUHS work? And what is the length of the tours? I've seen 2 years is average.

Hello,
Does anyone happen to have any insights into the questions listed above?
Also, I was wondering about how the post-ADSO period works. I know that there are 4 years of Individual Ready Reserve, and will being in that status affect looking for physician jobs in the civilian world post-ADSO?

Thanks for any responses!

Originally Posted by fior1

Hello,
Does anyone happen to have any insights into the questions listed above?
Also, I was wondering about how the post-ADSO period works. I know that there are 4 years of Individual Ready Reserve, and will being in that status affect looking for physician jobs in the civilian world post-ADSO?

Thanks for any responses!

Positions at USUHS are pretty much by application. They are not your usual assignments. In general, you need to be fairly senior (O5/6), but there are O4s there. It is rather cliquey and who you know is probably more important that what you know.

I have seen people stay at USUHS for over 10 years, but the standard orders are for 3. Deployments out of USUHS are rare.

As to the IRR comittment, you need to hold on to your commission for 8 years after your first day of active duty. You could spend all that time on active duty and resign or spend some of it in the IRR. Being in the IRR should have no impact on getting a job in the civilian world.

Thanks. With the Air Force HPSP, I'm planning on doing civilian deferment for residency for Internal Medicine (3 years) after med school, and then completing my 4-year active duty service obligation afterwards. I would just really like to be in the D.C./Maryland area.

What do you think is the likelihood of being in the D.C./Maryland area, assigned at USUHS/Walter Reed, or Andrews/Bolling Air Force Bases, if I make it very clear that those would be my top choices?

I'm guessing that Walter Reed/USUHS placements would be more academic/research-oriented. Do you have any suggestions for how it might be possible to prepare during medical school or residency to get a hospitalist/staff physician/research position at USUHS/Walter Reed for ADSO?

Thanks so much!

Originally Posted by fior1

Thanks. With the Air Force HPSP, I'm planning on doing civilian deferment for residency for Internal Medicine (3 years) after med school, and then completing my 4-year active duty service obligation afterwards. I would just really like to be in the D.C./Maryland area.

What do you think is the likelihood of being in the D.C./Maryland area, assigned at USUHS/Walter Reed, or Andrews/Bolling Air Force Bases, if I make it very clear that those would be my top choices?

I'm guessing that Walter Reed/USUHS placements would be more academic/research-oriented. Do you have any suggestions for how it might be possible to prepare during medical school or residency to get a hospitalist/staff physician/research position at USUHS/Walter Reed for ADSO?

Thanks so much!

People who are married to the idea of being in one geographic location should strongly consider that the HPSP and milmed in general is not the best idea. How are you "planning" on civilian deferment in an IM residency? That isn't really something you can plan for esp. at this stage in your training. Nor can you plan for assignment in the DC area. You can hope, but you stand a better shot of being stationed at Altus, OK than DC, most likely. You also are more likely going to be training in-house (active duty) than deferred, playing the odds. That means Dayton, Travis AFB (CA), Biloxi, or San Antonio for IM. Further complicating this crystal ball reading is that you have no (medical) academic track record to speak of thus far. I think you need to have far more realistic expectations or really need to decide if USAF HPSP is the right choice for you.

Originally Posted by J-Rad

People who are married to the idea of being in one geographic location should strongly consider that the HPSP and milmed in general is not the best idea. How are you "planning" on civilian deferment in an IM residency? That isn't really something you can plan for esp. at this stage in your training. Nor can you plan for assignment in the DC area. You can hope, but you stand a better shot of being stationed at Altus, OK than DC, most likely. You also are more likely going to be training in-house (active duty) than deferred, playing the odds. That means Dayton, Travis AFB (CA), Biloxi, or San Antonio for IM. Further complicating this crystal ball reading is that you have no (medical) academic track record to speak of thus far. I think you need to have far more realistic expectations or really need to decide if USAF HPSP is the right choice for you.

I fully understand that there are no guarantees with the AF HPSP. I committed with that understanding, and I'm attending COT this summer. But, I took a look at the GME placements for AF HPSP, and there were 10/50 civilian deferred in general internal medicine. My recruiter made it seem like many HPSP students would prefer military residencies or civilian sponsored residencies, so by requesting a civilian deferment, I might be opening a slot for someone who would prefer an IM military residency. Of course this is all an exercise in probability, but assuming that I don't fail out of medical school and get an okay Step 1 score, I'll match with ERAS. In addition, my uncle, who also did AF HPSP, received a civilian sponsorship to train in NJ, and also got the base of his choice in CA. He also made it clear that I wouldn't have complete control over my training, but I'm hoping that if I make my preferences clear and they also fulfill AF needs, things will fall into place.

Originally Posted by fior1

I fully understand that there are no guarantees with the AF HPSP. I committed with that understanding, and I'm attending COT this summer. But, I took a look at the GME placements for AF HPSP, and there were 10/50 civilian deferred in general internal medicine. My recruiter made it seem like many HPSP students would prefer military residencies or civilian sponsored residencies, so by requesting a civilian deferment, I might be opening a slot for someone who would prefer an IM military residency. Of course this is all an exercise in probability, but assuming that I don't fail out of medical school and get an okay Step 1 score, I'll match with ERAS. In addition, my uncle, who also did AF HPSP, received a civilian sponsorship to train in NJ, and also got the base of his choice in CA. He also made it clear that I wouldn't have complete control over my training, but I'm hoping that if I make my preferences clear and they also fulfill AF needs, things will fall into place.

Dude, you do realize that for anything beyond the accessions process, recruiters are useless sources of information, right? They are wrong about 80% of the time about post-accession issues. Your (idiotic) statement is a prime example (please don't be offended; "idiotic" is directed at the recruiter, not you. You are just naive). Active duty residencies and civilian deferred are most preferred. The AD residency has the advantage of a MUCH better resident paycheck (~150-170% better) AND no functionally added commitment (as the payback commitment from residency will run concurrently with that from medical school). Deferred is also preferred for many because if you are competitive, you have a great shot at training at a program of much better quality than that available in the .mil without added time commitment*. Civilian sponsored for residency isn't highly sought after. It makes your residency commitment contiguous with that from med school, i.e. if you did a civ. sponsored residency in IM your payback would be seven years active duty time. Oh, and by the way, at least in the Air Force, there often seems to be a bizarre mentality that if you ask for a civilian residency, then you are a lesser candidate because you aren't as much "career officer material". Look, seriously, you can get lucky. If I told you how lucky I have been, you would think I have the F'n North Star in my back pocket (I'm talking it'll be 50 years+ before anyone else gets as lucky as I've been). But if you are committed to the AF HPSP, you really need to adjust your expectations else you become the next in a long line of people sorely disappointed and disgruntled with Air Force medicine.

*This calculus changes with fellowships as the fellowship can add quite a bit of long term earning potential and having .mil funding via a sponsored fellowship will open many doors to many programs.

Originally Posted by J-Rad

Your (idiotic) statement is a prime example (please don't be offended; "idiotic" is directed at the recruiter, not you. You are just naive). Active duty residencies and civilian deferred are most preferred.

I read his "or" as a typo. Given the context of what followed, I think he meant to write:

Originally Posted by fior1

My recruiter made it seem like many HPSP students would prefer military residencies over civilian sponsored residencies, so by requesting a civilian deferment, I might be opening a slot for someone who would prefer an IM military residency.

I have to agree with J-Rad. Wanting something is simply not good enough. Deferments are the exception rather than the rule. It is difficult to predict who will get them. First assignments after residency are typically less desirable locations. The AF will have you by the short and curlies and you do not have a lot of room to negotiate. Can people get their top choice? Yes, but it is more often by luck than careful planning.

When joining the military, you have to accept that your worst possible scenario could play out. If you can live with that scenario, go ahead and join. If not, you really have no business in the service. There are far too many people in the service who are bitter because they did not get what they wanted, when they wanted, in the order they believed it should happen. Don't become one of those.

Originally Posted by notdeadyet

I read his "or" as a typo. Given the context of what followed, I think he meant to write:

While the poster is free to chime in to correct me, I do not infer the same as you based on follow-on context. I can see it very much as recruiter saying, esentially: "hey, great, you want a civilian deferred residency (so you can be in the town you want)? Perfect, everyone wants an AD residency or to be sponsored so if you're asking to be a cheap resident (i.e. deferred), then you should be a shoe-in since everyone wants the other two".

Honestly, though, even if it was a miswording, I think the rest of what I wrote holds true.

Originally Posted by J-Rad

While the poster is free to chime in to correct me, I do not infer the same as you based on follow-on context. I can see it very much as recruiter saying, esentially: "hey, great, you want a civilian deferred residency (so you can be in the town you want)? Perfect, everyone wants an AD residency or to be sponsored so if you're asking to be a cheap resident (i.e. deferred), then you should be a shoe-in since everyone wants the other two".

Honestly, though, even if it was a miswording, I think the rest of what I wrote holds true.

Hi poster here, and yes, that is what I thought the recruiter meant regarding being a "cheap resident". I would definitely prefer to complete residency in a major urban area, where there might be better teaching/exposure, and would probably prepare me to become a better physician when I enter the AF MSC active duty.

What objections would the Air Force have to deferring a HPSP student to complete residency in a civilian institution (assuming that said student matches with ERAS), in a specialty like internal medicine, with no added cost to them?

Originally Posted by fior1

Hi poster here, and yes, that is what I thought the recruiter meant regarding being a "cheap resident". I would definitely prefer to complete residency in a major urban area, where there might be better teaching/exposure, and would probably prepare me to become a better physician when I enter the AF MSC active duty.

What objections would the Air Force have to deferring a HPSP student to complete residency in a civilian institution (assuming that said student matches with ERAS), in a specialty like internal medicine, with no added cost to them?

I just got a deferment from the AF this year for Gen Surg. I made it clear from day one (all ADTs, military interviews, personal statement, etc). Prepare to have a better reason than, "I want to be in an urban area" and then be ready to jump through a LOT of hoops to back up your reasoning. Not to mention I was pretty lucky this year as the AF deferred 20 for GS compared to taking 10 in house.

Originally Posted by fior1

Hi poster here, and yes, that is what I thought the recruiter meant regarding being a "cheap resident". I would definitely prefer to complete residency in a major urban area, where there might be better teaching/exposure, and would probably prepare me to become a better physician when I enter the AF MSC active duty.

What objections would the Air Force have to deferring a HPSP student to complete residency in a civilian institution (assuming that said student matches with ERAS), in a specialty like internal medicine, with no added cost to them?

Last year the AF had 42 active duty IM residency positions at 4 locations and 10 spaces for Civ def according to the 2011 HPERB. They are going to want to fill up all 42 of those spots before they send someone to civilian training. If those fill up they have the additional spots to send people to civilian programs, which Im sure does happen, but I would think in most cases they would want to keep the better applicants in their training programs.

Originally Posted by teacherman84

Last year the AF had 42 active duty IM residency positions at 4 locations and 10 spaces for Civ def according to the 2011 HPERB. They are going to want to fill up all 42 of those spots before they send someone to civilian training. If those fill up they have the additional spots to send people to civilian programs, which Im sure does happen, but I would think in most cases they would want to keep the better applicants in their training programs.

I see, thanks for sharing!

What about family considerations (spouse, children, parents, etc.) that would make one strongly prefer pursuing residency in a particular city and request civilian deferment?

Spartan Bob, how did you make your preference for civilian deferment clear through ADTs, military interviews, personal statement?

Originally Posted by fior1

I see, thanks for sharing!

What about family considerations (spouse, children, parents, etc.) that would make one strongly prefer pursuing residency in a particular city and request civilian deferment?

Spartan Bob, how did you make your preference for civilian deferment clear through ADTs, military interviews, personal statement?

PM'd you

not going to be good enough.

Originally Posted by NavyFP

I have to agree with J-Rad. Wanting something is simply not good enough. Deferments are the exception rather than the rule. It is difficult to predict who will get them. First assignments after residency are typically less desirable locations. The AF will have you by the short and curlies and you do not have a lot of room to negotiate. Can people get their top choice? Yes, but it is more often by luck than careful planning.

When joining the military, you have to accept that your worst possible scenario could play out. If you can live with that scenario, go ahead and join. If not, you really have no business in the service. There are far too many people in the service who are bitter because they did not get what they wanted, when they wanted, in the order they believed it should happen. Don't become one of those.

Are you saying that merit, aptitude or personal preference plays no role at all in where you get placed in military medicine, which I find hard to believe?

Originally Posted by fior1

Are you saying that merit, aptitude or personal preference plays no role at all in where you get placed in military medicine, which I find hard to believe?

Yeah, pretty much.

You are, first and foremost, a warm body to fill a spot. I've seen Chief Residents get stuck in their fourth or sixth lcoation on their preference list, while middle of the road residents got their first or second choice. Huzzah, randomness.