2015 Navy HPSP

[medguy16]

I have a few quick questions about Navy HPSP I was wondering if someone could shed some light on.

First, I am up for review 'soon' for some open HPSP scholarships for the 2015 class. Does anyone know if I am picked up this semester - will they pay for last semester also and/or will I still owe a full year in payback? I'm certainly not only doing this for the money, just curious.

Second, I'm fairly positive that I want to go into emergency medicine. Is there somewhere I can read more about how well the Navy EM residency trains doctors?

Last, I've heard it's possible, but not likely, to get deferred for a civilian residency. Is this true? I'm not opposed at all to a military residency but should I get accepted into a top notch civilian residency, would I have the option of considering it?

Thanks for any insight.

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[Perrotfish]

Last, I've heard it's possible, but not likely, to get deferred for a civilian residency. Is this true? I'm not opposed at all to a military residency but should I get accepted into a top notch civilian residency, would I have the option of considering it?

The most important things to undertand when applying for HPSP is that when you sign up for the scholarship you are signing up for the military match. Do deferments happen? Yes, but its rare and the odds are based on luck much more than merit. The military match happens in December, three months before the civilian match. If you want a deferment you need to ask for one as your top choice in the military match. The military then calculates out how many doctors of each type they think they'll need from your class, subtracts the number they produce through their own residencies, and that's the number of deferments they grant. If they decide that your branch only needs 4 EM docs that year, and they already produce 4 or more through their own residencies, then no deferments. When they do issue deferments, its not necessarily the best students they send elsewhere. Think about it, would you want the best students to train outside the military if you were running military hospitals?

You also need to understand that the odds of being selected for different residencies in the military match is different from the civilian match. Pediatrics, a specialty which basically only requires a pulse in the civilian world, requires you to be at least an average student in the military. Emergency, which requires you to be slightly above average in the civilian world, is as competitive as ortho in the military. Dual residencies, PM&R, Peds EM, and some subspecialties don't exist at all in the military. Because the applicant pool is so small, the odds can also change drastically in a single year, because a few extra top students deciding to apply for a specialty can significantly change the odds for everyone else applying. If you accept the scholarship you accept those odds that come with military match.

Finally you need to understand the concept of a GMO tour. When you match in the Navy, you match into just an Internship. There is then a second match in December of your Intern year where you apply for the rest of your residency. About 1/3rd of the Navy Interns match and get to continue. 2/3rds do not match and does what the Navy calls a GMO tour. A GMO tour is 2-3 years of 'operational' medicine, which means after your Intern year you are embeded with the Marines, or with a ship, or with pilots, and you follow them around providing basic primary care in and out of combat. When you get to apply to complete your residency again at the end of those two years you will have extra points in the match, which usually, but not always, means you'll get a slot to finish your residency. The odds of doing a GMO tour are different depending on your specialty. I believe it has been at or near 100% for emergency medicine for the past several years, though I'll admit I'm not sure.

Having to do a military residency is not necessarily a negative. They pay twice what civilian residencies pay, with full benifits. The time you spend in a military residency counts towards the 20 years you need for retirement and towards promotion. The quality of training you recieve is something that attendings on this site debate, but so far I've had nothing but good experiences with my Navy Residency. I've had great patient volumes, good teaching, great mentorship, and strong support for my research projects. The patient population is awesome, and in my opinion the quality of the the support staff you get with military corpsmen and nurses is orders or magnitude better than what I've experienced with civilian nursing in my various rotations through civilian hospitals in medical school. I'm not in EM, of course, but I feel like the EM guys I've met that have been trained in the miltary seem to be extremely competent, which speaks to a good quality of training. The important thing is that you understand what you're signing up for before you sign the papers.

 

[medguy16]

"The important thing is that you understand what you're signing up for before you sign the papers."

Exactly, and that's all I'm trying to do here. I'm still not even sure if I'll get in - I was supposed to hear last Friday and still haven't heard anything yet. I'm not sure if that's a bad sign, or not. The head of our ED is a Navy guy and it one of the best physicians I've ever worked with.

Like I said, I would have no problem doing a military residency - I was just wondering how everything worked. Based on what you've said, if I get accepted to the program and go the EM route, I'm most likely going to end up doing a GMO? Can you tell me more about those? I understand the premise of them, but from a practical standpoint are they a good thing?

Thanks for the reply, I definitely appreciate your input!

 

[Perrotfish]

"The important thing is that you understand what you're signing up for before you sign the papers."

Exactly, and that's all I'm trying to do here. I'm still not even sure if I'll get in - I was supposed to hear last Friday and still haven't heard anything yet. I'm not sure if that's a bad sign, or not. The head of our ED is a Navy guy and it one of the best physicians I've ever worked with.

Like I said, I would have no problem doing a military residency - I was just wondering how everything worked. Based on what you've said, if I get accepted to the program and go the EM route, I'm most likely going to end up doing a GMO? Can you tell me more about those? I understand the premise of them, but from a practical standpoint are they a good thing?

Thanks for the reply, I definitely appreciate your input!

Correct, you will almost certainly have to do a GMO tour between your Intern year and the rest of your residency. In the Navy there are 5 main options to be a GMO:

1) Marines: A 2 year GMO tour. You go directly from Internship to a unit of marines. You are their physican, and are assisted by a handful of corpsmen led (hopefully) by a more senior corpsman. You provide basic primary care: evaluation sore ankles, nausea/vomitting, ingrown toenails, etc. You also train the corpsmen so that they know how to take care of bleeding/dying Marines if/when the unit deploys. When your Marines go into combat, you go with them and triage injuries and casualties at the batalion aid station (or equivalent).

2) Ship: A 2 year GMO tour. Same as the Marines, except that you attach to a ship full of sailors. You treat them on shore, and when they go to sea you go to sea with them.

3) Seabees: Yet another 2 year GMO tour. This time you attach to the Seabees (the Navy's engineers). Again, you go where they go and provide primary care

4) Flight Surgery: A 3 year GMO tour. This one you need to apply for. Accepted applicants go to flight surgery school in Pensacola florida. You learn the basic principles of flight and how flight affects the body. You also learn how to do flight physicals on pilots. They even put you through the first two phases of the Navy's flight school. When you finish your 6 months of school you attach to a wing. Like the GMOs above you provide primary care for your wing. However you also need to make sure the pilots meet the rigerous health standards necessary for them to keep flying. Again, you go where they go.

5) Dive medicine: Another 3 year GMO which you need to apply to. This time you go to dive school: the Navy teaches you to dive, and they teach you the basics of undersea medicine. These docs can attach to a variety of commands. Some follow navy divers around like the other GMOs follow their Marines/sailors/wings. Some attach to the special forces. Some attach to training commands. Finally some dive docs attch to subs, where they work to prepare the subs for sea (they don't serve on the subs at sea, though, that's a corpsman's job). The point is there are a lot of options with this one.

Are GMO tours a good thing? Depends on your perspective. Its certainly necessary for the Navy: those units need doctors function. A lot of docs describe their GMO time as formative and fun: It's the real military rather than just a military hospital. Its a chance to get away from the grind of residency and be treated as an important member of the command rather than just another powerless, dumped upon resident. Its a chance to do things you will never get to do again and which most people will never have the chance to do. It is, outside of deployments and deployment workups, very humane hours with weekends off. It is the most compliant patient population any physician will ever work with. I've met more than one physican who essentially had to be dragged back to residency, kicking and screaming, by the Navy's rule that you can't get promoted beyond O-4 without a board certification.

Others don't like the GMO tour. I've met docs who feel like they weren't adequately trained to practice after just an Intern year and were in constant dread of missing a fatal diagnosis. Others feel like the interuption in their training causes skill atrophy they feel down the line. A not uncommon sentiment was that residency training is too f-ing long already and the idea of still being stuck in residency in your mid 30s is awful. Still others point out that the GMO tours generally aren't located in garden spots, and especially if you have a spouse who works the spots where GMOs are based basically force you to choose between living seperately and your spouse abandoning her career. Finally there is the fact that the most dangerous warfighting jobs gets dumped on GMOs, and while we all understand that joining carries the near certainty of eventual deployment that doesn't mean we all have a burning desire to see Kandahar as often as possible.

Again, the odds of doing this vary by specialty. If you want Peds, FP, or Psych there is a good (though not 100%) chance you can finish residency straight through. EM is a nearly 100% chance of a GMO tour.

BTW: I've never done a GMO tour. This is all second hand.

 

[torshi]

Correct, you will almost certainly have to do a GMO tour between your Intern year and the rest of your residency. In the Navy there are 5 main options to be a GMO:

1) Marines: A 2 year GMO tour. You go directly from Internship to a unit of marines. You are their physican, and are assisted by a handful of corpsmen led (hopefully) by a more senior corpsman. You provide basic primary care: evaluation sore ankles, nausea/vomitting, ingrown toenails, etc. You also train the corpsmen so that they know how to take care of bleeding/dying Marines if/when the unit deploys. When your Marines go into combat, you go with them and triage injuries and casualties at the batalion aid station (or equivalent).

2) Ship: A 2 year GMO tour. Same as the Marines, except that you attach to a ship full of sailors. You treat them on shore, and when they go to sea you go to sea with them.

3) Seabees: Yet another 2 year GMO tour. This time you attach to the Seabees (the Navy's engineers). Again, you go where they go and provide primary care

4) Flight Surgery: A 3 year GMO tour. This one you need to apply for. Accepted applicants go to flight surgery school in Pensacola florida. You learn the basic principles of flight and how flight affects the body. You also learn how to do flight physicals on pilots. They even put you through the first two phases of the Navy's flight school. When you finish your 6 months of school you attach to a wing. Like the GMOs above you provide primary care for your wing. However you also need to make sure the pilots meet the rigerous health standards necessary for them to keep flying. Again, you go where they go.

5) Dive medicine: Another 3 year GMO which you need to apply to. This time you go to dive school: the Navy teaches you to dive, and they teach you the basics of undersea medicine. These docs can attach to a variety of commands. Some follow navy divers around like the other GMOs follow their Marines/sailors/wings. Some attach to the special forces. Some attach to training commands. Finally some dive docs attch to subs, where they work to prepare the subs for sea (they don't serve on the subs at sea, though, that's a corpsman's job). The point is there are a lot of options with this one.

Are GMO tours a good thing? Depends on your perspective. Its certainly necessary for the Navy: those units need doctors function. A lot of docs describe their GMO time as formative and fun: It's the real military rather than just a military hospital. Its a chance to get away from the grind of residency and be treated as an important member of the command rather than just another powerless, dumped upon resident. Its a chance to do things you will never get to do again and which most people will never have the chance to do. It is, outside of deployments and deployment workups, very humane hours with weekends off. It is the most compliant patient population any physician will ever work with. I've met more than one physican who essentially had to be dragged back to residency, kicking and screaming, by the Navy's rule that you can't get promoted beyond O-4 without a board certification.

Others don't like the GMO tour. I've met docs who feel like they weren't adequately trained to practice after just an Intern year and were in constant dread of missing a fatal diagnosis. Others feel like the interuption in their training causes skill atrophy they feel down the line. A not uncommon sentiment was that residency training is too f-ing long already and the idea of still being stuck in residency in your mid 30s is awful. Still others point out that the GMO tours generally aren't located in garden spots, and especially if you have a spouse who works the spots where GMOs are based basically force you to choose between living seperately and your spouse abandoning her career. Finally there is the fact that the most dangerous warfighting jobs gets dumped on GMOs, and while we all understand that joining carries the near certainty of eventual deployment that doesn't mean we all have a burning desire to see Kandahar as often as possible.

Again, the odds of doing this vary by specialty. If you want Peds, FP, or Psych there is a good (though not 100%) chance you can finish residency straight through. EM is a nearly 100% chance of a GMO tour.

BTW: I've never done a GMO tour. This is all second hand.

thanks for the info

 

[ClumsyRunner]

First, I am up for review 'soon' for some open HPSP scholarships for the 2015 class. Does anyone know if I am picked up this semester - will they pay for last semester also and/or will I still owe a full year in payback?.

I can shed a little light here. Your official date of commissioning must come before the end of the semester you want to have paid for. So if you get commissioned before the official start of the next semester, they will pay for the current semester your are in.

I am in the class of 2014 HPSP program. I applied a little late but still got accepted; however, as the military is wont to do, they kept delaying my commissioning date. I eventually had to threaten not following through in order to get commissioned in time to have my first semester paid for.

I met a few people at ODS the next year that were not so lucky, and got screwed out of a semester's tuition.

 

[BOHICA-FIGMO]

Correct, you will almost certainly have to do a GMO tour between your Intern year and the rest of your residency. In the Navy there are 5 main options to be a GMO:

1) Marines: A 2 year GMO tour. You go directly from Internship to a unit of marines. You are their physican, and are assisted by a handful of corpsmen led (hopefully) by a more senior corpsman. You provide basic primary care: evaluation sore ankles, nausea/vomitting, ingrown toenails, etc. You also train the corpsmen so that they know how to take care of bleeding/dying Marines if/when the unit deploys. When your Marines go into combat, you go with them and triage injuries and casualties at the batalion aid station (or equivalent).

2) Ship: A 2 year GMO tour. Same as the Marines, except that you attach to a ship full of sailors. You treat them on shore, and when they go to sea you go to sea with them.

3) Seabees: Yet another 2 year GMO tour. This time you attach to the Seabees (the Navy's engineers). Again, you go where they go and provide primary care

4) Flight Surgery: A 3 year GMO tour. This one you need to apply for. Accepted applicants go to flight surgery school in Pensacola florida. You learn the basic principles of flight and how flight affects the body. You also learn how to do flight physicals on pilots. They even put you through the first two phases of the Navy's flight school. When you finish your 6 months of school you attach to a wing. Like the GMOs above you provide primary care for your wing. However you also need to make sure the pilots meet the rigerous health standards necessary for them to keep flying. Again, you go where they go.

5) Dive medicine: Another 3 year GMO which you need to apply to. This time you go to dive school: the Navy teaches you to dive, and they teach you the basics of undersea medicine. These docs can attach to a variety of commands. Some follow navy divers around like the other GMOs follow their Marines/sailors/wings. Some attach to the special forces. Some attach to training commands. Finally some dive docs attch to subs, where they work to prepare the subs for sea (they don't serve on the subs at sea, though, that's a corpsman's job). The point is there are a lot of options with this one.

Are GMO tours a good thing? Depends on your perspective. Its certainly necessary for the Navy: those units need doctors function. A lot of docs describe their GMO time as formative and fun: It's the real military rather than just a military hospital. Its a chance to get away from the grind of residency and be treated as an important member of the command rather than just another powerless, dumped upon resident. Its a chance to do things you will never get to do again and which most people will never have the chance to do. It is, outside of deployments and deployment workups, very humane hours with weekends off. It is the most compliant patient population any physician will ever work with. I've met more than one physican who essentially had to be dragged back to residency, kicking and screaming, by the Navy's rule that you can't get promoted beyond O-4 without a board certification.

Others don't like the GMO tour. I've met docs who feel like they weren't adequately trained to practice after just an Intern year and were in constant dread of missing a fatal diagnosis. Others feel like the interuption in their training causes skill atrophy they feel down the line. A not uncommon sentiment was that residency training is too f-ing long already and the idea of still being stuck in residency in your mid 30s is awful. Still others point out that the GMO tours generally aren't located in garden spots, and especially if you have a spouse who works the spots where GMOs are based basically force you to choose between living seperately and your spouse abandoning her career. Finally there is the fact that the most dangerous warfighting jobs gets dumped on GMOs, and while we all understand that joining carries the near certainty of eventual deployment that doesn't mean we all have a burning desire to see Kandahar as often as possible.

Again, the odds of doing this vary by specialty. If you want Peds, FP, or Psych there is a good (though not 100%) chance you can finish residency straight through. EM is a nearly 100% chance of a GMO tour.

BTW: I've never done a GMO tour. This is all second hand.

Good and mostly accurate observations here. Here is my input as a current GMO/UMO.
My opinion: there is no role for the physician GMO in modern military medicine. In garrison, IDCs and PAs can do 99% of the work. In theater, all the major **** gets MEDEVAC'd directly to the role 3. GMO tours also lead to skill and knowledge atrophy. The ONLY advantage is the introduction to the way the line does business.

My input: not sure how true this will hold in post 2014, but, in general, UMOs (Dive docs) don't deploy. Flight docs deploy. Marine BN GMOs deploy. If I had it to do all over, I would do flight surgery instead of dive medicine. $0.02

 

[cmoore16]

How do you complete all four AT's required for the navy HPSP program? I understand one is the ODS school, two will probably get done through away rotations your fourth year, but what about the last one? How are we supposed to do 45 days during 2nd year of medical school where there really isn't a summer break/no time to go away?

 

[bulldogmed]

How do you complete all four AT's required for the navy HPSP program? I understand one is the ODS school, two will probably get done through away rotations your fourth year, but what about the last one? How are we supposed to do 45 days during 2nd year of medical school where there really isn't a summer break/no time to go away?

The AT is "school orders." You're studying for the boards, but you're considered AD. It's actually a nice pay bump that helps defray the costs of test prep books and qbanks.

 

[cmoore16]

The AT is "school orders." You're studying for the boards, but you're considered AD. It's actually a nice pay bump that helps defray the costs of test prep books and qbanks.

oh gotcha, thanks! I'm guessing you have to fill out some paperwork for that as well?

 

[bulldogmed]

oh gotcha, thanks! I'm guessing you have to fill out some paperwork for that as well?

Yeah, it's only one page though.