ADHPLRP After Residency, Advice Needed

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kypdurron5

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I'm currently in the position of being in my final year of residency and trying to decide what to do next. I've heavily researched HPSP, FAP, etc. over the years but didn't want to commit to a 4 year contract, and at least with the former, limited options for residency. And the whole GMO issue of certain branches.

I've recently run across the ADHPLRP (Active Duty Health Professions Loan Repayment Program) but haven't found many posts here about it. I've read the contract and the fine print and it looks pretty good to me:

1) Must be in the final year of training. Check.
2) 40K/yr for loan repayment on top of other benefits
3) 1:1 active duty service obligation for the benefit
4) 2 year minimum active service commitment for physicians
5) Standard 8 year commitment overall (= 2 years active, 6 years inactive reserves with no obligations (i.e. scheduled training) assuming nothing crazy happens). And if something crazy did happen, I would enjoy the opportunity to serve in that environment.

I'm looking for advice about this pathway. My debt load is medium-low, so it's not a huge issue and especially not given the civilian income of my specialty, although the 2-year benefit of this program would almost wipe it all out.

Upsides:
1) Serve my country, help veterans, become a veteran myself
2) Money for loan repayment
3) A unique resume builder and experience to bring to the civilian world
4) Low commitment
5) Live somewhere new, try something completely different; even if horrible, I can do anything for 2 years

Downsides:
1) All the negative posts here about military medicine in general
2) Significant salary cut over private practice, somewhat lessened by only a 2 year commitment
3) A commitment contract that cannot be broken
4) Risk of inactive reserve activation and interference with civilian practice (from 0% with Air Force to ?% with Army), risk of poor deployment (middle of nowhere vs. getting great experience at a front-line hospital)

The variables I specifically cannot find clear details on relate to overall compensation. As per everything above, my goal is not to come out on top over civilian practice, but as with any decision one must consider the costs of that decision. Specifically:

1) Can anyone detail the total breakdown of compensation in 2015/2016 dollars? Does medical specialty incentive pay apply when you use this program, board certification pay, etc., what rank could I expect after a 4 year residency (O3 or O4)? Is a single physician eligible for off-base housing allowance, or only families?
2) Would it be better to do direct commission for higher pay vs. using a loan repayment incentive program? Would the active duty commitment be longer?
3) Is the experience even valuable; it seems so, but I suppose some practice environments may not care, and the experience varies according to deployment and branch?
4) What branch offers the best patient-centered medical practice environment? Reading through these forums, it seems Navy>Air Force>Army? What branch would give me the best chance at a unique overseas deployment, given that my specialty is uniquely hospital and not clinic-based?
5) Is this a good idea to consider, given the upsides I see to it?

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So I've never heard of the Active Duty Health Professions Loan Repayment Program, but it sounds pretty awful.

You get $40K/year in loan repayment for two years. This will come to about $27K in actual loan repayment (they take out taxes). Compare this with the Reserve Corps loan repayment plan in which you get $40K/year in loan repayment for up to 6 years. And this is for Reserve Corps duty (e.g.: the theoretical one weekend/month and two weeks/year).

So for the sake of the singee receiving $54K in debt burden removed, the military gets 2 years of active duty service and 6 years of break-the-glass in which they can call up a trained and ready physician. Who is getting the better deal here?

I would look into the Direct Accession bonus instead. It was in the neighborhood of $180-$200K for primary care type specialties, $290K for EM, and higher for subspecialties. Not sure what the commitment is, likely four years active duty.
 
So I've never heard of the Active Duty Health Professions Loan Repayment Program, but it sounds pretty awful.

You get $40K/year in loan repayment for two years. This will come to about $27K in actual loan repayment (they take out taxes). Compare this with the Reserve Corps loan repayment plan in which you get $40K/year in loan repayment for up to 6 years. And this is for Reserve Corps duty (e.g.: the theoretical one weekend/month and two weeks/year).

So for the sake of the singee receiving $54K in debt burden removed, the military gets 2 years of active duty service and 6 years of break-the-glass in which they can call up a trained and ready physician. Who is getting the better deal here?

I would look into the Direct Accession bonus instead. It was in the neighborhood of $180-$200K for primary care type specialties, $290K for EM, and higher for subspecialties. Not sure what the commitment is, likely four years active duty.

As I mentioned, my loan burden isn't that big; I could conceivably pay off my loans with 1 year of private practice salary. That said, I'm interested in reading more about the reserve corps repayment plan and commitments; do you have a link? Google isn't helping much.

As for the Direct Accession, that is a large bonus (taxed even higher though), but I'm not so down with the 4 year commitment, especially not having experience in the medical corps and not even knowing what I'm really committing to.
 
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