I've been looking at the Navy for an HPSP scholarship, but I'm pretty apprehensive about what that entails... I have a few questions.
1) let's say 4 years of college 4 years of med. school, I report for duty at age 26. What age will my commitment be over, including training + GMO?
2) Is it possible to start a family during this commitment? Or do you spend most of your time on a ship? I saw somewhere 1 6-month deployment per 4 years, is this accurate?
3) How are different specialties treated in the Navy? Ex. Would pediatricians get more base jobs whereas EM doctors would find themselves overseas or on a ship more often?
4) How do residencies work with HPSP?
Thanks in advance!
1) This is complicated. Basically you start out owing 4 years. Internship is mandatory and obligation neutral, so you still owe 4 years at the end of it. Now after Internship you have multiple choices
-GMO and out: you do 4 years as an Internship trained GP with the marines/Navy, finish your obligation, and apply to civilian residencies at 31
-GMO to short residency, or straight through training: You train in the military straight through and then work in your specialty for 4 years, or you do a 2 year GMO and then do a two year residency (IM/FM/Peds) in the military. You work in your specialty and then finish your obligation at 33 and go get a job.
-GMO to long residency: This is the one you need to understand. At the end of residency you owe either what you owed going into residency or the length of your residency, whichever is more. So if you do a 2 year GMO tour you go into residency owing 2 years. If its a 2 year residency (IM/Peds/FP) you leave owing 2 years, but if you do a 4 year surgery residency then you leave residency owing 4 years. So GMO to surgery means finishing your obligation at 37.
-Fellowship: If you do a fellowship in the military at the end of the fellowship you owe whatever you owed going into fellowship plus the length of the fellowship. So if you were to get straight through training in IM and then cardiology, at the end you would owe 7 years (4 years coming out of IM + 3 years length of cardiology fellowship).
2) Yes it is possible to start a family and it seems like most people do manage it during either a GMO tour or utilization tour. Residency is a rough time to have babies but people to that as well. The number of deployments can vary tremendously based on operational tempo. At the height of the Iraq war the army was deploying for a full year every other year. Now many physicians, even GMOs, never deploy at all. They could legally deploy you for the duration of your commitment, though that would be unlikely.
3) If you complete your Residency training you will, at least initially, work in that specialty. Usually you do your first tour after residency in your specialty in an undesirable, small MTF. That tour goes for 3 years with an option to extend to 4 if you want to. After that if you want to stay in you either go to fellowship, go to a big MTF, take a command role in a smaller MTF, or do an operational tour. Many people just get out, though.
BTW 'base jobs' frequently are overseas. Almost everyone can be stationed in Guam, Italy, or Japan, as well as bases so isolated in the US that they almost feel like another country. If you can bring your family (Japan is an 'attached' billet) they can keep you there for three year orders. That's why they train us, after all. They don't have trouble attracting high quality physicians to San Diego and DC.
4) In your fourth year, you apply to the military match for an Internship. This works like the regular match, except you're only allowed to list military Internships and the Match happens in December rather than martch. If you want a civilian residency you can apply for the right to enter the normal match the following March, but they probably won't give it to you. Alternatively they can deny you a military residency and for you to scramble for a civilian residency, though that is rarer. The miltary match works like the civilian match in that the best candidate gets the job, but its different in that the odds are both different (EM is much harder, derm slightly easier, etc), the military values different aspects of the application differently (research matters more, prior service helps, step one is theoretically weighted less), and most importantly because the numbers involved are so small the odds can vary dramatically from year to year while the odds in the civilian world almost never change.
If you get deferred to the civilian match you go get civilian pay, suffer through your civilian residency, and come back when you're trained.
If you match with the Navy, you're not done yet, because you've only matched into an Internship. Now you apply for ANOTHER match, again in December, for the rest of residency. If you don't match (or don't apply) you do a GMO tour. The odds of matching vary tremendously by specialty. Right now Gen Surg and Ob will only have 1 straight through resident per class, IM and Peds will be 50/50, and Psych is 100% straight through. This can turn on a dime too: EM used to be 100% GMO, now its mostly straight through.