Considering FAP/Air Force

[pruritis_ani]

So, I have read the pros and the cons of military medicine, and I am still at a loss...

My situation: I have matched in the residency of my choice (ob/gyn) and start June 19. I am about 130k in debt from med school. I have always liked the idea of military medicine as compared to private or group practice, as I don't really want to be a businessman, would rather show up, practice good medicine in the field I love and get paid a fair wage than be a producer and a malpractice target.

So, I am considering FAP with the Air Force. The idea of paying off my debt while in residency and coming out with a job, and at worst a 4 year commitment sounds good to me. I am single, don't mind traveling around a bit and I don't think anything can kill me in four years. But, I do have some concerns...

1. As an ob/gyn, I am cool with getting sent all over the world, but I really don't want to end up practicing anything but ob/gyn. What are the chances of them sticking me in a clinic somewhere as a GP, or making me do trauma surgery on the front line?

2. How much money will I make as an officer, post residency?

3. How can they really screw me, and how likely is it that I will get some sort of royal shafting?

4. The Air Force recruiter assures me that they cannot yank me from my residency...that would be a deal breaker for me, as I will not risk not finishing my residency, nor would I screw my program like that. So, is he speaking the truth, is he lying through his teeth? How do I verify that this is the real situation, and not a sales pitch?

5. I have never thought of myself as a "military" person. I mean, I love my country, have a ton of respect for our soldiers that put lives on the line, and am happy to do my part. But, I also am a bit of a liberal, and a bit passionate about my views....not some crazy left winger, but a moderate who believes in peace, and has some significant issues with the current administration. Is this going to be a deal breaker, or are there others like that out there that survive and thrive.

Basically, all of the docs I know that did the military short term were happy. They said there was the ever present military/beaureacratic (sp) BS, but they mainly showed up, did a good job, got paid decent and had good bennies. The didn't move all that much (2 or 3 times), had kids and families, and no regrets. Happy to get out, sure, but not a lot of serious regrets.

Anyhow, I am a bit confused. It sounds good on paper, makes sense financially, and seems like a decent idea. But, I just want to get all the information I can...if anybody can give me some general insight, that would be great. But, I am really after information on the five points above...

Thanks in advance, and any help is appreciated.

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[Croooz]

1. As an ob/gyn, I am cool with getting sent all over the world, but I really don't want to end up practicing anything but ob/gyn. What are the chances of them sticking me in a clinic somewhere as a GP, or making me do trauma surgery on the front line?

Not likely since you come in as an ob/gyn.

2. How much money will I make as an officer, post residency?

After a 4 year residency I believe you would come in as an O3. Which base pay is currently
$51,564 Base pay
$ 2,244 Food allowance
$12,000 Housing (rough estimate. This amount depends on where you're stationed)
$ 4,992 Variable Special Pay
$31,000 Specialty pay

Comes out to $86,331. I charged your base pay at 30% tax. This is a VERY rough estimate and probably not 100% accurate. I'm going thru the number crunching myself so anyone else feel free to correctify me. I'm not sure about tax on the VSP or specialty pay. http://www.dod.mil/dfas/militarypay/2006militarypaytables.html

3. How can they really screw me, and how likely is it that I will get some sort of royal shafting?

The screwing will be more with the mental anquish of dealing with the constant BS.

4. The Air Force recruiter assures me that they cannot yank me from my residency...that would be a deal breaker for me, as I will not risk not finishing my residency, nor would I screw my program like that. So, is he speaking the truth, is he lying through his teeth? How do I verify that this is the real situation, and not a sales pitch?

I don't believe you can get yanked from residency during FAP. Simply because during FAP you can opt out and only pay back, in time, what you got.

5. I have never thought of myself as a "military" person. I mean, I love my country, have a ton of respect for our soldiers that put lives on the line, and am happy to do my part. But, I also am a bit of a liberal, and a bit passionate about my views....not some crazy left winger, but a moderate who believes in peace, and has some significant issues with the current administration. Is this going to be a deal breaker, or are there others like that out there that survive and thrive.

You are their to defend democracy not practice it. Best advice is to stand clear of political discussions. When your troops bring it up just stick to the "company line" about "support and defend".....


I'm leaning toward USU for my situation which is different than yours. I am of the opinion that FAP is a good deal because you are in the residency you chose. If you are okay with dealing with some BS for 4 years then I think your decision should be FAP. Since I have yet to be accepted to med school I don't know which direction I will take. If I don't get into USU I would lean more toward FAP than HPSP. This way I get to go into the residency I choose.

There'll be more responses with corrections to my math so wait and see what the pros recommend.

 

[wook]

I don't believe you can get yanked from residency during FAP. Simply because during FAP you can opt out and only pay back, in time, what you got.

I looked at this as well, but received concerning information advising that they have not yanked anyone from residency, but could. Buried somewhere in the paperwork is a clause that they can (according to a recruiter). To my knowledge (limited to folks I know), no one has been yanked from residency, but it is a remote possibility.


Wook

 

[DD214_DOC]

Not likely since you come in as an ob/gyn.

After a 4 year residency I believe you would come in as an O3. Which base pay is currently
$51,564 Base pay
$ 2,244 Food allowance
$12,000 Housing (rough estimate. This amount depends on where you're stationed)
$ 4,992 Variable Special Pay
$31,000 Specialty pay

You forgot BCP and MASP, which add another $17,500

 

[Croooz]

You forgot BCP and MASP, which add another $17,500

Which are those?

 

[Croooz]

I looked at this as well, but received concerning information advising that they have not yanked anyone from residency, but could. Buried somewhere in the paperwork is a clause that they can (according to a recruiter). To my knowledge (limited to folks I know), no one has been yanked from residency, but it is a remote possibility.

It's always a possibility. The question is how much of a possibility. I have spoken to quite a number of FAP docs and none were taken out of residency, nor ever heard of someone being taken out. A few chose FAP over HPSP because of this. I've heard of HPSP getting snatched up but not FAP. The surest thing with the military is "the needs of the military".

 

[haujun]

So, I have read the pros and the cons of military medicine, and I am still at a loss...

My situation: I have matched in the residency of my choice (ob/gyn) and start June 19. I am about 130k in debt from med school. I have always liked the idea of military medicine as compared to private or group practice, as I don't really want to be a businessman, would rather show up, practice good medicine in the field I love and get paid a fair wage than be a producer and a malpractice target.

So, I am considering FAP with the Air Force. The idea of paying off my debt while in residency and coming out with a job, and at worst a 4 year commitment sounds good to me. I am single, don't mind traveling around a bit and I don't think anything can kill me in four years. But, I do have some concerns...

1. As an ob/gyn, I am cool with getting sent all over the world, but I really don't want to end up practicing anything but ob/gyn. What are the chances of them sticking me in a clinic somewhere as a GP, or making me do trauma surgery on the front line?

2. How much money will I make as an officer, post residency?

3. How can they really screw me, and how likely is it that I will get some sort of royal shafting?

4. The Air Force recruiter assures me that they cannot yank me from my residency...that would be a deal breaker for me, as I will not risk not finishing my residency, nor would I screw my program like that. So, is he speaking the truth, is he lying through his teeth? How do I verify that this is the real situation, and not a sales pitch?

5. I have never thought of myself as a "military" person. I mean, I love my country, have a ton of respect for our soldiers that put lives on the line, and am happy to do my part. But, I also am a bit of a liberal, and a bit passionate about my views....not some crazy left winger, but a moderate who believes in peace, and has some significant issues with the current administration. Is this going to be a deal breaker, or are there others like that out there that survive and thrive.

Basically, all of the docs I know that did the military short term were happy. They said there was the ever present military/beaureacratic (sp) BS, but they mainly showed up, did a good job, got paid decent and had good bennies. The didn't move all that much (2 or 3 times), had kids and families, and no regrets. Happy to get out, sure, but not a lot of serious regrets.

Anyhow, I am a bit confused. It sounds good on paper, makes sense financially, and seems like a decent idea. But, I just want to get all the information I can...if anybody can give me some general insight, that would be great. But, I am really after information on the five points above...

Thanks in advance, and any help is appreciated.

I think you answered your own Q's. "I never thought myself as a military person...It makes sense financially.."
Talk to currently active duty OBGYN USAF docs.
Freedom is priceless.

 

[Croooz]

I think you answered your own Q's. "I never thought myself as a military person...It makes sense financially.."
Talk to currently active duty OBGYN USAF docs.
Freedom is priceless.

Good call. Need to get my eyes checked.

 

[pruritis_ani]

Thanks to everyone for the input, it is very helpful! I appreciate it.

I think you answered your own Q's. "I never thought myself as a military person...It makes sense financially.."
Talk to currently active duty OBGYN USAF docs.
Freedom is priceless.

With the above quote, are you saying that it is probably not a good idea for somebody like me, who has never thought of themselves as "military". By that I don't mean that I have any strong dislike or anything, just never imagined myself in it, and I am pretty ignorant of what it actually would be like. My take, after talking to a lot of relatives and doctors I work with is that going in knowing that it is the military, but that you will be out in 4 years is not a deal breaker. Just eat $hit like it is your favorite dish, do you time, and come out debt free seems to be the common consensus. And, everybody keeps telling me that while there is some BS, it really isn't that bad.

I don't know, I am leaning more toward the FAP, it sounds pretty good. My thoughts are that as long as I finish my residency, and come in as an ob/gyn, I can certainly put up with pretty much anything in exchange for having my loans paid off, especially for just 4 years....and, it really doesn't sound that terrible, to be honest.

I guess I just am freaked a bit by the unknown, but all of the real stories I have heard actually sound like a good experience with the occasional dose of BS.

I will talk to my recruiter tomorrow and see what he has to say. But, again, thanks to all for the information. Much appreciated.

 

[Croooz]

pruritis,
Just a warning.........
this is the thing I see. You are merely looking for your loans to be paid and avoid the costs with a civilian practice. "Doing your part" sounds like just you just want to collect a paycheck and call it a day. More to it that that.

, would rather show up, practice good medicine in the field I love and get paid a fair wage...

Your eventually going to have to go into private practice so you're just postponing the inevitable for $130k? I'm guessing the amount you would pay in loans after the military will be replaced with malpractise so it saves you money...?

Unfortunately in my experience these situations are the type that truly are a drain on the military. Sure you're willing to deal with crap for 4 years but how much crap are you willing to take on yourself to keep off your troops?

This exactly why line officers don't respect physicians because the line believes this is the case with every physician. Remember the military sees you as an officer first and those in the military see you as just another guy worried about self.

Nothing sounds that bad when you're focusing on the money.

 

[pruritis_ani]

pruritis,
Just a warning.........
this is the thing I see. You are merely looking for your loans to be paid and avoid the costs with a civilian practice. "Doing your part" sounds like just you just want to collect a paycheck and call it a day. More to it that that.
Your eventually going to have to go into private practice so you're just postponing the inevitable for $130k? I'm guessing the amount you would pay in loans after the military will be replaced with malpractise so it saves you money...?

Unfortunately in my experience these situations are the type that truly are a drain on the military. Sure you're willing to deal with crap for 4 years but how much crap are you willing to take on yourself to keep off your troops?

This exactly why line officers don't respect physicians because the line believes this is the case with every physician. Remember the military sees you as an officer first and those in the military see you as just another guy worried about self.

Nothing sounds that bad when you're focusing on the money.

Well, I think you are right in that I am considering it because it makes financial sense. But, call me crazy, I would be surprised if that was not the case with a good percentage of the folks that do FAP or any other military scholarship.

About half of the docs that I have talked to got the scholarship money, did the time and walked away. These guys thought it was worthwhile, and I am sure the military got their money's worth as well.

I guess I don't really get your point. The military offers these financial benefits to make it an offer worth considering for many that wouldn't have thought of the military otherwise. And it seems that you are saying that this is somehow harmful to the service?

I guess I don't see how it is a "drain on the military". And I don't understand what you mean by asking "how much am I willing to take on myself to keep off my troops"? Is the implication that I am somehow a lazy slacker, just going to show up for a check? If that is what you are thinking, you are way off.

I look at it as a mutually beneficial arrangement. They give me extra money to pay of my loans as a resident. I give them 4 years of the best medicine I know how to practice, at a fair (but below market) wage.

If you think that this is an opportunity that should only be taken by those that are gung-ho lifers, that is fine. But, in my experience, most that take this path are not this type of person/doctor. How on earth do these people that come in, do the best they can for the troops and get out a "drain on the military"?

Sorry, I just find your tone a bit condescending and insultiing.

 

[deuist]

3. According to StayNavy's Pay Calculator, a fresh ob/gyn makes $98,870.68 per year.

4. I'm not aware of anyone's getting pulled out of residency. You were hired to be an ob/gyn, not a GMO.

5. As stated above, keep away from politics. Legally, you are not allowed to say things publicly that defame the president or secretary of defense. You are allowed to keep your own opinions regarding other matters. However, you cannot ever use your uniform or position as an officer for political or personal gain.

 

[Croooz]

That is the problem with those who take any military scholarships just for the money. Maybe it's the difference between the AirForce and Navy, I don't know. What I do know are the physicians I was stationed with who came in looking to get loans paid off were only concerned with doing their time and getting out. They wanted very little to do with the military and could've cared less if one of their corpsman was having some kind of problem. The med. company would be left sucking the high t!t because we had no officer representation. So much so that the company 1st LT would be the advocate because the doc would be too busy.

I don't know you. All I know is that taking any money from the military and not focusing on the fact that you are viewed as an officer 1st, physician 2nd is a foundation for problems.

It's not about being gungho lifers. It's about coming in with the realization that you are going to be a leader and some of these troops are going to look to you for guidance and dare I say mentorship. There more to the BS than paperwork and nurses.

 

[pruritis_ani]

Well, Croooz, I see your point, but I have a couple problems with it.

1. The Air Force is recruiting me as a physician, not as an officer. If you want the military to get people who put being an officer ahead of being a doctor, you should really talk to the recruiters. It has been emphasized to me time and time again that as a doc, they just expect me to be a doc. That seems to be the foundation of the problems you speak of, not the doctors. It seems a bit crazy to expect sombody to come in and be an officer first if the entire recruiting process simply emphasized the money and the lifestyle of a military physician.

2. I don't think that it is appropriate to assume that I (or anybody else) will be a poor leader or mentor simply because the military makes financial sense. I am no the kind of person that avoids responsibility, nor am I the kind of person to leave anybody in a lurch. If my patients or my colleagues need my help, they will get it, military or otherwise. To imply that I am going to do otherwise is offensive.

3. I know many good doctors that did work in the military, did it for the money, served the time they owed and entered the private sector. They are all proud of the work they did. They all worked hard. It bothers me that you would minimize the contribution they made. It is pretty dismisive to imply that there is a "problem with those who take any military scholarship just for the money". My guess is that a large percentage of doctors do it for just that reason, and that many of them still do a very good job.

I can appreciate your concern about some selfish slacker coming into the military. I just don't appreciate the assumption that I am going to be one of those people simply because I will benefit financially from the military.

 

[haujun]

Well, Croooz, I see your point, but I have a couple problems with it.

1. The Air Force is recruiting me as a physician, not as an officer. If you want the military to get people who put being an officer ahead of being a doctor, you should really talk to the recruiters. It has been emphasized to me time and time again that as a doc, they just expect me to be a doc. That seems to be the foundation of the problems you speak of, not the doctors. It seems a bit crazy to expect sombody to come in and be an officer first if the entire recruiting process simply emphasized the money and the lifestyle of a military physician.

2. I don't think that it is appropriate to assume that I (or anybody else) will be a poor leader or mentor simply because the military makes financial sense. I am no the kind of person that avoids responsibility, nor am I the kind of person to leave anybody in a lurch. If my patients or my colleagues need my help, they will get it, military or otherwise. To imply that I am going to do otherwise is offensive.

3. I know many good doctors that did work in the military, did it for the money, served the time they owed and entered the private sector. They are all proud of the work they did. They all worked hard. It bothers me that you would minimize the contribution they made. It is pretty dismisive to imply that there is a "problem with those who take any military scholarship just for the money". My guess is that a large percentage of doctors do it for just that reason, and that many of them still do a very good job.

I can appreciate your concern about some selfish slacker coming into the military. I just don't appreciate the assumption that I am going to be one of those people simply because I will benefit financially from the military.

Just don't get majority of info. from recruiters or past military docs.
Being in the military is much more than a job..it's way of life.
You are signing your life away for next 8-9 years away...You don't know what your future may hold!!! For example I was deployed for a year and left a pregnant wife behind, missed a birth of my first born during my NCO year.
However if your first reason is to serve your soldiers and your country then welcome.
In any case, please talk to current active duty USAF OBGYN Docs.

 

[dpill]

Well, Croooz, I see your point, but I have a couple problems with it.

1. The Air Force is recruiting me as a physician, not as an officer. If you want the military to get people who put being an officer ahead of being a doctor, you should really talk to the recruiters. It has been emphasized to me time and time again that as a doc, they just expect me to be a doc. That seems to be the foundation of the problems you speak of, not the doctors. It seems a bit crazy to expect sombody to come in and be an officer first if the entire recruiting process simply emphasized the money and the lifestyle of a military physician.

2. I don't think that it is appropriate to assume that I (or anybody else) will be a poor leader or mentor simply because the military makes financial sense. I am no the kind of person that avoids responsibility, nor am I the kind of person to leave anybody in a lurch. If my patients or my colleagues need my help, they will get it, military or otherwise. To imply that I am going to do otherwise is offensive.

3. I know many good doctors that did work in the military, did it for the money, served the time they owed and entered the private sector. They are all proud of the work they did. They all worked hard. It bothers me that you would minimize the contribution they made. It is pretty dismisive to imply that there is a "problem with those who take any military scholarship just for the money". My guess is that a large percentage of doctors do it for just that reason, and that many of them still do a very good job.

I can appreciate your concern about some selfish slacker coming into the military. I just don't appreciate the assumption that I am going to be one of those people simply because I will benefit financially from the military.

I’ve already served 13 years in the military (10+ years AD) and was very happy in the Reserves as a line officer. I certainly don't mind admitting that I am going back on active duty primarily for financial reasons (i.e. if they didn't offer a scholarship I would not be going back on AD). No reason to be ashamed of that.

I am also fairly liberal- not everyone in the military is conservative (not everyone “agrees” with this administration, the current situation with the war, etc.)- you just have to understand the legal constraints on expressing those views. As long as you can serve in good conscious and don’t mind keeping politics to yourself (at least know your audience), you won't have a problem.

I think a lot of people that go into the military strickly for financial reasons are unhappy and conclude in the end it wasn't worth it, hence the words of caution from so many on this board. There is a lot of BS... but there are some good points too. Just make the decision with your eyes wide open (talk to active duty OB/GYN!)
Good luck!

 

[pruritis_ani]

Just don't get majority of info. from recruiters or past military docs.
Being in the military is much more than a job..it's way of life.
You are signing your life away for next 8-9 years away...You don't know what your future may hold!!! For example I was deployed for a year and left a pregnant wife behind, missed a birth of my first born during my NCO year.
However if your first reason is to serve your soldiers and your country then welcome.
In any case, please talk to current active duty USAF OBGYN Docs.

As I understand it, I am only signing away 4 years...that would be my commitment after residency. Currently, I am single and have no issue with being sent anywhere in the world. I am a bit of a wanderer as it is, lived in several states, studied medicine in Europe...so, the moving doesn't bug me too much.

My biggest concern is fear of the unknown, and unfortunately that hasn't cleared up much. I did get a lot of great info on this thread, though, so thanks to all. I will be getting some contact info for active duty ob/gyns today, so hopefully they can help out a bit.

Thanks!

 

[haujun]

As I understand it, I am only signing away 4 years...that would be my commitment after residency. Currently, I am single and have no issue with being sent anywhere in the world. I am a bit of a wanderer as it is, lived in several states, studied medicine in Europe...so, the moving doesn't bug me too much.

My biggest concern is fear of the unknown, and unfortunately that hasn't cleared up much. I did get a lot of great info on this thread, though, so thanks to all. I will be getting some contact info for active duty ob/gyns today, so hopefully they can help out a bit.

Thanks!

I am just saying your situations or views toward military.. (single, priorities...) may change during next 8-9 years as you complete your residency and obligation years. I don't know if you will need to do IRR though...Good luck to you.

 

[chopper]

Well, Croooz, I see your point, but I have a couple problems with it.

1. The Air Force is recruiting me as a physician, not as an officer. If you want the military to get people who put being an officer ahead of being a doctor, you should really talk to the recruiters. It has been emphasized to me time and time again that as a doc, they just expect me to be a doc. That seems to be the foundation of the problems you speak of, not the doctors. It seems a bit crazy to expect sombody to come in and be an officer first if the entire recruiting process simply emphasized the money and the lifestyle of a military physician.

2. I don't think that it is appropriate to assume that I (or anybody else) will be a poor leader or mentor simply because the military makes financial sense. I am no the kind of person that avoids responsibility, nor am I the kind of person to leave anybody in a lurch. If my patients or my colleagues need my help, they will get it, military or otherwise. To imply that I am going to do otherwise is offensive.

3. I know many good doctors that did work in the military, did it for the money, served the time they owed and entered the private sector. They are all proud of the work they did. They all worked hard. It bothers me that you would minimize the contribution they made. It is pretty dismisive to imply that there is a "problem with those who take any military scholarship just for the money". My guess is that a large percentage of doctors do it for just that reason, and that many of them still do a very good job.

I can appreciate your concern about some selfish slacker coming into the military. I just don't appreciate the assumption that I am going to be one of those people simply because I will benefit financially from the military.

Well said.

I think there is an undercurrent of many people's posts that the military is some sort of messianic calling. To some, it is. I know people who could not or would not do anything but gung ho military.

But also realize NO ONE is born into the military. Everyone was a civilian for at least 17 years of their life. Some go in gung ho, are dissillusioned, and become terrible soldiers. Some come in for 'selfish' reasons and end up becomming generals. MANY do it for the money or some related self-serving reason. And that's OK. There are so many 'kinds' of people on Acitive Duty, it does disservice to stereotype them in one way.

You do need to realize that you will have less say over your life than in the civilian world. But our military is just a segment of our society. Just look at how much reserve and guard units are utilized right now. As long as you have a good atttitude, and don't let the B.S. get to you, you will end up fine.

 

[FliteSurgn]

As I understand it, I am only signing away 4 years...

Every commitment to the military is for a minimum of 8 years. You'd be signing up for 4 years for active duty and 4 years of inactive reserve (IRR).

Someone above mentioned some of the specialty pay...you're not eligible for the multi-year bonus until your initial commitment has expired and you've stayed on anyway. You're not eligible for board-certified pay until you actually attain certification (often a year or more after you finish your residency depending on your specialty).

 

[Surgess]

As I understand it, I am only signing away 4 years...that would be my commitment after residency. Currently, I am single and have no issue with being sent anywhere in the world. I am a bit of a wanderer as it is, lived in several states, studied medicine in Europe...so, the moving doesn't bug me too much.

My biggest concern is fear of the unknown, and unfortunately that hasn't cleared up much. I did get a lot of great info on this thread, though, so thanks to all. I will be getting some contact info for active duty ob/gyns today, so hopefully they can help out a bit.

Thanks!

FAP is 1 for 1 plus 1, so if your residency is four years you owe back 5 years of active duty plus 4 years IRR.

 

[deuist]

FAP is 2 years payback for the first year of assistance, then 6 months payback for every year of assistance thereafter. A four-year residency incurs a 3.5 year commitment.

 

[Croooz]

FAP is 2 years payback for the first year of assistance, then 6 months payback for every year of assistance thereafter. A four-year residency incurs a 3.5 year commitment.

Please post where you got this information from. I've never heard nor seen a 6month payback for 1 year of money from the military. I've seen year for year +1 but never what you are describing. This would be good.

There is still the IRR time. That doesn't change.

 

[deuist]

Please post where you got this information from

www.airforce.com

 

[Croooz]

www.airforce.com

Well wonders ever cease?!
That's a winner. Not bad at all. Still looking for the loop hole on that one.
Thanks deuist!

 

[deuist]

Well wonders ever cease?!
That's a winner. Not bad at all. Still looking for the loop hole on that one.
Thanks deuist!

What loop holes are you looking for?

 

[no oxygen]

I've gotten two different explanations of the FAP obligation from the Air Force. On airforce.com, as the above poster said, it says 2 yrs for the first year and 6mos for every year after that. When I talked to a recruiter today, he said it is year for year +1.

I'm supposed to talk to someone specific for health professions tomorrow. We'll see.

 

[yobabydoc]

Pruitus ani,

I appreciate your really articulate argument! I actually met with a recruiter recently because I had heard so many negative things about the military on this website but I am not one to just go by what other people say. So I met with him and told him just what the dealio was because I have absolutely nothing to lose right? It was the Airforce....I think it is a financially wise decision and that would be the main reason I join the AF and quite frankly they are pitching the financial benefit piece so when asked why AF my answer is the benefits! point blank, if it is the wrong answer so be it. I am not sure if I am going to do it or not because I can sell my house and pay off my debts too. So anyways, I didnot know about the IRR piece hwat does that really mean...anyone....because the way things are going in this wonderful country of us with the superb Commander in chief there may be a draft sooner thatn later, what does that mean to a former military doc? thanks

 

[no oxygen]

I've spoken with a USAF physician recruiter today and he said the obligation is year-for-year plus 1 (you take the $ 4 years = 5 year committment)

 

[Surgess]

I've spoken with a USAF physician recruiter today and he said the obligation is year-for-year plus 1 (you take the $ 4 years = 5 year committment)

I spoke with a recruiter today as well. He honestly was not aware that the website states that the committment is not 1 for 1 plus 1. He says that it is possible that changes are coming down the pipeline that haven't made it to the recruiters yet. He's checking with his superiors to get a true answer.

 

[Croooz]

What loop holes are you looking for?

I've never heard of the military requesting less time than they pay for. I only know of year=year.

youbaby,
sure go ahead and make the wise financial decision. The military will own you for 8 years. So after you payback the FAP you are still on the books for 4 more years. During that time you can be recalled and after recall there is the stop loss but FAP makes good financial sense so don't forget that. Regardless of what happens you are making the right financial decision. Numbers never lie.

 

[Med_Leviathan]

How the hell does no one know how this works? Is the program really that poorly organized?

 

[militarymd]

How the hell does no one know how this works? Is the program really that poorly organized?

 

[Croooz]

How the hell does no one know how this works? Is the program really that poorly organized?

When recruiters are lurking these boards and surfing the internet to find out how their programs work there is a problem. Ohhhhh...but it's a great financial decision. Don't ever forget that.

 

[The White Coat Investor]

So, I have read the pros and the cons of military medicine, and I am still at a loss...

My situation: I have matched in the residency of my choice (ob/gyn) and start June 19. I am about 130k in debt from med school. I have always liked the idea of military medicine as compared to private or group practice, as I don't really want to be a businessman, would rather show up, practice good medicine in the field I love and get paid a fair wage than be a producer and a malpractice target.

So, I am considering FAP with the Air Force. The idea of paying off my debt while in residency and coming out with a job, and at worst a 4 year commitment sounds good to me. I am single, don't mind traveling around a bit and I don't think anything can kill me in four years. But, I do have some concerns...

1. As an ob/gyn, I am cool with getting sent all over the world, but I really don't want to end up practicing anything but ob/gyn. What are the chances of them sticking me in a clinic somewhere as a GP, or making me do trauma surgery on the front line?

2. How much money will I make as an officer, post residency?

3. How can they really screw me, and how likely is it that I will get some sort of royal shafting?

4. The Air Force recruiter assures me that they cannot yank me from my residency...that would be a deal breaker for me, as I will not risk not finishing my residency, nor would I screw my program like that. So, is he speaking the truth, is he lying through his teeth? How do I verify that this is the real situation, and not a sales pitch?

5. I have never thought of myself as a "military" person. I mean, I love my country, have a ton of respect for our soldiers that put lives on the line, and am happy to do my part. But, I also am a bit of a liberal, and a bit passionate about my views....not some crazy left winger, but a moderate who believes in peace, and has some significant issues with the current administration. Is this going to be a deal breaker, or are there others like that out there that survive and thrive.

Basically, all of the docs I know that did the military short term were happy. They said there was the ever present military/beaureacratic (sp) BS, but they mainly showed up, did a good job, got paid decent and had good bennies. The didn't move all that much (2 or 3 times), had kids and families, and no regrets. Happy to get out, sure, but not a lot of serious regrets.

Anyhow, I am a bit confused. It sounds good on paper, makes sense financially, and seems like a decent idea. But, I just want to get all the information I can...if anybody can give me some general insight, that would be great. But, I am really after information on the five points above...

Thanks in advance, and any help is appreciated.

1. Pretty low chances I would suppose, but anything is possible. I trained in emergency medicine and I'm going to be doing urgent care. Close, but not quite the same. You really need to talk to multiple active duty ob/gyns in your selected service to get a true answer to this question. If your recruiter cannot provide names and numbers, tell him to get lost.

2. You won't make squat compared to your fellow trainees. They will likely sign for, I don't know, 200K, and you'll get about 100K. As far as the pay, you will get:
Basic Pay: $47,300.40
BAS: $2249.98
BAH: 12-$19,000 (use calculator here https://secureapp2.hqda.pentagon.mil/perdiem/bah.html
for examples (just insert zip codes)
VSP: $5000
ISP (specific to OB/GYN) $31,000
BCP (board certified pay, you don't get it your first year) $2500

Source: http://www.dod.mil/dfas/militarypay/newinformation/WebPayTableVersion2006updated.pdf

For a grand total of $88,050.40 + 12-19K (tax-free) for housing.
Keep in mind you don't get multi-year specialty pay until your commitment is finished, this is the incentive money to sign back on. I don't know what OB/GYNs are making in your part of the country, but over here its a helluva lot more than 100K + 1/4 of your FAP benefits.

I could have gotten out of medical school with only $75K in debt. I'd trade my 4 year commitment now for $130K cold hard cash in a second. My friends are signing contracts for $200K. I could have paid my loans back THE FIRST YEAR rather than now having a 4 year commitment. Do everyone a favor and make sure the financial reasons you're signing up are way, way down the list of reasons. It isn't as good of a deal as it seems. I know you're poor now (believe me, I donated plasma in college) but you won't be poor forever.

3. As an FAP applicant, you get to miss the biggest possibility of getting screwed, that is with the military match. But you still have lots of screw potential. You could be stationed somewhere you hate living, and endure multiple deployments to the sandbox. Imagine 4 months of prison at 120 degrees working 12 hours per day. That's deployment. It used to be you could "see the world" and "meet the people" but doctors are locked down for their own security on deployments now. A more concerning screw might be lack of case volume. How many c-sections do you need to do a year to keep your skills up? How many Vag hysterectomies? I don't know the answer, but before I signed on, I would speak with at least 2 different active duty ob/gyns in your selected service and find out exactly what the case load has been. A frequent complaint of military surgeons is low case load.

4. I suppose it is always possible to get yanked from residency, but it happens so infrequently I personally thought it was a risk worth running. If you don't want to run it, I'm sure the military will let you sign up after residency if you would like. You can probably get a fair chunk of change to help pay back loans when you sign up.

5. I'm not a military person either. I'm not particularly liberal, much more of a moderate (voted for Bush the first time, Nader the second ). I don't know that your political views would be a huge problem ( you could always just keep quiet) but may dislike the regimented lifestyle, the constant saluting and "yes, sirs" and wearing a uniform. If there is anything I've learned in residency, its that I much prefer wearing pajamas to work than camouflage. Be well aware that despite what the recruiter tells you, you will be expected to be an officer first, and any non-doctor military person you complain about this to will think you're a sellout to your country.

Call if you want to talk. PM me for the number.

 

[pruritis_ani]

Thanks to all for the outpouring of good information...since you were all so helpful, i thought I would share my conclusions.

I have decided against it for a few reasons....

1. The money, while pretty nice, is really not that great. The decision came down to the question of whether the extra $160,000 I would get during residency would be worth the difference in salary between military and civilian secotrs as a physician. It came close, I guess, but civilian seems to win. The military would pay about half of what I would make in the real world, which comes to about $400,000 over the four years of active duty. Even when you consider the extra interest I will be paying during my residency, it still makes sense financially to stick with the public sector.

2. Without the money incentive, it was tough to justify venturing off into the unknown, and accepting the risk that is involved for me joining the military...ie, the questions about where I would live, if I would be doing ob/gyn, how my case numbers would be, would my skills atrophy, what kind of obstacles to good care would I encounter far outnumbered the potential upside, in my case.

Basically, I came to the conclusion that others were trying to say all along...really, the military option appears to be good for those that want the long term military commitment. Financially, it is not a bad deal, but you can certainly do better. But, the benefits are great, and if that is the lifestyle you want, then it sure sounds a lot better!

I am just glad that financially I am not that desperate. I mean, getting a $30k check is very tempting for any of us in residency, not to mention the additional monthly money. But, after loan payments and taxes you ain't gonna be taking home a lot more than you would without loan payments and a lower salary....sure, you still have the debt at the end of 4 years, but in my case I am looking at starting in the $200k range, vs. <$100k. Big difference...

Anyhow, all the best. I still think that if the dollars do make sense, you could consider it. Just look at all the risks and all that you will give up carefully, and balance that against the gains. In some cases, I am sure it is still a good deal.

Thanks again, everyone!

 

[pruritis_ani]

Btw, I did find it interesting that 100% of the ex-military docs and officers I talked to thought I was crazy for NOT doing FAP. They all had pretty decent things to say about it, and enjoyed the time. And, they all did it for money or to pay for college. Granted, most of them were in the military many years ago, and I am sure lots has changed...

But, it was surprising....the only people (outside of this site, of course), that had big reservations either had no personal experience, or they were ex-Vietnam vets who were drafted. And, even some of the drafted guys said that as an officer, it would a different story, and that I should really consider it!

Made me think that either times have changed drastically or that there is a vocal minority of disenchanted docs on the board (granted, my sample size was pretty small, so my conclusions are likely inaccurate), and that most of the negative stuff comes from folks with little/no knowledge of the military.

I just thought it was interesting....I had a hard time getting real solid information, and was surprised at the positive feedback I did recieve, as it far outnumbered the negative. But, still the positive was not quite convincing enough, especially after I did a bit more math.

 

[Croooz]

Thanks to all for the outpouring of good information...since you were all so helpful, i thought I would share my conclusions.

Anyhow, all the best. I still think that if the dollars do make sense, you could consider it. Just look at all the risks and all that you will give up carefully, and balance that against the gains. In some cases, I am sure it is still a good deal.

Thanks again, everyone!

You made a smart choice for yourself. Food for thought, the MD's I work with who were military also have nothing negative to say about the military and encourage it. It struck me as odd because I was there when they were hating life and couldn't wait to get out. I am of the opinion that since no one wants to be viewed as an idiot for making such a huge decision these docs are "positive" about others joining. I actually have never spoken to a physician who has hated the military....but after a few beers and close a few doors, the stories change.

 

[mitchconnie]

Btw, I did find it interesting that 100% of the ex-military docs and officers I talked to thought I was crazy for NOT doing FAP. They all had pretty decent things to say about it, and enjoyed the time. And, they all did it for money or to pay for college. Granted, most of them were in the military many years ago, and I am sure lots has changed...

Made me think that either times have changed drastically or that there is a vocal minority of disenchanted docs on the board (granted, my sample size was pretty small, so my conclusions are likely inaccurate), and that most of the negative stuff comes from folks with little/no knowledge of the military.

Times HAVE changed drastically over the past 5-10 years and the opinions of someone who got out prior to the late 90's are probably not very relevant. When I started internship with the Air Force in 1996, virtually all the surgeons, even ones who got out after their initial commitment, had generally positive things to say about their military time. Many even recommended that I consider the Air Force as a career. By 2001 when I finished residency, everyone was bitter and angry and hating life--many actively "anti-recruiting" (a la MilMD and USAFDoc).

The institution of Tricare (the military HMO) had essentially wiped out the medical centers. Surgical case loads plummeted, and it was hard to keep skills current. Admin. reorganization had put more non-clinicians (i.e. nurses) in charge of physicians. Quality GME became very difficult to maintain and the caliber of applicants seemed to drop off. Deployments to the desert started coming fast and furious (and inevitably the major burden seemed to fall on the younger, less well-connected docs).

Add to that the fact that compensation for military physicians has hardly increased at all over the past 7 or eight years, and you can see that it is MUCH different deal to join military medicine now than it was 5-10 years ago. It may still be a good program for a handful of folks, but probably not for the majority of students who just want to "get some loans paid." You can easily end up dealing with WAY more crap than you bargained for. I certainly have.

 

[dpill]

I spoke with a recruiter today as well. He honestly was not aware that the website states that the committment is not 1 for 1 plus 1. He says that it is possible that changes are coming down the pipeline that haven't made it to the recruiters yet. He's checking with his superiors to get a true answer.

Check the AFI for the facts on commitment (not quite sure how to interpret the last paragraph). Recruiters always seem to give erroneous info. I don't understand why recruiters don't already know the answers when the number one question any potential recruit is going to ask is "how much time do I owe."

MEDICAL HEALTH CARE PROFESSIONS
SCHOLARSHIP PROGRAMS
AFI41-110 23 AUGUST 2004
1.5. Program Contract Agreement of Terms, Financial Assistance Program (FAP)
1.5.1. Obligations and benefits for physicians and dentists pursuing specialized training must:
1.5.1.1. Sign a FAP contract: outlines the USAF policy and includes the participant’s commitment, duties, and responsibilities.
1.5.1.2. Sign the Statement of Understanding: describes the AF benefits and mutual obligations.
1.5.1.3. Accept an appropriate appointment or designation in the MC or DC according to current appointment instructions.
1.5.1.4. Incur an ADO (Active Duty Obligation) for a FAP participation for two years, or the actual number of years of FAP sponsorship plus one year, whichever is greater. Participants incur an additional commitment of six months for each six months (or any part) of participation in the program.
1.5.1.5. Incur an eight-year service obligation for any period of program participation. Participants may serve in the IRR any ADO that exceeds either two years or the actual number of years of program participation plus six months for each six months participation or any part of beyond the first year. The Secretary of the Air Force and the participant may mutually agree that the participant will serve this part on active duty. Subject to mutual agreement, a participant may fulfill the IRR service period in the Selected Reserve.

 

[Galo]

Times HAVE changed drastically over the past 5-10 years and the opinions of someone who got out prior to the late 90's are probably not very relevant. When I started internship with the Air Force in 1996, virtually all the surgeons, even ones who got out after their initial commitment, had generally positive things to say about their military time. Many even recommended that I consider the Air Force as a career. By 2001 when I finished residency, everyone was bitter and angry and hating life--many actively "anti-recruiting" (a la MilMD and USAFDoc).

The institution of Tricare (the military HMO) had essentially wiped out the medical centers. Surgical case loads plummeted, and it was hard to keep skills current. Admin. reorganization had put more non-clinicians (i.e. nurses) in charge of physicians. Quality GME became very difficult to maintain and the caliber of applicants seemed to drop off. Deployments to the desert started coming fast and furious (and inevitably the major burden seemed to fall on the younger, less well-connected docs).

Add to that the fact that compensation for military physicians has hardly increased at all over the past 7 or eight years, and you can see that it is MUCH different deal to join military medicine now than it was 5-10 years ago. It may still be a good program for a handful of folks, but probably not for the majority of students who just want to "get some loans paid." You can easily end up dealing with WAY more crap than you bargained for. I certainly have.

I wholeheartedly agree with this, and that is why I also consider myself and "anti-recruiter" to the highest degree. Military medicine in this day and age is a BIG LOOSER, and Dangerous.