FAP: Read before signing HPSP

[NeedToStudy]

1
2. About Dec/Jan before the end of residency they give you a list with 20 slots on it to list your base preferences. Depending on your specialty on certain bases are available. Once they receive the list, they find out which bases you didn't put down and send you to one of those.

4.If you matched, they need that specialty, and you don't have medical issues, not very hard.

How large is the demand usually for Family Medicine?

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[Aspiring Doctor1]

Could you do the FAP for only one year of your residency even if your residency is longer to be in the military for 2 years?

 

[sav0405]

I know that this has been explained, but I just wanted to confirm. IF I received the HPSP for say 3 years, I'd only owe 4 years of active duty AFTER I completed my residency? Or if I did a military residency (as I would have to) that was 4 years, would I then owe 5 years of active duty AFTER residency? Or would I actually end up owing 8 years (3 years for HPSP, 4 for residency, +1)?

I'm still at the beginning of the whole process of becoming a doctor (just applying to schools right now, don't even have an acceptance). I plan on going to a TX med school and have TX residency, so I know that the debt I'll come out with will be relatively small compared to what it could be. I do have an interest in practicing medicine in the military, but not for life and ideally not for more than 6 years. I'm a girl as well, so that kind of factors in.

Thanks to everyone who's contributed to this thread!
-Previous lurker, now poster

 

[dry dre]

10 years later.

I am happy to adjust the first entry to this thread with current financial numbers and/or to clarify common concerns that have come up. Please post ideas.

I stand to be corrected, but if if you are a graduating med student or resident matched into a residency field that the military service has a need for, then you won't have a problem with the FAP route (unless you have personal factor issues that are unique to the individual).

Regarding two points: 1) difficulty in going through this program and 2) "what if they don't need the specialty that I'm going into?" My basic position or opinion is that the second point is the most important concept to understand. If you go HPSp you can easily find yourself out of medschool doing something that you don't want to do. For years.

The older you get, the more you realize that life is way too short to spend time doing things that you don't really really want to do. Especially as a physician as the opportunity costs are incredibly high. Even if you are are able to rationalize and compartmentalize in a healthy manner the time you previously wasted, you regret wasting the time. Moreover, you learn that even the least-paid physician with substantial med school debt can live a far above-average lifestyle after residency (assuming s/he doesn't have to drive a Mercedes and doesn't insist on living in a 3%'r house).

Worth over-emphasizing: in my opinion, the FAP (or direct accession) should be the ONLY program that the military routinely uses to bring in physicians. HPSP at best is effective in recruiting financially scared premed and med students to ensure (for the good of the service, not necessarily serviceman or woman, or country for that matter) that warm bodies are showing up a few years later to man sick call clinics and/or to ~force said individuals into specialties that the individual service needs that may not be the prime choice of the HPSPr.

 

[Red Lobster Actual]

I know that this has been explained, but I just wanted to confirm. IF I received the HPSP for say 3 years, I'd only owe 4 years of active duty AFTER I completed my residency? Or if I did a military residency (as I would have to) that was 4 years, would I then owe 5 years of active duty AFTER residency? Or would I actually end up owing 8 years (3 years for HPSP, 4 for residency, +1)?

The answer to this question depends what you ultimately match in for residency. I'll give two extreme examples but the general gist is this:

you owe the military the number of years depending on your HPSP obligation or length of residency, whichever is greater.

The actual math is more complex but this is as simple as I can describe it and works for most cases. There is a caveat that ruins this method and will force me to reveal the actual math but until you utter that three letter abbreviation I will not say anymore.

All assuming 3 year HPSP. If you do Family Medicine:

Intern year (obligation neutral) + 2 year residency. You now owe the military 3 years of active duty service after residency because 3 years from HPSP is greater than the 2 years from your residency. Time in Service (TIS) = 1 + 2 + 3 = 6 years in uniform.

If you do Neurosurgery:

Intern year (obligation neutral) + 6 year residency. You now owe the military 6 years of active duty service after residency because 6 years from residency is greater than the 3 years from HPSP. TIS = 1 + 6 + 6 = 13 years in uniform.

 

[packersfans]

If I'm reading the previously page correctly, it looks like FAP is currently at $45k per year of residency. Can anyone confirm? Additionally is there a signing bonus? Im seeing $200-400k tossed around in a few places, but I cant tell if that is concurrent with the $45k through residency or only for board certified docs.

I've been selected for HPSP but haven't signed or commissioned yet. Currently staring at a full cost of attendance of over $8ok/year. So approximately $400k at graduation and $500k at the end of a 3 year residency. I'm trying to figure out if FAP would be be able to make a dent on my financial situation.

 

[123nontrad]

The FAP is $45k per year plus about $2200 per month. I don't think you get an additional bonus. With the FAP, you're certain of your specialty and you shoot for the residency program of your choice. The catch is it's hard to know your chances of getting an FAP slot. I'm told there were only 9 last year and that the specialties vary year to year. I'm doing Navy psychiatry through the FAP and excited about it.

 

[123nontrad]

You can also wait until after residency if you want to serve your country/avoid insurance hassles/get some adventure. I'm not sure if it's easier to become a military physician that way than through FAP. I suspect it's easier to get an HPSP spot than FAP, by the way.

 

[deuist]

You can also wait until after residency if you want to serve your country/avoid insurance hassles/get some adventure.

Spoken like a true recruiter. Every physician services country by promoting health and welfare among the nation's population. As far as insurance hassles, while I do not have to worry about how a patient is going to pay for his medicine, getting subspecialty care can be particularly difficult as Tricare will need to approve consultations and procedures. If you count sitting in a trailer in the desert adventure, then more power to you. I did more on my church sponsored medical mission trips that I did when I was deployed.

 

[123nontrad]

Sounds like you had a tough time. Hope your current situation suits you better. I'm a bit idealistic when it comes to military service. I think it should be mandatory, for example. I think part of the problem with the military is that there's too much of a disconnect from the general population... leading to bad decisions and complacency.

Not sure exactly what the Navy has in store for me but I'm looking forward to being a role model and trying to improve things. I'm not a recruiter.

 

[ScallyKat]

I only know Navy numbers. Last year the Navy took 5. And the stated policy from BUMED is that they will only consider critically undermanned specialties in the immediate future.

Is that people accepted for FAP 5 nationwide? I was trying hard to get HPSP last year when I was accepted to medical school but due to various circumstances my MCAT score wasn't high enough and both the Army and Navy told me to reapply for a 3 yr scholarship after my first term if I had good grades - above a 3.0. It's now after first term and I have a 3.7 GPA but both the Army and Navy now say the minimum MCAT score is still the DQing factor and I should apply for FAP after I graduate...but if it's that difficult to get I'm becoming increasingly more concerned. Any advice or intel would be appreciated.

 

[deuist]

Any advice or intel would be appreciated.

My advice: don't join. Use your good grades to get into the residency of your choice, be happy with your civilian freedom and salary, and never look back.

 

[Bermie]

Interested in doing primary care and most likely attending an expensive private school. I come from a Navy family and like the idea of serving in the military. My plan is to wait till after med school and see how I feel then and possibly do FAP. Is the combination of private school and primary care enough for anyone here to recommend hpsp over FAP? I know joining isn't all about financial incentives but since I already have a desire to serve in the military and I have a decent idea of what I am getting into, I don't know if I'm making a mistake by not just pursuing an hpsp now?The stress of military match / GMO possibility and all that just doesn't seem worth it. I would rather join as a trained doctor from a civilian residency. I'm just worried the FAP won't be enough to alleviate some serious loans of $300,000+ when the time comes.


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[WernickeDO]

Interested in doing primary care and most likely attending an expensive private school. I come from a Navy family and like the idea of serving in the military. My plan is to wait till after med school and see how I feel then and possibly do FAP. Is the combination of private school and primary care enough for anyone here to recommend hpsp over FAP? I know joining isn't all about financial incentives but since I already have a desire to serve in the military and I have a decent idea of what I am getting into, I don't know if I'm making a mistake by not just pursuing an hpsp now?The stress of military match / GMO possibility and all that just doesn't seem worth it. I would rather join as a trained doctor from a civilian residency. I'm just worried the FAP won't be enough to alleviate some serious loans of $300,000+ when the time comes.


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You hit it right there. Stay far away from HPSP. Get through medical school and residency, and explore FAP if you still want to wear a uniform. Or, become a civilian contractor if you want to take care of soldiers. I know that debt is scary but you will be in a position to pay the loans off with attending salary even within primary care. Good luck.

 

[deleted646902]

Hi everyone,

Wanted to get some quick advice....

Air Force recruiter recently told me that 2 year HPSP scholarships only have a 2 year AD commitment. Before hearing this I was certain I was going to take the FAP route as I was under the impression the 2 year HPSP still had a 3 year AD commitment....however hearing about this has given me pause....Does anyone have thoughts about this?

 

[pgg]

Don't know if the 2y HPSP incurs a 2y ADSO or not, but just remember that your obligated service is the greater of your med school or residency obligations. A short med school obligation isn't a benefit if you do anninservice residency.

If you graduate med school, do an internship, then go straight through to a 4 year inservice residency, you're going to owe 4 years of service whether your HPSP obligation was 2 or 4 years.

 

[deleted646902]

Don't know if the 2y HPSP incurs a 2y ADSO or not, but just remember that your obligated service is the greater of your med school or residency obligations. A short med school obligation isn't a benefit if you do anninservice residency.

If you graduate med school, do an internship, then go straight through to a 4 year inservice residency, you're going to owe 4 years of service whether your HPSP obligation was 2 or 4 years.

Here is the kicker though ... he told me that his command told him that for 2 year HPSP recipients that is not the case. You will owe 2 years of AD even if residency is longer. He stated that the only way you can incur more obligation is if you get a civilian residency. So I'm just trying to get the best answer I can on this.

 

[pgg]

Here is the kicker though ... he told me that his command told him that for 2 year HPSP recipients that is not the case. You will owe 2 years of AD even if residency is longer. He stated that the only way you can incur more obligation is if you get a civilian residency. So I'm just trying to get the best answer I can on this.

That doesn't remotely come close to passing the sniff test.

First, that info came from a recruiter. He probably wasn't lying; he probably just doesn't know how medical GME obligations work. It's a complicated system - read some of the threads here and you'll see some occasional debate and confusion, even between those of who are military doctors who've lived the ADSO thing. There's probably one medial corps accession per 50 or 100 recruiters out there. The vast, vast majority of them simply don't deal with us enough to pass a threshold level of competence. We are different than enlisted and the officer line.

Second, civilian deferred residencies don't incur additional obligation. That bit of info is just wrong.

Third, I'm about 99.2% certain that all military inservice residencies always incur 1:1 obligation (to be served concurrently with the ADSO from HPSP or USUHS) no matter what path you took to get there. Because once you're in the medical corps and in uniform, you look just like the guy next to you. There's no special 2-year-HPSP exemption that I've ever heard of. And I think I'd have heard of it if such a beast existed.

I've never done the math rigorously, but a 2 year HPSP probably doesn't make financial sense even if you go GMO & out - you'll still have loans from 1/2 of med school, and those will compound during your GMO days.

 

[deleted646902]

That doesn't remotely come close to passing the sniff test.

First, that info came from a recruiter. He probably wasn't lying; he probably just doesn't know how medical GME obligations work. It's a complicated system - read some of the threads here and you'll see some occasional debate and confusion, even between those of who are military doctors who've lived the ADSO thing. There's probably one medial corps accession per 50 or 100 recruiters out there. The vast, vast majority of them simply don't deal with us enough to pass a threshold level of competence. We are different than enlisted and the officer line.

Second, civilian deferred residencies don't incur additional obligation. That bit of info is just wrong.

Third, I'm about 99.2% certain that all military inservice residencies always incur 1:1 obligation (to be served concurrently with the ADSO from HPSP or USUHS) no matter what path you took to get there. Because once you're in the medical corps and in uniform, you look just like the guy next to you. There's no special 2-year-HPSP exemption that I've ever heard of. And I think I'd have heard of it if such a beast existed.

I've never done the math rigorously, but a 2 year HPSP probably doesn't make financial sense even if you go GMO & out - you'll still have loans from 1/2 of med school, and those will compound during your GMO days.

Ok thank you for the response. Let me put two scenarios on play then and if my thinking is correct....

If the 2 year HPSP does carry a 1:1 residency obligation if it is longer the FAP would make more sense to start serving and paying off loans as well. However my concern with this scenario is that FAP is taxable.... so in reality 45K sounds great to pay off each year of medical school however in reality wouldnt this chunk of money really turn out to be about 28 K after taxes? So is this way really better than taking the HPSP route? Unless your view is that Civilian residency choice is the golden goose.

 

[deuist]

The only advantage to FAP is getting to choose your residency. Financially it's no good as you'll lock yourself into working for the military as an attending. Depending on your specialty, you could stand to lost a lot of money. I recently ran through the numbers for my case: 4-year HPSP, forced civilian internship I didn't want, civilian 3-year EM residency, and then 4 years of pay back left me $300,000 behind had I just taken out student loans, went to residency immediately after graduation, and then worked for 5 years at the same institution where I am headed after my commitment finished.

 

[coogs4life]

Anybody know of the various special pays/bonuses they have for Oral Surgery and FAP? Also can you qualify for an accession bonus after residency prior to active duty?