Fellowship Commitment Time

[xact76]

Hello guys, I'm sure this has been talked about but i couldn't find it explicitly.

If one were to do a 4 year HPSP scholarship a 3 Year military residency, (and if lucky enough) a 3 year military fellowship what would be the active duty commitment time required??

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[colbgw02]

I think it's 5 years, assuming there is no gap in your training. You owe 4 from HPSP and 5 from GME (2 from residency and 3 from fellowship), which both start getting paid off the day you graduate from fellowship.

 

[idq1i]

1 year of internship + 2 years of residency = 3 years in uniform, so far, and you owe 4 more on AD.

assuming you get picked up for fellowship right after residency, and it's civilian sponsored - you just gained 3 more years of AD

so, 1 year internship, 2 years of residency, 4 year payback, 3 years tacked on from fellowship = 1+2+4+3=10 years in uniform (plus 3 years that you are not in uniform-fellowship-and you are accruing obligation). Technically, your obligation is 4+3=7, but in intership and residency you are wearing a uniform, so I think it should count.

 

[idq1i]

I think it's 5 years, assuming there is no gap in your training. You owe 4 from HPSP and 5 from GME (2 from residency and 3 from fellowship), which both start getting paid off the day you graduate from fellowship.

You can't pay off HPSP, GME ADSO and Fellowship ADSO concurrently. There is the MSP loophole that I think you have in mind (where you start serving your fellowship ADSO before completing your HPSP ADSO), but that requires you to be in your last year of ADSO payback.

 

[colbgw02]

You can't pay off HPSP, GME ADSO and Fellowship ADSO concurrently, AFAIK. There is the MSP loophole that I think you have in mind, but that requires you to be in your last year of ADSO payback.

No, I'm not thinking of MSP. You can't pay off two GME commitments simultaneously, which is why the residency (2) and fellowship (3) obligation totals 5 years. You can pay off an HPSP and a GME commitment simultaneously. Contrary to popular belief, you're not paying off any GME or HPSP obligation while in residency or fellowship, even if it's an active duty program.

If it helps, think about it as a 6-year GS program with a research year (same total number of GME years). A 4-year HPSP owes four from the scholarship and 5 from the residency, for a total of 5 years of post-training time in uniform.

 

[Militarydoc1]

This has been covered elsewhere, but if you are not familiar w/ MSO vs. ADSO, it can be confusing. When you sign up for HPSP, you automatically incur an 8 year military service obligation (MSO- active duty + reserve time). If you decide to sign up for a 4 year scholarship, you will incur at least a 4 year active duty service obligation (ADSO). Residency will count towards fulfilling your MSO, but not your HPSP ADSO. To confuse things even further, residency will actually incur additional yrs of ADSO, but can be served concurrently w/ HPSP ADSO - most don't realize internship does not add ADSO. You will start your ADSO after residency completion. If you decide to pursue fellowship, you will add additional years of ADSO, but can be served concurrently with HPSP ADSO. Also, any remaining years on MSO after ADSO is fulfilled will be served in IRR (Inactive Ready Reserves)

For example, if you signed a 4 year HPSP contract, after completing 1 yr internship/2 yrs of residency, you will need to remain on active duty for another 4 yrs to complete your ADSO (2 yr residency = 2 yr ADSO, but served concurrently w/ 4 yr HPSP) after which you can separate (ETS), but still owe 1 more year of MSO in IRR.

However, this is where it may get even more confusing. Let's say 2 yrs after residency, you get picked up for a 3 yr fellowship. Prior to starting fellowship, you have already completed 2 yrs ADSO and only owe 2 more years, but a 3 yr fellowship will entail an additional 3 yr ADSO, but can be served concurrently with HPSP ADSO. In essence, you will have to serve 3 more years after completing fellowship.

Of note, there have been changes to how fellowships are awarded. Priority is given to those who have deployed, served overseas or worked as Battalion/Brigade/Flight Surgeons and less based on actual academic/clinical merit. I am told programs are less inclined or discouraged from picking up fellows straight after residency. Therefore, a 1 or 2 yr gap after residency is a realistic scenario if you choose to pursue fellowship. I opted to pursue a civilian fellowship. Good luck!

 

[colbgw02]

This has been covered elsewhere, but if you are not familiar w/ MSO vs. ADSO, it can be confusing. When you sign up for HPSP, you automatically incur an 8 year military service obligation (MSO- active duty + reserve time). If you decide to sign up for a 4 year scholarship, you will incur at least a 4 year active duty service obligation (ADSO). Residency will count towards fulfilling your MSO, but not your HPSP ADSO. To confuse things even further, residency will actually incur additional yrs of ADSO, but can be served concurrently w/ HPSP ADSO - most don't realize this. You will start your ADSO after residency completion. If you decide to pursue fellowship, you will add additional years of ADSO, but can be served concurrently with HPSP/residency ADSO. Also, any remaining years on MSO after ADSO is fulfilled will be served in IRR (Inactive Ready Reserves)

For example, if you signed a 4 year HPSP contract, after completing 1 yr internship/2 yrs of residency, you will need to remain on active duty for another 4 yrs to complete your ADSO (2 yr residency = 2 yr ADSO, but served concurrently w/ 4 yr HPSP) after which you can separate (ETS), but still owe 1 more year of MSO in IRR.

However, this is where it may get even more confusing. Let's say 2 yrs after residency, you get picked up for a 3 yr fellowship. Prior to starting fellowship, you have already completed 2 yrs ADSO and only owe 2 more years, but a 3 yr fellowship will entail an additional 3 yr ADSO, but can be served concurrently with HPSP ADSO. In essence, you will have to serve 3 more years after completing fellowship.

Of note, there have been changes to how fellowships are awarded. Priority is given to those who have deployed, served overseas or worked as Battalion/Brigade/Flight Surgeons and less based on actual academic/clinical merit. I am told programs are less inclined or discouraged from picking up fellows straight after residency. Therefore, a 1 or 2 yr gap after residency is a realistic scenario if you choose to pursue fellowship. I opted to pursue a civilian fellowship. Good luck!

Sounds right, and a nice summary, except for the bolded part. Are you sure that a fellowship ADSO can be served concurrently with a residency ADSO? I am fairly confident that any GME obligations must be served sequentially, as this became an issue for a recent graduate from my program who ultimately declined his fellowship.

 

[Militarydoc1]

I stand corrected. ADSO's from GME training cannot be served concurrently; they can be served w/ HPSP ADSO. To answer the OP's question, although more difficult these days to fast track into fellowship after residency, I also believe you would owe 5 yrs ADSO after residency/fellowship.

 

[xact76]

Thanks so much for you're responses. I'm only a first year trying to understand what I've gotten myself into and some long term goals. Nevertheless its all extremely helpful

This has been covered elsewhere, but if you are not familiar w/ MSO vs. ADSO, it can be confusing. When you sign up for HPSP,
Of note, there have been changes to how fellowships are awarded. Priority is given to those who have deployed, served overseas or worked as Battalion/Brigade/Flight Surgeons and less based on actual academic/clinical merit. I am told programs are less inclined or discouraged from picking up fellows straight after residency. Therefore, a 1 or 2 yr gap after residency is a realistic scenario if you choose to pursue fellowship. I opted to pursue a civilian fellowship. Good luck!

If this is true then the most realistic possibility is serving two years after residency and hopefully get picked up then. This would mean 5 years active (1 year internship, 2 residency, 2 ADSO). Then being picked up for a 3 year fellowship + additional 3 year ADSO (6 more years) would yield a total of 11 years active.

So as long as you get into a fellowship within 2 years after residency the total service time should not change (11 years total). Anything longer than a two year gap would result in more active years?

 

[idq1i]

No, I'm not thinking of MSP. You can't pay off two GME commitments simultaneously, which is why the residency (2) and fellowship (3) obligation totals 5 years. You can pay off an HPSP and a GME commitment simultaneously. Contrary to popular belief, you're not paying off any GME or HPSP obligation while in residency or fellowship, even if it's an active duty program.

If it helps, think about it as a 6-year GS program with a research year (same total number of GME years). A 4-year HPSP owes four from the scholarship and 5 from the residency, for a total of 5 years of post-training time in uniform.

My colleague got picked up for a 1 year fellowship 2 years into his 4 yr ADSO payback. had a 4 year commitment, served 2 years, will accumulate 2 more (1 yr sponsorship=at least 2 yr commitment), and will have to pay back 4 more (2 remaining and 2 from fellowship, so he is at 6 yr payback with fellowship (not including the 5 years in uniform for residency). His obligation is additive, not concurrent. I read his contract.

If they do some other math for short residencies, that's not too bad of a deal, assuming they don't ROFR you into a in-service military fellowship

 

[colbgw02]

My colleague got picked up for a 1 year fellowship 2 years into his 4 yr ADSO payback. had a 4 year commitment, served 2 years, will accumulate 2 more (1 yr sponsorship=at least 2 yr commitment), and will have to pay back 4 more (2 remaining and 2 from fellowship, so he is at 6 yr payback with fellowship (not including the 5 years in uniform for residency). His obligation is additive, not concurrent. I read his contract.

If they do some other math for short residencies, that's not too bad of a deal, assuming they don't ROFR you into a in-service military fellowship

Yes, as I've said, his GME obligations are additive.

It's difficult to work it out exactly without knowing the length of his residency, but here's how the math works for someone like your colleague with a 5-year residency and a 4-year HPSP. The residency results in a 4-year ADSO, and there is a 4-year ADSO from HPSP. These two can be paid off concurrently, so...

He graduated from residency and went into practice for two years, so at the moment he went into fellowship he still owed 2 years from residency and 2 years from HPSP. He spends 1 year in fellowship, during which he pays back nothing and incurs an additional two years for participation in a GME program. Therefore, these additional years are added to the two remaining years from his residency ADSO. The moment he steps out of fellowship, he goes back into repaying his obligation, which now consists of a 4-year GME commitment (2 remaining from residency and 2 from fellowship) and 2 years remaining from HPSP. Those are paid off concurrently, meaning he owes 4 years after fellowship.

 

[njones9]

This is a great thread with a lot of great info. As a current HPSP med student, I have a question... I understand that after serving some kind of utilization tour (as a FS, etc.) you receive extra points when you apply for a fellowship. Does anyone have any inkling of how competitive these fellowships are? I am sure that it varies year to year (based on how many positions are available). And if you are really set on doing a certain fellowship, can you keep reapplying year after year (as you accrue more and more time in service)? Or is that viewed unfavorably? Thanks in advance.

 

[HighPriest]

How competitive depends upon the fellowship, because it depends upon the number of applicants and the number of people already active in your branch of service who do that job. The military won't train people to do a fellowship if they feel that they already have enough of that type of doc lying around.
Reapplying year after year shouldn't influence your chances significantly. If you're a poor candidate you're a poor candidate, and if you previously weren't allowed to apply for a fellowship because it is competitive or because it wasn't needed, that's not your fualt. Plus, it could potentially give you time to "beef up" your resume from either a mikitarybor research perspective (assuming you end up someplace where you can practically do research).
The way fellowship matches work, at least in the Army and in my specialty, is that the consultant and the program directors all get together and barter for PCS locations and fellowships for all of their graduating residents. If you're a good candidate, you'll make a strong argument (assuming, again, that the military needs people to train in that field).

 

[HighPriest]

As long as you can handle the taste of additional years of service,that is. (it tastes a lot like hemlock)