HPSP Advice

[advn1]

I'm currently waiting to hear back from MD schools (yes, I know it's extremely late in the cycle) and I have been strongly considering HPSP...up until I did some research here on SDN.

I'm quite indifferent about serving in the military (part of me is curious and wants to try it). And flat out, I was considering the HPSP for purely financial reasons. I do not mind travelling or being moved to different places. Does HPSP really (negatively) affect your growth as a physician?

Based off of what many of you have said about your experiences in the HPSP program, it seems like a gamble. It can either turn out really well or end up being a waste of time. From my understanding, the 2-year GMO commitment is not mandatory if you match in a civilian residency, which would be my plan if I went ahead and applied for the scholarship. However, after my residency, while paying back my years, it seems that the military could place me in a position where I am not in my specialty. Is this correct?

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[MightBeACylon439]

"take loans and never look back!" "NEVER DO IT FOR THE MONEY!" "It was a great experience for me!" "It is what you make of it." "The needs of the service outweigh the wants of the individual."

-Every response to questions like this in the SDN MILMED forum.

 

[Red Lobster Actual]

From my understanding, the 2-year GMO commitment is not mandatory if you match in a civilian residency, which would be my plan if I went ahead and applied for the scholarship.

You're talking about the civilian deferral. You might as well boil some tea leaves and see what patterns they arrange inside your kettle to determine whether or not you can get the deferral because it is just so random. I wouldn't count on it.

However, after my residency, while paying back my years, it seems that the military could place me in a position where I am not in my specialty. Is this correct?

Yes, absolutely correct. After residency they might send you off for a few years to practice whatever specialty you wind up in but then after that you must share the misery with everyone else. Battalion surgeons for the Army, flight surgeons for the Air Force, and GMO for the Navy (though the Navy tends to do this before residency). Different names for the same thing.

And flat out, I was considering the HPSP for purely financial reasons.

Yea don't take the money. Do HPSP because you want to do your part. The money and tuition is a constellation prize.

 

[advn1]

"take loans and never look back!" "NEVER DO IT FOR THE MONEY!" "It was a great experience for me!" "It is what you make of it." "The needs of the service outweigh the wants of the individual."

-Every response to questions like this in the SDN MILMED forum.

Yeah, I've read things like that over and over, hence why I am so lost now. I was hoping someone can tell me something other than those kinds of details ^.

 

[HighPriest]

You will not find the answer to your personal situation on this thread or anywhere else. There are plenty of additional details spread throughout the hundreds of posts on the forum here, but ultimately if you want specific answers you need to ask specific questions. Even if you have those answers, you're going to get different perspectives and ultimately this is a personal decision rather than on that will be directed by members here.

I would encourage you to read more if you are truly interested in HPSP. I would strongly advise you not to take HPSP if you have contingencies concerning whether or not you'll be allowed to defer to a civilian residency, whether or not you want to do a GMO, and whether or not you need to work in your specialty. The only real truth is that once you sign you have minimal control over all of these things. Right now you don't even know what kind of med student you'll be. If you're a stellar, top 5% student then you'll get whatever specialty you want, but it will probably be in the military. That's about the most control you have over the situation, and yes the rest is very circumstantial and unpredictable.

 

[j4pac]

 

[MightBeACylon439]

You will not find the answer to your personal situation on this thread or anywhere else. There are plenty of additional details spread throughout the hundreds of posts on the forum here, but ultimately if you want specific answers you need to ask specific questions. Even if you have those answers, you're going to get different perspectives and ultimately this is a personal decision rather than on that will be directed by members here.

I would encourage you to read more if you are truly interested in HPSP. I would strongly advise you not to take HPSP if you have contingencies concerning whether or not you'll be allowed to defer to a civilian residency, whether or not you want to do a GMO, and whether or not you need to work in your specialty. The only real truth is that once you sign you have minimal control over all of these things. Right now you don't even know what kind of med student you'll be. If you're a stellar, top 5% student then you'll get whatever specialty you want, but it will probably be in the military. That's about the most control you have over the situation, and yes the rest is very circumstantial and unpredictable.

This is what I was trying to convey in my response, albeit in a very smart-ass way. If you decide to accept (remember, doing it for the money is not a good reason, you will probably regret it), then your experience will be uniquely your own. No one on this forum will be able to give you an answer that fits who you are and what your experience will be.

 

[advn1]

You will not find the answer to your personal situation on this thread or anywhere else. There are plenty of additional details spread throughout the hundreds of posts on the forum here, but ultimately if you want specific answers you need to ask specific questions. Even if you have those answers, you're going to get different perspectives and ultimately this is a personal decision rather than on that will be directed by members here.

I would encourage you to read more if you are truly interested in HPSP. I would strongly advise you not to take HPSP if you have contingencies concerning whether or not you'll be allowed to defer to a civilian residency, whether or not you want to do a GMO, and whether or not you need to work in your specialty. The only real truth is that once you sign you have minimal control over all of these things. Right now you don't even know what kind of med student you'll be. If you're a stellar, top 5% student then you'll get whatever specialty you want, but it will probably be in the military. That's about the most control you have over the situation, and yes the rest is very circumstantial and unpredictable.

I have read from other HPSP physicians here on SDN that the years spent paying back are "wastes of time" and that you will become a much better physician if you avoid joining. Have you found this to be true in your experience and observations of your colleagues?

 

[HighPriest]

Again, this all kind of eludes to what kind of experience you have. To start: I don't think there is anything inherent about military medicine that would suggest that you will be a worse physician by joining and completing your committment. There are certainly some hardships. This is a contract with the military that obligates you to years of service. It isn't a car loan. It isn't a non-refundable cruise. You may end up at a station at which your practice is limited by the type of patients you see and by the type of patients you can treat. I you are at a MEDCEN, you'll see a full gamut of patients and be able to treat them. If you're at a small community MEDDAC, you will do neither of those things. For some providers, that results in some skill atrophy and for others it does not. The only way they can really screw you from the standpoint of a medical career is to put you in a battalion surgeon billet, where your skills will almost certainly suffer (especially if you go into a mechanically challenging field like surgery). That COULD happen. It does NOT happen to most people.

Most people join HPSP when they are at your point in training - premed. So there is little, if any, selection bias towards "good" or "bad" medical students in HPSP. Some people will argue that some military residencies aren't very good. I would argue that mine was quite good, and that I feel that I came out with excellent training. I would also argue that there are plenty of crap civilian residencies. Whether or not military residency training is generally better or worse than civilian training - as a whole - is very debatable. Comparing any given military program to Johns-Hopkins is not a fair comparison to begin with.

Whether or not it is a waste of time financially also depends upon what career path you take. It is generally not favorable for subspecialty surgeons, yet it is actually quite favorable for many primary care physicians.

My colleagues leave the military with no difficulty finding work or additional fellowship training. But whether they consider their time 'wasted' depends upon many factors, and upon which metric we're measuring.

I moonlight with both military and civilian surgeons in my field, and I can say with some certainty that I generally trust the military docs more....but there is definite selection bias within the moonlighting community....

 

[YourMD]

Hey guys I was recently accpeted to a high OOS cost of attendance D.O school. I have always been interested in the military lifestyle. Is it too late to apply for HPSP? if not, How should i go about doing this? is there an MCAT requirement?

 

[TurtleDO2012]

There is an MCAT requirement, it changes from year to year in terms of those applying. In the peak war years the min was 23, non war years it was more competitive and supposedly 29-30 was the min. Find a medical recruiter and inquire with them. They'll know if any more positions are available. My year I started around this time of year to get everything going.

 

[j4pac]

Hey guys I was recently accpeted to a high OOS cost of attendance D.O school. I have always been interested in the military lifestyle. Is it too late to apply for HPSP? if not, How should i go about doing this? is there an MCAT requirement?

Would you go into the military even if the scholarship wasn't offered? If the answer is no...then it's not worth it.

 

[globaldoc31]

Again, this all kind of eludes to what kind of experience you have. To start: I don't think there is anything inherent about military medicine that would suggest that you will be a worse physician by joining and completing your committment. There are certainly some hardships. This is a contract with the military that obligates you to years of service. It isn't a car loan. It isn't a non-refundable cruise. You may end up at a station at which your practice is limited by the type of patients you see and by the type of patients you can treat. I you are at a MEDCEN, you'll see a full gamut of patients and be able to treat them. If you're at a small community MEDDAC, you will do neither of those things. For some providers, that results in some skill atrophy and for others it does not. The only way they can really screw you from the standpoint of a medical career is to put you in a battalion surgeon billet, where your skills will almost certainly suffer (especially if you go into a mechanically challenging field like surgery). That COULD happen. It does NOT happen to most people.

Most people join HPSP when they are at your point in training - premed. So there is little, if any, selection bias towards "good" or "bad" medical students in HPSP. Some people will argue that some military residencies aren't very good. I would argue that mine was quite good, and that I feel that I came out with excellent training. I would also argue that there are plenty of crap civilian residencies. Whether or not military residency training is generally better or worse than civilian training - as a whole - is very debatable. Comparing any given military program to Johns-Hopkins is not a fair comparison to begin with.

Whether or not it is a waste of time financially also depends upon what career path you take. It is generally not favorable for subspecialty surgeons, yet it is actually quite favorable for many primary care physicians.

My colleagues leave the military with no difficulty finding work or additional fellowship training. But whether they consider their time 'wasted' depends upon many factors, and upon which metric we're measuring.

I moonlight with both military and civilian surgeons in my field, and I can say with some certainty that I generally trust the military docs more....but there is definite selection bias within the moonlighting community....

I was wondering how the fellowship process works with the HPSP. Can you give me some more information on this as far as the difficulty of getting a military fellowship?

Is it a common trend for docs leaving the military to go into a fellowship program considering that their application may be a little bit stronger with their military background?

 

[advn1]

Again, this all kind of eludes to what kind of experience you have. To start: I don't think there is anything inherent about military medicine that would suggest that you will be a worse physician by joining and completing your committment. There are certainly some hardships. This is a contract with the military that obligates you to years of service. It isn't a car loan. It isn't a non-refundable cruise. You may end up at a station at which your practice is limited by the type of patients you see and by the type of patients you can treat. I you are at a MEDCEN, you'll see a full gamut of patients and be able to treat them. If you're at a small community MEDDAC, you will do neither of those things. For some providers, that results in some skill atrophy and for others it does not. The only way they can really screw you from the standpoint of a medical career is to put you in a battalion surgeon billet, where your skills will almost certainly suffer (especially if you go into a mechanically challenging field like surgery). That COULD happen. It does NOT happen to most people.

Most people join HPSP when they are at your point in training - premed. So there is little, if any, selection bias towards "good" or "bad" medical students in HPSP. Some people will argue that some military residencies aren't very good. I would argue that mine was quite good, and that I feel that I came out with excellent training. I would also argue that there are plenty of crap civilian residencies. Whether or not military residency training is generally better or worse than civilian training - as a whole - is very debatable. Comparing any given military program to Johns-Hopkins is not a fair comparison to begin with.

Whether or not it is a waste of time financially also depends upon what career path you take. It is generally not favorable for subspecialty surgeons, yet it is actually quite favorable for many primary care physicians.

My colleagues leave the military with no difficulty finding work or additional fellowship training. But whether they consider their time 'wasted' depends upon many factors, and upon which metric we're measuring.

I moonlight with both military and civilian surgeons in my field, and I can say with some certainty that I generally trust the military docs more....but there is definite selection bias within the moonlighting community....

Thanks for your input. I definitely agree, there are so many factors that go into someone's experience that it's almost impossible to predict how things will turn out. Particularly in my case since I have not even started med school yet, and I don't know what specialty I will end up in, what kind of student I will be, or how "active" I will be in my medical education.
I've been around military docs and military hospitals for the last 5 years, and I definitely think I would enjoy it just as much as being in a civilian environment. I've thought about serving since high school, but I can't say I'm passionate about it.

Have you (heard or observed by others) found that civilian deferment for residency is as "random" or impossible as "Red Lobster Actual" made it sound?
And after residency, how often have you heard or seen physicians being placed in positions unrelated to their specialty? It seems like you hinted at it being not that often.

 

[globaldoc31]

Thanks for your input. I definitely agree, there are so many factors that go into someone's experience that it's almost impossible to predict how things will turn out. Particularly in my case since I have not even started med school yet, and I don't know what specialty I will end up in, what kind of student I will be, or how "active" I will be in my medical education.
I've been around military docs and military hospitals for the last 5 years, and I definitely think I would enjoy it just as much as being in a civilian environment. I've thought about serving since high school, but I can't say I'm passionate about it.

Have you (heard or observed by others) found that civilian deferment for residency is as "random" or impossible as "Red Lobster Actual" made it sound?
And after residency, how often have you heard or seen physicians being placed in positions unrelated to their specialty? It seems like you hinted at it being not that often.

I'm pretty much in the same position as you as far as whether to apply to the HPSP. I just spoke with an Army 4th year HPSP med student and he said that civilian deferments really don't exist in the army but they are more common in the AF. He also said that you will never be sent to a position outside of your specialty after your residency.

 

[HighPriest]

Civilian deferrments depend upon the branch and the needs of the service. If the branch of service needs a lot of X, and they can't train enough X to fill their billets, they will defer students to train at civilian X residencies. The reason is depends upon the branch is that each branch has different numbers of training spots.

Fellowships are a crap shoot. It depends upon what you want to do and upon the needs of the service. Some fellowships are easy to get, some fellowships are far more difficult to get in the military because the service is saturated and they simply won't approve you to even apply for a fellowship If you are selected to apply for a fellowship, however, military residents tend to be extremely competative because they're free labor for the accepting training program. Plus you earn your military pay, so you make more money than most civilian fellows, which is nice.

Whether or not you're placed into a position unrelated to your specialty depends upon how saturated your service is as well. From how it was explained to me by my consultant, and this may be Army-specific, your chances of being pulled into an operational (non-clinical) spot are dependent upon whether your specialty is over-staffed or not. If there are more than enough of "your people," then the Army will demend that one of you be volunteered for an operational spot. That is 2 years away from patient care. This is a relatively rare occurance for specialists, but it is something that constantly hovers in the minds of everyone in the military because it is a killshot for your skillset. Primary care docs are more often billeted into operational slots. I can't speak to how often or how that comes about. Some people volunteer in the traditional sense because it is very good for a military career.

 

[HighPriest]

I think the issue is: yes it is rare to be forced into an operational slot. The question is what level of risk are you willing to accept? For most people, especially subspecialists, and especially surgeons, the risk of a career ending transfer into a non-clinical slot is too great, even if it's 1,000:1.

 

[colbgw02]

He also said that you will never be sent to a position outside of your specialty after your residency.

To be explicit, his assertion is false.

 

[HighPriest]

I'm pretty much in the same position as you as far as whether to apply to the HPSP. I just spoke with an Army 4th year HPSP med student and he said that civilian deferments really don't exist in the army but they are more common in the AF. He also said that you will never be sent to a position outside of your specialty after your residency.

I wouldn't seek advice from an HPSP student in medical school. I knew two things about military medicine when i was a 4th year HPSP student: jack and $#!T. Civilian deferrments to occur in the Army, but are less frequent than the AF perhaps, and if so because the AF has fewer training spots. The second part, as mentioned already, is just the BS his recruiter sold him. Don't get me wrong, you're not going to deploy as an infrantryman. So to some extent what he's saying is accurate, but you may be placed in a job that is not what you trained to do.

 

[Chonal Atresia]

Civilian deferrments depend upon the branch and the needs of the service. If the branch of service needs a lot of X, and they can't train enough X to fill their billets, they will defer students to train at civilian X residencies. The reason is depends upon the branch is that each branch has different numbers of training spots.

Fellowships are a crap shoot. It depends upon what you want to do and upon the needs of the service. Some fellowships are easy to get, some fellowships are far more difficult to get in the military because the service is saturated and they simply won't approve you to even apply for a fellowship If you are selected to apply for a fellowship, however, military residents tend to be extremely competative because they're free labor for the accepting training program. Plus you earn your military pay, so you make more money than most civilian fellows, which is nice.

Whether or not you're placed into a position unrelated to your specialty depends upon how saturated your service is as well. From how it was explained to me by my consultant, and this may be Army-specific, your chances of being pulled into an operational (non-clinical) spot are dependent upon whether your specialty is over-staffed or not. If there are more than enough of "your people," then the Army will demend that one of you be volunteered for an operational spot. That is 2 years away from patient care. This is a relatively rare occurance for specialists, but it is something that constantly hovers in the minds of everyone in the military because it is a killshot for your skillset. Primary care docs are more often billeted into operational slots. I can't speak to how often or how that comes about. Some people volunteer in the traditional sense because it is very good for a military career.

I love the "kill shot" comment. It is spot-on. In the end, the military does not give a flying f$&@ about your career or aspirations. They need to fill manufactured operational slots as mandated by the nurse general, which makes it even harder to swallow. I wish she would be relieved of command like she seems to be doing to physicians and non-physicians alike at an alarming rate.

So glad I am out of that cancer of an organization. Is their any morale left?

 

[TurtleDO2012]

Opportunity for those crappy operational and dedicated line positions will possibly increase. My PA is telling me that in terms of the PA world they are being told that they need to pursue more of the random command positions and move away from providing care in the line positions so that come promotion board time they will appear better when compared to the medical service corp officers.

Shuffling of resources for sake of shuffling will continue to plague the military.

 

[HighPriest]

I think those op spots are perfect for PAs, frankly.

 

[paulryan2701]

Hey guys I was recently accpeted to a high OOS cost of attendance D.O school. I have always been interested in the military lifestyle. Is it too late to apply for HPSP? if not, How should i go about doing this? is there an MCAT requirement?

Hey guys I was recently accpeted to a high OOS cost of attendance D.O school. I have always been interested in the military lifestyle. Is it too late to apply for HPSP? if not, How should i go about doing this? is there an MCAT requirement?

Where are you located at? If you are in the Bay Area then I can connect you with someone.

 

[brdlh_15]

How strict are the fitness requirements (APFT scores) for the HPSP students? Also, are opportunities for women to receive the scholarship limited?

Also, how are the chances for acceptance generally? What if they have a 3.8 GPA, >70th percentile MCAT (>30 on old MCAT; >500 on new MCAT), and are accepted into an accredited MD program?

I was also wondering whether this scholarship is right for me. I have some time before I apply for the program, but I know I will have the above credentials/statistics by the time I apply. My biggest concerns are whether completing a residency extends my commitment because I wanted to do a 3 yr commitment and return before I turned 30. Also, I think I want to specialize but placement is not guaranteed as I have no idea as to what my board scores will be like. In terms of the military portion of it, I have not had any experiences with the military but I have been committed to service and healthcare since my high school years. Also, I went to a school with a military history even though I myself was not part of a military program. Obviously, a part of the decision is the money, but I am also hoping this experience will provide me with opportunities for character development and a small adventure as I hope to settle down, have a family, or something like that after age 30. Would I have a chance?