Army HPSP Questions

[SergeantBuzzKill]

Hello, I was recently accepted into the HPSP program and am unsure if I am going to commit. I have some questions and any input would be appreciated.

1. I want to be a surgeon, but I hear that you don't get the experience you can receive as a civilian. Is there any truth to this? Keep in mind this was coming from a civilian physician with military ties (never served). He mainly referenced military surgeons "sitting on their hands" during deployments and "don't get as much experience with trauma as one would in an urban hospital." I have also heard from a HPSP resident that you will receive some of the best surgery training in the world in the military, so I am not sure what to think at this point.

2. If I am fortunate enough to become a surgeon, does it make sense for me to do HPSP from a financial stand point, or would I be able to pay back my loans in a matter of a few years?

3. Based on webinar data, it seems that you can get away with lower step scores and still match into surgery than in the civilian world. Is this generally true? (From the data I saw, the mean COMLEX step 1/2 scores for general surgery were hovering around 560, whereas the mean for civilians was 600+).

4. Is it generally more difficult to match into a surgery residency in the military than in the civilian world? On one hand, there are many more surgery residencies in the civilian world, but there are also many more applicants for those positions.

5. I realize for the Army, you are required to do DCC and BOLC. I am concerned that these ADTs will coincide with the time I am given to study for my step exams. Can anyone shed any light as to when students typically go through these?

6. I have heard that military physicians generally have less free time than their civilian counterparts. Why is that? I have read some complaints about paperwork taking up a lot of time, but wouldn't this be true for both civilian and military?

7. If you had to give me the top 5-10 pros and cons of military medicine, what would they be?

Don't get me wrong, I want to serve my country and make a genuine difference in the military. I do not mind a lot of the "physical drawbacks" many complain about, such as crappy living conditions/food during deployment, less than "ideal" living conditions is expected in the military. I am mainly struggling with the lack of control I will have and the time away from my wife/kids (no family now, but I imagine things will [hopefully] be different 8 years down the line). Thanks in advance!

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[Helpful Troll]

3. Based on webinar data, it seems that you can get away with lower step scores and still match into surgery than in the civilian world. Is this generally true? (From the data I saw, the mean COMLEX step 1/2 scores for general surgery were hovering around 560, whereas the mean for civilians was 600+).

4. Is it generally more difficult to match into a surgery residency in the military than in the civilian world? On one hand, there are many more surgery residencies in the civilian world, but there are also many more applicants for those positions.

I am mainly struggling with the lack of control I will have and the time away from my wife/kids (no family now, but I imagine things will [hopefully] be different 8 years down the line). Thanks in advance!

Army only -
3. This is not generally true. It is a result of a smaller number of available military residency positions than civilian. Search google for GME Slideshow 2016 and 2017 - some of the links on SDN no longer work because the MODs website is not publicly accessible any longer. I can't link them right now. 2016 GS Comlex scores are not listed because too few Osteopathic applicants were accepted to GS (**Data restricted to protect student privacy). 2017 GS Comlex lvl 1 Mean 582 and Range 529-667. GS Comlex lvl 2 Mean 632 and Range 578-716. The 2018 match slideshow is not yet available.

4. Tyranny of small numbers - Army 2016 match had 27 GS Residency positions for and 2017 - 24. Each year there are applicants to GS not selected and they commonly do an Intern year and GMO following.

"...lack of control,... time away,...and different 8 years down the line". It will be different but it's unlikely it will be better.

 

[WernickeDO]

Hello, I was recently accepted into the HPSP program and am unsure if I am going to commit. I have some questions and any input would be appreciated.

1. I want to be a surgeon, but I hear that you don't get the experience you can receive as a civilian. Is there any truth to this? Keep in mind this was coming from a civilian physician with military ties (never served). He mainly referenced military surgeons "sitting on their hands" during deployments and "don't get as much experience with trauma as one would in an urban hospital." I have also heard from a HPSP resident that you will receive some of the best surgery training in the world in the military, so I am not sure what to think at this point.

2. If I am fortunate enough to become a surgeon, does it make sense for me to do HPSP from a financial stand point, or would I be able to pay back my loans in a matter of a few years?

3. Based on webinar data, it seems that you can get away with lower step scores and still match into surgery than in the civilian world. Is this generally true? (From the data I saw, the mean COMLEX step 1/2 scores for general surgery were hovering around 560, whereas the mean for civilians was 600+).

4. Is it generally more difficult to match into a surgery residency in the military than in the civilian world? On one hand, there are many more surgery residencies in the civilian world, but there are also many more applicants for those positions.

5. I realize for the Army, you are required to do DCC and BOLC. I am concerned that these ADTs will coincide with the time I am given to study for my step exams. Can anyone shed any light as to when students typically go through these?

6. I have heard that military physicians generally have less free time than their civilian counterparts. Why is that? I have read some complaints about paperwork taking up a lot of time, but wouldn't this be true for both civilian and military?

7. If you had to give me the top 5-10 pros and cons of military medicine, what would they be?

Don't get me wrong, I want to serve my country and make a genuine difference in the military. I do not mind a lot of the "physical drawbacks" many complain about, such as crappy living conditions/food during deployment, less than "ideal" living conditions is expected in the military. I am mainly struggling with the lack of control I will have and the time away from my wife/kids (no family now, but I imagine things will [hopefully] be different 8 years down the line). Thanks in advance!

1: there are pros and cons to military surgery. I am speaking as one that did a GS internship but did not complete training. You will likely have fewer cases in your log book compared to a civilian trained resident, but the trade off is that you will likely have more actual hands on surgery time in the military. Bottom line is that mil surgeons typically finish well trained and ready to either practice independently or move on to fellowship. My former colleagues were by and large happy with their training. You do see less trauma than a large civilian institution but will get plenty of trauma experience on your away rotations. You absolutely can sit on your hands in a deployment, depending on the nature of the deployment. No one was sitting on their hands in 2005 in Iraq. Skill atrophy is very real depending on the assignment and has been discussed ad nauseam. the best surgery training in the world using what metric? In-training scores? Complications? Most time spent waiting for an OR to turn over?

2: HPSP only makes financial sense if you go to an extremely expensive school and go into primary care.

3, 4: See Helpful Troll's response.

5: Seems like they are wanting you to do DCC before med school and BOLC after first year. Any hiccups to this time line will absolutely encroach on your board prep time. It used to be no DCC and BOLC just had to be finished before you made Major. Looks like this is changing.

6: General consensus is that you will have more free time and a "better lifestyle" in the military than civilian. Most docs who got out say that they work harder as a civilian. Some would say that's a good thing.

7: Check out the stickies on the milmed forum homepage.

Service to your country means separation from your future family, being stationed in places that will suck and potentially inhibit your spouse's career, being forced into an admin job, being denied fellowship, and watching your hard-earned surgical skills wither on the vine. There are lots of good reasons to join the military as a doc but you need to try and understand the potential pitfalls and drawbacks. Ask yourself this: would you be okay with being denied surgical training despite having a solid application and spending 4 years as a GMO shuffling paperwork? If the answer is no, then don't join.

 

[HighPriest]

Hello, I was recently accepted into the HPSP program and am unsure if I am going to commit. I have some questions and any input would be appreciated.

1. I want to be a surgeon, but I hear that you don't get the experience you can receive as a civilian. Is there any truth to this? Keep in mind this was coming from a civilian physician with military ties (never served). He mainly referenced military surgeons "sitting on their hands" during deployments and "don't get as much experience with trauma as one would in an urban hospital." I have also heard from a HPSP resident that you will receive some of the best surgery training in the world in the military, so I am not sure what to think at this point.

2. If I am fortunate enough to become a surgeon, does it make sense for me to do HPSP from a financial stand point, or would I be able to pay back my loans in a matter of a few years?

3. Based on webinar data, it seems that you can get away with lower step scores and still match into surgery than in the civilian world. Is this generally true? (From the data I saw, the mean COMLEX step 1/2 scores for general surgery were hovering around 560, whereas the mean for civilians was 600+).

4. Is it generally more difficult to match into a surgery residency in the military than in the civilian world? On one hand, there are many more surgery residencies in the civilian world, but there are also many more applicants for those positions.

5. I realize for the Army, you are required to do DCC and BOLC. I am concerned that these ADTs will coincide with the time I am given to study for my step exams. Can anyone shed any light as to when students typically go through these?

6. I have heard that military physicians generally have less free time than their civilian counterparts. Why is that? I have read some complaints about paperwork taking up a lot of time, but wouldn't this be true for both civilian and military?

7. If you had to give me the top 5-10 pros and cons of military medicine, what would they be?

Don't get me wrong, I want to serve my country and make a genuine difference in the military. I do not mind a lot of the "physical drawbacks" many complain about, such as crappy living conditions/food during deployment, less than "ideal" living conditions is expected in the military. I am mainly struggling with the lack of control I will have and the time away from my wife/kids (no family now, but I imagine things will [hopefully] be different 8 years down the line). Thanks in advance!

1 - You will get more cases and see more varied pathology in a civilian setting during training. You may or may not do more as a civilian surgeon in a rural setting than you'll do in the military. You may even do more in the military. But if you're a civilian surgeon who's gung ho about trauma, and you go work in Baltimore or Chicago, you're going to see WAY more trauma than you would in the military. That being said, you won't see a lot of major blast trauma. You get good surgery training in the military. "some of the best in the world" is nice and subjective. I don't necessarily agree with that, and I'm one of the guys who generally defends HPSP surgical training. I think you get good training to be a good community physician. You're not going to be an all-star trauma doc. I agree that you'll probably get more hands-on experience, which will make you a good clinical and operative community surgeon. It will not make you great at complicated cases, because you won't see the volume.

2 - Depends upon what kind of surgeon you are, and where you practice, and what kind of loan repayment deal you land. Generally, if you play your cards right, you'll be able to pay off your loans in a few years without HPSP. You won't be living a rockstar lifestyle for those few years, however. As stated above, it really makes the most sense for primary care after a really expensive medical school. It ALSO makes sense for more specialists if they have a hugely long ADSO and they decide to stick around until retirement. If you're thinking 4 and done, then the scales are really tipped more towards not doing HPSP if you're a surgeon.

3 - Last I checked, becoming a general surgeon in the military was pretty hard compared with the civilian side. It's been a few years since I looked in to it. Generally, however, if you're competitive you're more likely to match SOMEWHERE in the civilian world simply because there are more spots for which to apply.

4 - as above

5 - Never did DCC. I did BOLC during my first summer, so it didn't mess with anything.

6 - Less free time? I had so much free time in the Army that I honestly had a constant feeling of anxiety for about 2 years after residency. What you do have is a lot more time dedicated to non-clinical BS. I mean a LOT more time on online training, ra-ra sessions with the hospital commander, urinalyses, etc. I was convinced by other military physicians that things like that still occurred on the civilian side, and maybe that's true some placed, but I haven't done ANY of it in almost 1 year. Whereas I did non-clinical BS every single week in the Army. The annual training package is weeks of your time, every year. But most military physicians see far fewer patients than their civilian counterparts, and hence have far more time available. That's one of the perks: the system is too broken to be efficient and busy. The paperwork. If you're talking about clinically relevant paperwork (EMR entries, etc.) then, yes you have that on both sides. If you're talking about ridiculous non-clinical work like online safety training, cyber-security, anti-terrorism training, etc.: I do none of that now. None. It used to be something that came up every month.

7 - This is really something addressed in lots of other threads. I'll give a few examples. Keep in mind that the pros/cons list is HEAVILY dependent upon your specific military experience. You may get the residency you want, the fellowship you want, and then the duty station you want. If so, things are great. OR you may get none of those things, in which case the pill is harder to swallow. It is only merit-based to a point.
Pros: taking care of soldiers is great. you don't have to work very hard. In theory you can deploy and serve your country.
Cons: Horribly, terribly inefficient management with no value placed on actual patient care. Skill rot is a major issue, especially for surgeons.

Honestly, if lack of control is a hot button issue for you, or even if it might be, the military is going to be real challenging. I never realized how much control over my life meant to me until I was in the Army. Then I realized that it was hugely important. And I would not do HPSP again if I had the choice. It's not that it was all bad. It wasn't. But it is so very nice to have the final say over your life...

 

[SergeantBuzzKill]

Army only -
3. This is not generally true. It is a result of a smaller number of available military residency positions than civilian. Search google for GME Slideshow 2016 and 2017 - some of the links on SDN no longer work because the MODs website is not publicly accessible any longer. I can't link them right now. 2016 GS Comlex scores are not listed because too few Osteopathic applicants were accepted to GS (**Data restricted to protect student privacy). 2017 GS Comlex lvl 1 Mean 582 and Range 529-667. GS Comlex lvl 2 Mean 632 and Range 578-716. The 2018 match slideshow is not yet available.

4. Tyranny of small numbers - Army 2016 match had 27 GS Residency positions for and 2017 - 24. Each year there are applicants to GS not selected and they commonly do an Intern year and GMO following.

"...lack of control,... time away,...and different 8 years down the line". It will be different but it's unlikely it will be better.

What were the averages/ranges for Emergency Medicine and Internal Medicine in 2017?

 

[WernickeDO]

What were the averages/ranges for Emergency Medicine and Internal Medicine in 2017?

Army GME Slideshow

 

[SergeantBuzzKill]

Army GME Slideshow

Thank you, but this is 2018

 

[USArmyHPSP]

What @WernickeDO supplied is the latest. The 2018 results be determined between November and February, and the will be availabele next March.

 

[Cranjis McBasketball]

What @WernickeDO supplied is the latest. The 2018 results be determined between November and February, and the will be availabele next March.

Is there a similar slideshow for navy?

 

[backrow]

Is there a similar slideshow for navy?

No.


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