HPSP training and residency

[deyerlba]

I have just finished my first year of medical school and am considering the HPSP scholarship, leaning more towards air force. I had a few questions that I wondering if anyone would know the answer to.

First, I know there is a 5-weekish training required when beginning the program. But since I will not have another summer throughout medical school that is 5 weeks long, what would I have to do about that? Would they make me go to the training and miss school? Or is there some sort of substitute if you can't go?

Second, what is the competitiveness for military residencies? I am currently interested in Emergency Medicine. With no prior military service, what are the chances of getting a spot in a field like that? And if you don't get a spot, what are you options? Can you choose whether or not to do a civilian residency then come back or do some sort of GMO or flight surgery program?

I don't know much about the military or how it works, so I apologize if I am not explaining my questions very well. Thank You.

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[UltimateDO]

All of your questions are answered in the forum to some degree or another. I would suggest starting with the stickies above...that is what they are there for.

Just out of curiosity why are you considering HPSP if you don't know much about the military or how it works? You should absolutely, positively NOT take this scholarship for financial reasons only.

 

[colbgw02]

I don't know much about the military or how it works, so I apologize if I am not explaining my questions very well. Thank You.

For this reason alone, you should not do HPSP. If you educate yourself and still choose military medicine, then so be it. Otherwise, you have a very high likelihood of regretting your decision.

 

[deuist]

I have just finished my first year of medical school and am considering the HPSP scholarship, leaning more towards air force.

Don't do it. If you're a masochist and are dead set on a lifetime of disappoint, then you might consider taking the scholarship.

 

[BigNavyPedsGuy]

The bottom line is that by joining the military you would be giving up the final say in your choice of residency, specialty, where to live and what you do for a living. Don't do it unless you are OK with that.

 

[playaodamonth]

The bottom line is that by joining the military you would be giving up the final say in your choice of residency, specialty, where to live and what you do for a living. Don't do it unless you are OK with that.

Is this true even if I opt to do GMO to serve my HPSP commitment time and then get out to do a civilian IM residency?

 

[colbgw02]

Is this true even if I opt to do GMO to serve my HPSP commitment time and then get out to do a civilian IM residency?

To my knowledge, the military cannot force you to do a specific residency against your will. Internship? Yes. Residency? No.

That said, they don't want people retiring after 19 years in GMO land, so there is an expectation that you will do a residency eventually or separate. And, of course, there are all sorts of unofficial pressure that can be brought to bear, but a dean at a medical school can do the same thing.

I would imagine GMO tours do all sorts of crazy things to career plans. There are people whose GMO time just delayed their residency, and there are people who changed paths because of GMO time. I would think that some people choose less competitive fields in order to either avoid being a GMO altogether or to get out of GMO land ASAP, but there are also people who become competitive for specialties because of GMO time that they otherwise wouldn't have - be it in or out of the military.

 

[deuist]

Is this true even if I opt to do GMO to serve my HPSP commitment time and then get out to do a civilian IM residency?

Even as a volunteer GMO you still do not chose where to live, who to work with, when to deploy, or how ofter you must move.

 

[playaodamonth]

Even as a volunteer GMO you still do not chose where to live, who to work with, when to deploy, or how ofter you must move.

I'm perfectly fine with that. I grew up in a military family and lived in over 5 countries cause of it, had my parents both deploy for 8 months at a time, no biggie. Plus I'm single. My billet, when I deploy, and how often I PCS is up to the needs of the Navy and I support that 100%. I was just taken back by the "you are forced into a residency" statement. I only plan to fulfill my HPSP commitment via GMO tours and get out to go to a civilian IM residency. I don't see the downfall unless I'm missing something (i.e. forced into residency which I never heard of happening to anyone).

 

[deuist]

You won't be forced into residency. You are required to complete an internship so that you're eligible for licensure.

 

[colbgw02]

I don't see the downfall unless I'm missing something (i.e. forced into residency which I never heard of happening to anyone).

The "downfall" is that internship-trained independent practice hasn't been the standard in this country for decades. If you're lucky, you'll get stationed somewhere with a hospital/MTF nearby to refer out complex cases. If you're not, then you'll be forced to practice medicine beyond your training level, which opens up everybody to bad outcomes. It works out for almost everyone, meaning they come through it with an unblemished license, but a good outcome is not the result of a good decision in this instance.

 

[deuist]

You mention being single. I was single when I signed the contract 8 years ago. I'm just now starting my pay back. I'm also married and forcing my wife to give up her job so that we can move definitely puts a strain on the relationship. You also mention that you plan to get out and do IM. Can you really live on a $40,000 - $50,000 a year salary after making twice as much for 4 years? I would really love to do a fellowship in critical care, but I don't see that ever happening given the financial strain it would cause after my commitment is up. Just look at BigNavyPedsGuy. He had to give up pursuing a fellowship for similar reasons. This board is full of similar stories from people who had to give up their professional dreams courtesy of the military.

 

[playaodamonth]

You mention being single. I was single when I signed the contract 8 years ago. I'm just now starting my pay back. I'm also married and forcing my wife to give up her job so that we can move definitely puts a strain on the relationship. You also mention that you plan to get out and do IM. Can you really live on a $40,000 - $50,000 a year salary after making twice as much for 4 years? I would really love to do a fellowship in critical care, but I don't see that ever happening given the financial strain it would cause after my commitment is up. Just look at BigNavyPedsGuy. He had to give up pursuing a fellowship for similar reasons. This board is full of similar stories from people who had to give up their professional dreams courtesy of the military.

This is true. Although I do not plan on getting married anytime soon or anytime during my military career, you never know what could happen. The girl I'm currently dating is a SWO in the Navy so she understands the risks, so hopefully if I do end up with someone by then it'll be with her. Aside from that, although easier said than done, I think I could handle the transition from 100k to 45k for the remaining 2 years I'm in a civilian residency. It will be tough, but doable I think.

Is this drastic cut in pay so burdensome that it makes doing a 3-year fellowship so difficult to do?? Aren't those civilian med students who go straight into residency after graduating too have financial strains throughout residency and fellowship, especially with the loan debt?

 

[colbgw02]

Is this drastic cut in pay so burdensome that it makes doing a 3-year fellowship so difficult to do?? Aren't those civilian med students who go straight into residency after graduating too have financial strains throughout residency and fellowship, especially with the loan debt?

Lifestyle creep is a very real phenomenon. If you have the discipline to live off a fraction of your military pay, then the pay cut during civilian training won't sting nearly as much. Many, probably most, people can't do that though. Military medicine is filled with people who opted for the active duty fellowship because they couldn't stomach the pay cut.

 

[deuist]

Aren't those civilian med students who go straight into residency after graduating too have financial strains throughout residency and fellowship, especially with the loan debt?

Student debt is deferred during residency. And you try telling your wife that she needs to live like a pauper for 2-3 years during fellowship after she has seen what attendings make.

 

[denali]

Military medicine is filled with people who opted for the active duty fellowship because they couldn't stomach the pay cut.

...try telling your wife that she needs to live like a pauper for 2-3 years during fellowship after she has seen what attendings make.

THESE! Ignore at your own peril...