Navy or Army HPSP in 2016??

[ubertrooper60]

So I am a senior in university who has been fortunate enough to be accepted to medical school and will be attending in the fall. I am strongly considering the HPSP, but I just have a few aversions/questions. I know this has been posted many times on SDN, but things change over the years, and I would really appreciate your honest thoughts/opinions, particularly if you have been through either.

Why should I pick one branch over the other? I know the Army is larger and less competitive, which means more residency spots and the likelihood of me getting the specialty I would want. It also means likely not doing a GMO tour following medical school. However, some of their locations are bases essentially in the middle of nowhere. The Navy, on the other hand, is smaller, which means more competition. I may have to do a GMO tour with them. Yet, their base locations are more lucrative. I also really like the humanitarian and service oriented mission of the Navy, which seems more prevalent than the Army. I also think it could be fun to travel on a ship for awhile.

However, my biggest trepidation right now is the GMO tour. My recruiter and other military docs have informed me that tour is the time to do some pretty awesome things, like flight school, dive medicine, serving with the Marines, etc. I've been told I would most certainly not be simply taking care of runny noses for two years. I understand the GMO's are still the grunts in the military medicine world, but what exactly would such a tour be like? Will I be doing boring stuff for two years? Can you do all the awesome things I mentioned? Did you like your GMO time? I've heard it can be a nice, refreshing break from the constant grind of the medical training process, similar to a gap year.

It's also worth mentioning that I am fortunate enough to have no undergrad debt, and my family has essentially no money at all. I know finances are not necessarily the reason to do HPSP, but the financial ease of mind during medical school and having no debt at all is hard to pass up, even if I won't make as much during my payback years post-residency.

Is military medicine really that bad/controlling/freedom restricting?

I am really, really strongly considering the HPSP, but I want to get more opinions and advice.

What are your thoughts? Which branch, and why?

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[HighPriest]

Do FAP.

 

[pgg]

Where are you going to med school? Whether or not HPSP is a good deal depends a lot on whether you're going to an in-state public school or a private DO school or super expensive Ivy.


Army has GMO tours too - they just call them "brigade surgeon" tours and they get done after residency. That may be better or worse than Navy GMO time.


The vast, vast majority of Navy medical personnel never do any meaningful humanitarian work. I would not join any branch of the military expecting to have that opportunity.

 

[turkish]

Do not join the Army unless you want to deploy to a combat zone out of your speciality. If you are thinking about it any other way, you will be sorely disappointed, or worse yet, you will try to evade this responsibility and cause the rest of us to have to go more often.

The US Army is a worldwide deployable destructive force, a killing machine that takes no breaks, and does not care about your specialty or situation. It is truly awesome at what it does, but you are a warm body, and you will be required to participate. You should come into this with the correct expectations.

I cannot personally vouch for or against the navy, but my experience working with them has been that they don't deploy out of specialty, and rarely deploy subspecialists at all.

 

[ubertrooper60]

@HighPriest What about the financial ease of mind during medical school and residency? Having the monthly stipends plus the sign on bonus is pretty nice, and I would also get paid more during residency. Sure, I will probably make half of my civilian counterparts after residency, but if that turns out to be that horrible, I can leave after my payback years. And I would do so completely debt free, from both undergrad and medical school.

Medical school and residency take up a lot of years, and I have no semblance of family money to rely on at all, so having financial freedom then would be pretty nice.

Can anyone comment on what a Navy GMO tour is like?

 

[BlackFrancis33]

Devil's advocate time. I think there are some reasons to join the Army over the Navy. More and more I seem my Navy colleagues practicing in admin sorts of jobs so that they can make the next rank. We are being told that to make O-6 in the Army we will have to show career progression, but if you do your rank appropriate training promotion to at least O-5 is very likely if you are 'just a doc' (imagine this last bit said with intense sarcasm). Again, in my opinion this is worse in the Navy when I compare myself to my colleagues. The threat of a brigade surgeon tour is very real for all of us in the Army, but at least you get both specialty pays during that 2-3 year hiatus from your specialty. The Navy is cutting back on subspecialists faster than the Army, Peds is the most obvious example I have seen. If you look at the GMO tour it is a way to get paid less during the entirety of your payback. If you look at me (Army) compared to my Navy friends who graduated from USU the same year, 7 years after residency I have been receiving both specialty pays all 7 years. My Navy colleagues who did a GMO, then residency in the middle then, 2-5 years of payback only received both pays for 2-5 years. HPSP changes that calculus a little, let's say you do a 2 year GMO, 4 year residency, and owe a 2 year payback after residency, then you are still getting screwed for 2 of the 4 years of payback time (in my opinion). USUHS did a good job of brainwashing my Navy classmates that a GMO was a good thing, but to me it seems like a waste of 2-4 years of your life when you could be finishing training.

 

[Homunculus]

So I am a senior in university who has been fortunate enough to be accepted to medical school and will be attending in the fall. I am strongly considering the HPSP, but I just have a few aversions/questions. I know this has been posted many times on SDN, but things change over the years, and I would really appreciate your honest thoughts/opinions, particularly if you have been through either.

Why should I pick one branch over the other? I know the Army is larger and less competitive, which means more residency spots and the likelihood of me getting the specialty I would want. It also means likely not doing a GMO tour following medical school. However, some of their locations are bases essentially in the middle of nowhere. The Navy, on the other hand, is smaller, which means more competition. I may have to do a GMO tour with them. Yet, their base locations are more lucrative. I also really like the humanitarian and service oriented mission of the Navy, which seems more prevalent than the Army. I also think it could be fun to travel on a ship for awhile.

However, my biggest trepidation right now is the GMO tour. My recruiter and other military docs have informed me that tour is the time to do some pretty awesome things, like flight school, dive medicine, serving with the Marines, etc. I've been told I would most certainly not be simply taking care of runny noses for two years. I understand the GMO's are still the grunts in the military medicine world, but what exactly would such a tour be like? Will I be doing boring stuff for two years? Can you do all the awesome things I mentioned? Did you like your GMO time? I've heard it can be a nice, refreshing break from the constant grind of the medical training process, similar to a gap year.

It's also worth mentioning that I am fortunate enough to have no undergrad debt, and my family has essentially no money at all. I know finances are not necessarily the reason to do HPSP, but the financial ease of mind during medical school and having no debt at all is hard to pass up, even if I won't make as much during my payback years post-residency.

Is military medicine really that bad/controlling/freedom restricting?

I am really, really strongly considering the HPSP, but I want to get more opinions and advice.

What are your thoughts? Which branch, and why?

these are all answered more or less in the forum. cliffs notes version (wow, now that i finish this isn't cliffs notes as much as abridged):

Army v. Navy. Army has bigger GME, sneaks the congressionally mandated to be eliminated GMO tour as a "brigade surgeon" or "flight surgeon" or "WTU surgeon" tour, and you very much are not doing anything "awesome." or if you are, the "awesome" thing will likely not balance the rest of the admin crap. The army has bases in crappier locations. The navy has bases near water, which humans tend to be drawn to, and therefore tend to be more civilized. they aren't "lucrative" since your BAH will be adjusted but that's about it. do not expect to get rich off your 1-2k per month higher BAH.

do NOT joint for the "humanitarian mission" line. all the recruiters must sell HPSP from a script, like a car or hot tub salesman. my wife fell for the humanitarian line. these are so rare, that when they do occur (ebola, for example) ID and other people will take them before you will. and, (shocking) the humanitarian game is primarily a NGO one. or the CDC. no one wants the military showing up due to all the baggage we bring along (deserved or not). we may have a lot of resources to bring to bear, but people who have done this their whole lives are much better at it. the opportunities will be fleeting and mostly done for political gain/dog and pony show reasons and have little lasting impact (see, navy hospital ships). also, "travel on a ship for awhile" takes on a new meaning when you are responsible for the medical care of the people onboard. i imagine it's like a floating FOB-- 24/7 call and you are it (after a year of an internship, naturally). if this does not stress you out you need to find a different career.

financially, HPSP changes depending on the cost of your school. years of life vs a monthly payment is a personal decision. which, you do not mention spouse/kids. you'll be making this decision now, but paying it off in 7 or more years. if you have a professional spouse, are they ok being non employed or underemployed for your payback? are you ok leaving your infant or young children for several months (year?) at a time? are your children's schools important? all things to potentially consider. you alone aren't paying your ADSO, your family will be paying it, too.

military medicine bad/controlling/freedom restricting? depends. you are limited on moonlighting. you are limited when/if you can take leave. you can't travel on a weekend outside a certain radius without taking leave. OCONUS travel requires over a month of planning and clearances. do you have any entrepreneurial aspirations? not gonna happen. protected research time? only if you carve it out yourself. want to avoid committees and admin? good luck when you are told by your boss that's one of your new responsibilities. are these horrible things to deal with? each alone, not so much. but added together it's the definition of death by a thousand cuts.

upside? "debt free" (financially), GI bill transfer, military discounts, and TSA precheck. used to be CME, which may be slowly coming back. no employees to manage (but also good luck firing them). you are plug and play and can move here/there and transition roles without too much hassle. pay per patient is probably higher than the civilian side, but at the same time the more you work, the less your hourly pay becomes. oh, and if you make it to 20, the cliff style retirement cheese is there. but that is not calculated using any of your medical pays so you will make the same as any other retired O5 or O6. one last turn of the anti-medical screw.

it always comes down to the same issues, and unfortunately there are no easy answers. only best guesses. some people have charmed careers, get the training they want, homestead or get the duty stations they want, get promoted, and are happy as clams and retire and come back as GS to milk the system some more. these people tend to be the previous "generation" that made most of their hay right pre 9/11 or right after and are currently our leadership. my generation, the ones that were in when 9/11 happened but signed up prior, have seen the whole system turn on its head. we got screwed early in our careers with GMOs, later with deployments, and now again with brigade surgery tours. the newest generation, the post 9/11 crowd, seem much more informed overall and at least have us to look at as guinea pigs. we make decent mentors for them in this environement, unfortunately for my crowd, our mentors have no idea what we are going through. they all made O6 without much work, but if we want to even sniff it we have to have ILE, "career progression", operational tours, and the like. which is why if i stay in long enough i'm totally fine being a terminal O5.

good luck with your decision, and should you end up joining please continue to post on your experience. good to have people from all walks in the forum.

--your friendly neighborhood therapeutic more than cliffs notes i guess caveman

 

[Red Lobster Actual]

@HighPriest What about the financial ease of mind during medical school and residency? Having the monthly stipends plus the sign on bonus is pretty nice, and I would also get paid more during residency. Sure, I will probably make half of my civilian counterparts after residency, but if that turns out to be that horrible, I can leave after my payback years. And I would do so completely debt free, from both undergrad and medical school.

Medical school and residency take up a lot of years, and I have no semblance of family money to rely on at all, so having financial freedom then would be pretty nice.

Can anyone comment on what a Navy GMO tour is like?

Have you read through the stickies? It is a lot but there are quite a few experiences in there that others have written. It also might be worth finding someone that has gone through this in real life. There was at least half a dozen attendings in my undergrad institute that went through HPSP. Look them up and reach out to them. Their faculty biographies are generally not explicit but if it says they did their residency training at a military facility chances are good they are veterans.

Also, it seems like you already made your decision and you are looking at strangers to validate your decision...however I will pass onto you what an old retired Navy captain laconically told me a few years ago when I asked him the same question you are asking.

Him: Were you born with a silver spoon?
Me: No.
Him: You should probably join the Navy.

I think he passed away shortly after that...but I digress. Military service may be many things but one thing that almost never changes about it is that it allows gutter trash peasants like you and me (at least from what you said) to climb the socioeconomic ladder since the days of antiquity. That's my take on it at least.

Have you actually calculated the "financial ease of mind" you are talking about? This thread is worth a look with the added benefit of it being only a few years old:
http://forums.studentdoctor.net/threads/hpsp-is-financially-worth-more-than-what-people-say.1066502/

White Coat MD made a few financial arguments about HPSP as well (He was Air Force HPSP now EM doc), might want to check out his webpage.

Good luck on your decision! And congrats on getting into medical school!

 

[Chonal Atresia]

these are all answered more or less in the forum. cliffs notes version (wow, now that i finish this isn't cliffs notes as much as abridged):

Army v. Navy. Army has bigger GME, sneaks the congressionally mandated to be eliminated GMO tour as a "brigade surgeon" or "flight surgeon" or "WTU surgeon" tour, and you very much are not doing anything "awesome." or if you are, the "awesome" thing will likely not balance the rest of the admin crap. The army has bases in crappier locations. The navy has bases near water, which humans tend to be drawn to, and therefore tend to be more civilized. they aren't "lucrative" since your BAH will be adjusted but that's about it. do not expect to get rich off your 1-2k per month higher BAH.

do NOT joint for the "humanitarian mission" line. all the recruiters must sell HPSP from a script, like a car or hot tub salesman. my wife fell for the humanitarian line. these are so rare, that when they do occur (ebola, for example) ID and other people will take them before you will. and, (shocking) the humanitarian game is primarily a NGO one. or the CDC. no one want the military showing up due to all the baggage we bring along (deserved or not). we may have a lot of resources to bring to bear, but people who have done this their whole lives are much better at it. the opportunities will be fleeting and mostly done for political gain/dog and pony show reasons and have little lasting impact (see, navy hospital ships). also, "travel on a ship for awhile" takes on a new meaning when you are responsible for the medical care of the people onboard. i imagine it's like a floating FOB-- 24/7 call and you are it (after a year of an internship, naturally). if this does not stress you out you need to find a different career.

financially, HPSP changes depending on the cost of your school. years of life vs a monthly payment is a personal decision. which, you do not mention spouse/kids. you'll be making this decision now, but paying it off in 7 or more years. if you have a professional spouse, are they ok being non employed or underemployed for your payback? are you ok leaving your infant or young children for several months (year?) at a time? are your children's schools important? all things to potentially consider. you alone aren't paying your ADSO, your family will be paying it, too.

military medicine bad/controlling/freedom restricting? depends. you are limited on moonlighting. you are limited when/if you can take leave. you can't travel on a weekend outside a certain radius without taking leave. OCONUS travel requires over a month of planning and clearances. do you have any entrepreneurial aspirations? not gonna happen. protected research time? only if you carve it out yourself. want to avoid committees and admin? good luck when you are told by your boss that's one of your new responsibilities. are these horrible things to deal with? each alone, not so much. but added together it's the definition of death by a thousand cuts.

upside? "debt free" (financially), GI bill transfer, military discounts, and TSA precheck. used to be CME, which may be slowly coming back. no employees to manage (but also good luck firing them). you are plug and play and can move here/there and transition roles without too much hassle. pay per patient is probably higher than the civilian side, but at the same time the more you work, the less your hourly pay becomes. oh, and if you make it to 20, the cliff style retirement cheese is there. but that is not calculated using any of your medical pays so you will make the same as any other retired O5 or O6. one last turn of the anti-medical screw.

it always comes down to the same issues, and unfortunately there are no easy answers. only best guesses. some people have charmed careers, get the training they want, homestead or get the duty stations they want, get promoted, and are happy as clams and retire and come back as GS to milk the system some more. these people tend to be the previous "generation" that made most of their hay right pre 9/11 or right after and are currently our leadership. my generation, the ones that were in when 9/11 happened but signed up prior, have seen the whole system turn on its head. we got screwed early in our careers with GMOs, later with deployments, and now again with brigade surgery tours. the newest generation, the post 9/11 crowd, seem much more informed overall and at least have us to look at as guinea pigs. we make decent mentors for them in this environement, unfortunately for my crowd, our mentors have no idea what we are going through. they all made O6 without much work, but if we want to even sniff it we have to have ILE, "career progression", operational tours, and the like. which is why if i stay in long enough i'm totally fine being a terminal O5.

good luck with your decision, and should you end up joining please continue to post on your experience. good to have people from all walks in the forum.

--your friendly neighborhood therapeutic more than cliffs notes i guess caveman

Well said!

EVERY prospective HPSP student should read this blog multiple times. Even then, I don't think most would know what truly lies ahead. This fact is what "the machine" counts on and how they win.

 

[68PGunner]

So I am a senior in university who has been fortunate enough to be accepted to medical school and will be attending in the fall. I am strongly considering the HPSP, but I just have a few aversions/questions. I know this has been posted many times on SDN, but things change over the years, and I would really appreciate your honest thoughts/opinions, particularly if you have been through either.

Why should I pick one branch over the other? I know the Army is larger and less competitive, which means more residency spots and the likelihood of me getting the specialty I would want. It also means likely not doing a GMO tour following medical school. However, some of their locations are bases essentially in the middle of nowhere. The Navy, on the other hand, is smaller, which means more competition. I may have to do a GMO tour with them. Yet, their base locations are more lucrative. I also really like the humanitarian and service oriented mission of the Navy, which seems more prevalent than the Army. I also think it could be fun to travel on a ship for awhile.

However, my biggest trepidation right now is the GMO tour. My recruiter and other military docs have informed me that tour is the time to do some pretty awesome things, like flight school, dive medicine, serving with the Marines, etc. I've been told I would most certainly not be simply taking care of runny noses for two years. I understand the GMO's are still the grunts in the military medicine world, but what exactly would such a tour be like? Will I be doing boring stuff for two years? Can you do all the awesome things I mentioned? Did you like your GMO time? I've heard it can be a nice, refreshing break from the constant grind of the medical training process, similar to a gap year.

It's also worth mentioning that I am fortunate enough to have no undergrad debt, and my family has essentially no money at all. I know finances are not necessarily the reason to do HPSP, but the financial ease of mind during medical school and having no debt at all is hard to pass up, even if I won't make as much during my payback years post-residency.

Is military medicine really that bad/controlling/freedom restricting?

I am really, really strongly considering the HPSP, but I want to get more opinions and advice.

What are your thoughts? Which branch, and why?

Join the Army Reserve after your residency. You will thank me later. Being an active duty doc sucks a$$. The money isn't worth it considering the number of available loan forgiveness programs out there.

 

[HighPriest]

@HighPriest What about the financial ease of mind during medical school and residency? Having the monthly stipends plus the sign on bonus is pretty nice, and I would also get paid more during residency. Sure, I will probably make half of my civilian counterparts after residency, but if that turns out to be that horrible, I can leave after my payback years. And I would do so completely debt free, from both undergrad and medical school.

Medical school and residency take up a lot of years, and I have no semblance of family money to rely on at all, so having financial freedom then would be pretty nice.

Can anyone comment on what a Navy GMO tour is like?

You'll find plenty of ways to pay off your student debt without the military. Be at ease knowing that most physicians don't take the military route, and most are not starving. What you should be is worried that you'll not be able to match into the specialty of your choice because the DOD says so, or that you'll be forced into an operational slot after residency because the DOD says so, or that you'll end up living in the @$$hole of the world watching your skills slowly rot away because the DOD says so.
If you do the FAP, you can let the military pay back your debts once you actually know what it means to be a physician, and when you have a realistic idea of what you might be giving up.

Plus, unless you know 100% that you're going into primary care (and you don't), the fiscal numbers for subspecialists still weigh towards not using a DOD route to pay for anything.

I strongly echo what has been said above: humanitarian missions are a red herring. They occur, and the military does occasionally get involved - usually when there has been massive loss of life and more specifically the imminent threat of additional loss of life due to precarious situations on the ground (during E-bola, after the tsunamis, etc.). But as mentioned, most people don't want the military to be involved. People look at us as an invasion force. You can like that or not, but they do. It probably has something to do with the huge war machines that we ride around on, or the fact that we spend 99% of our time training to kill as many people as possible. So if there's a tsunami in England where the US has been viewed as friendly for the last 250 years, then we'll get open arms. If there's a problem in the third world (where the vast, vast majority of issues occur), then we're viewed with a heaping helping of suspicion. Thus, we rarely get involved and if we do, as mentioned, you're always going to lose out a spot to someone more senior.

 

[Red Lobster Actual]

. So if there's a tsunami in England where the US has been viewed as friendly for the last 250 years, then we'll get open arms.

Weren't we at war with England 250 years ago? We have been friendly with the Moroccans for the past 250 years though.

 

[HighPriest]

Weren't we at war with England 250 years ago? We have been friendly with the Moroccans for the past 250 years though.

True enough I -think- I mean to type 150, but who the %&(* knows what was going through my mind. I kind of go red when I'm talking about military medicine. That being said we haven't had a war with Pakistan either, but I don't think they like us.

 

[ubertrooper60]

Thank you for all your replies. It really is very helpful information, and I have a lot to consider. I'm going to lay out how I envision a potential career path as, say, a Navy HPSP student. Please fill me in on if this seems far too naive or if I am still missing rather large important points.


I will enter medical school next fall, and at some point, have to do several weeks of officer training. I will also, likely during 4th year, have to do 2 or 3 elective rotations at Navy facilities. That will be my only commitment in medical school. All the while, I'll have had the good fortune of a generous stipend and a sign on bonus that will really help financially in the near future.

Then, I will apply for either a Navy residency if they offer my chosen specialty (at this point, I don't see myself wanting to go very deep into any subspecialty), or a civilian deferment if they don't. If I am not granted either of those, I will do a GMO tour for two years. My understanding of the GMO tour is that it is the time when I could do cool things like flight medicine, dive medicine, serve with the Marines, etc, even though my actual medical work will be somewhat boring I am sure.

After my GMO tour, I would be more competitive for the Navy residency specialty of my choosing, probably near the water. At this point, hopefully I'll get it. If I do, I would then do, say, a 4 year residency for my specialty. During this time, I will also be paid fairly handily for a medical resident, at least compared to my civilian counterparts.

After my residency training, I will then enter my payback years, and I believe there would be 4 of them. During this time, I would serve at some Naval facility practicing my specialty. I will be paid substantially less than my civilian counterparts during these years. There is also the high probability that I will be deployed somewhere, potentially on a ship. If I am on a ship, I would likely be the only doc there, and it would be pretty stressful I imagine. However, something about being on a ship I think would be fun to a degree. It would at least be an interesting experience.

After those 4 years, I would have the option of then leaving the Navy. I would be around 37 or 38 years old at this time. If I do so, I would go to the civilian world and make a much higher wage, completely debt free. Or I could stay with the Navy if I love it and work toward a pretty lucrative retirement package.


Is there anything I am still missing? Is doing medicine on a ship or at a Naval base really that bad? Medicine in general seems fairly restricting, just based on how hard I'll have to work, so is it that much worse with the military? Am I wrong in my interpretation of a GMO? I currently am incredibly single, and my thought is that I can only look so far ahead. Maybe I won't meet anyone. Maybe I do, and they're stoked about my Navy status. Who knows? Am I still really naive about all this?

 

[ubertrooper60]

Also, sorry about all the posts, but I really do appreciate you all helping me out. This is a huge decision, and I had heard a lot of positive things from other docs and students before coming on SDN, but I just really wanna make sure I cover all my bases.

 

[Red Lobster Actual]

After my GMO tour, I would be more competitive for the Navy residency specialty of my choosing, probably near the water. At this point, hopefully I'll get it. If I do, I would then do, say, a 4 year residency for my specialty. During this time, I will also be paid fairly handily for a medical resident, at least compared to my civilian counterparts.

You have one more option. Go 4 years of GMO and apply to match into a civilian program the year before you separate and collect on Montgomery GI Bill while in residency. My mentors during my pre-med days all did that and was my original plan too.

I currently am incredibly single, and my thought is that I can only look so far ahead. Maybe I won't meet anyone. Maybe I do, and they're stoked about my Navy status. Who knows? Am I still really naive about all this?

Girlfriends are much more likely to follow you around if you're in the Navy, less so in the Army.

On a side note my mentor described to me his only regret in taking HPSP was being separated from his wife while GMO'ing for a few years in Diego Garcia.

 

[pgg]

That was a basically accurate summary, in broad terms.

Specific things I would correct:

Then, I will apply for either a Navy residency if they offer my chosen specialty (at this point, I don't see myself wanting to go very deep into any subspecialty), or a civilian deferment if they don't. If I am not granted either of those, I will do a GMO tour for two years. My understanding of the GMO tour is that it is the time when I could do cool things like flight medicine, dive medicine, serve with the Marines, etc, even though my actual medical work will be somewhat boring I am sure.

Civilian deferments are uncommon, and hard to predict. Flight and dive GMO tours are 3 years.

After my residency training, I will then enter my payback years, and I believe there would be 4 of them.

This is a little complicated. The obligation after an inservice (military) residency is the longer of
1) your remaining HPSP or USUHS obligation, or
2) the length of your residency

If you owed 4 years for HPSP, did an internship (still owe 4), spent two years as a GMO (now owe 2), and did a 4 year residency, you would owe 4 years at that point.

If you owed 4 years for HPSP, did an internship (still owe 4), spent three years as a GMO (now owe 1), and did a 4 year residency, you would still owe 4 years.

If you owed 4 years for HPSP, did an internship (still owe 4), did NOT do a GMO tour but went right to a 4 year residency, you would still owe 4 years.

The key is that HPSP and residency obligations are served concurrently, so the GMO tour is effectively a backdoor that squeezes extra payback years out of you if you ultimately decide to do an inservice residency. Be sure you understand these things about GMO tours:
1) They are a delay in completing your training.
2) The extra years of obligated time you end up serving at GMO-Navy-doctor wages, not residency-trained-Navy-doctor wages.
3) Perhaps the hardest for pre-meds to grasp and appreciate, the risk of practicing in the GMO environment as an incompletely trained physician. In fairness, this is a controversial subject. My opinion is that the risk is real and the burden on GMOs is inappropriate, but others disagree.

You can do some fun stuff as a GMO, or it might be a swirling vortex of suck. I had a good time as a GMO and look back at it as a basically good time in my life, but I know people who were justifiably miserable because of the particular job and CO they had.

Another option:

If you owed 4 years for HPSP, did an internship (still owe 4), spent four years as a GMO, then you could get out of the Navy and complete residency as a civilian. Many people do this and generally find that they are well received by civilian residency programs.

During this time, I would serve at some Naval facility practicing my specialty. I will be paid substantially less than my civilian counterparts during these years. There is also the high probability that I will be deployed somewhere, potentially on a ship. If I am on a ship, I would likely be the only doc there, and it would be pretty stressful I imagine. However, something about being on a ship I think would be fun to a degree. It would at least be an interesting experience.

There are relatively few physicians serving on ships in the Navy. Most ships don't have doctors. Most of the ships that do have doctors, need GMOs not specialists. The ships that are left tend to be carriers of one variety or another. There's not a lot of medical work to do on them, generally speaking.

The vast majority of Navy physicians serve the vast majority of their time on land at Navy hospitals, or with the Marines. Deployments the last 15 years have mostly been to landlocked deserts.

 

[HighPriest]

Girlfriends are much more likely to follow you around if you're in the Navy, less so in the Army.

Those are technically called "marines," but it's a new DOD so have at it.

 

[Red Lobster Actual]

Those are technically called "marines," but it's a new DOD so have at it.

On the other hand that explains why I haven't found my Hooters girlfriend yet.

 

[Homunculus]

Thank you for all your replies. It really is very helpful information, and I have a lot to consider. I'm going to lay out how I envision a potential career path as, say, a Navy HPSP student. Please fill me in on if this seems far too naive or if I am still missing rather large important points.

All the while, I'll have had the good fortune of a generous stipend and a sign on bonus that will really help financially in the near future.

your good fortune and generous stipend are purchased with years of your life. this is the hook, like a "12 months no payments" financing on an expensive car. with what you will be evantually paying, I hope that yes, it would be good financially.

if they offer my chosen specialty(at this point, I don't see myself wanting to go very deep into any subspecialty) or a civilian deferment if they don't.

you don't see yourself wanting to subspecialize, but what if you do? can you live with the past version of yourself screwing the future version of yourself? it's all about options. money may not be as important now, but staring down a primary care field for 30 years may look different then.

that it is the time when I could do cool things like flight medicine, dive medicine, serve with the Marines, etc, even though my actual medical work will be somewhat boring I am sure.

if you are lucky it will be boring. what "cool" things do you suspect will be happening?

hopefully I'll get it.

yes, hopefully. but if not?

I would serve at some Naval facility practicing my specialty. I will be paid substantially less than my civilian counterparts during these years. There is also the high probability that I will be deployed somewhere, potentially on a ship. If I am on a ship, I would likely be the only doc there, and it would be pretty stressful I imagine. However,

something about being on a ship I think would be fun to a degree. It would at least be an interesting experience.

what do you think would be "fun?" honestly just asking-- this may help you figure this out. also-- many things can be "interesting." that does not necessarily make them worthwhile.

lucrative retirement package.

1- not sure what "lucrative" means but you may want to check the pay tables. you won't be retiring at 46 and living it up in paradise on 50% of an O6 salary. remember, medical pays don't count for this.

currently am incredibly single

this definitely changes the equation. perhaps you will meet your future spouse in the navy and you'll add that to the "well, that's a positive about the military" (like I did). or perhaps your pre navy spouse won't adjust to the transition well and you'll get divorced during residency (like mine did). like I said-- it's a decision you are making for your future self and future family.

Am I still really naive about all this?

yes, but it's not your fault. no one can predict this many variables. I think you should evaluate what is "cool", "fun", "interesting", and what may be meaningful to you in your 30's that you haven't quite hit yet in your 20's (geographic stability, family situation, income potential, schools, etc). everyone likes "adventure" in their younger days. spouses and kids and realizing your own mortality sometimes tweaks that a bit.

--your friendly neighborhood fun loving cool and interesting caveman

 

[ubertrooper60]

In regard to "trading years of your life" for generous financial incentives during med school and residency, how bad is Army or Navy medicine though? I mean it's not like I'm going to prison for 4 or 5 years in exchange for the money. I guess being a military doctor just doesn't seem that bad to me, so I don't view it as "trading years of my life". But I could be totally wrong with that. Why is it considered so much worse than practicing civilian medicine?

In regard to subspecializing, why can't I do that? I mean I know spots are more limited, but I could always do a general residency, serve my time with the military, and then subspecialize in the civilian world if I really do discover that's a passion of mine. I really think I would like something more broad though, like trauma surgey, EM, Internal Med, etc. I don't think I want to subspecialize simply because it seems more boring to me in that the kinds of things I'd see regularly would be essentially the same thing.

I really like the idea of doing flight or dive medicine or serving with the Marines for a little while, I think. I am an adventurous sort of person, and I think that would be fun. That is my interpretation of what I could do for my GMO time. Is that wrong?

In regard to being on a ship, I have always loved being on the water. I know that seems pretty stupid because everyone loves water and being on a ship for 9 months is not the same as boating off the beach. But being on a Naval ship comes with the opportunity to dock at new places around the world and to be part of likely a great community. I can't really pinpoint why I think I would like it, but I believe I would. Anything I'm missing that would actually just make it totally suck?

As for a girlfriend, my thought is you can't really call that sort of thing at any point in life. Like I said, I may never meet anyone or she might be thrilled that I am in the Navy. And if she's not, maybe it wasn't meant to be, you know?

Idk I guess I am just having a hard time seeing what is so bad about it all. To a degree, in the field of medicine, no one really has as much choice as they want, at least not until later in the career. And if I find it's really that horrible, it's all temporary right? I can enjoy financial ease of mind during medical school and residency and then serve my miserable 4 years. Then, I can leave and go back to the civilian world totally debt free (which is pretty great considering the current expense of medical school and the interest rates on loans).

 

[HighPriest]

In regard to "trading years of your life" for generous financial incentives during med school and residency, how bad is Army or Navy medicine though? I mean it's not like I'm going to prison for 4 or 5 years in exchange for the money. I guess being a military doctor just doesn't seem that bad to me, so I don't view it as "trading years of my life". But I could be totally wrong with that. Why is it considered so much worse than practicing civilian medicine?

Read the forum. This is basically the topic of 75% of the threads.

In regard to subspecializing, why can't I do that? I mean I know spots are more limited, but I could always do a general residency, serve my time with the military, and then subspecialize in the civilian world if I really do discover that's a passion of mine. I really think I would like something more broad though, like trauma surgey, EM, Internal Med, etc. I don't think I want to subspecialize simply because it seems more boring to me in that the kinds of things I'd see regularly would be essentially the same thing.

You may or may not want to specialize at some point. Some people like it, some don't. You can, technically, do a "general residency" and then specialize after your commitment. The vast majority of people who delay their training never do this, however. There are always exceptions, but you should plan for what is likely. Additionally, the issue isn't that you CAN do it when you finish, but that you might want to do it and be unable to do it. You may not believe it now, but some people end up in a specialty where they discover that they really don't like a lot of what they do. They love a small amount of what they do, and they just get irritated dealing with everything else. If that ends up being you (and I promise you that you cannot predict it), you're going to have a bad time if you can't specialize because the Army says so.

In regard to being on a ship, I have always loved being on the water. I know that seems pretty stupid because everyone loves water and being on a ship for 9 months is not the same as boating off the beach. But being on a Naval ship comes with the opportunity to dock at new places around the world and to be part of likely a great community. I can't really pinpoint why I think I would like it, but I believe I would. Anything I'm missing that would actually just make it totally suck?

This is a Thai Ladyboy thing, isn't it? Dude, just buy a ticket to Thailand and get it out of your system.

As for a girlfriend, my thought is you can't really call that sort of thing at any point in life. Like I said, I may never meet anyone or she might be thrilled that I am in the Navy. And if she's not, maybe it wasn't meant to be, you know?

Yeah, don't get hung up on that. BBC anyway, yo.

Idk I guess I am just having a hard time seeing what is so bad about it all. To a degree, in the field of medicine, no one really has as much choice as they want, at least not until later in the career. And if I find it's really that horrible, it's all temporary right? I can enjoy financial ease of mind during medical school and residency and then serve my miserable 4 years. Then, I can leave and go back to the civilian world totally debt free (which is pretty great considering the current expense of medical school and the interest rates on loans).

To a degree, no one in life has as much choice as they want. But at least a man with legs can go for a run. Yes, military life is temporary, but it is long enough to ruin your skillset, leaving you unfit for duty elsewhere. It is long enough to put you in a worse situation financially than you would otherwise be in (potentially). It is long enough that you may come to regret your decision for years before you're free. There are two possibilities here: 1: you are exactly the right candidate for military medicine because nothing ever bothers you and you don't mind putting your head down and remaining intentionally oblivious or 2: you are incredibly naïve. Just understand that the latter is far, far more common. Read more threads. Also: you will pay off your loans regardless. I just had a conversation with my partner this week about it. He's military. His wife is a civilian general surgeon. She's paying off all of her loans on a monthly basis. His statement was: it's a lot of money out the window every month, and we don't even notice it relative to her total income. He regrets joining the military every day, mostly because of the deal his wife has. In my opinion, deciding that DOD medicine is a good idea because you don't worry about finances during medical school or residency is similar to electing Hitler so that you feel safe from the Bolsheviks. There were a few great years there in the 30's...

 

[pgg]

WRT sailing around the world and visiting new places -

The vast majority of Navy doctors never do. Those opportunities are scarce. I can count the number of days I've spent aboard a ship in the last ~14 years using only my fingers and toes.

It does happen. The hospital ship Comfort recently got back from a humanitarian trip. Getting a deployment like that however isn't something one can really control.

If you want to travel and see the world, you'll likely do it on vacation, just like the doctors who work for Kaiser. There are good reasons for joining the military, but travel isn't one of them.

Tuition assistance isn't a great reason, but it's not itself a terrible reason. I think the people on the forum are a little too quick to dismiss the financial benefits and tell applicants to just get loans.

The best reason to join is if you want to be in the military. Just be sure that the reasons you're attracted to military service are things that reflect reality.

I'm not trying to talk you out of joining - we need people to join who want to be with us. But we want those people to know what they're actually getting, because few things suck more than working with a perpetually angry and bitter colleague who feels he was bait-n-switched by the service.

Be sure you thoroughly understand the GME system and its opportunities/limitations before joining.

 

[HighPriest]

I don't necessarily recommend that people take out loans. I recommend that people consider taking out loans, and that they don't quickly dismiss the idea of taking out loans. The problem is that people don't usually come on to the forum with the attitude that they're planning on taking out loans, but they'd like to be talked into doing military medicine. They come on feeling that military medicine is the right choice for them, and they're looking for alternative viewpoints. Or they come on to the forum with the idea that if they don't find someone to pay for their medical school, then they simply can't go to medical school. That's an important perspective when it comes to crafting a discussion.

There's this gestalt that no matter what you do, your student loans are going to be this horrific yeti following you around for decades after you finish residency. That simply isn't true in many, many cases. Military service CAN take care of your student debt. But there are other options to include loan repayment programs, simply paying your loans out of pocket if you're in a field with higher reimbursement, or things like FAP. The military isn't free medical school. It's medical school paid for with decreased pay, decreased personal freedom, a real chance of having your skillset destroyed before you separate, and most importantly a pound of flesh. As you've stated, financial aid is helpful in balancing that scale, but it isn't enough. You really do need to want to be in the military. You really do need to feel like you're doing something meaningful for your country, your family, or yourself. You really do need to have the type of personality with which you can put your head down and not really care about the inefficiency and ridiculousness around you (which is not easy for most "type A" people.) Even then, there's a real chance that you'll find out that wasn't enough to be happy in the military, but it's the best start you can ask for. After that, it's just pure chance as to whether you'll get your residency, your fellowship, a good post, a non-operational job throughout the course of your service, etc., etc.

But the idea that the military is right for you because they pay for your debt and "hey, it doesn't seem so bad" is not the right attitude. That is going to lead to a very, very bad day.

 

[ubertrooper60]

Thanks again everyone. I really do appreciate it, even if I clearly am coming off as naive and stupid.

I would like to say that my attitude is not purely "hey, it doesn't seem so bad". I was really excited about the prospect of being in the military, regardless of medicine. Serving my country is both exciting, worthwhile, and hopefully rewarding. I have a lot of respect for those in the military, and quite frankly, I'd be honored to be among them, particularly to serve them medically.

That being said, there are certainly a lot of pros and cons to making this decision, many of which have been covered already. I am definitely a type A person. I have been lucky enough to attend a prestigious undergrad university and am looking at some top programs for medical school as well, which is a good position to be in. Regardless of military, I am not sure of what direction I want my career to go, in terms of specialty, academia, public/global health work, research, private practice vs. hospital, etc. What I do know, however, is that I certainly aim to be damn good at whatever my career path ends up being and I am definitely the leader type and would be unsatisfied not being able to consistently improve and grow.

I have been told, by both my recruiter (which probably isn't worth much) and several docs, that there are great opportunities to lead and be in charge of some unique opportunities in military medicine. You could be running a clinic or residency long before your peers.

And of course I would be able to pay back my loans in some way or another, especially since I don't have undergrad debt. However, as important as it is to think long term, the next 8 years of my life are pretty important also, and I have no money. Having the military financial benefits during medical school and residency is certainly not something I can overlook. Yes, that comes back to bite me in the ass with decreased pay later and having to be a military, active duty doc. But I can deal with decreased pay later because it's certainly not like I will be poor, I'll have no debt, and if that ends up really bothering me, it's only for 4 or so years.

Maybe I'm missing something (probably), but the numbers for specialty matching don't seem as restricting or limiting as I'm hearing. With the Army, for a lot of specialties, it seems there is a 1:1 match placement coming out of medical school, at least based on the information I am getting.

I've also heard of some docs loving military medicine because they hate the way civilian practice is going, with things like HMO's. So that's why I ask if military medicine is really that bad.

I believe that I was interested in the HPSP for a number of good reasons, but the overwhelming sentiment on here is that it's like selling your soul to the devil. Where are all the people that have had good experiences with it, if there are any?

 

[notdeadyet]

That being said, there are certainly a lot of pros and cons to making this decision, many of which have been covered already. I am definitely a type A person. I have been lucky enough to attend a prestigious undergrad university and am looking at some top programs for medical school as well, which is a good position to be in. Regardless of military, I am not sure of what direction I want my career to go, in terms of specialty, academia, public/global health work, research, private practice vs. hospital, etc. What I do know, however, is that I certainly aim to be damn good at whatever my career path ends up being and I am definitely the leader type and would be unsatisfied not being able to consistently improve and grow.

The bold is completely appropriate for your current level. It's also why HPSP can be such a rotten deal.

You will find that some people loved their HPSP experience and are happy with their decision. You will also find that other people absolutely hated it and wished they'd never taken it. The challenge is that it is ENTIRELY in retrospection. Many of the folks who are the strongest opponents of HPSP were some of the biggest supporters when they were medical students or even residents.

You will not know if HPSP is a good choice for you until long after you sign on the dotted line. For the things you are considering in bold, HPSP may make for a good fit or it may be incredibly limiting. But you don't know yet. This is particularly acute for folks who have the marks to get into decent medical schools and for whom all of the options you bolded will not be out of their reach.

HPSP is the equivalent of buying a home in a place you've never been too. If you grow up in Florida and since childhood it's been your goal to live in Burlington, Vermont and you dream of heavy snowfall, fall colors, and handmade candles, you can sign up for the mortgage and you maybe you'll be thrilled. But I sure wouldn't sign that mortgage after shrugging and saying, well, Akron could be okay.

 

[HighPriest]

I have been told, by both my recruiter (which probably isn't worth much) and several docs, that there are great opportunities to lead and be in charge of some unique opportunities in military medicine.

Yes, if you want to stop working a clinical practice, there are unique leadership opportunities. Otherwise, not so much.

 

[HighPriest]

can deal with decreased pay later because it's certainly not like I will be poor, I'll have no debt, and if that ends up really bothering me, it's only for 4 or so years.

Famous last words. I think that's similar to how we ended up with $19 trillion in debt.

 

[coolrunnings22]

From what I've read on here, generally post-residency Navy docs won't do a GMO tour (unlike the Army). Is this still the case even if you are one of the few who manages to go straight to residency after school?

 

[Perrotfish]

From what I've read on here, generally post-residency Navy docs won't do a GMO tour (unlike the Army). Is this still the case even if you are one of the few who manages to go straight to residency after school?

In most cases, yes. There are no guarantees, and they certainly CAN make your first assignment operational, but at least so far they have been very good about making sure that physicians go from residency to somewhere where they are utilizing the skills they learned in residency. Since the current system is that the first assignment out of residency for an HPSP grad will be his only assignment that means no operational work unless your 'platform' deploys.

If you plan for a longer career it becomes more complicated. Above every GMO is an SMO, and that person is usually (though not always) a LCDR who is residency trained in something. Pretty much every career general Pediatrician I know eventually either volunteered or was voluntold to do an SMO assignment. They pull quite a few subspecialists as well.

 

[Perrotfish]

The bold is completely appropriate for your current level. It's also why HPSP can be such a rotten deal.

Is it really worse than medical school debt, though? Debt will also push you out of certain specialties, academic medicine, research, and many fellowships. I certainly could not have been a Pediatrician if I paid for school with loans. HPSP, even at its absolute worst, leaves you with a clean personal and financial slate to pursue your dreams only 4 years after finishing residency.

 

[68PGunner]

Is it really worse than medical school debt, though? Debt will also push you out of certain specialties, academic medicine, research, and many fellowships. I certainly could not have been a Pediatrician if I paid for school with loans. HPSP, even at its absolute worst, leaves you with a clean personal and financial slate to pursue your dreams only 4 years after finishing residency.

Debt is overrated. You can utilize PSLF to erase your debt after a five year residency, a 1-2 year fellowship, and 3-4 years with the VA. It's a hell lot better than the military in general.

 

[Red Lobster Actual]

Debt is overrated. You can utilize PSLF to erase your debt after a five year residency, a 1-2 year fellowship, and 3-4 years with the VA. It's a hell lot better than the military in general.

Maybe...let's see what Congress will do next year when they get the first round of the bill from PSLF.

 

[68PGunner]

Maybe...let's see what Congress will do next year when they get the first round of the bill from PSLF.

I am very certain that if there's any changes, all loans taken before the enactment of the new bill will be grandfathered into the original stipulation.

 

[notdeadyet]

I am very certain that if there's any changes, all loans taken before the enactment of the new bill will be grandfathered into the original stipulation.

A lot of people were very certain about their pensions that the government is t honoring as well. You have more faith than I.


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[68PGunner]

A lot of people were very certain about their pensions that the government is t honoring as well. You have more faith than I.
Sent from my iPhone using Tapatalk

What part of the military's pension in which the government has gone back on its words? All men and women that joined the military before the stipulation of the new retirement plan has the choice to be grandfathered into the original plan or opt for the new plan.

It's not about a matter of faith. It's just logical considering that any changes to the original stipulation without a grandfather clause would make a substantial case against the government in the court of law.

 

[68PGunner]

A lot of people were very certain about their pensions that the government is t honoring as well. You have more faith than I.
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If you're talking about problems with preexisting state pensions, it's a different issue. First, according to bankruptcy laws in this country, you can rewrite obligations. Therefore, it's logical for bankrupt states to settle their liabilities in the bankruptcy court by new agreements.

However, I don't see our federal government ever tapping into the existing bankruptcy laws. In that scenario, we would have much bigger problems than student loans.

 

[notdeadyet]

Yeah, I've heard people make that argument, but I disagree. PSLF is a program, not a contract. The Army can also wipe out HPLRP for loan repayment and folks who joined while it was in effect won't get to use it when they reach the point they can. It's not the GI Bill.

Time will tell. I'll be happy if it sticks around, but counting on it, imho, is wishful thinking.

 

[68PGunner]

Yeah, I've heard people make that argument, but I disagree. PSLF is a program, not a contract. The Army can also wipe out HPLRP for loan repayment and folks who joined while it was in effect won't get to use it when they reach the point they can. It's not the GI Bill.

Time will tell. I'll be happy if it sticks around, but counting on it, imho, is wishful thinking.

It's a program by the government in order to provide incentives for professionals to go into certain fields. If anything, it will make government jobs much more attractive to college grads, which is the intent of the program in the first place.

 

[notdeadyet]

It's a program by the government in order to provide incentives for professionals to go into certain fields. If anything, it will make government jobs much more attractive to college grads, which is the intent of the program in the first place.

Not folks earning $200k/year. That wasn't the intent. We are just reading tea leafs here but they are already talking about limiting the loan write off amounts. My hunch is that salary caps will also come up. And should.


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[68PGunner]

Not folks earning $200k/year. That wasn't the intent. We are just reading tea leafs here but they are already talking about limiting the loan write off amounts. My hunch is that salary caps will also come up. And should.


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It doesn't matter if they earn $200k/yr or not bc the government salary isn't competitive with the private market right now. An ortho doc at a VA will start off with an annual salary of about $240-260K/yr while the same person will start off with $350-370K/yr in the private market.

PSLF provides incentives in order to push professionals to the government sector. I personally have a feeling that PSLF will remain uncapped and open for business for at least another 5-6 years until more data from PSLF start coming in. A lot of sons and daughters of politicians are taking advantage of this program. I doubt that they're going to chop off this program at this moment.

 

[notdeadyet]

I personally have a feeling that PSLF will remain uncapped and open for business for at least another 5-6 years until more data from PSLF start coming in. A lot of sons and daughters of politicians are taking advantage of this program. I doubt that they're going to chop off this program at this moment.

I agree with you there. They'll put in on the chopping block (or at least limit it to its original intent) once they see how folks are using it. For the cost of about four teachers and three social workers, you'll have one osteopath that owes $400K in debt that he makes IBR on for residency and then spends a few years at a county gig or VA. Which pays only slightly below market value for primary care and some of the non-lucre specialties.

This program isn't to get docs to work at the VA. If they cared about that, they'd put more skin in the game specifically for VA docs. Getting anything funded "for the vets" is a lot more palatable to voters than one that benefits education or (shudder) social services.

 

[COTOTS]

PSLF provides incentives in order to push professionals to the government sector. I personally have a feeling that PSLF will remain uncapped and open for business for at least another 5-6 years until more data from PSLF start coming in. A lot of sons and daughters of politicians are taking advantage of this program. I doubt that they're going to chop off this program at this moment.

Hmmmm... didn't Obama propose a 59K cap to the program? Or at least supported the platform. It hasn't passed, but the cap is floating around Washington.

Also, they won't have data on the program until 2017. The thing is, with PSLF you aren't part of the program until you fulfill all the requirements (so you have to make 10 years of the payments until you can even apply).

 

[68PGunner]

Hmmmm... didn't Obama propose a 59K cap to the program? Or at least supported the platform. It hasn't passed, but the cap is floating around Washington.

Search for news of Obama and cap on PSLF. He has floated this idea for the past 3 years already. Congress doesn't care what Obama is proposing nowadays. They will continue to do nothing until more data are readily available. A proposal of a cap won't gain serious traction until 2019-2020 when we will have about 2-3 years of budgetary data on the program.

Also, they won't have data on the program until 2017. The thing is, with PSLF you aren't part of the program until you fulfill all the requirements (so you have to make 10 years of the payments until you can even apply).

Wrong. Even with the proposed cap, Obama has float the idea of a grandfather clause for all loans taken before the new stipulation. As a lawyer, he knows the necessity of this clause in order to avoid a lawsuit at the federal level.

If you read the tea leaves, all loans taken before the enactment of the supposed cap will be good to go for PSLF.

 

[COTOTS]

Wrong. Even with the proposed cap, Obama has float the idea of a grandfather clause for all loans taken before the new stipulation. As a lawyer, he knows the necessity of this clause in order to avoid a lawsuit at the federal level.

If you read the tea leaves, all loans taken before the enactment of the supposed cap will be good to go for PSLF.

Wait until 2017.

You are flat wrong by the way. The proposal for grandfathering is to avoid lawsuits, yes... but the government does a lot of things to avoid lawsuits even when they are in the legal clear. The exact wording of the program SPECIFICALLY STATES that the program is not automatically approved for all those who apply (even if you meet/qualify for their stated application requirements), and you cannot apply until reaching 10 years of structured payments. No one will be able to apply until 2017. No one is legally part of the program until being accepted.

Ask yourself this. Has Congress been proactive in anything like this in recent years? No.

Do you think there is going to be push-back when doctors earning six figure salaries start using the program? Yes.

In short, the showdown will happen late, just as it always does. And given that it must be approved on a case-by-case basis by a federal organization (which can take executive orders) it can be variable.

Depending on who is in government in 2017, it could go anywhere. The program was not made for doctors, they will be the first casualties. We already had people campaigning throughout schools in my area (Chicago) trying to get physician support to petition the government to keep it in. People can read the tea leaves fine, and they are worried.

 

[68PGunner]

The exact wording of the program SPECIFICALLY STATES that the program is not automatically approved for all those who apply (even if you meet/qualify for their stated application requirements), and you cannot apply until reaching 10 years of structured payments. No one will be able to apply until 2017. No one is legally part of the program until being accepted.

Give me a link and direct quote.

Do you think there is going to be push-back when doctors earning six figure salaries start using the program? Yes.

It depends. Why is HPSP for physicians still around since most freshly minted HPSP physicians nowadays rarely get deployed?

In short, the showdown will happen late, just as it always does. And given that it must be approved on a case-by-case basis by a federal organization (which can take executive orders) it can be variable.

Your wordings make it sound like only buddies of Congressmen will get approved. It will be analyzed case by case in order to make sure that the applications meet all criteria, which are currently set by law.

Depending on who is in government in 2017, it could go anywhere. The program was not made for doctors, they will be the first casualties.

Where in the program does it say that it's not made for physicians? Give me exact quote from a reputable source.

You're just secretly hoping that PSLF isn't available for the rest of your colleagues bc you're on the HPSP.

 

[notdeadyet]

Search for news of Obama and cap on PSLF. He has floated this idea for the past 3 years already. Congress doesn't care what Obama is proposing nowadays. They will continue to do nothing until more data are readily available.

Say what? The PSLF cap was included as part of the president's proposed budget. Congress failed to approve the budget proposed because of the same partisan games we've been seeing for years. If you think that congress has withheld approving the country's fiscal year budget out of concern for the PSLF cap, you are misinformed. They are not waiting "until more data are available." They are blocking the presdient's budget because it's the president's budget. It has nothing to do with PSLF.

Where in the program does it say that it's not made for physicians? Give me exact quote from a reputable source.

Oh, that's just silly. Nowhere "in the program" does it say that it's not made for congressmen either. Do you believe that this means that the program is made for congressmen? Point to where in the program it says that it was made for congressmen.

PSLF in its current form may stick around. PSLF in its current form may not. But to pretend that a program that no one has enrolled in is somehow guaranteed is just plain silly. We don't know.

I just have visions in the next few years of hearing doctors earning $200K/year whining about how it's "unfair" because they were counting on PSLF and they are entitled to it. No, you're not.

 

[68PGunner]

Say what? The PSLF cap was included as part of the president's proposed budget. Congress failed to approve the budget proposed because of the same partisan games we've been seeing for years. If you think that congress has withheld approving the country's fiscal year budget out of concern for the PSLF cap, you are misinformed. They are not waiting "until more data are available." They are blocking the presdient's budget because it's the president's budget. It has nothing to do with PSLF.

First of all, the budget proposal by Obama is nothing more than a recommendation. Congress has done fine meeting the deadlines for the federal budgets in the past few years. Otherwise this forum would be swarmed with military docs whining about the lateness of their paychecks.

Congress hasn't acted on PSLF bc it is negligible. It's a nonissue considering the lack of data about the cost and the results of the program. Congress isn't going to act on a financial issue when it is still costing the government zero dollar.

Oh, that's just silly. Nowhere "in the program" does it say that it's not made for congressmen either. Do you believe that this means that the program is made for congressmen? Point to where in the program it says that it was made for congressmen.

My post was in reply to this:
In short, the showdown will happen late, just as it always does. And given that it must be approved on a case-by-case basis by a federal organization(which can take executive orders) it can be variable.

It's very obvious that the quoted portion is some bs without any substantial fact, where it is mainly driven be a subjective opinion without any understanding of the interworkings of federal laws. I just hate misinformation.

PSLF in its current form may stick around. PSLF in its current form may not. But to pretend that a program that no one has enrolled in is somehow guaranteed is just plain silly. We don't know.

I just have visions in the next few years of hearing doctors earning $200K/year whining about how it's "unfair" because they were counting on PSLF and they are entitled to it. No, you're not.

Where did I say that PSLF is guaranteed for anything? I only mention that it will be very hard to justify in the federal court if the government does decide to change the rules in the middle of the game.

 

[COTOTS]

It's very obvious that the quoted portion is some bs without any substantial fact, where it is mainly driven be a subjective opinion without any understanding of the interworkings of federal laws. I just hate misinformation.


Where did I say that PSLF is guaranteed for anything? I only mention that it will be very hard to justify in the federal court if the government does decide to change the rules in the middle of the game.

I haven't combed through the entire law, but from https://studentaid.ed.gov:

"Will I automatically receive PSLF after I’ve made 120 qualifying monthly payments?
No. After you make your 120th qualifying monthly payment, you will need to submit the PSLF application to receive loan forgiveness. The application is under development and will be available prior to October 2017, the date when the first borrowers will become eligible for PSLF."

There is no "middle of the game". No one is playing yet. You cannot apply for the program until you qualify for it. Legally, no one is in the program, nor are they yet entitled to it. If they remove it, it will be a PR problem for the government, not a legal one.

 

[COTOTS]

In short, the showdown will happen late, just as it always does. And given that it must be approved on a case-by-case basis by a federal organization(which can take executive orders) it can be variable.

It's very obvious that the quoted portion is some bs without any substantial fact, where it is mainly driven be a subjective opinion without any understanding of the interworkings of federal laws. I just hate misinformation.

Found it. 34 CFR 685.219 - Public Service Loan Forgiveness Program.

(e) Application.
(1) After making the 120 monthly qualifying payments on the eligible loans for which loan forgiveness is requested, a borrower may request loan forgiveness on a form provided by the Secretary.
(2) If the Secretary determines that the borrower meets the eligibility requirements for loan forgiveness under this section, the Secretary—
(i) Notifies the borrower of this determination; and
(ii) Forgives the outstanding balance of the eligible loans.
(3) If the Secretary determines that the borrower does not meet the eligibility requirements for loan forgiveness under this section, the Secretary resumes collection of the loan and grants forbearance of payment on both principal and interest for the period in which collection activity was suspended. The Secretary notifies the borrower that the application has been denied, provides the basis for the denial, and informs the borrower that the Secretary will resume collection of the loan. The Secretary may capitalize any interest accrued and not paid during this period.

The secretary reviews each application, and eligibility is determined by review of the secretary.

The secretary is part of the executive branch. The executive branch has to enforce the laws... unless... (as determined by the supreme court)

"Under Article II of the Constitution and relevant Supreme Court precedents, the President must follow statutory mandates so long as there is appropriated money available and the President has no constitutional objection to the statute."

How much money is set aside for the program? Because the secretary could simply take that route, entirely legally.