The skyrocketing value of the HPSP scholarship

[pgg]

Hate to rain on your parade, but Barry's budget is DOA in congress.

Probably, but I'd put good odds on loan forgiveness for rich, greedy, rich doctors going away at some point.

Regardless, I'm not convinced that anything as distant as loan repayment will affect premeds' decisions at all. These are people who've been told their whole lives that getting into medical school was the finish line with wealth on the other side, that student loans don't matter. I bet if you polled everyone holding med school acceptances right now, very few of them would be aware of gov loan forgiveness or income based repayment schemes.


A couple years during the worst of Iraq, HPSP didn't fill. Since offering a signup bonus ($20K?) and increasing the monthly stipend, HPSP has been full. The gpa/MCAT for HPSP takers has been steadily increasing the last few years. The objective reality is that HPSP has become more competitive of late.

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[notdeadyet]

Everyone you've ever met tells you not to worry about those things, which led to a tremendous opportunity for abuse. Now they're worse than having half a million in credit card debt, you have to go back to pre-American Revolution England to find debt this abusive. At least with the military if you hate it you can wait it out, and if you get sick or go crazy they probably let you go without charging you anything. With the loans you are indentured for life.

Is this why you have so many physicians defaulting on their loans? Oh wait, you don't really.

If you feel that a $200k loan is a bad investment for a job that pays $175k salary, I hope you have a good accountant. I understand the sweet lemons/sour grapes phenomenon, but your hyperbole is over the top.

 

[chasm-e-baddoor]

Is this why you have so many physicians defaulting on their loans? Oh wait, you don't really.

If you feel that a $200k loan is a bad investment for a job that pays $175k salary, I hope you have a good accountant. I understand the sweet lemons/sour grapes phenomenon, but your hyperbole is over the top.

Sure the numbers will come out pretty good in the end....but that's looking only at the numbers

There is the part about sacrificing your 20s, not being able to settle down until after residency (and more realistically, probably a year or so after residency), and being dragged down by a debt to which you can barely even touch its interest until youre 30+ (assuming you enter med school ~24)

Nobody is saying that tanking a mortgage to become a physician is going to get you in the negatives over the course of your life. What people are saying is that the mortgage you take is going to be a ball chained to your ankle for years and years to come after you graduate. Compared to this, the HPSP is valuable for many reasons, which is what Perrotfish etc is saying and is why he made the topic. In exchange for a few years in the military, which, at worst would just be a pretty crappy job for someone, you gain the freedom from the Man for the rest of your life (not counting the other financial decisions you make). If youre a savvy investor, you could take advantage of the power of compound interest and really come out ahead vs a guy who is dragged down by the other end of the interest

I suppose to each his own. The situation of graduating medical school 200k in debt(im pretty sure the average is closer to 300k...and then there is the nightmare interest) is not appealing to me at all. I value the option of being able to walk away if i please. HPSP allows one to walk away much earlier. i personally I dont even think of military medicine as a con (at least at the moment lol, who knows what ill really think of it) but i understand not everyone shares this oppinion

 

[bulldogmed]

Sure the numbers will come out pretty good in the end....but that's looking only at the numbers

There is the part about sacrificing your 20s, not being able to settle down until after residency (and more realistically, probably a year or so after residency), and being dragged down by a debt to which you can barely even touch its interest until youre 30+ (assuming you enter med school ~24)

Nobody is saying that tanking a mortgage to become a physician is going to get you in the negatives over the course of your life. What people are saying is that the mortgage you take is going to be a ball chained to your ankle for years and years to come after you graduate. Compared to this, the HPSP is valuable for many reasons, which is what Perrotfish etc is saying and is why he made the topic. In exchange for a few years in the military, which, at worst would just be a pretty crappy job for someone, you gain the freedom from the Man for the rest of your life (not counting the other financial decisions you make). If youre a savvy investor, you could take advantage of the power of compound interest and really come out ahead vs a guy who is dragged down by the other end of the interest

I suppose to each his own. The situation of graduating medical school 200k in debt(im pretty sure the average is closer to 300k...and then there is the nightmare interest) is not appealing to me at all. I value the option of being able to walk away if i please. HPSP allows one to walk away much earlier. i personally I dont even think of military medicine as a con (at least at the moment lol, who knows what ill really think of it) but i understand not everyone shares this oppinion

Compound interest is extremely powerful. When you consider that the HPSP student can start a Roth-IRA at age 22 when he starts medical school. That is at least 4 years head start, but probably more like 7-10 years head start on those that take loans and then defer them through residency.

I think another point that deserves mention is that medical students and later residents and attending physicians are not going managers of money. Seeing that first paycheck when you graduate residency after living a decade as a pauper will make even the most financially savvy a little weak in the knees to spend the money. So I think there's some definite merit in taking away the huge burden of 300-500k in loans right from the get-go.

 

[colbgw02]

Sure the numbers will come out pretty good in the end....but that's looking only at the numbers

There is the part about sacrificing your 20s, not being able to settle down until after residency (and more realistically, probably a year or so after residency), and being dragged down by a debt to which you can barely even touch its interest until youre 30+ (assuming you enter med school ~24)

Nobody is saying that tanking a mortgage to become a physician is going to get you in the negatives over the course of your life. What people are saying is that the mortgage you take is going to be a ball chained to your ankle for years and years to come after you graduate. Compared to this, the HPSP is valuable for many reasons, which is what Perrotfish etc is saying and is why he made the topic. In exchange for a few years in the military, which, at worst would just be a pretty crappy job for someone, you gain the freedom from the Man for the rest of your life (not counting the other financial decisions you make). If youre a savvy investor, you could take advantage of the power of compound interest and really come out ahead vs a guy who is dragged down by the other end of the interest

I suppose to each his own. The situation of graduating medical school 200k in debt(im pretty sure the average is closer to 300k...and then there is the nightmare interest) is not appealing to me at all. I value the option of being able to walk away if i please. HPSP allows one to walk away much earlier. i personally I dont even think of military medicine as a con (at least at the moment lol, who knows what ill really think of it) but i understand not everyone shares this oppinion

There's a lot of crazy talk in this post.

Let's start with the simple thing: what in the hell is "tanking a mortgage"? Are you trying to say "taking out student loans"? I'm sorry, but if you don't know what a mortgage is, it's a little difficult to take the rest of what you're saying seriously.

Secondly, your numbers about medical school debt are way off. Numbers out of the AAMC from October 2013 indicate that only 5% of graduates have $300K or more in student loan debt at graduation. And only 40% have greater than $200K. Now, that may not include DO schools, which tend to be private and therefore more expensive, but even private allopathic schools only graduate students with $200K at a 48% rate. So, I'd say that $200K number is a lot closer to average than your guess.

Sure the numbers will come out pretty good in the end....but that's looking only at the numbers

Do you realize that you're arguing against using "numbers" as a reason to take out loans when the entire rest of the thread is predicated on using those same "numbers" to justify taking HPSP?

There is the part about sacrificing your 20s, not being able to settle down until after residency (and more realistically, probably a year or so after residency), and being dragged down by a debt to which you can barely even touch its interest until youre 30+ (assuming you enter med school ~24)

Nobody is saying that tanking a mortgage to become a physician is going to get you in the negatives over the course of your life. What people are saying is that the mortgage you take is going to be a ball chained to your ankle for years and years to come after you graduate. Compared to this, the HPSP is valuable for many reasons, which is what Perrotfish etc is saying and is why he made the topic. In exchange for a few years in the military, which, at worst would just be a pretty crappy job for someone, you gain the freedom from the Man for the rest of your life (not counting the other financial decisions you make).

I could take this quote, rearrange or change about 10 words or so, and it would be an equally effective reason to avoid military medicine. You use words like "sacrificing", "dragged down", "ball chained to your ankle", and "gain the freedom" to talk about debt in the same way that many of us in military medicine talk about dumping the .mil for civilian life.

 

[Perrotfish]

Is this why you have so many physicians defaulting on their loans? Oh wait, you don't really.

If you feel that a $200k loan is a bad investment for a job that pays $175k salary, I hope you have a good accountant. I understand the sweet lemons/sour grapes phenomenon, but your hyperbole is over the top.

So, first, its not 200K. The average COA for public schools is 210K and for private schools is 280K. Also, that's not what you pay back: it starts compounding at the start of medical school, so when you're ready to pay it back at the end of a 3 year residency you owe 450K. That's not what you pay back though: It keeps compounding while you pay it, so you end up actually paying 750K (10 year plan) - 1.2 million (20 year plan). Of course that's what you pay, in after tax dollars. If you're paying 35% state + federal income tax you actually need to earn 1.2-1.5 million. So at 175K you will spend about 7 years of your life working, full time, to pay back the loans and nothing else. This is how people get into trouble with loans: they look at the principle, look at the size of their salary, and think that the first number looks reasonable relative to the second, and they completely forget that taxes and interest are going to be responsible for more than 80% of what they need to earn.

That being said, you're right, IF you are physician making 175K loans are a good investment. They're a crappier financial deal than the HPSP scholarship, but they're a good investment compared to not doing medicine. What they cost you FREEDOM: the 175K is now a necessity, which means from the first day you take out the loans you are chained to medicine until you pay them off. What's really bad about student loans is the loan shark mentality of the government, whatever your question is the answer is you need to pay up right f-ing now. Want to quit being a doctor to be something else? f- you, pay me. Failed out? F- you, pay me. Job market collapsed for your profession? F- you pay me. There are lots of doctor wanabees who fail out of med school and residency, more than 10% of candidates. There are even more doctors who get sick or hurt. And right now the unemployment lines are littered with former lawyers and pilots who can testify that even the most secure looking careers can collapse in a matter of years. If things don't work out these loan will keep you in poverty for the rest of your life, and even if the government is currently granting some kind of income based repayment you live with the reality that they can choose to cancel it and take everything any time they want.

A loan from the government is like a loan from the mob: it will cost you a lot if you can pay it back, but your also betting your life that nothing is going to keep you from paying.

 

[Perrotfish]

There's a lot of crazy talk in this post.

Let's start with the simple thing: what in the hell is "tanking a mortgage"? Are you trying to say "taking out student loans"? I'm sorry, but if you don't know what a mortgage is, it's a little difficult to take the rest of what you're saying seriously...

I believe he is using the word mortgage to refer to student loans to emphasize the fact that the cost of our education has now surpassed the cost of a house, not because he doesn't understand the difference between student loans and secured mortgage debt.

Secondly, your numbers about medical school debt are way off. Numbers out of the AAMC from October 2013 indicate that only 5% of graduates have $300K or more in student loan debt at graduation. And only 40% have greater than $200K. Now, that may not include DO schools, which tend to be private and therefore more expensive, but even private allopathic schools only graduate students with $200K at a 48% rate. So, I'd say that $200K number is a lot closer to average than your guess

There is no number quite as useless as the mean of a bimodal distribution. The AAMC also releases the (edited) 4 year cost of attendance for public and private instutions, which are 210K and 280K respectively. The fact that the average debt is so much lower than those means reflects how much medical school admissions biases towards the upper class, which does not take out loans (or not many). My school had an average COA of nearly 300K and less than half of the class were even included on financial aid emails because the majority took out no loans at all.

I could take this quote, rearrange or change about 10 words or so, and it would be an equally effective reason to avoid military medicine. You use words like "sacrificing", "dragged down", "ball chained to your ankle", and "gain the freedom" to talk about debt in the same way that many of us in military medicine talk about dumping the .mil for civilian life.

I think that's the point. If both the loans and the military commitment involve a countdown to freedom, but the military countdown is only 4 years. The loan countdown is getting so long its approaching the countdown to retirement.

 

[colbgw02]

I believe he is using the word mortgage to refer to student loans to emphasize the fact that the cost of our education has now surpassed the cost of a house, not because he doesn't understand the difference between student loans and secured mortgage debt.

That makes more sense. Can't say I've ever seen that particular metaphor before.

There is no number quite as useless as the mean of a bimodal distribution. The AAMC also releases the annual cost of attendance for public and private instutions, which are 210K and 280K respectively. The fact that the average debt is so much lower than those means reflects how much medical school admissions biases towards the upper class, which does not take out loans (or not many). My school had an average COA of nearly 300K and less than half of the class were even included on financial aid emails because the majority took out no loans at all.

Zero percent chance the bolded is true. I think you meant to say that's the median cost of attendance for 4 years, not annually.

You're right in that about 14% of all comers won't have any debt. So let's look at median debt. It's not perfect, but it's better than the mean, and it's still $175K. Again, that's a far cry from the $300K number posted earlier.

I think that's the point. If both the loans and the military commitment involve a countdown to freedom, but the military countdown is only 4 years. The loan countdown is getting so long its approaching the countdown to retirement.

It's all a trade off, to be sure. Severe debt aversion is a good, but perhaps not sufficient, reason to take HPSP. Most of us have considered the calculus and come down firmly on the side of professional and geographic freedom over freedom from debt.

 

[Perrotfish]

Zero percent chance the bolded is true. I think you meant to say that's the median cost of attendance for 4 years, not annually.
.

You're right, that's what I meant to say. That' the COA for a degree. If you're going on loans and nothing else that's what its going to cost. If the median student h 175K that means the median student has 50-100K of Daddy's money to play with. I don't think that student will be looking at HPSP anyway, though.

Most of us have considered the calculus and come down firmly on the side of professional and geographic freedom over freedom from debt.

While those are definitely good reasons to consider not doing HPSP, I would point out that debt also limits professional and geographic freedom. I certainly couldn't be Pediatric subspecialist in a major city with the debt quoted above, which happens to be what I want. If I had those loans I would probably be doing an EM residency right now. And again, with the debt there would be no wading through a GMO tour and then doing what I wanted to do, I would be stuck for life.

 

[colbgw02]

You're right, that's what I meant to say. That' the COA for a degree. If you're going on loans and nothing else that's what its going to cost. If the median student h 175K that means the median student has 50-100K of Daddy's money to play with.

Or financial aid.

I don't think that student will be looking at HPSP anyway, though.

Or, at least, they won't be looking at it principally for the money.

You're right that for the subset of medical students graduating with extremely high-debt and particularly if they're entering low-reimbursement specialties, the financial benefits of HPSP are substantial. Whether or not those benefits are worthwhile is largely, if not entirely, up to the personal set of circumstances of the individual.

 

[deuist]

Sure the numbers will come out pretty good in the end....but that's looking only at the numbers

There is the part about sacrificing your 20s, not being able to settle down until after residency (and more realistically, probably a year or so after residency), and being dragged down by a debt to which you can barely even touch its interest until youre 30+ (assuming you enter med school ~24)

Nobody is saying that tanking a mortgage to become a physician is going to get you in the negatives over the course of your life. What people are saying is that the mortgage you take is going to be a ball chained to your ankle for years and years to come after you graduate. Compared to this, the HPSP is valuable for many reasons, which is what Perrotfish etc is saying and is why he made the topic. In exchange for a few years in the military, which, at worst would just be a pretty crappy job for someone, you gain the freedom from the Man for the rest of your life (not counting the other financial decisions you make). If youre a savvy investor, you could take advantage of the power of compound interest and really come out ahead vs a guy who is dragged down by the other end of the interest

I suppose to each his own. The situation of graduating medical school 200k in debt(im pretty sure the average is closer to 300k...and then there is the nightmare interest) is not appealing to me at all. I value the option of being able to walk away if i please. HPSP allows one to walk away much earlier. i personally I dont even think of military medicine as a con (at least at the moment lol, who knows what ill really think of it) but i understand not everyone shares this oppinion

You're only a medical student so I'm going to give you the benefit of the doubt about how woefully ignorant this post is. First of all, if I had done a civilian residency and gone straight to work as an attending, I could have easily paid off a $200,000 loan in four years. I would have also have been able to afford a mortgage, and because I chose the location of my practice and wouldn't have to frequently move across the country, my spouse would also have a job. So no, HPSP students cannot "walk away much earlier."

But... why would you walk away from student loan debt so quickly anyway? If your loans carry a 2.4% interest rate---as my undergraduate and grad school loans do---and the stock market is going at 5%, don't ever pay off the loans quickly. Use that cash to invest.

Second, as beaten to death on this board, you give up lots of freedoms when you join the military. You can't do the residency of your choice, you might not be allowed to pursue a fellowship, you can't practice in an environment that best suits you, and if you do get forced into flight medicine or a GMO tour, you will need to repeat internship and go through a residency later, meaning that you will be years behind your peers.

I'm sure for some people HPSP makes financial sense, but for me, it's been a financial, professional, and personal disaster.

 

[deuist]

think that's the point. If both the loans and the military commitment involve a countdown to freedom, but the military countdown is only 4 years. The loan countdown is getting so long its approaching the countdown to retirement.

See my above post about investing versus paying off student loans early. You're thinking like a single pre-med by measuring freedom in years to pay off student loans. Freedom also means getting to pick your residency/fellowship, your practice environment, and your practice geography.

 

[teacherman84]

But... why would you walk away from student loan debt so quickly anyway? If your loans carry a 2.4% interest rate---as my undergraduate and grad school loans do---and the stock market is going at 5%, don't ever pay off the loans quickly. Use that cash to invest.

My loans started at 5% and are now at 6.8%. Classmates who need to secure loans above and beyond federal loans have even higher rates.

 

[BigNavyPedsGuy]

...

While those are definitely good reasons to consider not doing HPSP, I would point out that debt also limits professional and geographic freedom. I certainly couldn't be Pediatric subspecialist in a major city with the debt quoted above, which happens to be what I want. If I had those loans I would probably be doing an EM residency right now. And again, with the debt there would be no wading through a GMO tour and then doing what I wanted to do, I would be stuck for life.

I wanted to be a pediatric sub specialist in a city too. But the military forced me to be a general pediatrician. By the time I earned my freedom I had 2 kids and the pay cut of a fellowship wasn't nearly as attractive as it was 3 years prior. My friends that took out loans all finished their fellowships last summer. There are tradeoffs in either path.

I also applied for fellowship training through the military and was rejected.

79 days!

 

[notdeadyet]

See my above post about investing versus paying off student loans early. You're thinking like a single pre-med by measuring freedom in years to pay off student loans. Freedom also means getting to pick your residency/fellowship, your practice environment, and your practice geography.

This is the concern I have with how most folks approach HPSP. They focus on the short cell. Medical students tend to be risk adverse by nature and the security of joining a program that takes student loans off the table is extremely appealing, particularly at a time when they know nothing about medicine and the importance of residency. They view the student loan burden as impossible to pay off since they typically lack any financial background and don't get the fact that by the numbers it's about as sound an investment as you'll find.

It's good this site has a lot of diversity of opinion. I just find it interesting that the arc of opinions is surprisingly consistent: excited med students who would do it for free but thanks for the tuition waiver, residents and GMOs who have the sweet lemons take that gets saltier each year and evolves to "it sucks but it MUST be better than the civilian path I DIDN'T take," and the attendings with a few years under their belts who range from, "I'm glad I served but I'd think twice about taking HPSP" to "don't take it/run." This has been consistent for the 10 or so years I've been reading this forum and that is is instructive.

There is a lot of pros to military medicine, but HPSP is just bad juju. I can't imagine making a blanket recommendation on joining as an MSI when you don't even understand how residency works or it's importance, let alone what type of specialty you'll actually want by the time you finish. If you aren't fussy on residency training, have a big loan burden, and are entering a low paying specialty, it can be a financial benefit. In other cases, it can be a break even or even a big loss. Who HPSP actually ends up truly being a good decision for in the big picture is largely a matter of luck after the fact. I strongly believe in military service and am glad their are alternate routes to doing so as a physician (FAP, direct accession, reserve corps) that give physicians the ability to join after choosing their residency, and if it's important to them, their residency training. Signing up people who have never set foot in medical school to a commitment to a limited set of professional options that ends about the time you are wrapping up the early stages of your career is bad for the prospect and bad for the military.

 

[HighPriest]

This is an interesting and repetative thread.

I'm biased for sure when it comes to HPSP. There is some argument to be made so far as debt is concerns, and there is certainly an argument to be made about the lack of personal freedom in the military (because, you know, it's the military). But I think the biggest issue with HPSP is (as mentioned) the lack of predictability in terms of location, training, and ultimately scope of practice. Everything else seems to boil down to personal experience and bias. The fact of the matter is (as mentioned) when you sign up as a kid out of college (ie: ignorant....sorry, but that is relatively accurate) you don't know what you want. You think you know, but you don't. You have no idea whether you'll handle the yoke of military service well. You have no idea where you'll be stationed. You have no idea whether or not you'll match into the specialty you want, and really you usually have no idea what specialty you are going to want. Also as mentioned, you don't really know how important those issues are.

If your expectations are met, then HPSP is a great financial deal. If not, then you'll always wonder if you would have had a better situation outside the military albeit shackled with debt. I haven't met too many people who didn't match into the field they wanted, didn't get stationed where they wanted, and didn't get the fellowship they wanted who still felt like HPSP was a good idea because they weren't in debt.

It's a tough, tough decision to make when you haven't even set foot in a medical school classroom, let alone had a real clinical rotation. I have a clear image and recurring nightmare of exactly when I made that decision - on a small plane flying from Green Bay, WI to Chicago O'Hare. Frankly, I felt like I needed to do something to avoid the massive debt (on top of my undergraduate debts) and I felt like I would be fine with the restrictions of military life (having had a lot of family in the Army). I got the scholarship, got the specialty I wanted, I feel like I had a great residency experience, but I didn't get a fellowship, I abhored my first station, and when I went through HPSP the stipend wasn't enough to pay rent and eat - you either chose one or the other or took out some additional loans.

I think the take home is that the problem with HPSP is that it is a huge gamble that you're asking a relatively desperate crowd of people to take with minimal information. Very Faustian.

 

[Perrotfish]

nvm

 

[twinning]

Sorry about the off topic question but I had to ask. Would it better to go to USUHS or take a HPSP scholarship at some other school?


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[colbgw02]

Sorry about the off topic question but I had to ask. Would it better to go to USUHS or take a HPSP scholarship at some other school?


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It's hard to advise someone to go to USUHS unless they intend to retire from the military. So, if you're not sold on staying in for 20 years, then HPSP is the way to go (unless USUHS is your only U.S. (or maybe U.S. allopathic?) medical school acceptance).

 

[narcusprince]

A Democrat president's budget has a line item to remove an entitlement: its probably getting removed. I'm not sure which other points in his budget will get negotiated into existence (a Paul Ryan budget is going anywhere either, so its going to be a negotiation), but when a Democrat says a program called 'public service loan forgiveness' needs chopping its like when a baseball player gets called out by someone on their own team. The program is probably getting chopped.

The loans have enormous downsides just like the scholarship. Both involve signing your life over to the government, and both are incredibly crappy deals relative to the deal that doctors received 20 years ago. However the scholarship is reigned in by the fact that people look at military 'deals' and don't trust them. Recruiters have always been equivalent to used car salesmen in our minds. Therefore the finances of the military have actually improved significantly during a period when almost every other white collar American saw significant declines (see my first post). However the loans? Everyone you've ever met tells you not to worry about those things, which led to a tremendous opportunity for abuse. Now they're worse than having half a million in credit card debt, you have to go back to pre-American Revolution England to find debt this abusive. At least with the military if you hate it you can wait it out, and if you get sick or go crazy they probably let you go without charging you anything. With the loans you are indentured for life. You could be 50 years out from the loans and they're still following you. And since the government reserves the right to change the conditions of your repayment at any time the feds basically own you.

Well Said Captain Perrotfish.

 

[twinning]

It's hard to advise someone to go to USUHS unless they intend to retire from the military. So, if you're not sold on staying in for 20 years, then HPSP is the way to go (unless USUHS is your only U.S. (or maybe U.S. allopathic?) medical school acceptance).

It is USUHS or a brand new unaccredited med school in central Michigan where I would be the second med class. Out of state tuition alone would run me 72k a year so after books and living expenses. I'm looking at close to 90-95k a year. HPSP will not cover unaccredited schools. Knowing that what would you do now?


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[pgg]

It is USUHS or a brand new unaccredited med school in central Michigan where I would be the second med class. Out of state tuition alone would run me 72k a year so after books and living expenses. I'm looking at close to 90-95k a year. HPSP will not cover unaccredited schools. Knowing that what would you do now?

Oh my god 400K before it even starts to compound during residency is outrageous. You're looking at $500K or more before getting out of residency.

Go to USUHS unless you don't want to be in the military. (The dirty little secret of HPSP is that if you do a GMO tour followed by an inservice residency, as is the Navy norm, you'll end up paying back about the same amount of years as a USUHS grad.)

USUHS is also likely to be a far better school than a newly established one.

 

[twinning]

Oh my god 400K before it even starts to compound during residency is outrageous. You're looking at $500K or more before getting out of residency.

Go to USUHS unless you don't want to be in the military. (The dirty little secret of HPSP is that if you do a GMO tour followed by an inservice residency, as is the Navy norm, you'll end up paying back about the same amount of years as a USUHS grad.)

USUHS is also likely to be a far better school than a newly established one.

That's what I was thinking. They just updated us and told us that the class of 2015 just had 140 scores out of 167 scores released and their mean of their step 1 scores is 231. Very impressive so it seems that whatever they are teaching at USUHS seems to be working. Is it that bad of an idea to serve back 7 and then leave? I heard if you go over ten years then you better stay to get the pension but 7 is debatable.


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[Kilgoretrout 65]

That's what I was thinking. They just updated us and told us that the class of 2015 just had 140 scores out of 167 scores released and their mean of their step 1 scores is 231. Very impressive so it seems that whatever they are teaching at USUHS seems to be working. Is it that bad of an idea to serve back 7 and then leave? I heard if you go over ten years then you better stay to get the pension but 7 is debatable.


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USUHS is a good school. Plenty of people leave after their USUHS payback. After 3+ years of military residency you will have 10+ years in when eligible to leave. The military pension rules
are being debated and could change but possibly you will be grandfathered into the current system. No one on this forum can predict whether you will be able to stomach military life. A lot depends
on the specialty you go into, the ability to get what you want, and deployments, etc.

 

[teacherman84]

Its USUHS or a brand new unaccredited med school in central Michigan where I would be the second med class. Out of state tuition alone would run me 72k a year so after books and living expenses. I'm looking at close to 90-95k a year. HPSP will not cover unaccredited schools. Knowing that what would you do now?


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It prob has at least conditional accreditation until it graduates its first class in which case you could get the HPSP scholarship. I had classmates at COT from RVU (a brand new DO school at the time without full accreditation) who had no issue getting the scholarship.

 

[GreatBrono7]

Hi I just had a quick question for some of you who have done the HPSP program. I am currently applying for a spot with the army. I was told that the army rarely requires GMO tours (probably fewer than 10% of students) and that it is fairly often required for Navy and Air Force physicians (close to 50%). Can anyone verify this information (and preferably with statistics not anecdotes).

 

[HighPriest]

Hi I just had a quick question for some of you who have done the HPSP program. I am currently applying for a spot with the army. I was told that the army rarely requires GMO tours (probably fewer than 10% of students) and that it is fairly often required for Navy and Air Force physicians (close to 50%). Can anyone verify this information (and preferably with statistics not anecdotes).

It's rare, though it happens on occasion. Can't comment on the percentile.

 

[twinning]

It's rare, though it happens on occasion. Can't comment on the percentile.

Why do Air Force and navy do gmo more often than army?


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[Snowdon48]

Why do Air Force and navy do gmo more often than army?


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Navy is the branch that is really known for having a high percentage of GMO tours.

 

[HighPriest]

Why do Air Force and navy do gmo more often than army?

As I do not make those decisions, I cannot say.

 

[Qurmish]

Why do Air Force and navy do gmo more often than army?

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Several others have observed that while the Navy tends to GMO more people before finishing residency, the Army is known to use residency and fellowship trained physicians to fulfill GMO positions. All branches seem to have their own flavor of frustration at the end of the day.

I'd be interested in an answer to this as well. The Navy requires a lot of basic medical care to support remote operations (ships, Marines, etc.) I would guess that this has a lot to do with the heavy use of GMOs.

 

[HighPriest]

Several others have observed that while the Navy tends to GMO more people before finishing residency, the Army is known to use residency and fellowship trained physicians to fulfill GMO positions. All branches seem to have their own flavor of frustration at the end of the day.

I'd be interested in an answer to this as well. The Navy requires a lot of basic medical care to support remote operations (ships, Marines, etc.) I would guess that this has a lot to do with the heavy use of GMOs.

I suppose that is technically true, although one could argue that there really isn't such a thing as a GMO position, since you're practicing as an untrained practitioner. Back in the days of the general practitioner it made sense, but as that doesn't fly outside the military anymore the concept of GMO is fairly arbitrary. The dark side of that is that now you have overqualified people doing the same job. But then that's true for most of what we do in the Army.

 

[idq1i]

The dark side of that is that now you have overqualified people doing the same job. But then that's true for most of what we do in the Army.

Well, technically having a neuroradiologist or a neonatologist doing sick is not really overqualified. Misguided, maybe? You know what they say - army strong!

 

[Silent Cool]

Oh my god 400K before it even starts to compound during residency is outrageous. You're looking at $500K or more before getting out of residency.

Go to USUHS unless you don't want to be in the military. (The dirty little secret of HPSP is that if you do a GMO tour followed by an inservice residency, as is the Navy norm, you'll end up paying back about the same amount of years as a USUHS grad.)

USUHS is also likely to be a far better school than a newly established one.

It *IS* outrageous. Oddly enough, when I questioned my classmates about how much debt they expect to have at graduation, they all said, "about 400k."

Thanks, federal government.

And people are supposed to enter primary care?
The sad thing is that it is even worse for dental students. They will owe ~500K (at least those from private schools) *AND* have to pay for specialty training *AND* buy a practice.

May God have mercy on their souls.

Edit: when I shadowed a physician a few years back, he was about to turn 40. I remember him saying, "next year when I turn 40, I'm going to start chipping away at those student loans." He finished his training at ~35.

Imagine how much worse it will be for the next generation.

 

[Silent Cool]

Also:

Any numbers published by AAMC or any other loan monitoring agency, etc..., are BS.

All of you should be smart enough to do two things:
1) Realize that a great many medical students come from rich families. Guess who is paying for their little darling's tuition?

2) Go to the website of any number of private medical schools. Look up their cost of attendance.

Here's Georgetown:
https://georgetown.app.box.com/s/hbdpvin1ewimsvze14s5
Here's AZCOM:
http://www.midwestern.edu/Documents/Financial Aid documents/OM_IL1314.pdf

Here's UPENN (Dental, but still):
http://www.dental.upenn.edu/academic_programs_admissions/dmd_program/tuition_fees
Here's USC Dental:
https://dentistry.usc.edu/programs/dds/cost-of-attendance/

It doesn't take a rocket scientist or a mathematician to calculate the final owed amount after four years (don't forget--interest accumulates from day one) and realize that a HUGE percentage of medical students have daddy paying for their education. I still read dentaltown and there is one particular poster on there discussing how he is going to pay for his son's 400K dental education (that's BEFORE interest).

What you should all be realizing is how much federal subsidization of higher education has actually increased the gap between rich and poor rather than decrease it.

 

[TheTruckGuy]

I'm probably just a naive M1, as someone who wanted to be in the military before wanting to be a doctor, I'm happy with the program so far. Wish I had gotten HSCP, instead of HPSP, but not that big of a deal.

 

[twinning]

I'm probably just a naive M1, as someone who wanted to be in the military before wanting to be a doctor, I'm happy with the program so far. Wish I had gotten HSCP, instead of HPSP, but not that big of a deal.

I'm going to be a M1 this fall at USUHS and having the military pay for you is all gravy until the payback begins. So I guess I'll have 8 good years (4 school 4 residency) before 7 bad years of paying it back.


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[Snowdon48]

For HPSP'ers I believe they refer to med school as the "honeymoon years". So I guess that means HPSP goes from being a hot young bride to a fat, cranky, adulterous b****.

 

[TLAD123]

Now the rub is that we are both in high paying specialty. The military screwed us in our first assignments. One there's the geographic separation. Two I am in an awful location in a MTF run by nurses.

1. I'm sorry you got separated. That rots!
2. Other than the fact that you're a physician, they're nurses, and you're supposed to be the leaders of the healthcare system... are they at least good managers?

 

[TLAD123]

I'm going to be a M1 this fall at USUHS and having the military pay for you is all gravy until the payback begins. So I guess I'll have 8 good years (4 school 4 residency) before 7 bad years of paying it back.


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If you get the residency right away

 

[HighPriest]

For HPSP'ers I believe they refer to med school as the "honeymoon years". So I guess that means HPSP goes from being a hot young bride to a fat, cranky, adulterous b****.

She was a fat b*** when you married her, you were just drunk.

 

[ArmyTiger]

She was a fat b*** when you married her, you were just drunk.

That does explain why I don't remember any anatomy...

 

[twinning]

If you get the residency right away

If I don't get residency right away and I go on a GMO tour (correct right?), that one year counts towards my payback doesn't it?


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[deuist]

If I don't get residency right away and I go on a GMO tour (correct right?), that one year counts towards my payback doesn't it?

It's 2 years, and it will count for payback. If you do a military residency afterward, however, you will increase your commitment.

 

[twinning]

It's 2 years, and it will count for payback. If you do a military residency afterward, however, you will increase your commitment.

I have to do a military residency afterwards, don't i? Why would I have to increase my commitment for having to do a residency?


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[HighPriest]

You have two options: you can complete your ADSO as a GMO and then apply for the civilian match (a lot of people do this), or you can apply for a military residency. If you are accepted into a military residency, then your commitment will increase, because the formula is that you owe a year for every year of residency (internship excluded), but you also pay back a year as well. In a nutshell, if you finish GMO and owe 2 years, but then match into a surgical residency (lets say Ortho, arbitrarily), then you'll pay back two during your residency, but accrue 4. Hence, you will owe four years. Always remember that Uncle Sam will dirty your sheets, but will never call you the next day.

 

[TLAD123]

If I don't get residency right away and I go on a GMO tour (correct right?), that one year counts towards my payback doesn't it?


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I am not a military physician, but what I gather is that intern year does NOT count towards payback, but does not incur additional ADSO either. The remaining year or two (depending on if your GMO is 2 or 3 years) will count towards your ADSO. See other threads for more info, as this is something that has been covered in extensive detail, in better ways than I can describe.

 

[Qurmish]

Because twinning is a USUHS student it would not be possible to complete the ADSO as a GMO, right? USUHS students have a far less chance of going to GMO land than HPSP grads for this reason, no?

Not that anyone would want to do this, but as a hypothetical, how long could someone stay as a GMO in the Navy or Airforce?

 

[Snowdon48]

You have two options: you can complete your ADSO as a GMO and then apply for the civilian match (a lot of people do this), or you can apply for a military residency. If you are accepted into a military residency, then your commitment will increase, because the formula is that you owe a year for every year of residency (internship excluded), but you also pay back a year as well. In a nutshell, if you finish GMO and owe 2 years, but then match into a surgical residency (lets say Ortho, arbitrarily), then you'll pay back two during your residency, but accrue 4. Hence, you will owe four years. Always remember that Uncle Sam will dirty your sheets, but will never call you the next day.

Let me see if I am understanding you correctly. The 4 years of residency that counts towards payoff will only erase the 2 years that you owed BEFORE starting residency? But the 4 years you accrue during residency will all still have to be payed back which is why you come out owing 4 years?

It seems like the time accrued and time payed off during residency should simply cancel out.

 

[colbgw02]

Because twinning is a USUHS student it would not be possible to complete the ADSO as a GMO, right? USUHS students have a far less chance of going to GMO land than HPSP grads for this reason, no?

Not that anyone would want to do this, but as a hypothetical, how long could someone stay as a GMO in the Navy or Airforce?

I don't think USUHS/HPSP factors into the GMO calculation in any official manner. Obviously, there are lots of USUHS grads in military medicine, and they're more likely to look favorably on other USUHS grads...yada yada yada. The only thing USUHS guarantees is that you won't do a civilian internship.

I've know some Army docs to do 5 years as a GMO, but I've never heard of anything longer than that. Not that it couldn't be done, but there is an expectation that you're at least working toward BE/BC status by the time you're up for O-4.