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[Man Of Tomorrow]

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[deuist]

1. Getting the scholarship has nothing to do with desired future specialties. If you get accepted to medical school, have good grades and MCAT scores, and can pass all the physical exam requirements, you can get the scholarship.

2. You could be split apart.

3. You don't owe the military anything until you start accepting money. If you are accepted for the scholarship and then decide that is not for you, you can walk away at any point.

 

[deuist]

1. Slim but doable.

2. This is accurate.

I am a duty physician who went through the HPSP route.

 

[WernickeDO]

If your goal is to stay close to your wife and to train in your desired specialty, whatever that may be, you would do well to RUN from HPSP. You are severely limiting your geographical and specialty options by binding yourself to the military. You cannot accurately predict what your life will be like 4 years from now, and can be complicated by numerous factors (kids, medical training desired, lack of training near family). When you join HPSP, you reliquish ALL control over your medical career. Yes, the mil will work with you but ultimately where you go and what you do is determined by the needs of the Army, Navy, AF. If you have a desire to serve in the military, go the civilian route and either sign up for FAP or return as a civilian contractor. You can hang on to some control at that point.

 

[Perrotfish]

On Co-location:

The Navy is required to co-locate you with an active duty spouse if it is at all feasible. The Navy has 7 teaching hospitals right now: 4 small ones where they train family practice doctors and 3 big ones where they train every other specialty. 2 of the FP training sites are within 45 minutes of one of the big hospitals, so if you're in training it is always feasible to co-locate you.

The technical definition of co-location is pretty broad. Actually I think its within 250 miles. However practically I have only known one physician who was 'technically' co-located with an active duty spouse far enough away that they couldn't actually live with their spouse. It was someone who was married half way through the process of detailing after the true co-location sites were gone, and they moved her to a new duty station one year later so they could actually be together.

A GMO tour does not change this calculus, if its feasible they have to keep you together. There are situations where its not feasible, mostly during the training phase for flight and dive surgery where you'd be separated for 6 months. If you're not at sea and you're not deployed they have to try to co-locate you.

You are correct that they can deploy you separately. The goal here is that, if you have kids, they don't deploy you both at once. The problem is that they can instead deploy you sequentially, so you might not see each other for the length of two deployments. In a very high tempo war where people are going on multiple deployments you might not see each other for a very long time. It happened to some couples at the peak of the Iraq war, its not happening at the moment but its a possibility.

 

[Perrotfish]

If your goal is to stay close to your wife and to train in your desired specialty, whatever that may be, you would do well to RUN from HPSP. You are severely limiting your geographical and specialty options by binding yourself to the military. You cannot accurately predict what your life will be like 4 years from now, and can be complicated by numerous factors (kids, medical training desired, lack of training near family). When you join HPSP, you relinquish ALL control over your medical career. Yes, the mil will work with you but ultimately where you go and what you do is determined by the needs of the Army, Navy, AF. If you have a desire to serve in the military, go the civilian route and either sign up for FAP or return as a civilian contractor. You can hang on to some control at that point.

This is a much stronger argument against medicine than against HPSP. The civilian couples match is its own nightmare, which I honestly think is at least as likely to either screw or separate a couple as the military match and military co-location policies. In any event if you join this profession you are giving up your right to decide where you live, what you wear, when you work, and under what conditions you work for at least 7 years. If that kind of thing is a deal breaker go do engineering

 

[notdeadyet]

In any event if you join this profession you are giving up your right to decide where you live, what you wear, when you work, and under what conditions you work for at least 7 years. If that kind of thing is a deal breaker go do engineering

No. If I am a good student and not going into a crazy competitive specialty, I can choose a locale. I can also choose to not apply to programs with conditions I don't want to work under. I can also transfer. I can also wear whatever I want a long as it's professional.

There is a significant loss of freedom when you are tied to the very small number of programs in the military match and the fact that your medical school performance dictate where you end up much less than civilian side. The loss of rights/power thug is a MUCH bigger thing military side than civilian.


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[Perrotfish]

No. If I am a good student and not going into a crazy competitive specialty, I can choose a locale. I can also choose to not apply to programs with conditions I don't want to work under. I can also transfer. I can also wear whatever I want a long as it's professional.

There is a significant loss of freedom when you are tied to the very small number of programs in the military match and the fact that your medical school performance dictate where you end up much less than civilian side. The loss of rights/power thug is a MUCH bigger thing military side than civilian.


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My friends were mostly going for non-competitive specialties, they were mostly at least top half of the class and none of them had failed anything or received any disciplinary probation. Many did not get what they wanted. They were shunted by the match to, among other garden spots, New Mexico, middle of nowhere Kansas, and rural Louisiana. You are right, though, that there were literally hundreds of crappy choices they could have ranked fifth and gotten forced to go to. You can go wherever you want unless its somewhere someone else wants to go, like SoCal, DC, or NYC. Being a good but not great student in the match is like being an average looking woman at ComiCon: you have your pick of terrible options.

Also, you can choose not to apply to programs you don't want to work for? You really think the one day of exposure you get at the interview gives you ANY information about whether or not its the kind of program you want to work for? And you really think you have a practical option to transfer afterwards? You have the option to transfer from you program to any program in the nation that is both so toxic that they have lost a resident from you class, and so oblivious that they will take a resident requesting to transfer laterally from another program in the same specialty, and only assuming your last PD doesn't sink you when you let him know that you're going to leave him with a hole in his roster. Residents move where they're told and they do what they're told. For practical purposes they are significantly less free than military residents, who at least have are recognized as part of a vulnerable population (service members) and have a body of law to protect them from abuses of power.

Anyway, that wasn't even what the OP was asking about, he was asking about staying with his wife, which means the couples match. For the purposes of his training he will be limited to applying to schools that are willing to interview both him and his spouse. He will match at the best possible location willing to accept both of them, rather than him individually. If he can't get enough dual interviews for both of them to feel safe (with EM ambitions that might mean almost 20) they might need to apply separately. And BTW HIS safety valve for an abusive work environment will be a two resident simultaneous transfer, meaning a hospital so malignant that they have lost multiple residents in different programs in one year. Good luck.

 

[notdeadyet]

My friends were mostly going for non-competitive specialties, they were mostly at least top half of the class and none of them had failed anything or received any disciplinary probation. Many did not get what they wanted. They were shunted by the match to, among other garden spots, New Mexico, middle of nowhere Kansas, and rural Louisiana.

We'll just have to agree to disagree. My experience and that of my friends seems very different from your own. Everyone I know that went into family practice, peds, and psych got into their first two or three choices, and almost all in competitive markets. And this isn't just from my medical school (which wasn't any Ivy by a wide margin), but from multiple medical schools. I wonder if your friends were osteopath or IMG, which can find the allopathic match a lot harder. I would always put the smarter money on lots of options vs a handfuls in a residency you have the option to leave. The malignant programs you describe are pretty easily avoided in these fields and if folks are limited to getting placed in cruddy programs in rural Kansas, there's something else at play. But to each their own...

 

[colbgw02]

My experience is more in keeping with notdeadyet's. I went to a middle tier (30-35, if USNWR is to be believed at the time) allopathic school. It was uncommon for our peds, FP, and psych students to fall below #2 on their match list. If you didn't want to leave the city/state/region or wanted to couples match, it was easy to do.

 

[Perrotfish]

We'll just have to agree to disagree. My experience and that of my friends seems very different from your own. Everyone I know that went into family practice, peds, and psych got into their first two or three choices, and almost all in competitive markets. And this isn't just from my medical school (which wasn't any Ivy by a wide margin), but from multiple medical schools. I wonder if your friends were osteopath or IMG, which can find the allopathic match a lot harder. I would always put the smarter money on lots of options vs a handfuls in a residency you have the option to leave. The malignant programs you describe are pretty easily avoided in these fields and if folks are limited to getting placed in cruddy programs in rural Kansas, there's something else at play. But to each their own...

Allopathic program, midrange, same school as me. To be fair they weren't all sad stories, I would say a (slim) majority of people did get what they wanted. Also the ones who really got shunted somewhere awful were mostly people who ranked their list in terms of distance from a particularly beloved area like SoCal and DC where they had support networks rather than ranking by quality of training, which is how good residents ended up in New Mexico and Nevada. The ones who wanted good but not great locations (Atlanta, New Orleans, etc) in uncompetitive specialties mostly got what they wanted.

I would point out that saying that someone got in the top three of their match list isn't saying much. In most cases, options 1 and 3 will be in a different city, often in a different state. So what the match offers: if you are a better than average student, and choose a worse than average specialty, you will likely get your one of your top two choices of city to live in, though there's a chance that you won't and you still need to go where you're told to go. Honestly the military does offer that minimal degree of self determination.

 

[Kilgoretrout 65]

My wife and I are applying to medical school in 2015 and looking into applying for the HPSP Scholarship.

We both have family connections to the Air Force and Navy, but prefer the Navy route. Our goal is to go to the same medical school, attend residency at the same hospital, and be stationed at the same hospital after residency. She has a strong preference for EM and I have a preference for Anesthesiology.

1. How feasible is this with the HPSP Scholarship? (Assuming we land the specialties we want/ assuming we don’t get the specialties we want)

2. I know the Navy has a GMO Tour for a year, how would this affect us being together?

3. I’m slightly worried about a scenario where we both apply for the scholarship and only one of use gets it. If you apply and are awarded the scholarship do you have to take it?

I’d love to hear from a married couple that has gone the HPSP route or current practicing physician in the armed services.

You and your wife will have much more freedom and choice if you stay away from HPSP.

 

[deuist]

Honestly the military does offer that minimal degree of self determination.

I still don't see where you are coming up with this. If I don't want to go to a particular residency program in the civilian world, I don't rank it. I don't have that luxury in the military. The military match forces applicants to apply to every program in the military, including ones that I have zero desire to go to. If the OP joins the military, he is giving up significant freedoms on location as well as specialty. Although he lists certain specialty desires now, for all you know his preferences could change by the time application season rolls around and what he wants may not even be available in the military. Perrot, you mentioned that spouses with children cannot be deployed at the same time. Maybe this rule is Navy-specific. In the Air Force, one of my coworkers was deployed alongside of her spouse two months after giving birth to her second child. Couple splits absolutely do happen in the military.

 

[BigNavyPedsGuy]

On Co-location:

The Navy is required to co-locate you with an active duty spouse if it is at all feasible. The Navy has 7 teaching hospitals right now: 4 small ones where they train family practice doctors and 3 big ones where they train every other specialty. 2 of the FP training sites are within 45 minutes of one of the big hospitals, so if you're in training it is always feasible to co-locate you.

The technical definition of co-location is pretty broad. Actually I think its within 250 miles. However practically I have only known one physician who was 'technically' co-located with an active duty spouse far enough away that they couldn't actually live with their spouse. It was someone who was married half way through the process of detailing after the true co-location sites were gone, and they moved her to a new duty station one year later so they could actually be together.
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I know a dual active duty, dual medical, married in medical school couple that were stationed 900+ miles apart for 3+ years. They were married well before the detailing process. The Navy just screwed them because it doesn't care about people.

 

[notdeadyet]

One thing to keep in mind, MOT, is that you can always join later. There is absolutely no rush.

You can take HPSP now, but this is the riskiest of propositions. You don't know what speciality you'll have interest in and whether the military has any offerings that are any good. You have no idea what kind of medical student you'll be and whether you'll have the opportunity to train at some field-leaders if you went civilian. You also have no idea what milmed will look like in 8 years and if it's trajectory for GME continues to decline.

You can take FAP later. You'll know your speciality, have secured your civilian residency, and will still get financial incentives. If you're not interested in FAP or are in a specialty it's not offered in, you can just sign up for a direct accession bonus, which can be from $200K-$450K, depending on specialty.

Couples will likely be an easier prospect civilian side. Milmed isn't going anywhere. Opting for HPSP is fine, but don't feel like you'll be missing some window if you walk away from it now.