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TxsMed14

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I've been planning to apply Navy HSPS for several years, read up on research/talked with scholarship recipients much as I could. But those my age haven't graduated into active service yet, and older generation I know served in a very different time.

Reading this forum has me a bit spooked. so many people seem miserable. Is this just selection bias, unhappy people more likely to submit? Can I get some stories on those who love their residency programs and would have made the same decision even without the money?

Bit of back story, 35MCAT/3.7sGPA + two years research and a nature publication. I want to do epidemiology research on infectious diseases, applying navy bc of the opportunities for international residencies, and some of my mentors with my dream jobs are former navy med ( MD working for DARPA, another was a intelligence officer on disease outbreaks for CDC)

How realistic are my expectations? I'm interested in defense research, but very little info out there on how common this is through HPSP. My recruiter is, shockingly, very optimistic.

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Can I get some stories on those who love their residency programs and would have made the same decision even without the money? This has to be a fake post.
 
I knew about this forum before I took the HPSP scholarship, and I wrote off the overwhelming negativity as a result of the phenomenon that people who are dissatisfied are much more likely to take the time to write about it. I could not in good conscience encourage anyone to take the scholarship, but there are people who have a good experience. I have a friend doing the Navy ID fellowship who is pretty happy with it. My friend isn't on SDN, and I don't know the specifics of the fellowship, so I'm afraid I can't help you with that... Good luck with the decision.
 
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How realistic are my expectations? I'm interested in defense research, but very little info out there on how common this is through HPSP. My recruiter is, shockingly, very optimistic.

There is no guarantee that you'll be able to do the research that you want to do in the Navy (or any research). Times have definitely changed a lot from when those senior docs you know were in the service.
 
No guarantee you will do research or, for that matter, even get funding to attend a conference. Join if you want to serve. Don't join for any other reason at all.

In addition, you can always be a GS civilian and work with a govt research institute if you wish after you establish a civilian career.
 
Also judging by your tag line about peace, you may not totally enjoy a deployment. Just saying. You can't later get out for being a conscientious objector. It's been tried, and the person failed so there is legal precedent. If you join, you are an officer first, a doctor second.
 
Reading this forum has me a bit spooked. so many people seem miserable. Is this just selection bias, unhappy people more likely to submit? Can I get some stories on those who love their residency programs and would have made the same decision even without the money?

It is both selection bias (people can be perky and positive in front of their colleagues and bosses, they only need to come to the Internet to complain) and a catalog of real issue you should be aware of before you sign. My advice would be not to go looking for opinions, but instead to look for facts. Ask questions that have concrete answers and then form your own opinion, since that's the only one that matters. You'll get rants anyway, but ignore those and build up an opinion based on the facts you accumulate. At a bare minimum make sure you understand what is different about the Navy residency and fellowship matches vs. civilian, how GMO tours work, what kind of duty stations you can be assigned to after Intern year/residency/fellowship, what your obligation will be, and your likely net financial gain/loss from taking the scholarsihp. I strongly believe that if you understand what you're agreeing to not only will you be more likely to make the right decision, but basic cognitive dissonance will lead to a happier experience no matter what decision you make.

FWIW I really like my residency program. Its significantly better than any of the civilian programs I have rotated through in terms of culture, didactics, and of course the quality of the patient population. I'm also grateful for the chance to be in my profession at all: I came from a crazy expensive school and I'm in an underpaid field, and I'm now contemplating an even more underpaid fellowship. I'm reasonably sure that without this scholarship I would have made a more pragmatic decision at the match and would be languishing in an Anesthesia residency, morbidly fantasizing about bludgeoning the surgeon with my Sudoku book.

I would agree that the opportunities for large scale international ID research can be difficult to obtain in a Navy residency, and variable depending on your duty station after that. While nothing is impossible, Navy residencies get pulled in a lot of different directions: everyone needs to be ready to practice in clinic a tertiary care center, alone as the only board certified doctor on a small island, and also in a warzone as an EM/SportsMed/FM/occupation med stand in for a battalion of marines. While I have had great mentorship, enthusiasm, and support for research projects I've proposed, we just don't get the kind of dedicated research time that allows civilian residents to pull of larger scale projects. There are just too many ICU months, GMO preparation months, and ACGME requirements to give you multiple full months to research things. Of course, the scale of things you're talking about sounds like it might be a little ambitious for anyone not currently in an ID fellowship. Residency is hard everywhere.
 
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There is no such thing as an international residency. A select small group of people do an ID fellowship after their internal medicine residency. Then an even smaller select group of them, are able to do research at unique overseas locations. That means the earliest you would get to do this would be 10 years after you start medical school (4yrs of school+3yrs of residency+3years of fellowship) IF you get to have straight through training. It could be a cool opportunity, but are you willing to let someone else choose your final say in specialty training, location, and what job you do for a chance to have a cool job after 10 years? If you start medical school in the fall, that means the earliest you could do this is 2024.

This is not a negative rant. It's an accurate description of the road the people you talked to went down. You honestly have NO IDEA what specialty you'll end up doing. To make a decision now based on a select few people's unique experience might be a bit unrealistic.
 
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I've been planning to apply Navy HSPS for several years, read up on research/talked with scholarship recipients much as I could. But those my age haven't graduated into active service yet, and older generation I know served in a very different time.

Reading this forum has me a bit spooked. so many people seem miserable. Is this just selection bias, unhappy people more likely to submit? Can I get some stories on those who love their residency programs and would have made the same decision even without the money?

Bit of back story, 35MCAT/3.7sGPA + two years research and a nature publication. I want to do epidemiology research on infectious diseases, applying navy bc of the opportunities for international residencies, and some of my mentors with my dream jobs are former navy med ( MD working for DARPA, another was a intelligence officer on disease outbreaks for CDC)

How realistic are my expectations? I'm interested in defense research, but very little info out there on how common this is through HPSP. My recruiter is, shockingly, very optimistic.

Navy HPSP: Caveat emptor.
 
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Reading this forum has me a bit spooked. so many people seem miserable. Is this just selection bias, unhappy people more likely to submit? Can I get some stories on those who love their residency programs and would have made the same decision even without the money?

I think if you read carefully, you'll find only few complaining about military GME, even some of the most jaded. Most of us have few qualms with our residencies, and even fellowships. GME is shielded by ACGME rules and influence from some of the nastier aspects of military medicine, as it should be. For the record, I was very happy with my residency.

Day to day practice in military medicine is truly the grind it's made out to be here. With any luck, this forum should be an antidote to your naïveté. The thing about the "dream jobs": you have to grind just like everyone else to have a shot at them, and even then, the needs of the services for filling the mundane billets is much greater than filling a slot at DARPA (which can easily by filled by a civilian/contractor).


Finally, ALL RECRUITERS LIE. I can't say it plainer than that. They'll tell you whatever you need to hear (and withhold what you don't want to hear) to get you to sign on the dotted line. The reality is that unless you know someone, got pull or influence over someone, or are just having a spectacularly lucky day, prepare to join the grind like the rest of us; your recruiter can't do a thing about it.
 
Also judging by your tag line about peace, you may not totally enjoy a deployment. Just saying. You can't later get out for being a conscientious objector. It's been tried, and the person failed so there is legal precedent. If you join, you are an officer first, a doctor second.

I've support a significant other through two deployments, have family members who serve. Call me naive, but I don't believe any of them joined the service because they didn't have any idealism.

Whether active duty has beaten it out of them is another matter, but I am familiar with the implications of service.
 
I think if you read carefully, you'll find only few complaining about military GME, even some of the most jaded. Most of us have few qualms with our residencies, and even fellowships. GME is shielded by ACGME rules and influence from some of the nastier aspects of military medicine, as it should be. For the record, I was very happy with my residency.

Day to day practice in military medicine is truly the grind it's made out to be here. With any luck, this forum should be an antidote to your naïveté. The thing about the "dream jobs": you have to grind just like everyone else to have a shot at them, and even then, the needs of the services for filling the mundane billets is much greater than filling a slot at DARPA (which can easily by filled by a civilian/contractor).


Finally, ALL RECRUITERS LIE. I can't say it plainer than that. They'll tell you whatever you need to hear (and withhold what you don't want to hear) to get you to sign on the dotted line. The reality is that unless you know someone, got pull or influence over someone, or are just having a spectacularly lucky day, prepare to join the grind like the rest of us; your recruiter can't do a thing about it.

Thanks for the input. Personally, I don't feel like 10 years is a horrible price to pay before starting my own career. I enjoy clinical work, and don't mind going where the wind blows in terms of deployments, placements etc.

To be honest, as a woman I will face discrimination in a research career track (pretty well documented) and likely a defense career. Im hoping that having paid my dues will give me a bit of legitimacy if I want to go into defense work later (esp. bioterrorism related)

Do you feel from your experience there's any merit to that?
 
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Navy HPSP: Caveat emptor. Seriously.

First of all, you have good baseline stats that will open doors up to some top medical schools, assuming you don't botch an interview and you can write a believable AMCAS personal statement. I'm not trying to be too cynical or belittle your Nature publication...but to be totally honest, to the Navy, a publication is a publication is a publication, not matter if it was in Nature, Science, JAMA, or the Myanmar Journal of Toenail Fungus. All military residencies use a point system for applications, and two publications in any peer-reviewed journal will max you out for research. Not to say that you should not continue to pursue scholarly activities everywhere you go, but you should know that Navy Medicine, in general, does not value research very highly--it's not a priority. Serving the OPFOR is the top priority, followed by caring for Tricare beneficiaries (dependents and retirees).

I know several Infectious Disease specialists who seem to be relatively happy in their jobs. The Navy ID Fellowship is 3 years, one of which is spent earning an MPH. One of these guys works at one of the Navy Research Units (google this) and spent two tours in Peru at a research facility. Another is a Professor at USUHS. A third spends a great deal of time on a "lecture circuit" teaching a Tropical Medicine course at USUHS and for the GMOs and other physicians at the overseas Navy hospitals. They have helped with disaster relief operations (2011 Japanese Tsunami, 2004 Japanese Tsunami, Haiti, etc), but strictly in a military capacity. Aside from this, there are very few opportunities for international work. You cannot, for example, decide to set up a free clinic in Sub-Saharan Africa on a whim because your humanitarian juices may be flowing. The Navy will put you where it needs you. Just remember this.

I did HPSP, and it was a complicated decision made with few alternate options. Despite a good academic record and strong recommendations, I still did a GMO tour before finally matching into my specialty of choice. My graduating HPSP class also had the lowest recruitment rate, which meant zero deferments for residency.

That being said, I cannot say that I am unhappy. My residency program is very laid back. Unlike some other clinical services, my department is strictly physician-run. Our chairman does a good job advocating for us. Our Department Head still takes call every few weeks and stays clinically-oriented. We only have two nurses, and they are strictly clinical. Our Enlisted personnel are very good at their job, motivated, and help things run smoothly in the Department. Our program director is also very receptive to our wishes and complaints. I can't see myself being terribly unhappy in the future, since I tend to make the best of my situation (something reinforced as a GMO). The only major issue I can foresee is the fact that the military seriously undercompensates physicians in my specialty relative to the Civilian world. There are, however, moonlighting opportunities (shhhhh) which could even things out a bit. The other problem I foresee is the lack of funding for FTOS fellowship spots. Maybe this will change when I'm done with residency and I have a staff tour under my belt.

So back to your original question. Don't do HPSP. Get into the best medical school you can go. Pay for it with student loans. Figure out what you want to do with your life, specialty-wise. Match into that specialty and start your residency. Then decide if you still want to serve in the military. If so, do Navy FAP (essentially, the Navy will repay your loans if you serve for 4 years after residency...the plus side is that you will have done a residency of your choice without doing a GMO tour).

HPSP brings with it many variables of which you should be aware. Hope this helps.

Also, take everything your recruiter says to you with a grain of salt. They will ALWAYS be overoptimistic about everything, because it's their job to find warm bodies to fill a future billet.

Hands down one of the most informative/helpful posts I've come across. Thanks man, this seems like a fair analysis. I've had a several people advise me to just take out the loans and join up after. That may well be the way I go, unless I end up at an expensive school with little financial aid.
 
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It is both selection bias (people can be perky and positive in front of their colleagues and bosses, they only need to come to the Internet to complain) and a catalog of real issue you should be aware of before you sign. My advice would be not to go looking for opinions, but instead to look for facts. Ask questions that have concrete answers and then form your own opinion, since that's the only one that matters. You'll get rants anyway, but ignore those and build up an opinion based on the facts you accumulate. At a bare minimum make sure you understand what is different about the Navy residency and fellowship matches vs. civilian, how GMO tours work, what kind of duty stations you can be assigned to after Intern year/residency/fellowship, what your obligation will be, and your likely net financial gain/loss from taking the scholarsihp. I strongly believe that if you understand what you're agreeing to not only will you be more likely to make the right decision, but basic cognitive dissonance will lead to a happier experience no matter what decision you make.

FWIW I really like my residency program. Its significantly better than any of the civilian programs I have rotated through in terms of culture, didactics, and of course the quality of the patient population. I'm also grateful for the chance to be in my profession at all: I came from a crazy expensive school and I'm in an underpaid field, and I'm now contemplating an even more underpaid fellowship. I'm reasonably sure that without this scholarship I would have made a more pragmatic decision at the match and would be languishing in an Anesthesia residency, morbidly fantasizing about bludgeoning the surgeon with my Sudoku book.

I would agree that the opportunities for large scale international ID research can be difficult to obtain in a Navy residency, and variable depending on your duty station after that. While nothing is impossible, Navy residencies get pulled in a lot of different directions: everyone needs to be ready to practice in clinic a tertiary care center, alone as the only board certified doctor on a small island, and also in a warzone as an EM/SportsMed/FM/occupation med stand in for a battalion of marines. While I have had great mentorship, enthusiasm, and support for research projects I've proposed, we just don't get the kind of dedicated research time that allows civilian residents to pull of larger scale projects. There are just too many ICU months, GMO preparation months, and ACGME requirements to give you multiple full months to research things. Of course, the scale of things you're talking about sounds like it might be a little ambitious for anyone not currently in an ID fellowship. Residency is hard everywhere.

I'll need to read this over a few times, great starting point. i definitely agree on understanding residencies and fellowships. The problem is the forum has so many acronyms its hard to understand what people are talking about without a pretty good knowledge of the system and lingo (most of my friends are Army infantry, so I picked up some following their careers. But MilMedicine is a completely different ball game)

A big factor in my decision is whether I end up at an expensive school, because I know 100% what fields I want to (eventually) work in, and none of them pay anything close to the average physician salary. I almost feel like I'll be more pressured to go into a field I don't want if I DON'T go through mil.. And as I mentioned on another post, I don't mind paying my dues with 10 years of clinical work wherever, as long as i can pick my specialty. though if I landed a cool fellowship that would be a plus, and it can't hurt to investigate what options are out there, even if there competitive or only landed by dumb luck.

I wonder if the main source of dissatisfaction is not the work itself, but people feeling like they missed out on a better civilian residency or fellowship? And there's no way I could research every potential mil vs. non mil opportunity I might someday come across and weigh the difference...
 
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I've been planning to apply Navy HSPS for several years, read up on research/talked with scholarship recipients much as I could. But those my age haven't graduated into active service yet, and older generation I know served in a very different time.

Reading this forum has me a bit spooked. so many people seem miserable. Is this just selection bias, unhappy people more likely to submit? Can I get some stories on those who love their residency programs and would have made the same decision even without the money?

Bit of back story, 35MCAT/3.7sGPA + two years research and a nature publication. I want to do epidemiology research on infectious diseases, applying navy bc of the opportunities for international residencies, and some of my mentors with my dream jobs are former navy med ( MD working for DARPA, another was a intelligence officer on disease outbreaks for CDC)

How realistic are my expectations? I'm interested in defense research, but very little info out there on how common this is through HPSP. My recruiter is, shockingly, very optimistic.


If "international residencies" (which don't actually exist) is your prime reason for applying Navy...please reconsider as you will be extraordinarily disappointed. Sounds like your mentors are the exception not the norm.


"I've support [sic] a significant other through two deployments, have family members who serve. Call me naive, but I don't believe any of them joined the service because they didn't have any idealism.


Whether active duty has beaten it out of them is another matter, but I am familiar with the implications of service."

Fair enough...however you didn't mention the above in your original post, hence the accusation of being naive. Like others have already eluded to, don't believe your optimistic detailer who know little about military medicine. Join if you want to serve...it's that simple. Don't join if you have very specific expectations (kinda like the above mentioned) as you will be disappointed.
 
Thanks for the input. Personally, I don't feel like 10 years is a horrible price to pay before starting my own career. I enjoy clinical work, and don't mind going where the wind blows in terms of deployments, placements etc.

Except that it's not just 10 years before you start your career. It's at best ten years before you're even eligible to do what you're supposedly signing up for in the first place, meanwhile at any given second the military might decide to screw you over. In ten years you might be married with kids and not want to go overseas for international research, assuming that option is still even available.

Furthermore, the ID fellowship will tack time on to your obligation. So by the time you're eligible to get out you'll already have 12 or 13 years in service, which stinks.
 
It sounds like your mind is made up and you want us to tell you it's the right decision. But we're not. So you aren't listening to us. We were you. We understand your side of things, and we're still telling you not to do it.
 
Thanks for the input. Personally, I don't feel like 10 years is a horrible price to pay before starting my own career. I enjoy clinical work, and don't mind going where the wind blows in terms of deployments, placements etc.

To be honest, as a woman I will face discrimination in a research career track (pretty well documented) and likely a defense career. Im hoping that having paid my dues will give me a bit of legitimacy if I want to go into defense work later (esp. bioterrorism related)

Do you feel from your experience there's any merit to that?

I think the discrimination you will face as a woman will be the same in or out of the military, frankly. You're aspiring to a position in academia and I certainly don't think the military has any new insights on that problem. I think your academic reputation is going to be far more important than having worn the uniform when it comes to the career you're envisioning for yourself.

Anyone on this board will tell you that by joining the military, you give up a significant amount of freedom/options throughout your training and subsequent career. Since you would like to pursue an end goal that is not necessarily what the military is looking for from the vast majority of the physicians and surgeons who wear a uniform, you'll want to retain as much freedom to chart your own course as you progress through your training.

My advice: obtain your undergraduate and graduate medical education (including fellowship) in the civilian sector, at some point find a position at the NIH, CDC, etc. to bolster your credentials, then negotiate from a position of strength with the military to get the job you want be it at WRAIR, USAMRIID, whatever the acronym/name is for the Navy lab in Peru, etc.

I think you could reach your goal either with or without the scholarship; I know one woman who made her way through a public med school on HPSP, completed residency in the same program I did, including chief resident, completed an ID fellowship, and now does bench and clinical ID research at WRAIR. I just think you would reach your goals more efficiently and with less risk of self-imposed head trauma by going the civilian route first.

Best of luck! Just remember what I said about recruiters.
 
Reading this forum has me a bit spooked. so many people seem miserable. Is this just selection bias, unhappy people more likely to submit? Can I get some stories on those who love their residency programs and would have made the same decision even without the money?

I've been happy with the Navy. Training in my specialty was solid. Practice and work environment has been good. I've moonlighted quite a bit over the last few years, and the civilian world has some issues too.

I have been fortunate.

Would I have taken the same path even without the money during med school? No, of course not. This isn't utopian la-la land. Money is important. Quality of life is important. Standard of living is important. Retirement accounts are important. Looking back, taking in the entire picture, I'm content and satisfied with the decision to join.

But my anecdotal experience doesn't help you. I joined a different Navy in the 1990s. I wasn't and am not interested in bench research. I'm in a different specialty than you're interested in, and anyway, odds are high you'll change your mind midway through med school, because everybody does.

Also, EVERYBODY applies to medical school thinking that doing research would be cool. Science is neat. Somewhere along the line though, 99% of us non-MD/PhD types decide that making research the focus of a career is unappealing. Odds are you'll discover the same thing.

This early in your pre-career education, the right answer is almost always to keep as many options open as possible. We don't know what you'll want in 10-15 years, and neither do you.


How realistic are my expectations? I'm interested in defense research, but very little info out there on how common this is through HPSP. My recruiter is, shockingly, very optimistic.

There's not a lot of research going on amongst active duty physicians. There's some, but the opportunities are not remotely comparable to what research-minded people are doing in the civilian world. There are lots of reasons for this ... research isn't really our purpose, frequent PCS moves get in the way of large studies, deployments are unpredictable and risk torpedoing any ongoing project, etc etc.

There's plenty of good cautious advice in this thread. You should join the military if you want to be in the military.
 
What about the Medical Scientist Training programs? Don't they pay for med school and allow you to get your PhD along the way? I have seen people graduate in 7 years from those programs. You could do all the micro or epidemiology research you want and more and then go work at the NIH or CDC. If you want to serve the country you could join the PHS. What most have been saying here is you join DoD and you become an asset to move around and nobody is looking out for your career. There are the few that have gotten to do everything they wanted; a subset of them most likely threw their colleagues under the bus along the way by dodging deployments or crappy admin jobs that someone else had to do.
 
And as I mentioned on another post, I don't mind paying my dues with 10 years of clinical work wherever, as long as i can pick my specialty.

In both the civilian and military worlds, you don't exactly pick your specialty, you apply for it in a process called the match. Some specialties are so uncompetitive that with an effective application strategy pretty much any US medical school graduate who applies will get in (Psych, Pediatrics, Family Medicine), some will only take a handful of the highest tier medical students (Dermatology, Ear Nose and Throat, Interventonal Rads) and the rest are somewhere in between.

What you need to understand about the military is that, when you take the military's money, you give them the right to decide whether you apply through their match or the civilian match, as well as what specialty you're allowed to apply to should they allow you to apply civilian. You also need to understand that the odds of getting a certain specialty in the military match can be drastically different than in the civilian world. Some specialties are probably easier to get in the military (the uber competitive stuff might be), some are harder (Pediatrics, emergency medicine), and some don't even exist (PM&R). Since the numbers are smaller, the year to year variability in the military is also drastically higher. Some fellowships basically only become available the year someone retires. Even the 'large' residency programs like IM and Peds have only a few dozen slots Navy wide, which means you can see significant year to year variability in availability. They won't pick your specialty for you, but being forced into the military match can still effectively lock you out of your specialty of choice.
 
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What you need to understand about the military is that, when you take the military's money, you give them the right to decide whether you apply through their match or the civilian match, as well as what specialty you're allowed to apply to should they allow you to apply civilian. You also need to understand that the odds of getting a certain specialty in the military match can be drastically different than in the civilian world. Some specialties are probably easier to get in the military (the uber competitive stuff might be), some are harder (Pediatrics, emergency medicine), and some don't even exist (PM&R). Since the numbers are smaller, the year to year variability in the military is also drastically higher. Some fellowships basically only become available the year someone retires. Even the 'large' residency programs like IM and Peds have only a few dozen slots Navy wide, which means you can see significant year to year variability in availability. They won't pick your specialty for you, but being forced into the military match can still effectively lock you out of your specialty of choice.

As a fourth year about to apply, this is something I'm realizing my recruiter flat out lied to me about, either through his ignorance (most likely, he was brand new to HPSP recruiting) or just wanting to get me to sign. Will see how things end up but at this point I am not loving the match process and have pretty low expectations.
 
The most clueless and useless Medical Admin officer at my command just left to go be an HPSP recruiter.....
 
What about the Medical Scientist Training programs? Don't they pay for med school and allow you to get your PhD along the way? I have seen people graduate in 7 years from those programs. You could do all the micro or epidemiology research you want and more and then go work at the NIH or CDC. If you want to serve the country you could join the PHS. What most have been saying here is you join DoD and you become an asset to move around and nobody is looking out for your career. There are the few that have gotten to do everything they wanted; a subset of them most likely threw their colleagues under the bus along the way by dodging deployments or crappy admin jobs that someone else had to do.

Yea, I looked into Md/PHD, actually spoke with program directors at different schools. But the general consensus is that the split is at most, 90% research to 10% clinical, and to sustain funding and get published, I can't spend much time working with patients. I'm actually not that interested in a long-term research career, or at least, something more of 40/60 clinical split. I've just had a backgorund in it and wondered how this would affect my path in the Navy. Answer: a couple bonus points here or there.

Still, I couldn't stand the attitudes of the MD/PHDs i spoke with. they kept saying, somewhat condescendingly, if I wanted to go to school "just to touch patients," it wasn't a good fit for me.

Call me crazy, but yea ... I actually want to go to medical school to practice medicine!
 
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Thanks to everyone who replied to this post, it has been a big help and I honestly will take all your input into consideration. I definitely get that this is not the right path if I won't be happy with whatever residency or fellowship the military assigns, and I have to seriously consider whether that is the case for me.

Best of luck to everyone, and regardless of how it's worked out for you so far, thank you for your service.
 
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