WPAFB hospital closing

[docb14]

Rumor has it that WPAFB hospital is going to become more of an outpatient clinic (similar to what happened at Offutt a few years ago) after 2015. While those of us who have been around know that in its current state the hospital already is a glorified outpatient clinic (at best)- I'm curious to get the general opinion of what this means for the future of AF med. If WP shuts down in-patient medicine and surgery then the ER will go away with them. What does this mean for the IM, Gen Surg and ER residencies that currently rotate through the hospital (which I'm guessing represent a healthy portion of AF residents overall)? I think we all know that AF medicine has been dying a very slow death for quite some time and ultimately needs to go away but is shuttering these sham "med centers" the first step or are all of us going to end up sitting around BAMC or DGMC getting CBT'd and Commanders Called to death? I think I unfortunately already know the answer. How much longer can the AF (or mil med in general) pretend that they can supply the volume and training required to have legitimate skill based specialists? I know I'm preaching to the choir here but I'm still amazed at the precipitous decline of mil med over my relatively short career.

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[aklark]

What's the argument against eliminating most or all military GME, giving out more civilian deferments, and using primarily civilian and military attendings?

My understanding is that HHS funds civilian residents' salaries because they cost, on paper at least, the hospitals money to train.

 

[colbgw02]

Would love to see that happen. Right now, the military's mission just gets in the way of GME. If we're going to hold ourselves to civilian standards for training (i.e. the ACGME), then let the civilian GME system handle it. This isn't 1981 and we're no longer offering unique or superior training.

 

[docb14]

My thoughts exactly, with all the line side talk of budget cuts and streamlining I can't understand why this hasn't happened yet. Give me the red marker- USUHS- CHOP (and I went there), understaffed and ill equipped med centers- CHOP, Military GME- CHOP. Please explain to me how it furthers our current mission to train pediatric subspecialists??? I'm sorry but in this day in age if you are not deployable to directly support the warfighter then you have no business taking up a billet. You have people getting these funded ridiculous fellowships that have zero bearing on operational medicine while the ER and surgery guys leave in droves. The few who stick around are a mix of dudes who made poor choices years ago and have exorbitant payback times b/c of Academy/ROTC/USUHS or incompetent *****s/burnouts who know they wouldn't last a minute on the outside. Of course its the latter group who tend to play the game and end up in command- hence one big reason we are where we are right now. I say keep a contingent of FP's and flight docs to support the airmen and flyers only- EVERYTHING else is farmed out to the civilian sector. As far as ER and trauma surgeons- work out some drug deals where there are groups of dudes in some type of reserve status that work day-to-day in civilian med centers but can deploy if needed- we already have very similar models on the SF side.... this wasn't meant to be so bitter but it just kind of flowed, sorry 10+ years of frustration.

 

[Rudy]

Totally agree with docb14. I am also a USUHS grad, and I believe it needs to go. At least from an AF perspective, the GME and operational billets are not robust enough to justify committing young pre-med students to commitments ranging from 10-13 yrs post medical school. It's becoming difficult to nearly impossible to maintain competency in many medical specialties, and that is not fair to the medical practitioner or the patient.

AF med has been dying an incredibly slow death. I've been watching it first hand since grad from usuhs in the early 2000s. Finally, some docs are being let go before commitment time is up. If Wright Pat goes down, this could signal the beginning of the end of AF med. From an AF point of view SAMMC has been a disaster, thus not much help in righting the ship. DGMC at Travis AFB is just not equipped to step into the new flagship role. Time to convert all non-operational billets to reservists and get out of the GME business entirely. There's no other rational solution.


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[Gastrapathy]

The AF realized that as long as the other services stay open, they can get out of the business of medicine. They've slowly pulled back for a decade.


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[colbgw02]

The AF realized that as long as the other services stay open, they can get out of the business of medicine. They've slowly pulled back for a decade.

QFT (holds tongue until separation).

 

[USAFGMODOC]

If WPAFB downscales to an outpatient clinic, then I would envision the future trend would be heavily leaning towards increasing the number of primary care providers (to include Flight docs, ER, FP, NP's, PA's and such) and decreasing many/most of the non-surgical AD physicians. I'm not sure the USAF has it's heart on continuing the business plan of ADAF specialty care physicians. Overall, (IMHO) the majority of the line guys don't see the USAF AD Medical Corps as mission essential….

As for future GME in the USAF; I found the recently released HPERB for 2014 interesting because it had a large increase in the number of FP slots (with overall mild increase in the slots for flight medicine and general surgery). However, most of the other fellowships/residency slots for other specialty fields were decreased from prior years. Does this mean we are too fat in the MC or is this just a one year GME anomaly?? Or, is there a future plan to downsize many of the active duty GME slots within the next 5-7 years??

 

[Homunculus]

The AF realized that as long as the other services stay open, they can get out of the business of medicine. They've slowly pulled back for a decade.

this.

case in point: malcolm grow. the AF has a seat at the table but the more they can hand over the more money they save. too bad not everyone can use the same model, or there'd be no one left to take care of patients.

--your friendly neighborhood 1 service down 2 to go caveman

 

[pgg]

The AF realized that as long as the other services stay open, they can get out of the business of medicine. They've slowly pulled back for a decade.

You have a way with words. The blunt truth in two sentences.

I'm convinced the AF culture of aggressively leading the rightsizing, outsourcing, and midleveling effort is why most of the really unhappy people on this forum are AF physicians.

 

[Gastrapathy]

Its clever, really. Put your docs at combined (i.e. Army) facilities and let the other services pay all the infrastructure costs. Gradually reduce your footprint until...well that's the question. Its not clear to me if this is part of a broader plan or just a simple play to keep building golf courses instead of hospitals without regard to the long-term consequences.

As for the .mil getting out of GME, it would create a crisis in medical education. I can't remember the numbers but military programs are a respectable percentage of all GME (I think its around 10% but someone can correct me).

I'm probably too blunt on the message board. Its me overcompensating for keeping my head down and being ever the diplomat through my AD time.

 

[Kilgoretrout 65]

Someone who trained at WPAFB should comment but my impression is that the residents there spent a huge percentage of their time at downtown hospitals so not that much changes. They can do
outpatient medicine or peds at the super clinic.

Years back the AF surgeon general, "Peach" Taylor, had a grand plan to downsize and just keep the bare minimum for the fight. Not a bad idea but since his tenure, the AF has been trying to overcome
that notion and hasn't totally committed to GME etc. If you're gonna do it, do it, don't sit there and move forward (or backward) at half speed. Where's Peach now? At DHA from his bio:

the Acting Principal Deputy Assistant Secretary of Defense for Health Affairs. Dr. Taylor also serves as the Principal Deputy Director, TRICARE Management Activity. In these two roles, Dr. Taylor assists in the development of strategies and priorities to achieve the health mission of the Military Health System, and participates fully in formulating, developing, overseeing and advocating the policies of the Secretary of Defense.

If DoD outsources GME, they should be prepared for some med students not to match as this last match was more competitive than ever, with the proliferating number of puppy farms, er med schools.
Of course those residents come with their own money so free labor.

 

[Kilgoretrout 65]

From an AF point of view SAMMC has been a disaster

Yes. We are all just Army employees now, or worse, new enlistees. APEQS anyone? I am waiting for someone to inspect my car before I drive to the airport on leave. Maybe I will take a cab instead.

 

[Monty Python]

You have a way with words. The blunt truth in two sentences.

I'm convinced the AF culture of aggressively leading the rightsizing, outsourcing, and midleveling effort is why most of the really unhappy people on this forum are AF physicians.

How much of the recent AF change is due to their lack of a MEDCOM/BUMED? The Army and Navy have separate medical commands to fight for budget, resources, etc, while the AF medical system rolls under the line operators for resources (if I remember my history lesson). This might also give the DHA rationale to try to "purple-suit" all things DoD medical. They sort-of contemplated that in the past, but it went nowhere.

 

[AFlightdoc]

so with the writing on the wall (so to speak) does anyone have legitimate info re: early seperation for docs? ive heard rumblings and seen mentions of it on this board but have yet to run into anyone at my shop who has actually pulled this off...

 

[pgg]

so with the writing on the wall (so to speak) does anyone have legitimate info re: early seperation for docs? ive heard rumblings and seen mentions of it on this board but have yet to run into anyone at my shop who has actually pulled this off...

Let me tell you something my friend. Hope is a dangerous thing. Hope can drive a man insane.

Physicians will not be offered early separation or retirement. A physician serving an ADSO is the best bargain the military has in any billet category, anywhere.

 

[colbgw02]

Let me tell you something my friend. Hope is a dangerous thing. Hope can drive a man insane.

Physicians will not be offered early separation or retirement. A physician serving an ADSO is the best bargain the military has in any billet category, anywhere.

I mentioned this on another thread, but not here: I personally know and have spoken with a few Air Force physicians who are on the shortlist to be RIF'ed. One just graduated from residency and owes 4 years on his GME ADSO (minus 1 day if you count today). They expect to hear something within the next six months and, if selected, be out by this time next summer.

 

[pgg]

Wow. I believe you, but I'll also believe it when I see it. It just makes zero sense.

 

[colbgw02]

Wow. I believe you, but I'll also believe it when I see it. It just makes zero sense.

Tell me about it. FWIW, the recently graduated guy doubts he'll be selected, as they're targeting people with less time on their ADSO. But want to hear the kicker? Those who are selected are expected to receive a $155K separation bonus (or whatever it's called).

 

[pgg]

Tell me about it. FWIW, the recently graduated guy doubts he'll be selected, as they're targeting people with less time on their ADSO. But want to hear the kicker? Those who are selected are expected to receive a $155K separation bonus (or whatever it's called).

I don't even know which way is up any more. You apply for early discharge, but get involuntary separation pay? I guess nothing the AF does should surprise me any more.

 

[denali]

I have a hard time imagining implementation of a medical officer early separation/SERB plan without first making significant reductions in bonus pays. That would allow targeted attrition of the undesired specialties and be less costly all around.

 

[Rudy]

I know of a few AF docs that have been given early sep with bonus and/or early retirement. Two radiologists at Travis AFB. Also a couple of dermatologists (not sure where stationed). Never thought I'd see the day, who knows how long it will last.


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[deuist]

That's amazing. I distinctly remember when the announcement was made during the fall that many people would be separated Air Force-wide, the next day Air Force Medical Services sent every physician and email saying that none of the docs would be let out of active-duty service obligations and that we should not expect to apply for early separation.

As far as shutting down the inpatient services at Wright Patterson, Andrews Air Force Base has already done this. There is still a standalone emergency department that functions at Andrews. All admissions go to outside facilities. As another poster mentioned, most of the residencies at Wright Patterson already spend most of their time at civilian hospitals. For EM, the residents only spend one month a year rotating through Wright-Patterson as part of their community medicine rotation.

 

[deuist]

As far as ER and trauma surgeons- work out some drug deals where there are groups of dudes in some type of reserve status that work day-to-day in civilian med centers but can deploy if needed- we already have very similar models on the SF side.

Air Force Special Operations has active-duty physicians stationed at the University of Alabama at Birmingham. There are also opportunities for active-duty physicians in emergency medicine, trauma surgery, and anesthesiology to work at the University of Cincinnati, Shock Trauma in Baltimore, or in St. Louis, Mo. My understanding is that the British keep all of their military physicians in reserve status and call them up only when needed for war purposes. I envision that a similar system could be implemented here in the United States whereby we all work for large group practices that would not necessarily miss us if we were gone for six months every two years.

 

[dr7859]

I've followed this board for a long time and have never felt the need to post anything until now. In regards to the Air Force medicine is dying theme...well it's already dead (at least from an in-patient medicine/ER/surgical standpoint). The following will describe why this is so...Now first, I don't pretend to have privileged information or a crystal ball but I've been told a few things from some folks who I believe know about as much about these hospital closings as anyone (as always take with a grain of salt). DHA is closing med centers- no surprise- and it looks like the army is taking the brunt of it, as far as the AF goes the "Medical Centers" at WP, Travis, Nellis and Eglin are all being looked at. Apparently final decisions will be made over the next 12-18 months. Now here comes the logic that is at the rotten heart of the AF med corps. My shop is on the chopping block, my CC has let this be known. The official med group response is "we have 12 months to show the AF how valuable we are!" This is wear the serious trouble is going to begin. The not so subtle context behind this statement is that we will be seriously looking over your shoulders and armchair quarterbacking every decision that is made to ship a patient out to the civilian tertiary care center down the street. Specifically mentioned were pediatric admissions, ICU admissions and inpatient surgical admissions. Well we have internists, pediatricians and general surgeons so on paper this looks reasonable- and I'm sure has been sold to big AF as completely feasible. Problem is my shop has some unique quirks (being kind)- here are a few- the acquisition of basic lab values is dicey at best. Routinely BMPs take hours to result and when they do at least half the time they are "hemolyzed" and are essentially worthless. We've had a recent issues with the accuracy of our troponins- troponins for god's sake- the one lab you can't get wrong. Labs have been confused between several patients numerous times over the last 6 months. Radiology does not exist on weekends and after hours- and I'm not talking about a radiologist in-house- I mean good luck getting a non-con CT abd/pelvis. If you need it you have to argue with the E-4 radiology tech, who may also be at home, or deal with the old "scanner is broken" routine. We have very junior, very green house staff/nursing staff who are simply not qualified to take care of pediatric, geriatric or critically ill patients. What this means is that over the next 12 months our med group leadership is prepared to force admissions that medically speaking should to be transferred to outside facilities in order to appear more relevant on paper. The irony is that all these issues have been brought to the leadership numerous times and have fallen on deaf ears. Now that the facility is on the block out come the admin weenies to crunch some numbers and -poof- like magic we have a robust inpatient capability overnight. Not only is this unrealistic its down right dangerous- patient care is going to suffer, people are going to get hurt all in the name of inflating numbers to avoid the BRAC. I'm seriously considering throwing my hat in the ring for a 365 and watch this debacle go down from OCONUS.

 

[aklark]

Does DHA have authority to close MTFs? In this article the comptroller says they'd need Congressional approval to consolidate hospitals. Another round of base closures seems like a non-starter.

Current DHA approach seems to be more focused on "recapturing" geriatric and pediatric beneficiaries back to military facilities.

 

[Handinhand]

Do you guys think this means that more and more HPSP students will be deferred to civilian residencies?

 

[Kilgoretrout 65]

I've followed this board for a long time and have never felt the need to post anything until now. In regards to the Air Force medicine is dying theme...well it's already dead (at least from an in-patient medicine/ER/surgical standpoint). The following will describe why this is so...Now first, I don't pretend to have privileged information or a crystal ball but I've been told a few things from some folks who I believe know about as much about these hospital closings as anyone (as always take with a grain of salt). DHA is closing med centers- no surprise- and it looks like the army is taking the brunt of it, as far as the AF goes the "Medical Centers" at WP, Travis, Nellis and Eglin are all being looked at. Apparently final decisions will be made over the next 12-18 months. Now here comes the logic that is at the rotten heart of the AF med corps. My shop is on the chopping block, my CC has let this be known. The official med group response is "we have 12 months to show the AF how valuable we are!" This is wear the serious trouble is going to begin. The not so subtle context behind this statement is that we will be seriously looking over your shoulders and armchair quarterbacking every decision that is made to ship a patient out to the civilian tertiary care center down the street. Specifically mentioned were pediatric admissions, ICU admissions and inpatient surgical admissions. Well we have internists, pediatricians and general surgeons so on paper this looks reasonable- and I'm sure has been sold to big AF as completely feasible. Problem is my shop has some unique quirks (being kind)- here are a few- the acquisition of basic lab values is dicey at best. Routinely BMPs take hours to result and when they do at least half the time they are "hemolyzed" and are essentially worthless. We've had a recent issues with the accuracy of our troponins- troponins for god's sake- the one lab you can't get wrong. Labs have been confused between several patients numerous times over the last 6 months. Radiology does not exist on weekends and after hours- and I'm not talking about a radiologist in-house- I mean good luck getting a non-con CT abd/pelvis. If you need it you have to argue with the E-4 radiology tech, who may also be at home, or deal with the old "scanner is broken" routine. We have very junior, very green house staff/nursing staff who are simply not qualified to take care of pediatric, geriatric or critically ill patients. What this means is that over the next 12 months our med group leadership is prepared to force admissions that medically speaking should to be transferred to outside facilities in order to appear more relevant on paper. The irony is that all these issues have been brought to the leadership numerous times and have fallen on deaf ears. Now that the facility is on the block out come the admin weenies to crunch some numbers and -poof- like magic we have a robust inpatient capability overnight. Not only is this unrealistic its down right dangerous- patient care is going to suffer, people are going to get hurt all in the name of inflating numbers to avoid the BRAC. I'm seriously considering throwing my hat in the ring for a 365 and watch this debacle go down from OCONUS.

Assuming the usual chain of command didn't work, when you have real problems with a laboratory you can always report them to the College of American Pathologists and they might get a surprise inspection.

 

[colbgw02]

I mentioned this on another thread, but not here: I personally know and have spoken with a few Air Force physicians who are on the shortlist to be RIF'ed. One just graduated from residency and owes 4 years on his GME ADSO (minus 1 day if you count today). They expect to hear something within the next six months and, if selected, be out by this time next summer.

Wow. I believe you, but I'll also believe it when I see it. It just makes zero sense.

BTTT to announce that I heard on Friday of two AF physicians who are officially getting RIFed, including the guy referenced above that finished his residency six weeks ago.

 

[Gastrapathy]

That's a criminal waste of money. Unreal.


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[pgg]

I am speechlessly amazed. Criminal is right. Someone ought to call the fraud waste and abuse hotline. :|

 

[deuist]

I never thought I would see the day where physicians are let go from the military before their contracts are up. Now the Air Force owes an explanation to everyone else still serving who wants to get out as I'm sure many people on this board would love to know how they too could be "reduced."

 

[Snowdon48]

If AF medicine is moving toward oblivion, why do they keep giving out so many HPSP scholarships each year? If it is advantageous to just contract civilians, why would they spend so much on training future doctors that they won't even need?

Im an AF HPSP'er and have been growing increasingly depressed while reading this thread. I knew mil med wasn't great, but I had no idea that AF medicine was in such bad shape even compared to other branches. I'm afraid to ask but does anyone have any insight into the state of Peds in the AF and the outlook for the future? WP/WS had 8 peds residency slots on the HPERB this year which was the most of any hospital so I found it pretty disturbing to hear about their rumored closing. Thanks

 

[Kilgoretrout 65]

It may be the same doc but I heard an allergist right out of fellowship that has been selected for separation. I think it is due to bureaucrats utilizing a rule book that makes no sense so
they see an application from a doc with the right rank and time in service and they let them go. It is crazy. They should at least involve the specialty leaders in this conversation.

When this all started we were told not to apply if we had "significant" payback
but apparently they needed to define significant. I want to know if there is an allergist shortage out there in the AF with a contract position offered... any allergy gossip out there?

I can see this as a morale killer if I was told to work harder because of a self inflicted manpower shortage.

The AF should try harder to downsize the crazy docs and worthless higher ranking docs before letting go the good ones.

 

[Kilgoretrout 65]

If AF medicine is moving toward oblivion, why do they keep giving out so many HPSP scholarships each year? If it is advantageous to just contract civilians, why would they spend so much on training future doctors that they won't even need?

Im an AF HPSP'er and have been growing increasingly depressed while reading this thread. I knew mil med wasn't great, but I had no idea that AF medicine was in such bad shape even compared to other branches. I'm afraid to ask but does anyone have any insight into the state of Peds in the AF and the outlook for the future? WP/WS had 8 peds residency slots on the HPERB this year which was the most of any hospital so I found it pretty disturbing to hear about their rumored closing. Thanks

If people at WP do 95% of their residency at the downtown hospital then it doesn't really matter except you didn't really get to match like civilians can. Not the first time your freedom will be limited. Just hope that civilian hospital
doesn't suck.

 

[colbgw02]

I got a little bit more information today...

Apparently, four AF docs from my specialty got selected. This is next-level strange because we've heard for years about how undermanned the AF would be in my field beginning this summer. Well, I guess the AF just doubled-down on the shortage.

The selectees have until December 2014 to get out. I'm not sure exactly what that means, except that maybe they can get out earlier if they get everything lined up with 1 December as a NLT date.

Everyone is getting a separation check around $66K. However, they're also obligated to repay the AF for the unfilled years of commitment. I have no idea how the AF will calculate this payment, but even after that $66K, it's safe to assume they'll be writing a decent sized check. These rules were evidently outlined before everyone volunteered to be selected.

 

[pgg]

ell oh ell

So the Air Force is going to cut involuntary separation pay checks ... then send a bill for early separation?

You just know the guys running Air Force Medicine were playing drinking games one night when this came about. Tequila'll do that to you ...

 

[Monty Python]

Everyone is getting a separation check around $66K. However, they're also obligated to repay the AF for the unfilled years of commitment. I have no idea how the AF will calculate this payment, but even after that $66K, it's safe to assume they'll be writing a decent sized check. These rules were evidently outlined before everyone volunteered to be selected.

Just to be clear: the AF solicited volunteer early separations (ie, these weren't involuntary separations), and the volunteers were aware of a potential cost? I'd be hard-pressed to see the AF having a legal leg to stand on for involuntarily separating anyone without cause as in a RIF, and then demanding reimbursement.

 

[colbgw02]

Just to be clear: the AF solicited volunteer early separations (ie, these weren't involuntary separations), and the volunteers were aware of a potential cost? I'd be hard-pressed to see the AF having a legal leg to stand on for involuntarily separating anyone without cause as in a RIF, and then demanding reimbursement.

Right, because that was my question when first hearing this, too. Presumably the AF laid out these ground rules when inviting volunteers, and one would hope they would provide the exact manner in which they would determine the dollar amount. Otherwise, I don't know how anyone could arrive at a reasonable conclusion (unless they really, really, really want to get out and don't care about the cost).

 

[Monty Python]

Right, because that was my question when first hearing this, too. Presumably the AF laid out these ground rules when inviting volunteers, and one would hope they would provide the exact manner in which they would determine the dollar amount. Otherwise, I don't know how anyone could arrive at a reasonable conclusion (unless they really, really, really want to get out and don't care about the cost).

I don't know why I find this so ironically funny, but watch their buy-out cost be a tax-deductible business expense. On the other hand, their separation pay will probably be taxable income.

 

[Chonal Atresia]

I got a little bit more information today...

Apparently, four AF docs from my specialty got selected. This is next-level strange because we've heard for years about how undermanned the AF would be in my field beginning this summer. Well, I guess the AF just doubled-down on the shortage.

The selectees have until December 2014 to get out. I'm not sure exactly what that means, except that maybe they can get out earlier if they get everything lined up with 1 December as a NLT date.

Everyone is getting a separation check around $66K. However, they're also obligated to repay the AF for the unfilled years of commitment. I have no idea how the AF will calculate this payment, but even after that $66K, it's safe to assume they'll be writing a decent sized check. These rules were evidently outlined before everyone volunteered to be selected.

What specialty?

 

[idq1i]

I have no idea how the AF will calculate this payment,

Actually, it's quite well-outlined in your contract. The only question is whether interest is charged, and at what rate, and the length of time for payback.

I hate my job and surroundings enough to sign up if offered...

 

[colbgw02]

Actually, it's quite well-outlined in your contract. The only question is whether interest is charged, and at what rate, and the length of time for payback.

I hate my job and surroundings enough to sign up if offered...

Not sure which contract to which you're referring, but it's definitely not in mine. I've read mine from soup to nuts several times looking for certain pieces of information. Not that my contract is emblematic; just that's it's not a foregone conclusion that such information is in there. Besides, I know these contracts (MASP, ISP, e.g.) have language about repayment should the servicemember be unable to fulfill the obligation, but it doesn't necessarily follow that the same formula would apply to RIF. I mean, it might, but seeing as this is such an uncommon situation, I doubt that a garden variety GME, MSP, or HPSP contract specifically addresses this issue.

 

[idq1i]

Not sure which contract to which you're referring, but it's definitely not in mine. I've read mine from soup to nuts several times looking for certain pieces of information. Not that my contract is emblematic; just that's it's not a foregone conclusion that such information is in there. Besides, I know these contracts (MASP, ISP, e.g.) have language about repayment should the servicemember be unable to fulfill the obligation, but it doesn't necessarily follow that the same formula would apply to RIF. I mean, it might, but seeing as this is such an uncommon situation, I doubt that a garden variety GME, MSP, or HPSP contract specifically addresses this issue.

 

[deuist]

Here is the same series of paragraphs from my contract. There is also a line earlier in the contract that says that I cannot buy my way out my obligation.

 

[HighPriest]

Here's the great thing about military contracts: the military isn't obliged to adhere to them. Sure, they probably won't just willy-nilly do whatever they want, but they can make up some completely random and BS excuse, an then do whatever they want in individual cases. Why? Because the fed is the one enfocing those contracts in the first place. So while these screenshots are good guidelines, it ultimately doesn't matter all that much what is in them. That's why they're vague. Faustian agreements, my friends.

 

[Monty Python]

I'm a little uneasy how those contracts simply say, "interest" without specifying a number or specific source. Would it be the current prime lending rate? The current IRS interest rate (not penalty rate) on late tax payments? Federal student loan interest rate?

 

[idq1i]

I'm a little uneasy how those contracts simply say, "interest" without specifying a number or specific source. Would it be the current prime lending rate? The current IRS interest rate (not penalty rate) on late tax payments? Federal student loan interest rate?

That depends on how much the regime dislikes you. This contract is quite scary, and in retrospect, I can't believe I actually signed it. My fault, my problem, but wow. The can demote you, promote you, send to another service, send you to enlisted side, send you to any federal agency, send you overseas, make you work outside your specialty, deny you training, force you to go into another field, keep you in the service and refuse to release you. It's all in there.

No matter what the current interest rate, it's better than working for them. DON'T JOIN THE MC through USUHS or HPSP. If you have a patriotic and/or idiotic (I don't mean patriotism=idiot, I'm talking about all the "daddy and grandpa were in service and I am going to join too" threads) desire to serve, join FAP.

 

[colbgw02]

All of that language is just as general as I expected it to be. As others have discussed, what exactly is this "interest"? And what if these people aren't under HPSP contracts any longer? What if they're just under a GME contract only? How would they determine the "cost of education" in that instance? There is a zero percent chance that I would trust the AF to calculate a reasonable number based on that language, so I'd say it's anything but "clearly outlined".

 

[boneboulderer]

Wanted to bump this thread and see if anyone had any new information on this? I know WP just matched another class of residents this year -- actually increased their peds residency by one spot compared to previous year.

Any new info on early seperations? Have deployments been down throughout at AF as well?