Anyone thinking of the National Health Service Corp?

HarveyCushing said:

If I get accepted this year, I have thought about the NHSC to pay for my medical school. I have just done some basic research into it and it seems like a great idea of you want to go into primary care and serve in an underserved area.

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i'd be careful unless you are dead set on primary care. Many, many students change their minds.

I thought it would be cool, but then realized it was limited to primary care. It would have been cool if it were primary care, or any specialty, but in an underserved area. Maybe if I ask them nicely, they will change it?

I looked into it because I have no doubt that I want to go into rural family medicine. The only problem is that if you take the scholarship, you have little choice over where they place you when you start working. I called the NHSC and talked to them about the specifics and they told me I could end up anywhere. Because I have children and absolutely want to remain on the east coast I decided that this was not a great option for me. I am going to try to work in work in an underserved area when I am practicing and have my loans paid back that way. 😀

Same here DoctorMom78 - well, except I don't have a family. Well, here's what I mean:
Hopefully I'll have a family by then, b/c you don't actually start the "payback" until after residency, and it will be hard to move to an area where there may be little opportunity for a husband, or for great education for the kids.
But other than that, it sounds like a great idea! If I wasn't deadset on being settled down, I don't think it would be much of a problem 🙂

I wouldn't touch that or a military scholarship with a ten foot pole.

I think the best option for the medical student who is not entirely dead-set on primary care would be to wait until you become a primary care clinician and then consider the NHSC Loan Repayment Program.

Also, there are many state loan repayment programs that would ensure that you at least stay within the same state, which would be great for RI residents.

If your only reason for taking a military scholarship is about not worrying about student loans then you will be sorry - that is what doctors who did this told me.

Understand you will be serving a 1:1 that is for each year of medical school you will serve 1 year of active duty, minimum requirement is 2 years active. You MAY be called for war at any time (except during medical school), if a recruiter tells you otherwise you are being mislead. But aside from that, the time given to serve your country is done after you finish your residency, so take that into consideration since you say you want to start a family. You are given 3 choices where to be sent for active duty, they will try, TRY, to get you into one of your choices, but remember they will TRY. I am not certain but I believe you are placed on 3 years reserve duty once you serve your time in the military.

If you want more information I suggest you visit www.goarmy.com and on right of screen select "Chat With a Recruitor". You don't want to meet a recruitor in person, they will spam you with emails and letters.

Also, there are 3 branches you can look into for a military full expenses paid scholarship; Army, Navy, and Air Force.

Protease said:

If your only reason for taking a military scholarship is about not worrying about student loans then you will be sorry - that is what doctors who did this told me.

Understand you will be serving a 1:1 that is for each year of medical school you will serve 1 year of active duty, minimum requirement is 2 years active. You MAY be called for war at any time (except during medical school), if a recruiter tells you otherwise you are being mislead. But aside from that, the time given to serve your country is done after you finish your residency, so take that into consideration since you say you want to start a family. You are given 3 choices where to be sent for active duty, they will try, TRY, to get you into one of your choices, but remember they will TRY. I am not certain but I believe you are placed on 3 years reserve duty once you serve your time in the military.

If you want more information I suggest you visit www.goarmy.com and on right of screen select "Chat With a Recruitor". You don't want to meet a recruitor in person, they will spam you with emails and letters.

Also, there are 3 branches you can look into for a military full expenses paid scholarship; Army, Navy, and Air Force.

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Better yet, PM "MedicalCorpse" on here and ask him how the military medical system actually works. He would know, he was a senior ranking anesthesiologist in the military for many years.

Back in the early eighties when I began DMU (then known as UOMHS) I was "awarded" an NHSC scholarship which I took for four years and thus had to return the favor with four years after my FP residency (osteopathic). My experience and thoughts follows in the next post - take it for what it's worth.

BklynWill said:

I think the best option for the medical student who is not entirely dead-set on primary care would be to wait until you become a primary care clinician and then consider the NHSC Loan Repayment Program.

Also, there are many state loan repayment programs that would ensure that you at least stay within the same state, which would be great for RI residents.

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👍 That is my plan!

Back in the early eighties when I began DMU (then known as UOMHS) I was "awarded" an NHSC scholarship which I took for four years and thus had to return the favor with four years after my FP residency. My experience and thoughts follow...one caveat - my experience is dated.

At the time the program was undergoing some changes because of so many complaints - including some lodged by the AMA and AAFP - about placement issues, inflexibility on the parts of the Feds, and poor treatment of the scholarship recepients. DMU had a fair number of students with NHSC awards and many of us faced similar dilemmas. I tried to keep up with the program after I completed my four years but over time I sort of lost touch with the details although I am familiar with the broad aspects.

In the early '80s DMU's tuition was about $12,000/year or so. While that may seem like a bargain now it was relatively steep at the time. And when the govt. basically forked over full tuition, paid for all books and fees, plus added a monthly stipend of - at the time - around $500+/month, it seemed like a good deal.

I had many friends who also took the NHSC scholarship - nearly all of us ran into hassles ranging from the minor to all out, full-blown nightmares. Looking back, that may have been due, in part, to our attitude rather than the reality of the program. Still - all of us managed - one way or another - to fulfill our obligation and get on with our lives.

So what is the final analysis? Despite the changes in the program certain aspects remain fixed so I'll address those. In addition, there are intangibles that came into focus down the road that I didn't take into account when I was cashing those checks and running around Des Moines and they played a bigger role than I would have expected.

I would think it would be wiser to sign up for the program after the fact and have the NHSC pay back any loans rather than take on the program in medical school but I'm unclear as to the current details and the postives and negatives of such a route as it exists today. In any event, loan payback generally wasn't available when I had the scholarship so that wasn't an option.

To start, if you're not 100% interested in primary care - don't hop on board with NHSC.

Once you sign they have you - and they'll treat you with benign disregard. They hold all the cards. The biggest problem we faced was NHSC simply sticking people wherever they wanted. They claimed to take into account your preferences but that was totally bogus. I had friends ask to stay in the midwest and they ended up in Guam, or some Indian reservation.

The Feds/NHSC had no sense of humor, let alone compassion. If you didn't follow the rules down to the letter you could easily get screwed.

Be aware that you might end up in Hillbillyville or Hayseed City so be sure you can deal with the cultural - and professional - shortcomings. I was initially "placed" in Rockford, Illinois, but the site was "de-designated" - the preferred term at the time for the Feds changing their mind - and I was sent to a town of 1200 people in a rural midwestern community to work at a Medicaid/Migrant Health Clinic. I lived in the county seat of 14,000 people. It took a while to get used to. Since I was married (my wife was also in the program) it made it easier but if you're single I expect it could certainly make things more difficult socially, although it was still not the most stimulating social and cultural environment. I did my residency in north Jersey near NYC so I could no longer hop on a train and be in Manhattan in 30 minutes. However, I could drive 90 minutes one way to see bad dinner theatre.

My salary was pretty awful but the cost of living was so low it sort of balanced things out. I was able to moonlight - which I did from time to time - but I only did so on occasion.

The NHSC is clearly not for docs looking to work in some suburban, upper-middle class practice. My patients were sick and many needed relatively aggressive care. While I was often tired of running to the hospital at 2am or doing things I didn't think I would do in the office (becuase there were no other docs around) after 4 years it made me a far better doctor than I ever thought I would be. My skill set far surpassed classmates who wound up in some outpatient family practice near a city after residency. That was one intangible and it allowed me to work anywhere with a fair amount of confidence in the years that followed.

I ended up becoming the medical director at the clinic during my last two years. While we didn't stay after our obligation was complete the "management" aspect helped broaden my resume. On the downside, I essentially had to "start over" somewhere else. I didn't really care but some people might want to get settled into a practice right away. However, many primary care DOs bounce from here to there over the years so it's not really a big deal. Still, another intangible is that your outlook on medical care will be different from those folks who weren't in the NHSC and it may affect how you view things in the years ahead.

I was virtually the only DO in an area filled with MDs. Once you realize how many mediocre MDs are floating around you'll be glad you went to DO school. Also, if you're concerned about the DO/MD thing among your NHSC patients - don't. Many of my rural patients couldn't even read, let alone pronounce "osteopathic." They were just glad somebody in a white coat was paying attention to them. The rest of the patients couldn't even speak English. When a little pregnant Hispanic woman has a blood sugar of 500 and is splayed out on an exam room table, believe me, the last thing on her mind is where I went to medical school.

Another intangible: I found that being part of an HHS-funded program and working through the public health service was a significant advantage when looking for jobs later on. Employers tended to respect that more than I would have guessed. In addition, it totally validated the DO degree to people who were unfamiliar with osteopathic meidicne. Over the years, if someone had any misconceptions about DOs, once they learned that I worked with the government at a PHS funded center in a physican shortage area most questions or confusion about my credentials ended immediately.

Now - aside from the cultural/professional/and perhaps social isolation - which is an individual matter - the biggest downside is losing control of what you want to do because you become beholden to the program. If you're concerned about being locked in or losing control of your life or perhaps want to explore other options - like go back to school or practice part-time or even travel - don't sign up.

Despite all the postives I gained, in the final analysis, I think if I had to do it again I would have taken out loans and not be constrained by the almost slave-like atmosphere of the NHSC. At the time I wanted to try other things (perhaps) and was unable because of the 4 years I owed to the Feds. It's possible I felt that way because I was stuck and you always want what you can't have. (By the way, there was no real payback option at the time - you either served your obligation or basically had your license taken away). I ultimately think it's better to owe money rather than time but that's easy for me to say now. I'm know others who were looking at $60,000 in student loans (circa 1988) wished they had taken an NHSC scholarship because they were working to pay back the loans.

I don't know if this has been helpful but it may provide food for thought. My best advice is to buy lottery tickets or marry rich - but they also come with their own special problems.

DOinPractice: THANK YOU! Excellent post with some great info on the NHSC. I want to go into rural family medicine in an area similar to what you spoke of, but since I have four children and a husband I do not have the flexibility to be moved around nor do I want to be in certain areas with my family. I was still somewhat considering applying for the NHSC scholarship, but thanks to your post I am definitely only going to plan on the loan repayments. Thank you again for the great info. 🙂

Great post DOinPractice! Thanks for your insights into avoiding bad dinner theatre!👍

my family knows a guy who got stuck working in a prison in north dakota. i think you all bring up a good point with looking at state-wide programs and waiting. at one of my interviews, they warned us to be 100% sure before we sign these contracts--they're hard to get out of and you will have to pay back all the 'loans' at a ridiculously harsh interest rate.

(ps--thanks for your help, DOinPractice )👍

when considering military scholarships, the health professions scholarship program through the army is pretty good, unless, of course, you don't feel like serving right after you get done with medical school.

you could also do what i plan on doing as long as i get into a medical school. that is, have the national guard pay for the tuition. most states offer 100% tuition through a graduate program (ms, phd, md, jd, etc.). the nice thing about the guard is that once you're done with residency, you are free to do whatever you want. and often times, the army will ask you if you'd like to be deployed (i.e. iraq or afghanistan) instead of telling you that you are going. deployments for medical personnel at this level are approximately six months at a time.

I have one question. I was planning on applying for the scholarship. When I called NHSC they said that you get to pick off of the list where you go after residency. Is this incorrect??

medmom said:

I have one question. I was planning on applying for the scholarship. When I called NHSC they said that you get to pick off of the list where you go after residency. Is this incorrect??

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I called them too and talked to them about how it works. The guy I talked to said that while you have some say in where you go, it is really not a lot. He advised me that it is really not the best choice for someone with children because you need to have the ability to move anywhere they need you to be. You also may get to a place and be there for a short period of time and have to move again because they changed the status of where you were located. It sounds great, but I think it is really not the best choice for either one of us because of our families. There are plenty of programs where you can get your loans paid back after graduation.🙂

I am an NHSC Scholar, now finishing residency, and I would agree that the best course for most people is to opt for loan repayment. With loan repayment, you can change your mind at any time. And there are many, many more sites from which to choose. Competition at some of the scholar sites can be tough.

On the other hand, things worked out pretty sweet for me. I went to medical school to be a small town doctor in a place where it would really make a difference. The NHSC paid me to do just that.

Thanks to the scholarship, I paid about $100 for med school (the NHSC didn't pay for the quarterly bus pass that my school required). They gave a very generous stipend for books, supplies, and travel costs - so much so that I got to bank some of it. They paid a monthly stipend (I think it was about $1050 a month) that we used for a house payment.

In July I'm headed to a rural community in my home state. The salary is very reasonable given the cost of living.

DoctorMom78 said:

you have little choice over where they place you when you start working. I called the NHSC and talked to them about the specifics and they told me I could end up anywhere.

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From my understanding, it seems more like:
A) You look at their job placement list
B) You apply for jobs from that list
C) You hopefully get a job from your personal list

So, if you don't get a job and location you'd prefer, you might, in that sense, have little choice. As in, you might now have to apply for and accept a job from your second or third tiers.
I talked to two separate representatives today, however, and neither said they "place" you.
Am I wrong?

Green Doc said:

From my understanding, it seems more like:
A) You look at their job placement list
B) You apply for jobs from that list
C) You hopefully get a job from your personal list

So, if you don't get a job and location you'd prefer, you might, in that sense, have little choice. As in, you might now have to apply for and accept a job from your second or third tiers.
I talked to two separate representatives today, however, and neither said they "place" you.
Am I wrong?

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You are correct. You apply for jobs on their list just like you would apply for any job. BUT there is competition and IF you cannot secure a job on their list on your own THEN they will place you ANYWHERE. At the "placement process orientation conference" they told us this happens to a couple of people a year.

And to address another misconception I've seen: If the site you begin work at drops off the list (meaning it is no longer underserved enough) you ARE able to continue to fulfill your service obligation at that site.

How competitive are we talking?

The only thing that bothers me, is not knowing how much money I will be making while they paid back my loans. If I were to only be making 75k then heck no! I will keep my HPSP. If I were to make 150k while they paid back my loan, then perhaps it would be worth it.
I know this is personal and private (apparently because they will not post the salaries on the website, or I cant find them) yet, is there anyone out there www. land that can shed some light on the pay?
Thanks

does anybody know if preventive medicine is considered a primary care practice??

OCHO said:

The only thing that bothers me, is not knowing how much money I will be making while they paid back my loans. If I were to only be making 75k then heck no! I will keep my HPSP. If I were to make 150k while they paid back my loan, then perhaps it would be worth it.
I know this is personal and private (apparently because they will not post the salaries on the website, or I cant find them) yet, is there anyone out there www. land that can shed some light on the pay?
Thanks

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This is from the NHSC Scholarship service fulfillment info, but the particulars are probably similar to the loan repayment. Basically, salary is yours to negotiate; there is no pre-determined salary.