Nov 6, 2014
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Sounds like a money now vs money later situation? I mean you suck up the 360k loan at ~6% interest like most medical graduates do and find a job after residency that involves them paying off your loans is a decent option. Then again, good advice for a 24 year old single bachelor might not apply to your situation considering you have mouths to feed and life will suck for the next 8-10 years depending on how fast you can pay down your loans.

HPSP will grant you $1800/month take home pay for the next 2 years. Once you hit residency you'll be making ~90k/year for 3 years plus access to healthcare for your family. Finally for your 2 payback years you'll be around 120-150k/year last time I crunched the numbers. Starting in residency you can pay down the interest at least. Of course, there are plenty of other miseries of the military that are different from being dead broke.

I don't know. Not a father myself. Just giving you a quick finance info before some other more wiser heads reply.
 
Nov 6, 2014
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There is also the National Health Services (?? I think that's what they are called) loan forgiveness and employment programs if you don't mind working in poopy areas. Only gave it a cursory glance since I am already locked in with the DoD.

The way it's coming out from my point of view at the moment when you become an attending in the military...

HPSP 2 year:
Graduate with 200k debt at 6% while making having a 24k salary for 2 years.
Military residency at ~90k salary for 3 years.
Serve as attending for 3 years. Might not have to PCS.

FAP 3 years (because why FAP for only 2 years? All the residencies you listed are 3 years):
Graduate with 360k debt at 6%.
Your matched civilian residency at ~120k salary for 3 years (50k resideny salary + 70k FAP).
Serve as attending for 4 years. Will probably PCS once.

Yea numerically FAP vs HPSP seems almost the same except FAP money might be taxed as regular income??? However, the ability to choose your residency by FAPing can be priceless.
 
Nov 6, 2014
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Permanent Change of Station. When they move you from one job to another job. Often from one side of the country to the other.
 

WernickeDO

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How would that work for residency? If you do psych you would likely accrue another year of ADSO, without the benefit of having another year of med school paid for.

At this stage in the game, FAP may be a better option for you.
 
Nov 6, 2014
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Gotcha.

I talked with my recruiter some more today and according to her the Air Force only requires 2 years of active duty service for a 2 year HPSP scholarship (recent change). Not sure if that's true but if it is that makes taking this route more worth while.
Echoing Dr. Wenicke above, this would work if you went into IM or FM. If you end up in psych you'll end up paying back with 3 years due to the length of psychiatry residency vs IM/FM
 
Nov 6, 2014
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Didn't know that. Why would I accrue an additional year if I did a longer residency like Psychiatry? I apologize if that's a rookie question but this stuff is not straight forward at all...
It never is. The overall general gist of it is your post training payback is based upon how many years of scholarship you have taken or how long your residency is with intern year being neutral in obligation. Whichever is greater.

So if you have taken the 2 year scholarship you would only payback 2 years in IM and FM since the residency for those is 1 year intern (obligation neutral) + 2 year residency.

For psych, if you take the 2 year scholarship you would payback 3 years since residency is 1 year intern + 3 year residency.
 

WernickeDO

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Didn't know that. Why would I accrue an additional year if I did a longer residency like Psychiatry? I apologize if that's a rookie question but this stuff is not straight forward at all...
RLA did a good job explaining why you would accrue more ADSO. One truism of military service is that they always get more out of you then you were expecting to give, and milmed is no exception. If you have any interest at all in being a clinical physician avoid the military. Keep reading this forum and you will see why.
 

WernickeDO

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I have seen more negative than positive postings regarding military medicine but I'm not sure if that's because the people who enjoy it just aren't vocal about it or if it really is that bad.

Also, it seems like most of the headaches come after residency as an attending in the military. Is that true? Or is it, in your opinion, bad all around?
No, it's not bad all around. Many people have great military careers, are very happy in their chosen professions and duty stations, and would sign up again in a second. And you have the flipside to that as well. You cannot predict what your military career will be like, because it is largely out of your control. You surrender any and all control when you sign. You can make requests and the mil will take it in to consideration, but if Big Mil decides that you are abandoning your clinic for 2 years to perform paperwork, then that's what is happening to you.

Ask yourself: How do you feel about graduating medical school, graduating residency, and then being prevented from practicing medicine? If that does not sound appealing, then avoid the military. Plain and simple. When I signed, I reasoned with myself. I said, "Hey WernickeDO, don't worry! It's not like the military is going to pay $300K to send you to medical school to have you do non-medical things!". I was wrong. My experience has been bad all around and you can only tell yourself to bloom where you're planted so many times. If you do not want to be an officer in the military, briefing the commander on readiness, taking part of MDMP meetings, and pissing in a cup, then avoid the military.