70% Navy get GME-1 1st choice!!!

[The White Coat Investor]

Don't get me started on the financial analysis of which works better, military vs non-military. Suffice to say that on average, the non-military route comes out ahead, even considering the time value of money. Debt-aversion usually works out poorly for the pre-med in that respect. The idea that if you have a family the military is a better deal is bogus too. The HPSP stipend isn't any bigger for families. No BAH there folks. And yes, of course civilian residents whine about low pay just like military attendings. Doesn't prove much. I maxed out two IRAs each year as a civilian resident, went on long vacations and still felt like we were living it up compared to living on that $930 stipend as an HPSP student.

And I'm not saying moonlighting is better than getting paid more. I only moonlit my last 6 months as a resident. 10 days total. But it is something to consider if you want to analyze the financial aspects of military vs non-military residency.

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[BigNavyPedsGuy]

I don't know how the Naval Hospitals on the West Coast are, or how they relate to their GMOs. BigNavyPedsGuy might be able to fill us in more on that.

I do know, when I was at Balboa on an Ortho rotation, the shipboard GMOs frequently called the Ortho residents with questions and to review xrays.

So I'm still on the ship (3days and a wakeup), but that's beside the point.

While I do have a SMO for support, every GMO for a LPd or LSD does not. That means for every one of my billets there are 1-2 ships in each battle group without that support.

Fleet Liaison at NMCSD does a great job interfacing with the ship. That being said, expect a 2 day turnaround. It's pretty easy to be in a situation on one of the other ships where you would have medical emergencies and not have backup available. We had patches where we had no connectivity and were too far from land to fly the guy out. He was stayin. These aren't the norm, but they are common occurences. I just think that most people know better than to get sick when they're that far away.

 

[pgg]

For those of you that have done utilization/GMO: Who's to say you still can't "train" during these time periods? Do you have enough downtime? I had a friend who said that he had enough downtime during his GMO to read/study almost all of Harrisons IM (so when he showed up for his IM residency, he was way ahead of the power curve). Is such downtime common? (I guess it depends on the job, but I'd imagine it is, especially if you're on a ship!)

Lots of down time, at least on deployment. I took a stack of books with me to Iraq. I read a lot. It slid off my brain like Teflon without the actual patients and practice to tie it all together, and without enough experience within my specialty to clue me in on what to pay attention to, and what was useless minutia.

At least for me, it was a lot of information and data to sift through without really having a feel for what I needed to know. Maybe it works better for IM since an IM internship gives you a lot of good exposure to what you'll be doing in years 2 & 3. But for the residencies that don't have categorical intern years, like anesthesia, radiology, derm, path, etc I'd guess it's harder to get useful directed studying done as a GMO.

Bottom line, I didn't feel ahead of the curve when I started residency. I felt like a ***** because 3 years of treating URIs and low back pain as a GMO rotted my brain.

Can I get the name of your broker?
My retirement accounts were bleeding cash this year.

I simply mean that I'm contributing money to those accounts rather than paying off student debt or, even worse, borrowing more money. What happens to the money that goes into the won't-spent-for-another-30-years accounts has been a source of sad/morbid curiosity of late.

Don't get me started on the financial analysis of which works better, military vs non-military.

I don't entirely disagree with you. It sucks to think I'll be making $150K/year starting this July when civilians finishing residency at the same time as me are having to sift through the $300K+ offers and pick the one they want in the location they want.

But again, as a USUHS student I could afford to have kids when I did, and we enjoyed a quality of life that wouldn't have been possible as a med student on loans.

 

[EMDoc0411]

Anyway, I know that the point of residency is training, but I just meant that if you're comparing adequate training from a civilian residency with adequate training from a higher paid military residency I think the military residency wins out. If you had a residency in the civilian world that paid twice as much as all the other residencies, I think you'd see it would rapidly become one of the most competitive residency programs as long as it maintined accreditiation. Again, this hasn't happened yet so it's all personal opinion.

But you're acquiring more payback time in the military residency. I wouldn't wish that on anyone.

 

[Mirror Form]

Don't get me started on the financial analysis of which works better, military vs non-military. Suffice to say that on average, the non-military route comes out ahead, even considering the time value of money.

I would agree with you, but the point made above by PGG is still very valid.

Given my extra years in service, my salary is literally obscene for a resident. I've been living very comfortably and accumulating lots of savings despite spending money like an idiot. While my civilian counter parts will more then make up for that in the future, it is nice to feel rich during residency.

 

[The White Coat Investor]

Given my extra years in service,

That's a very important detail.

 

[deegs]

Given my extra years in service, my salary is literally obscene for a resident.

Given my extra years of service, all as an officer, my salary as a USUHS med student is even more obscene. I make more than most senior residents, who already make a nice chunk of change more than their civilian counterparts. And when I make O-4 shortly after graduating med school, I will be literally rolling in it. (might make up for the ongoing debt known as a new baby I just racked up)

The military gives you A LOT of money up front. The future value of this money, weighed against the future value of the debt I would have racked up at a civilian medical school, coupled with being fully vested in the retirement system at the end of my service obligation, makes the modest salary I will make as staff for 7 years a net financial gain.

But as ActiveDutyMD said, prior service is an important detail. It was a pretty close call financially when I ran my numbers, and I doubt anybody without prior service could come out ahead, financially speaking.

 

[Jolie South]

But you're acquiring more payback time in the military residency. I wouldn't wish that on anyone.

Isn't that only true if you do a residency longer than your original payback time?

 

[notdeadyet]

Isn't that only true if you do a residency longer than your original payback time?

It depends on the residency length as well as if you had to do a GMO tour first, right? If you want to do a three year post-internship residency, have to do a GMO tour after, you've paid back 2 years and only owe 2 but have gained an additional year of payback.

 

[Jolie South]

It depends on the residency length as well as if you had to do a GMO tour first, right? If you want to do a three year post-internship residency, have to do a GMO tour after, you've paid back 2 years and only owe 2 but have gained an additional year of payback.

You're right. I was thinking of when you do match straight out of school, which I am aware doesn't happen in a lot of cases.

 

[The White Coat Investor]

You're right. I was thinking of when you do match straight out of school, which I am aware doesn't happen in a lot of cases.

Yes, this is a huge scam. You pick up 4 years of commitment in school, pay 3 back as a GMO, then, finally do your residency. But do you just owe that one last year? Nope. You owe three more thanks to that residency. Pretty lame when the person didn't CHOOSE to go do the GMO tour. The only other option is do one MORE year as a GMO and then just do a civilian residency. But at that point in life, it is a LOT harder to take the pay cut associated with civilian residency.

 

[sethco]

Yes, this is a huge scam. You pick up 4 years of commitment in school, pay 3 back as a GMO, then, finally do your residency. But do you just owe that one last year? Nope. You owe three more thanks to that residency. Pretty lame when the person didn't CHOOSE to go do the GMO tour. The only other option is do one MORE year as a GMO and then just do a civilian residency. But at that point in life, it is a LOT harder to take the pay cut associated with civilian residency.

There are options.

The GI Bill does help soften the pay cut. One can serve their 4 non-AD years in the Guard and get drill pay as an O-4 with 4+ years.

About 80% of the flight docs (GMOs) that I know are going this route and using the GI Bill benfits and/or Guard to offset their salary cut. I would say the other 20% are sucking it up and going into a military residency.

 

[deuist]

I wasn't aware of the guard option. What's the likelyhood of getting deployed while in residency? Is there any payback required?

 

[sethco]

I wasn't aware of the guard option. What's the likelyhood of getting deployed while in residency?

That depends on the particular unit that you are with, but it is usually assumed (and an agreement with the Med Group Commander) that you are non-deployable during residency. I posted (a couple of months ago) an AFI that basically stated that you are non-deployable during a residency training program, however (as usual) I remain skeptical, but it would be the same way with IRR, anyway.

Is there any payback required?

That depends on which bonuses you take. If you take no bonus and only do the weekend drill, you have no commitment and can leave whenever you want. If you take the "Stipend", which is about 1900/month, there is a 1:2 commitment (i.e. 1 year commitment for 6 months financial support). The payback on this starts on the reciept of the last payment of the stipend. The 50K cash bonus and 75K Loan Repayment Program require either a 3 or 4 year commitment and you must have finished at least your 2nd year of residency before you are eligible. I think the eligible specialties for the guard (this year) are flight surgeon, Ortho, Anesthesia, E Med, RAM, Fam Med, Int Med, and Opthamology.

Talking to a couple of docs in my office getting out this year, the plan was to take the Stipend for the 1st year of residency only and serve out their commitment while still in residency. At the same time, do the weekend drills when possible and try to get the required "points" for 1 year of Guard service.

 

[tsbuqh]

Talking to a couple of docs in my office getting out this year, the plan was to take the Stipend for the 1st year of residency only and serve out their commitment while still in residency.

Ok so I am prior submarine officer, starting medical school in Aug, and currently applying to the ARNG (Civilian Residency). While making countless spreadsheets and planning out life beyond the useful projection of a spread sheet, I had the same idea, take STRAP for 1 year and serve out the 2 years commitment in PGY2-3, however I recently found this document:

http://www.dmna.state.ny.us/arng/ocs...m_guidance.pdf

The STRAP may be taken for any number of years during the residency period. However, if the applicant only desires to take STRAP for a portion of the remaining residency period, the start date must be calculated from the residency end date. For example, if a Physician with a 4-year program ending June 2008 only wants 2 years of STRAP, he or she is not authorized to start the stipend receipt until July 2006.

And since we all know the military likes to hold you to the actual contract that you did not read well enough at the time of signing, at a minimum I expect anyone who tries to stop STRAP early would not be able to start repayment until the completion of residency. However, you may also have obligated yourself to take STRAP all remaining years of residency.

Most people I have talked to (recruiter included) say it is better to just wait and take the $25K yearly retention bonus if you qualify.

 

[sethco]

I had to look it up...

http://www.dtic.mil/whs/directives/corres/pdf/120521p.pdf

E10.1.2.3. I shall incur a Selected Reserve or an IRR (circle the one that
corresponds to the amount of stipend to be received) obligation of 2 years for each year
or partial year for which stipend assistance is provided. Repayment of the obligation
shall begin on completion of my residency training program and shall be in the (Name of
Reserve component) and in the medical specialty of (name of critically short wartime
specialty for which Stipend Program participation is approved), unless excused under
"convenience of Government" criteria. If I am also participating in the Health
Professional Loan Repayment Program, the service obligation incurred under that
program would run consecutively (not concurrently) following or preceding any service
obligation incurred from this Stipend Program. I currently have the following service
obligations from the Health Professional Loan Repayment Program:
______________________________________________. I must be able to fulfill all
required service obligations prior to my mandatory removal date or retirement eligibility
date in the Ready Reserve.


So, that is good to know not to take the Stipend if you plan to move after you finish residency or don't plan to stay in the Guard. If this is the case I would probably only do weekend drill until I know what I want to do regarding staying in the Guard or leaving.