Advantage of NOT doing HPSP, instead...

[jp92]

---

Members do not see this ad.

Hi guys.

As I was thinking about my possible future career, I came across with the following questions:

1. What is the advantage of NOT enrolling in HPSP? For example, if one chooses to complete MD program without any financial assistance of the military (for example, MSTP), and THEN enroll military (after graduating from the medical school, of course), what is the advantage of this over HPSP? Faster promotion? Better salary?

2. If one decides to do his residency at one of the medical facilities operated by the military (e.g. Walter Reed Army Medical Center), is this considered as serving military? (And let's assume that he is not a beneficiary of HPSP.)

3. Does one who completed MD/PhD program, as opposed to just MD, have any advantage over one who just finished MD?

Thanks!

 

[notdeadyet]

1. What is the advantage of NOT enrolling in HPSP? For example, if one chooses to complete MD program without any financial assistance of the military (for example, MSTP), and THEN enroll military (after graduating from the medical school, of course), what is the advantage of this over HPSP? Faster promotion? Better salary?

The main benefits are going to be training, insurance, and sign-on.

For training, the civilian residency training programs always offer better options than their military counterparts. For some areas, the military residencies are pretty solid (peds, fm, etc.) and the gap isn't as dramatic, but the training gap gets more pronounced in procedural oriented specialties.

For insurance, it's because the odds of someone entering medical school accurately predicting the specialty and type of career they will actually want by the time they leave med school is very small. One of the main reasons you get a lot of people unhappy with HPSP is because they entered picturing sailing the high seas for months on end as a family practitioner then found that they really wanted to be a cardiologist and raise a family. With joining after residency or even just after medical school, you'll have a much better idea of what you'll be doing and if the military can provide that to you.

For sign-on, the military offers pretty hefty sign-on bonuses to bc/be physicians. If you're going a primary care doc who attended a pricey DO school, it won't cover your loans, but if you went to a more affordable medical school or especially if you're entering a more expensive specialty, the sign-on bonus can cover the entirety of your loans and more ($220-$400K, last I saw).

Ex 1- Join HPSP, graduate 2015, enter the Navy, intern medicine, 2 year GMO, then 3 year residency, serve three more years and are eligible to leave, debt free, in 2024.

Ex 2- Don't join HPSP, graduate 2015, finish your residency civilian-side, then join. Serve 4 years active, then leave (with IRR time), debt free, in 2023.

There are countless variations of this, in which some you'll be financially better off taking HPSP (going to a ridiculously expensive school, performing poorly and not having a wealth of residency choices on graduating, and going into a low paying specialty) and some in which HPSP won't make financial sense.

Unfortunately, you probably don't have as solid an idea on the variables as you might expect until you've already gone through medical school. So I usually advice people that if there are any uncertainties, think long and hard about whether or not HPSP is a smart move unless your motives are nonfinancial and nonprofessional.

 

[jp92]

Thank you very much for your thought. However, I believe the answer that I was seeking was slightly different. What I meant by NOT ENROLLING HPSP was that, what if you graduate from the medical school WITH ZERO DEBT (maybe I can afford it, or the school is a state school with no tuition, or MTSP, etc) and there is no debt for the military to cover for me? If I decide to join a military residency with such status, will my residency (say, general surgery, so about 6~7 years) be considered as an active duty? That is, will I be eligible for promotion to a higher rank or does my total years of service increase?

Thanks again for your answer!

 

[J-Rad]

Thank you very much for your thought. However, I believe the answer that I was seeking was slightly different. What I meant by NOT ENROLLING HPSP was that, what if you graduate from the medical school WITH ZERO DEBT (maybe I can afford it, or the school is a state school with no tuition, or MTSP, etc) and there is no debt for the military to cover for me? If I decide to join a military residency with such status, will my residency (say, general surgery, so about 6~7 years) be considered as an active duty? That is, will I be eligible for promotion to a higher rank or does my total years of service increase?

Thanks again for your answer!

How are you going to join a military residency? They are generally exclusive to those with indebtedness to the military via HPSP, USUHS, ROTC during college, or Academy grads (the latter two of which receive educational delays to go to med school +/- additional funding via the former two programs). While there have been some limited historical exceptions to that fact, for the most part, the exclusivity remains. If some exceptional circumstance arises and you are allowed to train in a milmed residency, then you would be active duty (and must be qualified to be so) accruing Time In Service (TIS). When you finished residency, say a three year primary care residency, you'd be paid as an O-3 (Captain/Lieutenant) with greater than 2 years. Promotion times would be based on your time of commisioning and start in the program. If you bypassed all military time debt incurring programs, including residency*, you can sign up as a fully trained physician and may be given advanced rank/standing based on experience (I have no idea how they calculate such positions).

*Generally a 6-months-for-6-months commitment post internship, however, I wonder-but don't know-if you became an exception and trained in a military residency from "free agency" (for lack of a better term) whether you would be expected to pay back time from internship as well.

 

[deuist]

There is ZERO benefit to joining later other than you might be able to get a sign-on bonus and have some say in your first practice location (maybe). Rank is based upon number of years since medical school. Coming in via HPSP versus no HPSP does not make a difference. You will not get paid more.

Having a PhD in certain fields may qualify you for faster promotion, but my understanding is that many people have had problems getting their degrees recognized.